Code of Colorado Regulations — Department of Human Services

# Code of Colorado Regulations — Department of Human Services

## **501** Mental Health Services

##### **2 CCR 501-1** UNIFORM METHOD OF DETERMINING ABILITY TO PAY [Repealed eff. 11/01/2013] {#sec-2-ccr-501-1 omnilex-key=us-co-regs-official--department-9--2 CCR 501-1}

DEPARTMENT OF HUMAN SERVICES

Mental Health Services UNIFORM METHOD OF DETERMINING ABILITY TO PAY - Repealed eff. 11/01/2013 2 CCR 501-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

Uniform Method of Determining Ability to Pay rules were adopted effective 1/29/77 by the Colorado Department of Institutions.

These rule sections were rewritten and final adoption following publication at the 2/6/98 State Board of Human Services meeting, with an effective date of 4/1/98 (CSPR# 97-10-16-1). Statement of Basis and

Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Rules regarding ability to pay for mental health services, as originally found in 2 CCR 501-1, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 11/01/2013.

## **502** Behavioral Health

##### **2 CCR 502-1** Behavioral Health {#sec-2-ccr-502-1 omnilex-key=us-co-regs-official--department-9--2 CCR 502-1}

DEPARTMENT OF HUMAN SERVICES

BEHAVIORAL HEALTH

2 CCR 502-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

Statement of Basis and Purpose, Fiscal Impact/Regulatory Analysis and Specific Statutory

Authority Rules regarding the Care and Treatment of the Mentally Ill were originally adopted on 3/21/1977, and subsequently amended through April 20, 1993 (effective May 30, 1993), by the Department of Institutions.

The purpose of the 1991 revision of these rules is to make the regulations easier to locate within the document, easier to read and to understand; to incorporate policy statement formerly contained in the Division of Mental Health's Procedures Manual; and to add several changes recommended to the Department of Institutions by the Mental Health Advisory Board for Service Standards and Regulations.

These rules were proposed pursuant to Notice of Public Hearing published on November 10, 1991, and after proper notice, a public hearing was conducted on Thursday, December 5, 1991. Written and oral testimony presented to the Department of Institutions was considered in the determination to adopt these rules. The record of the rule-making proceeding demonstrates the need for these regulations; the regulations have been clearly and simply stated; and the regulations do not conflict with other provisions of law. The effective date for these rules is March 1, 1992.

Sections 103.2.A.2 and 103.2.A.3, which were adopted after January 1, 1992 and before January 1, 1993, were not extended by H.B. 93-1131 and therefore expired effective June 1, 1993.

The entire re-write of these rules were adopted following publication at the 4/2/2004 State Board of Human Services meeting, with an effective date of 6/1/2004 (Rule-making #03-5-14-1). Statement of

Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Addition of r ules concerning Acute Treatment Units, Sections 19.500 through 19.568.2 were adopted following publication at the 9/7/2007 State Board of Human Services meeting, with an effective date of 11/1/2007 (Rule-making #07-3-22-2). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revision of Section 19.421.3 was adopted following publication at the 7/12/2013 State Board of Human Services meeting, with an effective date of 9/1/2013 (Rule-making# 13-5-14-1). Statement of Basis and

Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Rules regarding care and treatment of the mentally ill, as originally found in 2 CCR 502-1 (Rule Vol. 19), are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 (Rule Vol. 21) as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 21.900 through 21.950 were adopted on an emergency basis at the 11/6/2015 State Board of Human Services meeting, with an effective date of 11/6/2015 (Rule-making# 15-10-20-1).

Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

Revisions to S ections 21.900 through 21.950 were adopted as final (permanent) at the 12/4/2015 State Board of Human Services meeting, with an effective date of 2/1/2016 (Rule-making# 15-10-20-1).

Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

Revisions to Sections 21.000 through 21.330 were adopted at the 3/4/2016 State Board of Human Services meeting, with an effective date of 5/1/2016 (Rule-making# 15-08-26-1). Statement of Basis and

Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

Revisions to Sections 21.120.3 and 21.120.31 were adopted at the 9/9/2016 State Board of Human Services meeting, with an effective date of 11/1/2016 (Rule-making# 16-5-11-1). Statement of Basis and

Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relation, State Board Administrator.

Addition of r ules concerning the Behavioral Health Crisis Response System, Sections 21.400 through 21.400.6 were adopted at the 9/9/2016 State Board of Human Services meeting, with an effective date of 11/1/2016 (Rule-making# 16-5-11-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these additions were incorporated by reference into rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relation, State Board Administrator.

The following Chapters 1 - 11 apply to all agencies that apply for, receive, or renew a Behavioral Health Entity license or 27-65 designation on or after January 1, 2024.

Chapter 1: General Statutory Authority and Definitions 1.1 Authority and Applicability A. The statutory authority for the promulgation of these regulations is set forth in Sections 27-50- 106, C.R.S., 27-50-107 (3), C.R.S., 27-50-301(5), C.R.S., 27-50-502, C.R.S., 27-65-118, C.R.S. and 27-65-128, C.R.S. This regulation is intended to be consistent with the requirements of the State Administrative Procedures Act (the “ APA”), Section 24-4-101 through -109, C.R.S.

B. Chapters 1-10 of these rules may be applicable to holders of the following license types or designation following approval of an application for a Behavioral Health Entity license or renewal of a designation:

1. Behavioral Health Entity license by the Colorado Department of Public Health and Environment;

2. Approval or designation by the Office of Behavioral Health, as it existed before the effective date of Section 27-60-203(5), C.R.S., or the BHA pursuant to Article 50 of Title 27, C.R.S. or Article 65 and 66 of Title 27 C.R.S.

C. On an annual basis, the BHA will review the effectiveness of these rules and produce a written report of the results of this review to the State Board of Human Services. This review will include engagement with stakeholders and may include, but is not limited to, analysis of grievance data and trends in enforcement actions taken by the BHA. The BHA will provide this report annually to State Board of Human Services (SBHS) by September 1 starting September 1, 2024. The BHA will present information in the report to SBHS at the board's next session following submission of the written report unless the board and the BHA agree that presentation of the report occur at a different session of the board. If it is determined based on this review that changes to these rules are advised, the BHA shall propose these changes to the State Board of Human Services for promulgation in accordance with Section 26-1-107, C.R.S. 1.2 General Definitions “27-65 Designated Facility” means an agency that has applied for and been approved by the Behavioral Health Administration (BHA) under these rules to provide mental health services governed by Article 65 of “42 C.F.R. Part 2” means the federal regulations issued by the United States Secretary of Health and Human Services found at 42 C.F.R. Part 2 (Jan. 2023), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S.

Department of Health & Human Services, Substance Abuse & Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD 20857 or at https://www.ecfr.gov/current/Title-42. These regulations are also available for public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during “42 C.F.R. Part 441” means the federal regulations issued by the United States Secretary of Health and Human Services found at 42 C.F.R. Part 441.151 (Feb.2023), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Health & Human Services, Substance Abuse & Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD20857 or at https://www.ecfr.gov/current/Title-42. These regulations are also available for public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during “72-hour Emergency Rule” means the regulation issued by the Drug Enforcement Administration (DEA) found at 21 C.F.R. § 1306.07 (Apr.2022), which is hereby incorporated by reference. No later editions or amendments are incorporated. This regulation is available at no cost from the DEA at 8701 Morrissette Drive Springfield, VA 22152 or at https://www.ecfr.gov/current/Title-21. This regulation is also available for public inspection and copying at the Behavioral Health Administration (BHA), 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours.

“988” means the National Suicide Prevention Lifeline (The Lifeline).

“Activities of Daily Living (ADLs)” means activities that are oriented toward taking care of one’s own body, such as bathing, showering, bowel and bladder management, dressing, eating, feeding, functional mobility, personal device care, personal hygiene and grooming, sexual activity, sleep, rest, and toilet hygiene.

“Acute Treatment Unit” (ATU) means an agency or a distinct part of an agency, with an endorsement as outlined in Chapter 6 for short-term psychiatric care, which may include treatment for substance use disorders, that provides a twenty-four-hour, therapeutically planned and professionally staffed environment for individuals who do not require inpatient hospitalization but need more intense and individualized services than are available on an outpatient basis, such as crisis management and stabilization services.

“ADDS” means the “ Alcohol and Drug Driving Safety” program, established under Section 42-4-1301.3, C.R.S., the Judicial Department administers an alcohol and drug driving safety program in each judicial district that provides pre-sentence and post-sentence alcohol and drug evaluations on individuals convicted of DUI, DUI per se, or DWAI.

“A dministration” means (a) assisting a person in the ingestion, application, inhalation, or, using universal precautions, rectal or vaginal insertion of medication, including prescription drugs, (b) doing so in accordance with the legibly written or printed directions of the attending physician or other authorized practitioner or as written on the prescription label and (c) making a written record thereof with regard to each medication administered, including the time and the amount taken, but “ administration” does not include judgment, evaluation, or assessments. Nor does it include the injection of medication, the monitoring of medication, or the self-administration of medication, including prescription drugs and including the self-injection of medication by a person.

“Admission” means that point in an individual’s relationship with an organized treatment service when the intake process has been completed and the individual is eligible to receive the services.

“Admission Summary” means a brief review of assessments and other relevant intake data, including screenings, which summarizes an individual’s current status and provides a basis for individualized service planning.

“Adverse Childhood Experiences (ACES)” means traumatic events that occur before the age of eighteen (18) years old. Aces can include but are not limited to:

A. A buse, which can be emotional, verbal, physical or sexual;

B. Neglect, either physical or emotional;

C. Witnessing or experiencing domestic violence;

D. Substance misuse by a member of the household;

E. Divorce or separation of parents and/or caregivers or parental abandonment;

F. Mental illness of a member of the household;

G. Loss of a member of the household;

H. Attempted, or death by, suicide of a member of the household; and, I. Incarceration of a member of the household.

“Affidavit of Enrollment” means the document approved by the Department of Revenue, Division of Motor Vehicles pursuant to Section 42-2-132(2)(II)(c), C.R.S. indicating proof of an individual’s current enrollment in a Level II Alcohol and Drug Education and Treatment program.

“Agency” means a behavioral health provider licensed, designated, or approved by the BHA.

“Aggrieved” means having suffered actual loss or injury or being exposed to potential loss or injury to legitimate interests as defined in Section 24-4-102(3.5), C.R.S.

“Alcohol and Drug Evaluation Specialists” or “ ADES,” means persons within the Judicial Department, qualified to conduct pre- and post-sentence evaluations on, and provide supervision for, individuals convicted of DUI/DWAI.

“Americans with Disabilities Act”, or “ ADA,” means the Federal Americans with Disabilities Act of 1990, pub. L. No. 101-336 (1990), codified at 42 U.S.C. § 12101 et seq. (Jan 2017).

“AS AM Criteria” means the publication from the American Society of Addiction Medicine by Mee-lee, D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., eds Titled the ASAM Criteria: Treatment Criteria for Addictive, Substance-related, and Co-occurring Conditions, 3rd ed. Carson City, NV: The Change Companies®; 2013, which is hereby incorporated by reference. No later editions or amendments are incorporated. The ASAM Criteria is available for a reasonable charge at www.asam.org. It is also available for public inspection at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, “Assent” means to agree or approve of something (such as an idea or suggestion) especially after thoughtful consideration.

“Assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment, and referral. Assessments establish justification for services.

“Auxiliary Aids or Services” means an aid or service that is used to provide information to an individual with a cognitive, developmental, intellectual, neurological, or physical disability, and is available in a format or manner that allows the individual to better understand the information.

“Behavioral Health” has the same meaning as provided in Section 27-50-101(1), C.R.S.

“Behavioral H ealth Administration” or “ BHA” has the same meaning as provided in 27-50-101(2), C.R.S.

“Behavioral Health Administration DUI/DWAI legal supplement”, or “ legal supplement,” means the document available to BHEs providing DUI/DWAI programming, incorporating information about recent legal updates to legislation impacting DUI/DWAI-involved individuals (2023 version), which is incorporated by reference. No later editions or amendments are incorporated. The legal supplement is available for inspection on the BHA website at https://bha.Colorado.gov/behavioral-health/DUI-services and at the Behavioral Health Administration headquarters, 710 South Ash Street, Unit C140, Denver, CO 80246, during regular business hours.

"Behavioral Health Crisis” means a significant disruption in a person’s mental or emotional stability or functioning resulting in an urgent need for immediate assessment and treatment to prevent a serious deterioration in the person’s mental or physical health.

"Behavioral Health Disorder" has the same meaning as provided in Section 27-50-101(3), C.R.S.

"Behavioral Health Entity" has the same meaning as provided in Section 27-50-101(4), C.R.S.

“Behavioral Health Provider” has the same meaning as provided in Section 27-50-101(6), C.R.S.

"Behavioral Health Safety Net Provider" has the same meaning as provided in Section 27-50-101(7), “Best Practices” are professional procedures, interventions, techniques, and treatment approaches that have some quantitative data showing positive treatment outcomes over a period of time but may not have enough research or replication to be considered an evidence-based approach.

“Breath or Blood Testing” has the same meaning as provided in Section 42-4-1301.1(2)(a)(I), C.R.S.

“Brief Therapeutic Interventions” means interactions that are intended to induce a change in a behavioral health-related behavior(s).

“Care Coordination” means services that support individuals and families and initiate care and navigating crisis supports, mental health and substance use disorder assistance, and services that address the social determinants of health, and preventive care services. ertificate of Compliance” means an official document issued by the Department of Public Safety, Division of Fire Prevention and Control for a building or structure as evidence that materials and products meet specified codes and standards, that work has been performed in compliance with approved construction documents, and that the provisions of applicable fire and life safety codes and standards continue to be appropriately maintained.

“Chemical Restraint” has the same meaning as provided in 26-20-102(2), C.R.S.

“Child/Children” means a person under eighteen (18) years of age.

“Clearance Practice” means the process of identifying specific health needs and conditions that may require specialty management in a higher level of care, such as a crisis stabilization unit or an inpatient psychiatric hospital. Accepting agencies may have varying requirements prior to accepting a referral.

“Clinically Managed” means services that are directed by clinical personnel, which may include but are not required to be, medical personnel. These services involve on-site behavioral health support to address problems related to emotional, behavioral, or cognitive concerns, readiness to change, relapse, or recovery environment.

“Clinically Monitored” means that behavioral health services are accessed in the community, and not provided directly on-site by the agency. The agency is responsible for monitoring of the individual’s engagement in services and coordinating care, as needed.

“Colorado Crisis Services” means the statewide behavioral health crisis response system offering individuals mental health, substance use, or emotional crisis help, information and referrals.

“Commissioner” has the same meaning as provided in Section 27-50-101(9), C.R.S.

“Community-Based” has the same meaning as provided in Section 27-50-101(10), C.R.S.

“Community-Based Respite Care Services” means services of a temporary or short-term nature provided to an individual to temporarily relieve the family or other home providers from the care and maintenance of such individual.

“Comorbid” means the simultaneous presence of two or more diseases or medical conditions in an ompetent to Proceed” has the same meaning as provided in Section 16-8.5-101(5), C.R.S.

“Comprehensive Community Behavioral Health Provider” has the same meaning as provided in Section 27-50-101(11), C.R.S.

“Continuum of Care” or "Behavioral Health Continuum of Care'' is a model of care that guides and tracks patient outcomes through a comprehensive array of health services that include strategies for prevention, early intervention, treatment, and recovery from mental health problems and disorders with the goal of supporting the individual’s ability to live productively in the community. ontrolled Substance” has the same meaning as provided in Section 18-18-102(5), C.R.S.

“Co-occurring” disorders may include any combination of two or more substance use disorders and mental disorders identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR).

“Crisis Assessment” means a standardized assessment form created by the Behavioral Health Administration, available on the BHA website.

“Crisis Stabilization Services” means services provided in a crisis stabilization unit (CSU).

“Crisis Stabilization Unit” (CSU) means an agency, endorsed for behavioral health crisis and emergency services per Chapter 6 and that provides short-term, bed-based crisis stabilization services in a twentyfour-hour environment for individuals who cannot be served in a less restrictive environment.

“Critical Incident” means a significant event or condition, which may be of public concern, which jeopardizes the health, safety, and/or welfare of personnel and/or individuals.

“Culturally and Linguistically Appropriate Services (CLAS)” means services that are respectful of and responsive to individual cultural health beliefs, practices, preferred languages, health literacy levels and communication needs.

"Danger to the Person’s Self or Others" means:

A. A person poses a substantial risk of physical harm to the person’s self as manifested by evidence of recent threats of or attempts at suicide or serious bodily harm to the person’s self; or B. A person poses a substantial risk of physical harm to another person or persons, as manifested by evidence of recent homicidal or other violent behavior by the person in question, or by evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them, as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the person in question.

“Deficiency” means a failure to fully comply with any statutory and/or regulatory requirements applicable to an agency.

“Designated Representative” means a designated representative of an individual or service provider who is a person so authorized in writing or by court order to act on behalf of the individual or service provider.

In the case of a deceased individual, the personal representative, as defined at Section 15-10-201(39), C.R.S., or, if none has been appointed, heirs shall be deemed to be designated representatives of the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision,” or “ DSM-5-TR,” is published by the American Psychiatric Association (2022), which is hereby incorporated by reference. No later editions or amendments are incorporated. A copy may be purchased directly from the American Psychiatric Association at https://www.psychiatry.org and/or inspected at the American Psychiatric Association, 1000 Wilson boulevard, Arlington, VA 22209-3901. A copy may also be inspected at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular isaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life or property resulting from any natural cause or cause of human origin, including but not limited to fire, flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in the state as defined in Section 24-33.5-703(3), C.R.S.

“Discharge” means the termination of treatment obligations and/or services between an individual and the agency. For agencies that provide concurrent behavioral health services to an individual, “ discharge” is specific to the discontinued treatment obligation or service and does not impact or apply to an individual’s concurrent, active behavioral health service(s).

“Dispense” means to interpret, evaluate, and implement a prescription drug order or chart order, including the preparation of a drug for an individual in a suitable container appropriately labeled for subsequent administration or use by an individual.

“Dispute” means a verbal or written expression of dissatisfaction to a BHE about the care or services received or not received by an individual, that cannot be resolved to the satisfaction of the person expressing the dispute at the time of submission to BHE personnel. Disputes may be submitted by the individual or a personal representative on behalf of the individual. ivert Status” means the period of time in which an agency is unable to accommodate new admissions for timely services. This status may be necessary for reasons including but not limited to, the maximum number of individuals the agency is able to serve is exhausted, unexpected personnel concerns, and safety or environmental concerns.

“DUI/DWAI” for purposes of this Chapter 10, includes the following impaired offenses:

A. “driving under the influence” as defined in Section 42-4-1301(1)(f), C.R.S.;

B. “driving while ability impaired” as defined in Section 42-4-1301(1)(g), C.R.S.;

C. “DUI per se” as defined in Section 42-4-1301(2)(a), C.R.S.;

D. Operating an aircraft under the influence as defined in Section 41-2-102, C.R.S.;

E. Operating a vessel while under the influence as defined in Section 33-13-108.1, C.R.S.; and F. Underage Drinking and Driving (UDD) as defined in Sections 42-1-102(109.7) C.R.S. and 42-4- 1301, C.R.S.

1. For the purpose of this section, UDD applies to individuals that are under twenty-one (21) years of age.

2. Agencies providing UDD services to individuals under eighteen (18) years of age shall comply with Chapter 8 of these rules.

“DUI/DWAI Reporting System” or “ DRS” is the official document generated from data entered by endorsed DUI/DWAI programs into the Treatment Management System (TMS). This document reflects at minimum an individual’s education and treatment enrollment, attendance, compliance, and discharge status.

“Early Intervention Services” means:

A. Services provided to an individual who is at risk of developing a mental health, substance use, or co-occurring disorder which may include screening, brief intervention, referral(s) to treatment (SBIRT), and/or education-only services;

B. Services provided to an individual who is currently diagnosed with a mental health, substance use, or co-occurring disorder and is undergoing screening, brief intervention, referral(s) to treatment (SBIRT), and/or education-only services.

“E gress Alert Device” means a device that is affixed to a structure or worn by an individual that triggers a visual or auditory alarm when an individual leaves the building or grounds. An egress alert device is considered restrictive when the device is used to prevent the elopement of an individual.

“Emergency” means an unexpected event that places life or property in danger and requires an immediate response through the use of state and community resources and procedures per Section 24- 33.5-703(3.5), C.R.S.

“Emergency Services” means the public organizations that respond to emergencies when they occur.

This includes, but is not limited to, police, ambulance, and firefighting services. It may also include emergency behavioral health services accessed during times of crisis, such as Colorado Crisis Services.

“Endorsement” means approval for an agency approved, licensed, or designated by the BHA to provide a specific service.

“Essential Behavioral Health Safety Net Provider” has the same meaning as defined in Section 27-50- 101(13), C.R.S.

“Evidence-Based” means practices, principles, and programming that uses interventions, techniques, and treatment methods that have been tested using scientific methodology and proven to be effective in improving outcomes for a specific population.

“External Services” means personal services and protective oversight services provided to an individual by family members, or health care professionals who are not personnel of the agency. External service providers include, but are not limited to, home health providers, hospice, private pay caregivers, friends, and family members.

“Facility,” as used in the definition of BHE set forth above in part 1.2 of these rules, means a Behavioral Health Entity licensed by the Department of Public Health and Environment; a public or private “treatment facility” required to meet the approval standards established under Section 27-81-106, C.R.S.; an entity providing emergency or crisis behavioral health services; an entity providing behavioral health residential services; or an entity providing withdrawal management services.

"Family Member" means a spouse, partner in a civil union, as defined in Section 14-15-103 (5), C.R.S., parent, adult child, or adult sibling of a person with a mental health disorder.

“Federally Qualified Health Center” has the same meaning as defined in the federal “ Social Security Act”, 42 U.S.C. Sec. 1395x(aa)(4)(2022).

“Fentanyl Education” means the fentanyl education program developed by the BHA pursuant to Section 27-80-1287, C.R.S. This program is accessible publicly and will be required for those individuals that have a court order to complete the program as a condition of probation or parole.

“F ollow-Up Services” means services that may include interactions after the initial early intervention session and are intended to reassess an individual’s behavioral health status and progress, promote, or sustain reduction in symptomology and risk factors for a behavioral health disorder, as defined by the DSM-5-TR, and assess an individual’s need for additional referral(s) to services.

“Full Time Equivalent” (FTE) means the scheduled working hours for personnel divided by the number of hours in a full-time workweek for the entity. For example, if the entity considers forty hours to be a fulltime workweek, then personnel working twenty hours per week would have an FTE of 0.5.

“Gender Identity” means a person’s innate sense of the person’s own gender, which may or may not correspond with the person’s sex assigned at birth. Gender identity does not include sexual orientation or gender non-conforming expressions.

“Good Standing” means that a license, certification, registration, or enrollment has not been revoked or suspended and against which there are no outstanding disciplinary or adverse actions.

“Governing Body” means the board of trustees, directors, or other governing body in whom the ultimate

authority and responsibility for the conduct of the agency is vested.

“G rievance” means an expression of dissatisfaction made to the BHA about the care or services received or not received by an individual, that could not be resolved to the satisfaction of the person expressing the grievance at the time of submission to BHE personnel. Grievances may be submitted by an individual or entity, including but not limited to, recipients of service, family members of recipients of service, authorized representatives of recipients of service, licensed facilities, state departments and members of the general public.

“Harm Reduction” means an approach that emphasizes engaging directly with individuals whose actions or behaviors place them at risk for a variety of adverse mental health, substance use disorder or physical health outcomes. Harm reduction is a set of practical strategies and ideas aimed at reducing potential negative consequences associated with a variety of actions or behaviors. These strategies and approaches may include but are not limited to safer drug use, overdose prevention, safer sex, medication adherence, managed drug use, abstinence, and addressing environmental conditions along with the actions or behaviors themselves.

“Health-Related Social Needs (HRSN)” means an individual’s unmet, adverse social conditions (e.g., housing instability, homelessness, nutrition insecurity) that contribute to poor health and are a result of underlying social determinants of health.

“HIPAA” means the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936 (1996), codified at 42 U.S.C. § 300gg (2012) and 29 U.S.C. § 1181 et seq. (2012) and 42 U.S.C. § 1320d et seq. (2012) and the federal regulations issued by the U.S. Department of Health & Human Services found at 45 C.F.R. part 160 (2017); 45 C.F.R. part 162 (2017); and, 45 C.F.R. part 164 (2017), which are hereby incorporated by reference. No later editions or amendments are incorporated.

These regulations are available at no cost from the U.S. Department of Health & Human Services, Office of Civil Rights, 200 Independence Avenue, SW, Room 509f, HHH building, Washington, D.C. 20201 or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246 during regular "Hospitalization" means twenty-four (24) hour out-of-home placement for treatment in a facility for a person with a mental health disorder. ncompetent to Proceed” has the same meaning as defined in Section 16-8.5-101(12), C.R.S. for adults and in Section 19-2.5-102(25), C.R.S. for youth.

“Individual” means a person seeking or receiving behavioral health services and includes a respondent, as defined by Section 27-65-102(29), C.R.S.

“Informed Consent” means an informed assent that is freely given. It is always preceded by the following:

A. An explanation of the nature and purpose of the recommended treatment or procedure in layman's terms and in a form of communication understood by the individual or the individual’s designated representative;

B. An explanation of the risks and benefits of a treatment or procedure, the probability of success, mortality risks, and serious side effects;

C. An explanation of the alternatives with the risks and benefits of these alternatives;

D. An explanation of the risks and benefits if no treatment is pursued;

E. An explanation of the recuperative period which includes a discussion of anticipated problems;

F. An explanation that the individual, or the individual’s designated representative, is free to withdraw consent and to discontinue participation in the treatment regimen at any time. nitial License” means the licensing of a facility or provider organization by the BHA that is not currently licensed by the BHA, as well as a licensure change from one type to another.

“Inpatient” refers to inpatient hospitalization as well as twenty-four (24) hour residential levels of care.

“In-Person” means services provided in the same physical location as the individual and agency personnel. This may include on-scene crisis responses.

“Inspection” means a process of review to ensure licensed, approved, or designated entities are operating in substantial conformity with applicable licensing, approval, and/or designation rules.

“Integrated Care Model” means the systematic coordination of mental health, substance use, and primary care services.

“Intensive Case Management” means community-based services provided to individuals with serious behavioral health disorders who are at risk of needing a more intensive 24-hour placement and is designed to provide extra support for living in the community. These services include assessment, care plan development, multi-system referrals, assistance with wraparound and supportive living services, monitoring and follow-up.

“Intensive Outpatient Program” or “ IOP” means a service provided for individuals that require a more structured outpatient treatment experience than can be received in standard outpatient services. Program may be treatment for mental health, substance-related, and co-occurring disorders.

“Interlock Enhancement Counseling”, or “ IEC,” means the evidence-based intervention curriculum which combines cognitive behavioral treatment with motivational interviewing/motivational enhancement as a treatment intervention. IEC was developed by Timken, Nandi, and Marques, for DUI/DWAI individuals who have alcohol ignition interlock devices installed in their vehicles (July 2012), which is incorporated by reference. No later editions or amendments are incorporated. This curriculum is available to providers of DUI/DWAI services at no cost through the BHA. A copy of the curriculum is available for inspection at the Behavioral Health Administration headquarters, 710 S. Ash Street, Unit C140, Denver, CO 80246, during “Lega l Guardian” is an individual appointed by the court, or by will, to make decisions concerning an incapacitated individual's or minor's care, health, and welfare.

“Legal Representative” means one of the following acting within the scope of their authority:

A. The guardian of the individual, as defined in Section 15-14-102, C.R.S., where proof is offered that such guardian has been duly appointed by a court of law, acting within the scope of such guardianship;

B. An individual named as the agent in a power of attorney (POA), as defined in Section 15-14- 500.5, C.R.S., that authorizes the individual to act on the individual's behalf, as enumerated in the POA;

C. An individual selected as a proxy decision-maker pursuant to Section 15-18.5-101 through -105, C.R.S., to make medical treatment decisions. For the purposes of these rules, the proxy decisionmaker serves as the individual's legal representative for the purposes of medical treatment decisions only; or D. A conservator, where proof is offered that such conservator has been duly appointed by a court of law, acting within the scope of such conservatorship.

“Lethal Means Restriction” means an approach to suicide prevention that reduces access to a fatal method of suicide (e.g., firearms, medications, sharps), thus preventing or reducing the lethality of an attempt.

“Let ter of Intent” means the notification provided to the BHA related to an application for an initial BHE license or safety net approval.

“Level I and Level II Alcohol and Drug Education or Treatment” means a BHA endorsed ADDS education or treatment program as defined in Section 42-4-1301.3(3)(c)(IV) C.R.S.

“Level II Four Plus”, also referred to as “ Track F” treatment, is an ADDS program, intended for an individual who has four (4) or more alcohol and/or drug impaired driving offenses, as noted in Section 42- 4- 1301.3(3)(c)(IV), C.R.S. This includes vehicular homicide and vehicular assault where alcohol or other drugs were involved. Only programs endorsed to provide Level II Four Plus treatment may accept referrals for this level of service.

“Level II Four Plus: competencies and phases” means the BHA-approved document available to Level II Four Plus programs, providing additional guidance regarding competency and phase completion. It is available on the BHA website.

“Level 3-Withdrawal Management” or “ Level 3-WM” means the on-site service offered twenty-four (24) hours per day to individuals who are intoxicated and actively withdrawing from the use of one (1) or more substances. It includes both Level 3.2-WM and Level 3.7-WM, as defined in part 1.2 of these rules.

“Living Space Assignment” means the assigned bathroom and sleeping quarters of individuals served by the agency.

“Managed Care Entity” has the same meaning as provided in Section 25.5-5-403(4), C.R.S.

“M edically Managed” means services that are directly provided and/or managed by licensed medical “Mechanical Restraint” means a physical device used to involuntarily restrict the movement of an individual or the movement or normal function of a portion of an individual’s body.

“Medically Monitored” means services that are provided by an interdisciplinary team of personnel including nurses, behavioral health professionals, other health care professionals and technical personnel, under the direction of a licensed physician. Medical monitoring is provided through a mix of direct individual contact, review of records, team meetings, twenty-four (24) hour coverage by a physician, and quality assurance programs.

“Medication/Psychiatric - Only Services” means services dedicated solely to the management of medications prescribed to an individual for the management of mental health, substance use, and/or cooccurring behavioral health disorders.

“Medication-Assisted Treatment,” or “ MAT” services, means the use of medications, in combination with or without counseling and behavioral therapies, to provide a whole-person approach to the treatment of substance use disorders. Medications used in MAT are approved by the United States Food and Drug administration (FDA) and MAT programs are clinically driven and tailored to meet each individual’s needs.

MAT services may include Medications for Opioid Use Disorder (MOUD) services for the specialized treatment of Opioid Use Disorder (OUD).

“Medi cation Diversion” means the transfer of any controlled substance from a licit to an illicit channel of distribution or use.

“Medication Formulary” means the Required Formulary Psychotropic Medications: 2018, which is available at no cost from the Colorado Department of Human Services at https://bha.colorado.gov/behavioral-health/medication-consistency. The medication formulary is a list of minimum medications, established pursuant to Section 27-70-103, C.R.S., that may be used by service providers to increase the likelihood that a broad spectrum of effective medications are available to individuals to treat behavioral health disorders, regardless of the setting or service provider. The medication formulary may not contain a complete list of medications, and providers may prescribe and/or carry any additional medications they deem necessary.

“Member” means a person or entity with an ownership interest in the limited liability company.

"Mental Health Disorder" has the same meaning as provided in Section 27-50-101(15), C.R.S.

“Mental Health Transitional Living Home” means a community-based residential agency providing residential support to individuals who require ongoing support with daily living due to their behavioral health diagnosis but whose needs do not rise to the level of hospitalization. There are two levels of mental health transition living homes:

A. “Level One Mental Health Transitional Living Homes” provide clinically monitored services as defined in part 1.2 of these rules.

B. “Level Two Mental Health Transitional Living Homes” provide clinically managed services as defined in part 1.2 of these rules.

“Mental Status Examination '' means a structured assessment of the individual’s behavioral and cognitive functioning. The specific cognitive functions of alertness, language, memory, constructional ability, and abstract reasoning are the most clinically relevant. The mental status examination can include but is not A. The individual’s appearance and general behavior;

B. Level of consciousness and attentiveness;

C. Motor and speech activity;

D. Mood and affect;

E. Thought and perception;

F. Attitude and insight; and G. Higher cognitive abilities.

“Milieu” means the shared living space of the agency and includes the living space assignments for individuals served.

“Mi nor in Possession” (MIP) is an offense committed by an individuals aged twenty-one (21) and younger for possession or consumption of ethyl alcohol or possession of two ounces or less or consumption of marijuana or possession of marijuana paraphernalia. MIP may result in fines, court-ordered public service, a substance use disorder assessment, and/or substance abuse education program per Section 18-13-122, C.R.S.

“Monitoring” means the observation, review, and documentation of results when tracking an individual’s progress over a period of time related to an event. This may include, but is not limited to, monitoring of medication compliance and administration, and monitoring of vital signs while actively withdrawing from substances.

“Motivational Enhancement” means the counseling approach to initiate behavior change by helping an individual resolve ambivalence about engaging in treatment services and reducing engagement in harmful behavior and activities. This approach employs strategies to evoke rapid and internally motivated change in the individual rather than guiding the individual stepwise through the recovery process.

“Multidisciplinary Team” or “ MDT” means a group of personnel, acting within their professional role(s) and respective scope(s) of practice, who are members of different professions, working together to provide services to individuals.

“Natural Supports” means the relationships that occur in everyday life. Natural supports typically involve family members, friends, co-workers, neighbors, and acquaintances and are self-defined by the individual in crisis.

“No Refusal Requirements” means the requirements found in 27-50-301(4), C.R.S. that establish the conditions under which a behavioral health safety net provider cannot refuse to treat an individual.

“On-Site” means at the location that is licensed, designated, or approved by the BHA for the provision of behavioral health services.

“Opioid Antagonist” has the same meaning provided in Section 17-1-113.4(4)(b), C.R.S.

“Outreach, Education, and Engagement Services” means services by an agency that have identified priority target populations and service needs in the area the agency serves that require higher levels of active engagement by the agency to produce positive behavioral health outcomes.

“Outpatient Competency Restoration” means a community-based program that allows adults and juveniles in the criminal justice or juvenile justice system, who are found incompetent to proceed by the court, to receive psychoeducation services, case management, and referrals to community-based services and supports throughout all of Colorado with the goal of restoring competency.

“O utpatient Treatment” means behavioral health services provided to an individual in accordance with their service plan on a regular basis in a non-overnight setting, which may include, but not be limited to, individual, group, or family counseling, peer support professional services, case management, or medication management.

“OWNPATH” is an online directory operated by the Colorado Behavioral Health Administration that allows individuals to find behavioral health providers licensed, designated, or approved by the BHA in order to access specific services or resources that best meet the individual’s behavioral health needs.

“Paired Mobile Response” means a mobile crisis response in which two personnel respond, one person on scene and the other person on scene or via telehealth. Both members of the paired response should be crisis professionals.

“Partial Hospitalization Program” or “ PHP” means a service provided for individuals that require regularly scheduled monitoring or management while providing clinical structure in an outpatient setting to treat mental health, substance use, or co-occurring needs in addition to providing direct access to medical, psychiatric, and laboratory services.

“Pass” means written permission by an agency for an individual to leave campus grounds.

“Peer Respite Home” means an agency staffed by peer support professionals that provides temporary accommodations to prevent behavioral health-related hospitalizations. eer Support” means recovery-oriented services provided by peer support professionals that promote self-management of psychiatric symptoms, relapse prevention, treatment choices, mutual support, enrichment, and rights protection. Peer support also provides social supports and a lifeline for individuals who have difficulties developing and maintaining relationships.

“Persistent Drunk Driver”, or “ PDD,” has the same meaning as provided in Section 42-1-102(68.5)(a), “Personal Services” means those services that an agency and its personnel provide for each individual A. An environment that is sanitary and safe from physical harm;

B. Individualized social supervision;

C. Assistance with transportation; and D. Assistance with activities of daily living.

“Person-Centered Care” means individuals participate in the development of treatment goals and services provided to the greatest extent possible. Person-centered service planning is strength-based and focuses on individual capacities, preferences, and goals. Individuals are core participants in the development of the plans and goals of treatment.

“Pharmacotherapy” means the treatment by an authorized practitioner of an individual’s behavioral health condition(s) through medicinal use of pharmaceutical products.

“Physical Management” means the physical action of placing one’s hands on an individual to gain physical control to protect the individual or others from physical harm after all attempts to verbally direct or de-escalate the individual have failed. Any attempts at physical management of a child is considered “Physical Restraint” means the use of bodily, physical force to involuntarily limit a person's freedom of movement, except that “ physical restraint” does not include the holding of a child or youth by one adult for the purpose of calming or comforting the child. lan of Action” is a description of how an agency plans to bring into compliance any standards identified as out of compliance within a specified time period.

“Postpartum” means the period of time following the end of a pregnancy or birth of a child up to one year.

“Primary Complaint” or “ Presenting Problem” means the reason, concern, or motivation which prompts an individual to seek services or that which the individual’s referral source identifies as the issue which requires intervention, usually in the individual’s own words.

“Priority Populations” has the same meaning as provided in Section 27-50-101(17), C.R.S.

“Protective Oversight” means guidance of an individual as required by the needs of the individual or legal representative or as reasonably requested by the individual including the following:

A. Being aware of an individual’s general whereabouts, although the individual may travel independently in the facility; and B. Monitoring the activities of the individual on the premises to ensure the individual’s health, safety, and well-being, including monitoring the individual’s needs and ensuring that they receive the services and care necessary to protect health, safety, and well-being. rosocial” means relating to or denoting behavior which is positive (e.g., friendly, expresses empathy to or about others, and respects rules as well as the boundaries of others), helpful, and intended to promote social acceptance and friendship which is positive, helpful, and intended to promote social acceptance and friendship.

“Protective Factor” means the characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. Protective factors are seen as positive countering events. Protective factors may include factors such as positive self-image, self-control, or social competence.

“Provider Organization,” as used in the definition of BHE set forth above, means a corporation, partnership, limited liability company, business trust, association, or organized group of persons, which is in the business of behavioral health care delivery or management and that (a) includes ten (10) or more full time equivalent (FTE) fully licensed or certified professionals providing diagnostic, therapeutic, or psychological services for behavioral health conditions under the providers’ Professional Practice Act.

“Psychiatric Advance Directive (PAD)” means a written instruction, created pursuant to Section 15-18.7- 202, C.R.S. concerning behavioral health treatment, medication, and alternative treatment decisions, preferences, and history to be made on behalf of the adult who provided the instruction.

“Psychotherapy” or “ psychotherapy services” has the same meaning as defined in Section 12-245- 202(14), C.R.S.

“Readiness to Change” means an individual’s emotional and cognitive awareness of and interest in the need to change, coupled with a commitment to change.

“Real-Time” documentation means that the personnel providing a monitoring activity enters the result in the individual’s record at the time of the monitoring activity, allowing necessary information to transition seamlessly between shift change. If this process involves delayed entry of results into an electronic health record or other tracking system, the documentation reflecting real-time communication must be included “R ecovery” means a process of change through which individuals improve their health and wellness and ability to live a self-directed life and strive to reach their full potential.

“Recovery Support Services Organization” (RSSO) has the same meaning as in 27-60-108(2)(c).

“Residential Child Care Facility (RCCF)” has the same meaning as described in Section 26-6-903(29), “Residential Services” means the on-site service for individuals whose mental health and/or substance use issues and symptoms are severe enough to require a twenty-four (24)-hour per day structured program and oversight, but that do not require hospitalization. It includes mental health transitional living homes, but does not include residential child care facilities.

“Restraint” has the same meaning as described in Section 26-20-102(6), C.R.S.

“Risk Factors” mean the characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. Risk factors on an individual level may include an individual’s genetic predisposition to addiction or exposure to alcohol or other potentially harmful substance(s) prenatally.

“Risk, Need, Responsivity,” or “ RNR,” means the model of evaluating how to best engage an individual involved in the criminal justice system. It incorporates the following principles:

A. C riminogenic risk: the likelihood that an individual will engage in future illegal behavior in the form of a new crime or failure to comply with conditions of probation or parole.

B. Criminogenic need: dynamic risk factors that increase an individual’s likelihood to engage in future illegal behavior in the form of a new crime or failure to comply with conditions of probation or parole. This includes, but is not limited to, factors such as lack of employment or livable wages, or the presence of a substance use disorder. These factors are malleable and responsive to C. Responsivity: maximizing the potential success of treatment intervention by tailoring the intervention to the learning style, secondary needs, motivation, and strengths of the individual.

“SAMHSA” means the Substance Abuse and Mental Health Services Administration overseen by the United States Department of Health and Human Services.

“Screening” means a brief process used to identify current behavioral health or health needs and is typically documented through the use of a standardized instrument. Screening is used to determine the need for further assessment, referral, or immediate intervention services.

“Seclusion” has the same meaning as described in Section 26-20-102(7), C.R.S.

“Self-Administration” means the ability of a person to take medication independently without assistance by administration from another person.

“Sequential Intercept Model (SIM)” means the model of how individuals with behavioral health disorders come into contact with and move through the criminal justice system.

“Service Plan” means a written description of the services to be provided by the agency to meet an individual's treatment needs.

“Session” means a face-to-face, telehealth, or audio-only interaction of the individual and personnel.

Session may include but is not limited to individual therapy, group therapy, medication-assisted treatment education and/or monitoring, family therapy, peer professional services, educational/occupational groups, recreational therapy, intake, discharge, service planning, and other therapies. ocial Determinants of Health” refers to the conditions in which individuals are born, grow, live, work and age. They include factors such as socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care.

“Stock Medication” means medication that is not labeled for, or intended for, use by a specific individual when it leaves the pharmacy but is intended to be stored and ultimately administered by a licensed health care professional in accordance with applicable laws and regulations.

“Sub-Endorsement” means a secondary endorsement for a specific type of service within the broader category of an endorsement.

"Substance Use Disorder" has the same meaning as provided in Section 27-50-101(20), C.R.S.

“Supervising Entity” means the official employed by probation, parole, or other representative of the criminal justice system who is responsible for oversight and supervision of the individual. Other representatives may include, but are not limited to, direct employees or contractors of the Department of Corrections, the Division of Criminal Justice, The Judicial Department, or the Department of Human Services. The supervising entity is often responsible for referring individuals into specific education and/or treatment services and reporting compliance with terms of supervision to the courts. upervision” for the purposes of Chapter 6 only means weekly clinical guidance from a licensee or “Telehealth” means delivery of services through telecommunications systems that are compliant with all federal and state protections of individual privacy, to facilitate individual assessment, diagnosis, consultation, treatment, and/or service planning/case management when the individual and the person providing services are not in the same physical location. Telecommunications systems used to provide telehealth include information, electronic, and communication technologies. Telehealth may include audio-only methods in accordance with state and federal regulation unless noted otherwise.

“Tiered Inspection” means an on-site re-licensure survey that has a reduced scope and reviews fewer items for compliance with applicable state regulations than a full re-licensure survey.

“Transfer” means being able to move from one body position to another. This includes, but is not limited to, moving from a bed to a chair or standing up from a chair to grasp adaptive equipment.

“Trauma-Informed” means an approach to care that realizes the widespread impact of trauma, understands potential paths for recovery, recognizes the signs and symptoms of trauma in individuals, families, personnel, and others involved in the system, and responds by fully integrating knowledge about trauma into policies, procedures, and practices, seeking to actively resist re-traumatization. The six key principles of a trauma-informed approach include:

A. Safety, trustworthiness and transparency;

B. Peer support, collaboration and mutuality;

C. Empowerment, voice and choice;

D. Cultural issues;

E. Historical issues; and F. Gender issues.

“Treatment Management System,” or “ TMS” means the database utilized by endorsed DUI/DWAI programs to electronically track and report an individual’s enrollment and status in required DUI/DWAI services through the completion of the “ DUI/DWAI reporting system,” or “ DRS” record. reatment Type” means the focus of behavioral health services that the agency provides. It may include services focused on mental health disorders, substance use disorders, or both, also referred to as “ cooccurring” disorders.

“Triage” means a dynamic process of evaluating and prioritizing urgent needs and intervention options based on the nature and severity of the individuals’ presenting situation.

“Two (2) Generational Approach'' means focusing on both children and parents’ and/or legal guardians’ needs at the same time. This approach focuses on breaking down barriers by strengthening education, economic supports, social capital, and health and well-being. The core principles of the Two Generational Approach are:

A. Measure and account for outcomes for both children and their parents and/or legal guardians;

B. Engage and listen to the voices of families;

C. Foster innovation and evidence together;

D. Align and link systems and funding streams; and E. Ensure access.

“Underinsured” means an individual’s insurance plan does not cover the cost of necessary care, either medical or behavioral, leaving the individual with out-of-pocket costs they are unable to pay.

“Understanding the ADDS Evaluation Training” means the mutually developed, webinar-based training offered by the BHA and State Court Administrator’s Office.

“Undue Hardship” means a situation where compliance with a rule creates a substantial, unnecessary burden on the applicant or agency’s business operation or the families or community it serves, and which reasonable means cannot remedy. An undue hardship does not include the normal cost of operating the business.

"Walk-In Crisis Services" means immediate and confidential, in-person crisis support, information, and referrals to any individual in need including to anyone experiencing a self-defined crisis.

“Warm Handoff” means an approach to care transitions in which a behavioral health care provider uses face-to-face or telehealth contact to directly link individuals being treated to other providers or services.

“Warm Line/Support Line” means a telephonic service where individuals can “opt in” from the statewide crisis line to receive individualized screening and resources by peer support professionals.

“Whole Person Health” means physical, mental, and social wellness which is achieved through integrated care and adequately addressing social determinants of health.

“Withdrawal Management” or “ WM” means the services required to assist an individual experiencing withdrawal from the use of one (1) or more substances, as identified by the individual’s acute intoxication and/or withdrawal potential, also known as the dimension 1 rating, from the ASAM Criteria. Withdrawal management is divided into the following levels:

A. “Lev el 1-WM” means ambulatory withdrawal management without extended on-site monitoring services. This is an outpatient service that involves medically supervised evaluation, withdrawal management, and referral services that are delivered on a regular schedule.

B. “Level 2-WM'' means ambulatory withdrawal management with extended on-site monitoring. This is an outpatient service that involves regularly scheduled sessions of physician approved monitoring of withdrawal management protocols.

C. “Level 3.2-WM” means clinically managed residential withdrawal management. This is an organized service delivered in a setting that provides twenty-four (24) hour supervision, observation, and support to individuals who are intoxicated and/or experiencing withdrawal. This service is characterized by its emphasis on peer and social support rather than medical and/or nursing care.

D. “Level 3.7-WM” means medically monitored inpatient withdrawal management. This is an organized service delivered by medical and nursing professionals, which provides for twenty-four (24) hour evaluation and withdrawal management in a permanent facility with inpatient beds.

Services are delivered under a defined set of physician-approved policies and physicianmonitored procedures or clinical protocols.

“Women’s and Maternal Behavioral Health Treatment” means creating an environment and service continuum that reflects an understanding of and is grounded in the unique biological, developmental, historical, relational, economic and social experiences that shape women's lives, and thus responds through factors which include, but are not limited to, site selection; personnel selection and training; program development; content; and wrap-around supports that address gender-specific issues in the course of prevention, intervention, treatment and recovery services. This was previously known as gender-responsive treatment.

“Y outh” means an individual who is under twenty-one (21) years of age. 1.3 Personnel Definitions “Administrator” means a person implementing policies and procedures on an agency-wide, endorsement, service, or physical location-specific basis, who is responsible for the day-to-day operation of such endorsement, service, or location.

“Advanced Practice Registered Nurse” or “ APRN” has the same meaning as provided in Section 12-255- 104, C.R.S.

“Approved Restoration Provider” means a comprehensive community behavioral health provider who appears on the approved provider list as passing all contract application requirements with the outpatient competency restoration services program department within the Office of Civil and Forensic Mental Health (OCFMH).

“Authorized Practitioner” means the person (a) authorized by law to prescribe treatment, medication, or medical devices, (b) who holds a current unrestricted license to practice, and (c) is acting within the scope of such authority. This includes persons registered with the Drug Enforcement Administration (DEA) to prescribe controlled substances. This includes, but is not limited to:

A. A physician, psychiatrist, medical doctor, or doctor of osteopathy licensed pursuant to Article 240 of Title 12, C.R.S., B. A physician assistant licensed pursuant to part 113 of Article 240 of Title 12, C.R.S., and C. An a dvanced practice registered nurse (APRN), licensed pursuant to part 255 of Title 12, C.R.S.

“Candidate” means a person receiving clinical supervision, acting within their scope of practice, and seeking licensure through DORA. It includes the following:

A. Psychologist candidates, pursuant to Section 12-245-3, C.R.S.;

B. Clinical social work candidates, pursuant to Section 12-245-4, C.R.S.;

C. Marriage and family therapist candidates, pursuant to Section 12-245-5, C.R.S.;

D. Licensed professional counselor candidates, pursuant to Section 12-245-6, C.R.S.; and E. Licensed addiction counselor candidates, pursuant to Section 12-245-8, C.R.S.

“Certified Addiction Specialist” or “ CAS,” means a person who possesses a valid, unsuspended, and unrevoked addiction counseling certificate issued by DORA, authorizing them to practice addiction counseling commensurate with their certification level and scope of practice, per Section 12-245-8, “Certified Addiction Technician” or “ CAT” means a person who possesses a valid, unsuspended, and unrevoked addiction counseling certificate issued by DORA, authorizing them to practice addiction counseling commensurate with their certification level and scope of practice, per Section 12-245-8, “Clinical Director” means a person responsible for overseeing individual treatment services, including, but not limited to ensuring appropriate training and supervision for clinical personnel.

“Clinical Supervision” means the following:

A. Supervision that is received to meet the standard qualifications for clinical supervision as defined by a professional practice board and standards in the Colorado Mental Health Practice Act, pursuant to Article 245 of Title 12, C.R.S. the delivery, frequency, and specific requirements may vary depending upon the credential and the respective skills of the two (2) professionals involved, and the population and/or the specific individual being served.

B. Supervision provided to personnel who are not seeking or not eligible for professional licensure but are otherwise qualified to provide services to individuals based on education, training, or other credentials implies that the supervisor accepts oversight and responsibility for the services provided by this personnel. The supervisor must follow standards in the Colorado Mental Health Practice Act, pursuant to Article 245 of Title 12, C.R.S. The nature of the supervisory relationship depends on the respective skills of the two professionals involved, the individual population and/or the specific individual being served. It is usually ongoing, required, and hierarchical in nature.

"Counselor-In-T raining" means a person currently in the process of obtaining a professional credential pursuant to Article 245 of Title 12, C.R.S. "Counselor-In-Training" does not include candidates as defined in this part 1.3.

“Colorado Department of Regulatory Agencies,” or “ DORA” means the division of professions and occupations within this state department as created in Section 24-1-122, C.R.S.

“Crisis Professional” means any person who is receiving or has received crisis professional curriculum training approved by the BHA specific to crisis assessment, management, de-escalation, safety planning and all relevant laws and provisions such that training is complete, and the person can lead a crisis response.

“Group Living Worker” means a person without a behavioral health credential or license that is adequately trained and supervised to recognize and respond to behavioral health concerns. This person may assist in twenty-four (24) hour management and oversight of the milieu and, in certain facilities, may also serve a correctional or supervision-focused role. This does not include peer support professionals.

“Intern'' means personnel completing a clinical degree program of study performing duties under the direct clinical supervision of degree-corresponding licensed personnel.

“Li censed Addiction Counselor” or “ LAC” means a person who possesses a valid, unsuspended, and unrevoked addiction counseling license issued by DORA, authorizing them to practice addiction counseling commensurate with their licensure level and scope of practice, per Section 12-245-801 through -806, C.R.S.

“Licensed Social Worker” means a person who:

A. Is a licensed social worker or licensed clinical social worker; and B. Possesses a valid, unsuspended, and unrevoked license issued pursuant to Section 12-245-404, “Licensed Professional Counselor” or “ LPC” means a person who is a professional counselor licensed pursuant to Section 12-245-601 through -607, C.R.S.

“Licensee” means a psychologist, social worker, clinical social worker, marriage and family therapist, licensed professional counselor, or addiction counselor licensed as defined in 12-245-202(8), C.R.S.

“Manager” means a person involved in and/or responsible for decisions made on behalf of an agency regarding clinical and/or operational policies, procedures, and actions for a physical location, endorsement, service type, and/or the agency. This may include administrators or clinical directors, depending on the structure and operation of the agency. An agency may have a single manager, or multiple managers, as appropriate for the combination of endorsements, services, and locations included in the agency license.

“Marriage and Family Therapist” or “ LMFT” means a person who possesses a valid, unsuspended, and unrevoked license as a marriage and family therapist pursuant to Section 12-245-504, C.R.S.

“Nurse” means a person who holds a current unrestricted license to practice pursuant to 12-255-110, C.R.S., and is acting within the scope of such authority.

“Peer Support Professional” means the following persons who meet the qualifications as described in

Section 27-60-108(3)(a)(III), C.R.S.:

A. A peer support specialist;

B. A recovery coach;

C. A peer and family recovery support specialist;

D. A peer mentor;

E. A family advocate; or F. A family systems navigator.

“Personnel” means persons employed by and/or providing services under the direction of an agency, including, but not limited to managers, administrators, clinical directors, employees, contractors, students, interns, volunteers, or treatment-involved mentors.

"Professional P erson" has the same meaning as described in Section 27-65-102(27), C.R.S.

“Psychologist” means a person who possesses a valid, unsuspended, and unrevoked license as a psychologist licensed pursuant to Section 12-245-304, C.R.S.

“Qualified Medication Administration Person” or “ QMAP” means a person who passed a competency evaluation administered by the Department of Public Health and Environment before July 1, 2017, or passed a competency evaluation administered by an approved training entity on or after July 1, 2017, and whose name appears on the Department of Public Health and Environment’s list of persons who have passed the requisite competency evaluation.

“Qualified Practitioner” means a physician or other person licensed, registered, or otherwise permitted to distribute, dispense, or to administer a controlled substance in the course of professional practice.

“Supervision” for the purposes of Chapter 6 only means weekly clinical guidance from a licensee or

Chapter 2: General Behavioral Health Entity Licensing Standards 2.1 Authority and Applicability A. Chapter 2 establishes the conditions that an agency must meet in order to be licensed as a Behavioral Health Entity (BHE), and the minimum standards for the operation of a BHE. The statutory authority for the promulgation of these regulations is set forth in Sections 27-50- 107(3)(b), C.R.S. and 27-50-502(1), C.R.S.

B. As of January 1, 2024, it is unlawful for any person, partnership, association, or corporation, not already possessing a valid license to operate a BHE or substance use disorder facility, to conduct or maintain a BHE, without having obtained a license from the Behavioral Health Administration (BHA) per Section 27-50-501, C.R.S.

C. Pursuant to Section 27-50-502(1)(g), C.R.S., these rules shall include a timeline for compliance with BHE standards that exceed the standards under which a BHE was previously licensed or approved. BHEs shall be subject to the following rule compliance timeline:

1. Upon these rules going into effect, the BHA shall take immediate action on rule violations that impact the health, safety, and welfare of individuals receiving services provided by a BHE.

2. Al l BHEs, licensed by the BHA, shall be in full compliance of these rules, and any rules that apply to any endorsements an entity has elected to obtain, by July 1, 2024. 2.2 License Requirement A. Any entity seeking initial licensure as a BHE shall apply for a license from the (BHA) if the entity would previously have been licensed or subject to any of the following:

1. BHE licensure by the Colorado Department of Public Health and Environment;

2. Approval or designation by the Office of Behavioral Health, as it existed before the effective date of this part, or the BHA pursuant to Article 50 of Title 27, C.R.S. or Article 66 of Title 27 C.R.S.; or 3. Approval by the Office of Behavioral Health, as it existed before the effective date of this

part, or the BHA pursuant to Section 27-81-106, C.R.S. as an approved treatment program for substance use disorders. This includes agencies that:

a. Are required by statute to be licensed by the BHA;

b. Receive public funds to provide substance use disorder treatment or substance use disorder education;

c. Provide such treatment to individual populations whose referral sources require them to be treated in agencies licensed by the BHA; or d. Ar e acquiring existing agencies or sites licensed by the BHA.

B. Entities previously licensed as described in part 2.2.A of this Chapter shall seek an initial BHE license at least sixty (60) calendar days prior to the expiration of their existing license.

C. Any entity that meets the definition of a BHE, as defined in these rules, shall be licensed pursuant to this Chapter 2.

D. Hospitals are exempt from BHE licensure as they do not meet the definition of providing community-based services. 2.3 General Licensing Requirements A. The BHE shall ensure compliance with the following:

1. The BHE may only provide services for which it holds an endorsement as part of its 2. If a BHE has not provided behavioral health services specific to its endorsement for one (1) year, the BHA will review the endorsement and may remove the endorsement from the BHE’s license.

3. The following endorsements are considered outpatient service endorsements:

a. Behavioral Health Outpatient services as described in Chapter 4 of these rules;

b. Behavioral Health High-Intensity Outpatient services as described in Chapter 4 of c. Walk-In Crisis services as described in Chapter 6 of these rules;

d. Mobile Crisis services as described in Chapter 6 of these rules;

e. Ambulatory Withdrawal Management without Extended On-Site Monitoring (Level 1- WM) as described in Chapter 4 of these rules; and f. Ambulatory Withdrawal Management with Extended On-Site Monitoring (Level 2- WM) as described in Chapter 4 of these rules.

4. T he following endorsements are considered residential/overnight endorsements:

a. Residential services as described in Chapter 5 of these rules;

b. Crisis Stabilization Unit services as described in Chapter 6 of these rules;

c. Acute Treatment Unit services as described in Chapter 6 of these rules;

d. Residential Respite services as described in Chapter 6 of these rules;

e. Clinically Managed Residential Withdrawal Management (Level 3.2-WM) as described in Chapter 5 of these rules; and f. Medically Monitored Inpatient Withdrawal Management (Level 3.7-WM) as described in Chapter 5 of these rules.

5. The BHE shall ensure all of its operations, locations, and services, including contracted services or personnel, comply with laws, regulations, and standards as applicable and required by Chapter 2 of these rules, in addition to Chapters specific to any endorsements held by the BHE.

6. The BHE shall meet the requirements in Chapter 2 of these rules, regardless of endorsements included as part of its BHE license.

7. The BHE shall meet endorsement-specific requirements, as applicable to the endorsements included as part of the BHE’s license.

8. The BHE shall have at least one endorsement and shall provide at least one type of service for each endorsement held. Endorsement standards are detailed in Chapters 3 through 10 of these rules.

B. A BHE may only provide services for which it holds an endorsement, and at locations authorized by its license.

C. A BHE will be issued a single entity-wide license which identifies all physical locations included in the license and endorsements for services the BHE is licensed to provide by location. The BHE shall display the license, or a copy thereof, in a manner readily visible to individuals at each physical location included in the license.

D. Each physical location of the BHE must meet the standards adopted by the director of the Division of Fire Prevention and Control (DFPC), as applicable to the services provided in that E. BHEs are prohibited from engaging in the following actions:

1. Making a false statement of material fact about individuals served by the BHE, its personnel, capacity, or other operational components verbally to a BHA representative or agent or in any public document or in relation to a matter under investigation by the BHA or another governmental entity;

2. P reventing, interfering with, or attempting to impede in any way the work of a representative or agent of the BHA in investigating or enforcing the applicable statutes or regulations;

3. Falsely advertising or in any way misrepresenting the BHE’s ability to provide services for the individuals served based on its license type or status;

4. Failing to provide reports and documents required by regulation or statute in a timely and complete fashion;

5. Failing to comply with or complete a plan of action in the time or manner specified; 6 Falsifying records or documents;

7. Knowingly using or disseminating misleading, deceptive, or false information;

8. Accepting commissions, rebates, or other forms of remuneration for referrals or other treatment decisions; or 9. Exercising undue influence or coercion over an individual to obtain certain decisions or actions or for financial or personal gain. A relationship other than a professional relationship, including but not limited to a relationship of a sexual nature, between an owner, director, manager, administrator, or other personnel and an individual, shall be considered exercise of undue influence or coercion. 2.4 Governance A. The BHE shall have a governing body consisting of members who singularly or collectively have professional or lived experience sufficient to oversee the types of endorsements, services, and number of physical locations included in the BHE’s license.

B The governing body shall meet at regularly stated intervals at least four (4) times per calendar year and maintain records of the meetings.

C. The governing body shall be responsible for high-level strategy, oversight, and accountability. If the BHE has a board of directors as its governing body, the board of directors may delegate operations and management responsibilities to an executive hired by the board who shall at the executive’s discretion delegate specific operations and management responsibilities including those in this part 2.4.C to an executive leadership team. These responsibilities include:

1. Ensuring the planning and organization of day-to-day operations.

2. Defining, in writing, the scope of services provided by the BHE, including services provided through arrangements with, or referrals to, other health care service providers.

3. Ensuring the provision of facilities, personnel, and services in compliance with applicable endorsement-specific standards found in Chapters 3 through 10 of these rules.

4. E stablishing organizational structures that clearly delineate personnel positions, lines of

authority, and supervision.

5. Ensuring all services and locations operate in compliance with applicable federal, state, and local laws and regulations, including but not limited to the rehabilitation act of 1973, 29 U.S.C. § 794, and the Americans with Disabilities Act, 42 U.S.C. § 12101, et seq.

6. Ensuring professionally ethical conduct on the part of all personnel providing services, whether paid, contracted, or volunteer, and ensuring a system is in place to implement corrective measures when needed and monitor such system.

7. Developing and implementing a quality management program in compliance with the requirements of part 2.17 of this Chapter, taking into account each endorsement's services and any significant differences in individual populations served.

8. Ensuring emergency preparedness for the BHE, in accordance with part 2.4.F of this 9. Establishing and maintaining a system of financial management and accountability for the BHE.

10. Developing, implementing, and reviewing policies at a minimum once every three years or as needed in accordance with part 2.4.D of this Chapter.

11. Maintaining relationships and agreements with treatment facilities, organizations, and services to provide individual transfers, referrals, and transitions of care.

12. E nsuring all marketing, advertising, or promotional information published or otherwise distributed by the BHE is accurate, including, the services the BHE provides.

13. Considering and documenting the use of individual input in decision-making processes in accordance with part 2.4.D.3.i of this Chapter.

D. The governing body or executive leadership team if so, delegated as described in part 2.4.C shall be responsible for ensuring the development and implementation of these policies and procedures and must review any changes to policies and procedures for the BHE. The governing body or executive leadership must ensure compliance with the policy requirements in this subpart and as found elsewhere in this Chapter. Every three (3) years, the governing body or executive leadership shall review all policies and procedures.

1. The BHE must have policies regarding administrative and/or clinical oversight of the BHE’s endorsements, services, and/or physical locations that meet oversight requirements. Requirements included in part 2.5.A of this Chapter, and shall include, but not be limited to:

a. Oversight positions within the BHE, such as an administrator or clinical director, and whether each position is for the endorsement, specific services, specific locations, or a combination thereof.

b. The authority and responsibilities for each oversight position.

c. The model or framework for clinical supervision. Such model or framework may differ by endorsement, service, or setting.

d. The procedure for accessing oversight personnel or their delegate when the oversight personnel are not on-site, including, but not limited to, methods of contact, on-call or other procedures, and required response times.

2. At a mi nimum, the BHE shall have policies and procedures that address the following items:

a. Critical incident and occurrence reporting in accordance with part 2.16 of this b. Individual rights in accordance with part 2.7 of this Chapter.

c. Individual grievances, including dispute resolution procedures, in accordance with part 2.8 of this Chapter.

d. Infection prevention and control in accordance with part 2.4.E of this Chapter.

e. Personnel, including a code of ethics for all personnel. This also includes those policies and procedures required by part 2.5 of this Chapter, and as required by the endorsements of the BHE license. This code of ethics must be made available to individuals upon request.

f. As applicable, screening, admission, assessment/discharge, service plan, and care policies as required by parts 2.10, 2.12, and 2.13 of this Chapter.

g. As applicable, medication administration in accordance with part 2.15 of this h. Defining and preventing conflicts of interest and dual relationships, and where such conflicts exist, developing and implementing controls to minimize such conflict and ensure decisions are made for the best interest of the individual.

i. The use of individual input and feedback in governing body decisions, including, (1) The formal or informal processes, appropriate for the individuals served and the size and complexity of services offered, to be used for collection of individual input and feedback.

(2) How the governing body will document individual input and how that feedback has been considered.

j. Individual records, including but not limited to confidentiality, access, and disposal/destruction of records as required by part 2.11 of this Chapter.

k. Building safety and security (1) Such policies may be for the agency, an endorsement, or physical (2) Policies must address the needs of the individual population being served and/or the services being provided.

(3) policies may include, but are not limited to, electronic surveillance, delayed egress, and/or locked settings as appropriate.

E. The BHE shall have infection prevention and control policies and procedures that reflect the scope and complexity of the services provided across the BHE, including but not limited to:

1. Maintenance of a sanitary environment.

2. Mitigation of risks associated with infections and the prevention of the spread of communicable disease, including, but not limited to, hand hygiene, bloodborne and airborne pathogens, and respiratory hygiene and cough etiquette for individuals and BHE 3. C oordination with other federal, state, and local agencies, including but not limited to a process for when and how to seek assistance from a medical professional and/or the local health department.

4. For BHEs that administer medications or injections on-site, as well as all agencies providing overnight or residential services, a requirement that at least one person trained in infection control be employed by or regularly available to the BHE.

F. The BHE shall be responsible for emergency preparedness policies and procedures, including 1. Completing a risk assessment of potential hazards and preparedness measures to address natural and human-caused crises including, but not limited to, fire, gas leaks/explosions, power outages, tornados, flooding, threatened or actual acts of violence, and bioterror, pandemic, or disease outbreak events. The governing body shall review such risk assessments annually and whenever BHE operations are modified through the addition or discontinuation of a physical location, service, or endorsement.

2. Developing and implementing a written emergency management plan addressing the hazards identified in part 2.4.F.1, above, and meeting, at a minimum, the following a. The plan must differentiate between endorsements, physical locations, and individual populations served and meet the requirements applicable to any endorsements held by the BHE.

b. The plan must be updated based on changes in the risk assessment conducted in accordance with part 2.4.F.1 of these rules, above.

c. The plan must address interruptions in the normal supply of essentials, including, but not limited to water, food, pharmaceuticals, and personal protective equipment (PPE), if these are regularly provided or used by BHE personnel or d. The plan must ensure continuation of necessary care to all individuals immediately following any emergency.

e. The plan must address the protection and transfer of individual information, as needed.

f. The plan must address the methods and frequency of holding routine drills to ensure BHE personnel’s familiarity with emergency procedures, in compliance with requirements established by the Department of Public Safety, Division of Fire Prevention and Control in 8 CCR 1507-31 (December 15, 2021), which is hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost at https://www.coloradosos.gov/CCR/DisplayRule.do?action=ruleinfo&ruleId=3177& deptID=17&agencyID=43&deptName=Department%20of%20Public%20Safety&a gencyName=Division%20of%20Fire%20Prevention%20and%20Control&seriesN um=8%20CCR%20150. These regulations are also available for public inspection and copying at the BHA, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours.

3. If the BHE has an automated external defibrillator (AED), personnel must be trained in its use, and it must be maintained in accordance with the manufacturer’s specifications. 2.5 Personnel and Contracted Services A. The BHE shall ensure administrative and/or clinical oversight of endorsement(s), service(s), and physical location(s), in accordance with policies and procedures adopted by the governing body under part 2.4.D of these rules, including, as required by those policies:

1. An administrator responsible for implementing endorsement and service policies and procedures adopted by the governing body, as well as the day-to-day operation of the endorsement, services, or location, including, but not limited to:

a. Management of business and financial operations.

b. Ensuring standards in part 2 of this Chapter are met in the endorsement, services, and location, including, but not limited to the standards in part 2.15 of these rules, medication administration.

c. Ensuring buildings are properly maintained and building safety/security needs are met.

d. Implementing infection control and emergency preparedness policies and procedures, in accordance with governing body policies.

e. Establishing and maintaining relationships with agencies, services, and behavioral health resources within the community.

f. Identifying personnel to whom administrator responsibilities are delegated during periods when the administrator is neither on-site nor available through interactive means within thirty (30) minutes.

g. A BHE may have a single administrator, or multiple administrators for the combination of endorsements, services, and locations included in the BHE 2. For BHEs providing clinical services, a clinical director, responsible for the overall clinical services provided to individuals, including, but not limited to:

a. Ensuring training and continuing education for all BHE personnel, relevant to the services provided by the personnel.

b. Ensuring supervision and clinical oversight of BHE personnel in accordance with

part 2.5.1 of these rules.

c. Including a method to provide clinical supervision and oversight during periods when the clinical director is unable to fulfill their duties within thirty (30) minutes.

d. Ensuring services provided are appropriate as indicated in screenings and assessments.

3. A BHE may have a single clinical director, or multiple clinical directors, as appropriate for the combination of endorsements, services, and locations included in the BHE license.

4. The minimum qualifications for the administrator and clinical director are set by the BHE’s policies and procedures.

5. An a dministrator or clinical director may be specific to a physical location or may be shared among locations, as appropriate for the services, size, and geographic dispersion of the services.

6. A single person may serve as both the administrator and the clinical director, if that person meets qualifications for both, and it is consistent with policies adopted by the governing body.

B. The BHE shall maintain a sufficient number of qualified personnel for each endorsement and at each physical location to provide the endorsed services, meet the clinical needs of the individuals, and comply with state and federal requirements. The BHE shall ensure personnel are only assigned duties they are competent to perform adequately and safely.

C. All personnel assigned to direct individual care must be qualified through either professional credentials, education, training, and/or experience in the principles, policies, procedures, and appropriate techniques for providing individual services.

1. Personnel providing individual services must be legally authorized to provide the service in accordance with applicable federal, state, and local laws.

2. Licensed, certified, and/or registered personnel must have an active license, certification, or registration in the state of Colorado and may only provide services within their scope of 3. The BHE shall verify the license, certification, or registration, and check for any disciplinary action against personnel providing individual services, through the Colorado department of regulatory agencies or other state or federal agency not more than thirty (30) days before official hire date prior to hire.

4. The BHE shall create policies and procedures regarding supervision of all personnel pursuant to part 2.5.1 of this Chapter.

D. The BHE shall obtain, prior to hire or contract of new personnel or acceptance of persons for volunteer service if that volunteer service involves unsupervised direct contact with individuals receiving services, a name-based criminal history record check for each prospective personnel or volunteer.

1. If the prospective personnel has lived in Colorado for more than three (3) years at the time of application, the BHE shall obtain a name-based criminal history report conducted by the Colorado Bureau of Investigation (CBI).

2. If the prospective personnel has lived in Colorado for three (3) years or less at the time of application, the BHE shall obtain a name-based criminal history report for each state in which the prospective personnel has lived during the past three (3) years, conducted by the respective states’ bureaus of investigation or equivalent state-level law enforcement agency, or a national criminal history report conducted by the federal bureau of investigation.

3. T he BHE shall bear the cost of obtaining such information.

4. If a BHE contracts with a staffing agency for the provision of services, it shall require that the staffing agency meet the requirements of this part 2.5.D.

5. When determining whether a prospective personnel is eligible for hire or contract, if the criminal history record check reveals the person has a conviction or plea of guilty, active deferred judgment, or nolo contendere, the BHE shall follow its policy developed in accordance with part 2.5.E.3.a of this Chapter.

E. The BHE shall have written personnel policies developed in accordance with part 2.5.C of this

Chapter, including, but not limited to:

1. Line of authority/management hierarchy of personnel.

2. Job descriptions/responsibilities.

3. Written criteria and procedures for evaluating which convictions or complaints make prospective personnel unacceptable for hire, or for existing personnel unacceptable for retention, including:

a. Factors to be considered when determining whether prospective personnel are eligible for hire when their criminal history record check reveals a conviction or plea of guilty, active deferred judgment, or nolo contendere, including, but not (1) The nature and seriousness of the offense;

(2) The nature of the position and how the offense relates to or may impact the duties of the position. Experience in the criminal justice system is not necessarily a disqualifier and, in certain circumstances, a BHE may determine that some lived experiences would benefit a particular position;

(3) The length of time since the conviction or plea;

(4) Whether such conviction is isolated or part of a pattern; and (5) Whether there are mitigating or aggravating circumstances involved.

4. Conditions of employment, including but not limited to:

a. That personnel refrain from sexual or romantic relationships between supervisors and supervisees and sexual or romantic relationships with individuals served.

5. Position qualifications and required credentials.

6. Orientation, training, and continuing education requirements, for the populations served and services provided.

7. Routine monitoring of personnel credentials and disciplinary actions.

8. Requirements for self-reporting of new or current investigations, criminal charges, indictments, or convictions that may affect the personnel’s ability to carry out their duties or functions of the job.

9. Policies requiring all personnel to be free of communicable disease that can be readily transmitted in the BHE.

a. All personnel that have direct contact with individuals must be required to have a tuberculin skin test prior to direct contact with individuals. In the event of a positive reaction to the skin test, evidence of a chest x-ray and other appropriate follow-up may be required in accordance with community standards of practice.

F. T he BHE shall ensure that all personnel have access to and know about the BHE’s policies, procedures, and state and federal laws and regulations relevant to their respective duties.

G. The BHE must maintain records on all personnel, including, but not limited to:

1. Date of hire;

2. Job description;

3. Results of criminal history record checks;

4. Documentation of professional credentials, education, and training;

5. Documentation of any disciplinary action taken against the person by a credentialing body;

6. Documentation of orientation and training;

7. Evidence of review of the BHE’s policies, procedures, and state and federal laws and regulations relevant to their respective duties; and 8. Documentation of tuberculosis testing and results, for personnel who have direct contact with individuals.

H. The BHE must ensure that all personnel complete an initial orientation on basic infection prevention and control, safety, and emergency preparedness procedures.

I. The BHE must ensure that all personnel receive the following training prior to working independently with individuals, and on a periodic basis consistent with policies developed in accordance with part 2.5.E of this Chapter, above 1. Training specific to the particular needs of the populations served, including the provision of person-centered, trauma-informed, harm reduction-focused, physically and programmatically accessible, and culturally and linguistically responsive services;

2. Infection control;

3. Emergency preparedness, including de-escalation of potentially dangerous situations, including but not limited to threats of violence, acts of violence, and abuse/mistreatment of an individual;

4. Critical incident reporting;

5. Suicide prevention;

6. Individual rights of the population served;

7. Confidentiality, including individual privacy and records privacy and security;

8. BHE policies and procedures;

9. Mandatory reporting requirements for suspected abuse or neglect in accordance with part 2.8.A.9.a of this Chapter; and 10. Understanding of b asic pharmacology and medications that are relevant to the treatment type and population served by the agency, including but not limited to medicationassisted treatment (MAT) services and medications for opioid use disorders (MOUD).

a. This training requirement may not be used as reason to hold unqualified personnel out as experts in pharmacology. BHEs must not encourage personnel to hold themselves out as able to make recommendations that are outside of their scope of practice to individuals receiving services. Rather, this training requirement is meant to ensure that personnel receive a base knowledge for the behavioral health community they service and allow for meaningful, timely, and supportive recovery-focused interactions with individuals receiving services. 2.5.1 Clinical Supervision A. The BHE must ensure that all personnel providing behavioral health services, with the exception of peer support professionals, receive clinical supervision, as defined in part 1.3 of these rules.

B. The BHE will develop policies and procedures for supervision that address the following:

1. Supervisee’s mandatory disclosure statement that clearly states they are under supervision and by whom;

2. Requirements for regular evaluation of the supervisee’s progress with a rubric that is tied to the responsibilities assigned;

3. Documentation and frequency of supervisor reviews and feedback provided;

4. Maximum number of supervisees a supervisor oversees; and 5. How supervision/consultation is covered by personnel with comparable credentials when the usual supervisor is not available.

C. Clinical supervisors must at minimum:

1. Meet the standard qualifications for clinical supervision as defined by the supervisor’s professional practice board.

2. Deliver clinical supervision within the supervisor’s professional practice license and ethical standards for:

a. Those that are licensed or seeking professional licensure; or b. When supervising personnel that are not seeking or not eligible for professional licensure, such as group living workers, the supervisor must follow standards in the Colorado Mental Health Practice Act, as defined in Article 245 of Title 12, 3. Dedicate time between the supervisor and supervisee to instruct, model, and encourage self-reflection regarding acquisition of clinical and administrative skills by the supervisees.

Clinical supervisor will determine skills through observation, evaluation, feedback, and mutual problem-solving.

4. Address ethics and ethical dilemmas as aligned with the appropriate professional practice board.

5. Provide professional direction based on experience, expertise, and/or for ethical or safety concerns.

6. Ensure that safety and crisis management plans are followed and that clinical supervisors are available to personnel for assistance in crisis situations and processing of the crisis event afterwards.

7. Document the date, duration, and the content of supervision session for their supervisee(s), which may include a professional development plan. All documents pertaining to clinical supervision must be provided to the supervisee and the BHA upon D. P ersonnel-specific clinical supervision requirements 1. Licensees and authorized practitioners will be provided with clinical supervision and/or consultation at minimum upon request by the licensee or authorized practitioner or during times of individual emergency.

2. Candidates will be provided with clinical supervision at a rate that will meet their licensing requirements for the license they are pursuing or at a minimum of one (1) hour every two (2) weeks, whichever provides a higher level of clinical supervision.

3. All clinical documentation completed by a counselor-in-training and/or intern still in pursuit of their clinical degree must be reviewed and co-signed by a clinical supervisor able to supervise pursuant to their scope of practice.

4. Personnel not seeking or not eligible for licensure, but that are providing clinical services, will be provided clinical supervision at a frequency that ensures treatment to individuals is appropriate, safe, and in line with assessment treatment needs and the individual’s 2.6 General Building and Fire Safety Provisions A. Each BHE shall be in compliance with all applicable local zoning, housing, fire, and sanitary codes and ordinances of the city, city and county, or county where it is situated.

B. All physical locations of a BHE must be constructed in conformity with the standards adopted by the director of the DFPC at the Colorado Department of Public Safety, as applicable.

C. A BHE that is subject to fire prevention and life safety code requirements, may not provide services in areas subject to plan review, except as approved by DFPC.

D. The BHE shall provide an interior environment that is clean and sanitary, maintained and in good repair, and free of hazards to health and safety.

E. The BHE shall ensure the prominent posting of evacuation routes and exits in each physical F. The BHE shall prominently post the hours of operation at the entrance of each physical location, and on the BHE’s website. 2.7 Individual Rights A. The BHE shall develop and implement a policy regarding individual rights. The policy must ensure that each individual or, when applicable, the individual’s designated representative, has the right to:

1. P articipate in all decisions involving the individual’s care or treatment.

2. Be informed about whether the BHE is participating in teaching programs, and to provide informed consent prior to being included in any clinical trials relating to the individual’s care.

3. Refuse any drug, test, procedure, service, or treatment and to be informed of risks and benefits of this action.

4. Receive care and treatment, in compliance with state statute, that is free from discrimination on the basis of physical or mental disability, race, ethnicity, socio-economic status, religion, gender expression, gender identity, sex, sexuality, culture, and/or languages spoken; and that recognizes an individual's dignity, cultural values and religious beliefs; as well as provides for personal privacy to the extent possible during the course of treatment.

5. Be informed of, at a minimum, the first names and credentials of the personnel that are providing services to the individual. Full names and qualifications of the service providers must be provided upon request to the individual or the individual’s designated representative or when required by the department of regulatory agencies.

6. Receive, upon request:

a. Prior to initiation of non-emergent care or treatment, the estimated average charge to the individual. This information must be presented to the individual in a manner that is consistent with all state and federal laws and regulations.

b. The BHE’s general billing procedures.

c. An itemized bill that identifies treatment and services by date. The itemized bill must enable individuals or their legal representatives to validate the charges for items and services provided and must include contact information, including a telephone number, for billing inquiries. The itemized bill must be made available either within ten (10) business days of the request, thirty (30) days after discharge, or thirty (30) days after the service is rendered – whichever is later.

7. Give informed consent for all treatment and services. The personnel must obtain informed consent for treatment they provide to the individual. Informed consent includes:

a. A w ritten agreement executed between the BHE and the individual or the individual’s legal representative at the time of admission. The parties may amend the agreement if there is written consent of both parties. No agreement will be construed to relieve the BHE of any requirement or obligation imposed by law or

regulation.

b. Individual consents must include consent to treatment. If the individual is refusing treatment or an aspect of treatment, the BHE must have the individual sign a form to confirm their refusal.

c. If the governor or local government declares an emergency or disaster, a BHE may obtain documented oral agreements or consents in place of written agreements or consents. Documented oral agreements and consents may only be used as necessary because of circumstances related to the emergency or disaster. The BHE shall send a hard copy or electronic copy of the documented agreement or consent to the individual within two (2) business days of the oral agreement or consent.

8. Register disputes with the BHE and grievances with the BHA and to be informed of the procedures for registering complaints and grievances including contact information.

9. Be free of abuse and neglect.

a. The BHE must develop and implement policies and procedures that prevent, detect, investigate, and respond to incidents of abuse or neglect. This includes suspected physical, sexual, or psychological abuse; exploitation and/or caretaker neglect; as well as child abuse, neglect and/or child safety issues, which must include definitions of abuse and neglect under the Colorado Children’s Code (Section 19-1-103, C.R.S.), and that are consistent with the reporting of child abuse allowed under federal law. Policies and procedures must also be consistent with definitions and mandated reporting requirements for mistreatment, abuse, neglect, and exploitation of at-risk adults under the Colorado Human Services and Criminal Codes (Sections 26-3.1-101, 26-3.1-102, 18-6.5-108, C.R.S.).

(1) Prevention includes, but is not limited to, adequate staffing to meet the needs of the individuals, screening personnel for records of abuse and neglect, and protecting individuals from abuse during investigation of allegations.

(2) Detection includes, but is not limited to, establishing a reporting system and training personnel regarding identifying, reporting, and intervening in incidences of abuse and neglect.

b. The BHE shall investigate all allegations of abuse or neglect against BHE personnel, or made against an individual, when the allegation occurs during service provision or on BHE premises. The BHE shall implement corrective actions in accordance with such investigations.

10. Be fr ee from the improper application of restraints or seclusion. Restraints or seclusion may only be used in a manner consistent with part 2.14 of this Chapter.

11. Expect that the BHE in which the individual is admitted can meet the identified and reasonably anticipated care, treatment, and service needs of the individual.

12. Receive care from the BHE in accordance with the individual’s needs.

13. Have the confidentiality of their individual records maintained.

a. A BHE must comply with all applicable state and federal laws and regulations for release of information including but not limited to 42 C.F.R. Part 2, Section 27- 65-123, C.R.S. and HIPAA.

b. When obtaining informed consent or an authorization for release of information, the signed release must state, at a minimum:

(1) Persons who may receive the information in the records;

(2) The purpose for obtaining this information;

(3) The information to be released;

(4) That the release may be revoked by the individual, or legal representative at any time; and (5) That the release of information is only valid for a time period specified but such time cannot exceed two (2) years from the date of signature.

14. Receive care in a safe setting.

15. Be notified if referrals to other providers are to entities in which the BHE has a direct or indirect financial benefit, including a benefit that has financial value, but is not a direct monetary payment.

16. Formulate medical and psychiatric advance directives and have the BHE comply with such directives, as applicable, and in compliance with applicable state statute.

a. When the BHE is aware that an individual has developed advance directives, the BHE shall make good faith efforts to obtain the directives and the directives must become part of the individual’s record.

b. The BHE shall disclose the policy regarding individual rights to the individual or the individual’s designated representative prior to treatment or upon admission, where possible. For any services requiring multiple individual encounters, disclosure provided at the beginning of such care or treatment course must meet the intent of the regulations. 2.8 Dispute and Grievance Resolution A. Each BHE shall post a clear and unambiguous notice of dispute and grievance procedures in each physical location in an area that is open to the public and on the BHE’s website. The notice must also be provided in writing and/or electronically upon admission to services.

1. T he BHE shall establish a uniform procedure for prompt management of disputes brought by individuals accessing, receiving, or being evaluated for services and their family members. The BHE shall develop policies and procedures for handling disputes.

2. The BHE shall provide a fair dispute resolution process that allows options for submitting both verbal and/or written disputes. The process must provide the individual with a response no later than thirty (30) business days from submission of the dispute. If the dispute is received verbally, the representative shall create a written documentation of the dispute.

B. As part of the BHE’s resolution process, the BHE must inform persons who have submitted a dispute verbally or in writing that they may also submit a grievance to the BHA. The BHE must provide information about how to submit a grievance to the BHA.

1. The BHE shall designate a representative, who must be available to assist individuals in resolving disputes.

2. The BHE shall educate individuals and their representatives about the mechanisms in place for filing disputes. This education must include an explanation of the individual's rights; the dispute process and procedures; and the name, contact information, and responsibilities of the designated representative within the BHE. Appropriate contacts for external appeal must also be provided, which may include, but are not limited to, the following: the Colorado Department of Regulatory Agencies; the Colorado Department of Public Health and Environment; the Colorado Department of Health care policy and financing; or the governor’s designated protection and advocacy system for individuals with mental illness. Documentation in the records must include the dated signature of the individual receiving the information.

3. The BHE must post a notice of rights, dispute procedure, and the designated representative’s name, office location, responsibilities, and telephone number in prominent locations where persons access, receive or are evaluated for services. The notice shall be translated into languages commonly used by the populations in the service area.

4. The BHE must maintain a record of submitted disputes, separate from the individual records that include the date, the type of dispute, and the outcome of investigation.

These dispute records must be provided annually to the BHA.

5. Upon request, the BHE must provide an individual and any interested person with contact information for registering complaints with any other state departments. 2.9 Individual Services A. The BHE must ensure individuals are provided services in the least restrictive setting that meets the individual's needs.

B. The BHE may use telehealth methods for the provision of services under these regulations except for services that specifically require in-person contact. If a service is allowable via telehealth according to state and federal regulations, appropriate methods will be noted within the applicable endorsement Chapter. If an individual prefers to receive services in-person and the BHE does not offer the appropriate service in-person, the BHE shall refer the individual to another entity that offers the service in-person.

1. If the BHE uses telehealth methods, it must develop and implement policies and procedures regarding telehealth services, including:

a. Collection of required signatures;

b. Training for personnel specific to the modality or manner for determining competence with the modality;

c. Procedure for personnel response if an individual experiences an emergency while receiving services via telehealth, including collection of information about the individual’s remote location for each session;

d. Confidentiality protocols designed to protect the individual’s privacy in accordance with state and federal law; and e. Specification as to whether policies apply to the BHE as a whole, a physical location, or a specific endorsement, as appropriate.

2. Services provided via telehealth methods must be documented in the individual’s record, consistent with documentation requirements for in-person services.

3. Services may be provided through synchronous audio-visual methods but must not include text-only methods such as text message or email. Some services may be provided through audio-only methods according to state and federal regulations. If audioonly methods are used, the following must be noted in the individual record:

a. The reason that audio-visual methods were not utilized.

b. T he clinical determination of appropriateness for service delivery method.

C. If the BHE uses public community settings for the provision of services, it shall develop and implement policies and procedures regarding the delivery of such services, including:

1. Collection of required signatures when necessary;

2. Selection and utilization of public spaces that are safe and accessible to the individuals being served;

3. Procedures for how the BHE will ensure individual privacy and confidentiality in the public setting according to state and federal regulations;

4. Procedure for personnel response if an individual experiences an emergency while receiving services in the public setting;

5. Procedure to promote and monitor personnel safety while providing services in this setting; and 6. Such policies may apply to the BHE as a whole, a physical location, or a specific endorsement, as applicable.

D. The BHE shall develop and implement policies and procedures regarding behavioral health emergency services and methods for addressing individuals or individuals with unexpected high acuity and/or urgent behavioral health needs. Such policies and procedures may apply to the BHE as a whole, a specific endorsement, or a physical location, as appropriate, and must include, but not be limited to:

1. The behavioral health emergency services provided by the BHE, if any, and the hours during which such behavioral health emergency services are available.

2. H ow the BHE ensures access to behavioral health emergency services when not provided directly by the BHE, including, but not limited to:

a. Criteria used in determining when behavioral health emergency services are needed;

b. Internal protocols for personnel and supervisors in response to behavioral health c. Protocols for facilitating transfers to other agencies; and d. Methods of providing information to individuals to ensure understanding of how to access behavioral health emergency services.

3. The methods for identifying and responding to and/or mitigating sudden or unpredictable high-acuity or increased needs in existing individuals within twenty-four (24) hours of notification of increased need E. The BHE must develop and implement policies and procedures regarding access to emergency medical services. Such policies and procedures may be for the BHE as a whole, a specific endorsement, or a physical location, as appropriate, and must include, but are not limited to:

1. The medical emergency services provided by the BHE, if any, and the hours during which such medical emergency services are available.

2. How the BHE ensures access to medical emergency services when not provided directly by the BHE, including, but not limited to:

a. Criteria used in determining when medical emergency services are needed;

b. Internal protocols for personnel in response to a medical emergency; and c. Protocols for facilitating transfers of individuals to emergency medical providers or facilities.

3. Methods of providing information to individuals to ensure the individual’s understanding of how to access medical emergency services.

F. The BHE shall inform individuals how to access medical and behavioral health crisis or emergency services twenty-four (24) hours per day, seven (7) days per week.

G. The BHE shall provide care coordination to individuals consistent with the following requirements:

1. Care coordination must be carried out in keeping with the individual's needs for care and, to the extent possible, in accordance with the individual's expressed preferences. Care coordination may involve the individual's family, parent, legal guardian, caregiver, and other supports identified by the individual.

2. Care coordination services may include the following, as appropriate for the needs of the a. Screenings to identify the individual’s priorities, goals, strengths, and the barriers faced, including those related to health-related social needs.

b. S upporting the individual in accessing care and services within the health care and social service systems and equipping the individual with information to navigate and manage their care.

(1) This shall include providing accessible and culturally and linguistically meaningful resources and information, including resource directories such as OWNPATH.

c. Conducting application assistance, referrals, and warm hand-offs to access appropriate resources and care.

3. Information sharing a. The BHE shall prioritize information sharing with other providers delivering services to the individual for the purpose of care coordination.

b. Information sharing must occur as clinically indicated, and as approved by the individual, throughout an individual’s episode of care.

c. Information sharing must include obtaining or demonstrated efforts to obtain records from previous or existing behavioral health, physical health, and other social needs service providers, during the assessment period, and on an ongoing d. The BHE shall ensure individuals’ preferences for shared information are adequately documented in individual records, consistent with the principles of person and family-centered care.

e. The BHE shall obtain authorization for release of information from individuals or their legal representative for all care coordination relationships. If the BHE is unable, after reasonable attempts, to obtain authorization for any care coordination activity as required by this Chapter, the attempts must be documented in the individual’s record and revisited periodically, such as during transitions of care or when the individual receives a new diagnoses or has a change in condition.

(1) Information sharing that is permissible under HIPAA without authorization from the individual or legal representative is not subject to this requirement.

f. The BHE must maintain the necessary documentation to satisfy the requirements of all applicable federal and state privacy laws, including individual privacy requirements specific to the care of children.

g. A referral must include, in accordance with individual consent and as clinically necessary and applicable, information regarding:

(1) Health status;

(2) Active diagnoses;

(3) Known allergies;

(4) Test results;

(5) Lab results;

(6) Medications list;

(7) Treatment course, time and detail of modalities used, and response to treatment or other recovery supports (status of changes);

(8) E xisting scheduled appointments to include physical health, behavioral health and other recovery and supportive services that may be part of the care plan;

(9) Recent history or risks for urgent/acute care (e.g., recent emergency department visit, hospitalization, etc.); and (10) Reasonable accommodations.

h. All information sharing must occur in compliance with applicable federal and state laws, including but not limited to HIPAA and 42 C.F.R. Part 2.

H. Medication consistency 1. The BHE shall ensure all clinical staff are aware of and have access to the medication formulary.

2. The BHE shall ensure personnel have access to the medications on the medication formulary when prescribing medications to treat behavioral health disorders for an individual who is or was involved with the criminal or juvenile justice system. 2.10 Admission and Discharge Criteria A. For applicable services, the BHE shall develop and implement admission and discharge policies.

Such policies may be for the BHE as a whole, a particular endorsement, and/or a specific physical location, as appropriate, and must include, at a minimum:

1. Criteria to ensure the BHE, endorsement, and/or location only treats individuals for whom it can provide immediate assessment and treatment based on the individual’s needs.

2. Admission criteria to ensure treatment in the least restrictive setting based on the individual’s level of care needs. The following must not be the sole reason for treatment ineligibility:

a. Relapse;

b. Leaving previous treatment against advice or lack of engagement in previous c. Pregnancy;

d. Drug use;

e. Involuntary commitment;

f. Current utilization of any medication-assisted treatment (MAT) or interest in beginning MAT services;

g. Previous or pending disputes, grievances, or appeals; or h. Place of residence.

3. P rocedures for transferring an individual from a level of care to a different level of care within the BHE.

4. Procedures for referring an individual to other service providers when the individual cannot be admitted to the BHE.

5. Criteria and procedures for an individual's discharge from treatment, including, but not a. When an individual is being transferred from the BHE to another provider.

b. Timely discharge of an individual receiving voluntary services upon the individual’s request, once appropriate screening and assessment is complete.

c. Discharge and transfer procedures for an individual receiving services on an involuntary basis, if applicable.

d. Subparts 2.10.A.5.a, 2.10.A.5.b and 2.10.A.5.c of this Chapter must comply with the following requirements:

(1) At the time of discharge, the BHE must, unless the individual refuses, provide support to facilitate a smooth transition to alternate services to address any existing service needs.

(2) If an individual declines support in connecting with additional services at the time of discharge, the reason given by the individual shall be documented within the record.

(3) When the individual agrees to BHE support in transitioning providers, the BHE must obtain a release of information to communicate with and share records with the new provider. The BHE shall ensure that the discharge summary meets the requirements set forth in part 2.10.A.6 of this

Chapter and is provided to the receiving provider no later than fifteen (15) days from the date of discharge. The BHE shall make every effort to complete and send the discharge summary prior to the individual’s initial appointment with the receiving provider.

(4) When the BHE facilitates the transition of care to a new behavioral health provider or alternative resource at the time of discharge, the BHE shall inform the individual of the date, time, and location of the scheduled visit and/or any other information necessary to access the service or resource to which the individual is referred. The BHE shall consider barriers to care for the individual and support the individual in connecting with necessary resources to promote access to care. If this cannot be completed, the BHE shall document the reason within the record as well as any attempts made.

e. I nformation and documentation to be provided to the individual upon discharge, unless clinically contraindicated, including, but not limited to:

(1) Medication information, including medication name, dosage, instructions for follow-up, and whether the individual was provided with medication upon discharge.

(a) The BHE may provide individuals with unused, prescribed medications as part of the discharge process, unless it has been determined that doing so would pose a risk to the health and safety of the individual.

(2) Detailed information on transitioning care to other providers, including referral information, when providing referrals.

(3) Documentation that the discharge is being made against the advice of the provider, as applicable.

(4) Documentation required when the above information in this subpart 2.10.A.5.e is not provided to the individual at discharge.

(5) Written notification of discharge with reason for discharge.

(6) Written notification of BHE and BHA dispute resolution and grievance 6. Requirements for a discharge summary to facilitate continuity of individual care, a. The timeframe for discharge summary completion, which may not be more than fifteen (15) calendar days after discharge.

b. Information to be included in the discharge summary to inform future providers of treatment history, including, but not limited to:

(1) Demographic information, including, but not limited to, name, date of birth, gender identity, emergency contact information, insurance information, preferred language, and any cultural factors to consider in (2) A brief summary of the episode of care, including, but not limited to, the presenting issue, services received, diagnosis assigned or modified, and any outstanding needs identified;

(3) Information on the individual’s status within the judicial system, including any type of behavioral health certification or hold;

(4) A summary of medications prescribed during treatment, including the individual's responses to medications;

(5) Medications recommended and prescribed at discharge; and (6) Documentation of referrals and recommendations for follow-up care.

c. This discharge information may be in narrative or abbreviated format and must be written in a manner that can be readily understood by a receiving provider to allow for prompt resumption of services. 2.11 Individual Records A. A confidential individual record must be maintained for each individual receiving services from the BHE. This record must not contain protected health information pertaining to other individuals B. Ea ch individual record must include at a minimum:

1. Demographic and medical information, including, but not limited to, individual name, address, telephone number, emergency contact information, physician or health provider information, and current diagnosis;

2. Screenings, assessments and reassessments, service plans, documentation of informed consent including consent to treatment, releases of information, physician or practitioner orders, documentation of services, treatment progress notes and medication, admission summary, discharge summary, and any endorsement or service-specific requirements, as set by this Chapter;

3. Medical and psychiatric advance directives when such directives are furnished by the 4. The individual’s medication administration record;

5. The out-of-state offender questionnaire, if providing substance use disorder (SUD) services;

6. Personal belonging inventories;

7. Court documents, when such documents are relevant to the individual’s treatment;

8. Records of required communication with referral sources such as court, probation, child welfare, and parole; and 9. Drug and alcohol testing and monitoring results.

C. Individual records must be available to an individual or their designated representative through the BHE or their designated representative at reasonable times and upon reasonable notice in accordance with all applicable state and federal laws, including but not limited to HIPAA and 42 C.F.R. Part 2.

1. If the service provider is deceased or unavailable, the current custodian of the record shall designate a substitute service provider for purposes of compliance with these D. A statement of the BHE’s procedures for obtaining records, and the right to appeal grievances regarding access to records to the BHA must be posted in conspicuous public places on the premises and made available to each individual upon admission to the BHE.

E. An individual, whether currently receiving services or discharged from a BHE, may inspect, or obtain a copy of their own record. The BHE must act on the request to review the individual’s record within a reasonable time, which must not exceed thirty (30) days except when an extension is allowable in accordance with 45 C.F.R. 164.524(b)(2).

F. BH

Es must not charge the individual or designated representative for inspection of the individual G. Records must be kept in accordance with all applicable state and federal laws and regulations.

H. Access to medical records contained within the individual’s records must be accessed in a manner that is consistent with all applicable state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

I. If there are changes/corrections, deletions, or other modifications to any portion of an individual record, the person who is making the changes must note in the record the date, time, nature, reason, correction, deletion, or other modification, and their name, to the change, correction, deletion, or other modification.

J. Records must be retained as follows:

1. Adult outpatient endorsements as defined in 2.3.A.3 of this Chapter must be retained for seven (7) years from the date of discharge from the BHE.

a. Records for individuals who are less than eighteen (18) years old when admitted to the BHE must be retained until the individual is twenty-five (25) years old.

2. Adult residential/overnight endorsements as defined in part 2.3.A.4 of this Chapter must be retained for ten (10) years from the date of discharge from the BHE.

a. R ecords for individuals who are less than eighteen (18) years old when admitted to the BHE must be retained until the individual is twenty-eight (28) years old.

3. The confidentiality of the individual record, including all medical, behavioral health, psychological, and demographic information must be protected in accordance with all applicable federal and state laws and regulations, including during record use, storage, transportation, transmission, and disposal.

4. When a BHE closes a physical location and/or discontinues any endorsement, it must maintain records of individuals served in accordance with the requirements of this part 2.11.J.

5. A BHE that ceases operation must comply with the provisions of part 2.24 of this Chapter regarding individual records.

K. Effect of this part 2.11 on similar rights of an individual 1. Nothing in this part 2.11 may be construed to limit the right of an individual or the individual’s designated representative to inspect individual records, including the individual’s medical or psychological data pursuant to Section 27-65-123, C.R.S.

2. Nothing in this part 2.11 may be construed to require a person responsible for the diagnosis or treatment of a child for substance use disorder or use of drugs, pursuant to Sections 25-4-409 and 13-22-102, C.R.S. to release records of such diagnosis or treatment to a parent, guardian, or person other than the minor or their designated representative.

3. N othing in this part 2.11 may be construed to waive the responsibility of a custodian of medical records in the BHE to maintain confidentiality of those records in its possession.

4. Nothing in this part 2.11 may limit the right of an individual, the individual’s personal representative, or a person who requests the medical records upon submission of a federal law compliant authorization, a valid subpoena, or a court order to inspect the individual’s records. 2.12 Screening, Initial Assessment, and Comprehensive Assessment 2.12.1 Screening A. Personnel meeting qualifications under part 2.5.C of this Chapter shall complete a screening and triage process to determine urgency of the individual’s needs, including the need for emergency or urgent medical or psychiatric services, and whether the BHE can provide the appropriate care in light of the individual’s needs.

B. Screening tools/approaches must be culturally and linguistically appropriate and trauma-informed and should accommodate an individual's disability/disabilities (hearing disability, cognitive limitations, visual impairment, etc.) as required.

C. Screenings must collect at least the following information from an individual seeking services:

1. Identifying information;

2. Primary complaint/reason for seeking services;

3. Current behavioral health symptoms, including severity, duration, mental status, and 4. Med ical concerns/chronic health issues, including pregnancy and postpartum status; and 5. Evaluation of imminent risk, including:

a. Suicide risk;

b. Danger to self or others;

c. Urgent or critical medical conditions, including withdrawal or overdose risk; or d. Other immediate risks, including threats from another person;

(1) If, at any point in the course of treatment, a screening of imminent risk is completed to assess the need for a mental health hold (M1 hold), all personnel conducting the screening shall use the BHA-designated M1 screening form notwithstanding any 27-65 designation.

6. Preliminary determination of level of care needed.

D. Screenings that identify an imminent risk must be reviewed by a licensee, licensed addiction counselor (LAC), a certified addiction specialist (CAS), authorized practitioner, or a licensure candidate performing within the scope of their practice.

E. Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings may be conducted via audio-visual or audio only telehealth. Clinical rationale must be documented in the case of a telehealth screening.

F. To avoid redundant screening, supporting documentation that a screening tool was administered within the past six (6) months may be incorporated into an individual’s record in place of similar screening requirements, with the exception of screenings for imminent risk as described in part 2.12.1.C.5 of this Chapter. Screenings for imminent risk as described in 2.12.1.C.5 of this

Chapter must be completed any time an individual is screened for treatment by a BHE notwithstanding any other recent screenings.

G. Any BHE providing substance use disorder (SUD) services for any level of care shall:

1. Screen and register adults with out-of-state offenses in accordance with Section 17-27.1- 101, C.R.S.

a. This does not apply to crisis services found in Chapter 6 of these rules or withdrawal management services found in Chapters 4 and 5 of these rules. 2.12.2 In itial Assessment A. An initial assessment must be completed and signed and/or approved by a licensee, licensed addiction counselor (LAC), a certified addiction specialist (CAS), authorized practitioner, or a licensure candidate performing within the scope of their practice. BHEs must meet timeline requirements set forth in applicable endorsement Chapters. See endorsement Chapters 4 through 10 of these rules for additional initial assessment requirements.

B. The initial assessment, including information gathered as part of the preliminary screening and risk assessment, includes, at a minimum:

1. Provisional diagnoses;

2. The source of referral;

3. The reason for seeking care, as stated by the individual or other referral source(s);

4. Identification of the individual’s immediate clinical care needs related to the diagnosis for mental and substance use disorders;

5. A list of current prescriptions and prescribing physicians, over-the-counter medications, and any other substances the individual may be taking, including doses and frequency;

6. An assessment of whether the individual is a risk to self or to others, including suicide risk factors;

7. An assessment of whether the individual has other concerns for their safety;

8. Assessment of need for medical care (with referral and follow-up as required);

9. A determination of whether the individual presently is or ever has been a member of the U.S. Armed Services;

10. Current health care providers; and 11. Screening all individuals for current pregnancy status and desire to become pregnant within the next year. If not pregnant or desirous of pregnancy in the next twelve (12) months, individuals must be asked if they want access to contraceptive/family planning care, and the individual must be appropriately referred.

a. Individuals shall be screened and appropriately referred, for past and present risk factors associated with behavioral health disorders and that are associated with:

(1) P regnancy complications, including risks to the health of the pregnant individual and fetus;

(2) Acquiring and transmitting Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), Tuberculosis (TB), Hepatitis A, B, or C, and other infectious diseases; and, (3) If clinically indicated by the presence of continuing risk factors, screening must be conducted at a minimum on a quarterly basis.

C. As needed, releases of information must be obtained. 2.12.3 Comprehensive Assessment A. The BHE must complete a comprehensive best practices assessment that focuses on personcentered care, which is signed and/or approved by a licensee, licensed addiction counselor (LAC), a certified addiction specialist (CAS), an authorized practitioner, or a licensure candidate performing within the scope of their practice. BHEs must meet timeline requirements set forth in applicable endorsement Chapters. See endorsement Chapters 4 through 10 of these rules for additional requirements.

B. Information gathered as part of screening and/or the initial assessment may be incorporated into the comprehensive assessment.

C. For BHEs that have or are seeking a SUD sub-endorsement for any level of care, assessments 1. Use the ASAM Criteria as a guide for assessing and placing individuals in the appropriate level of care;

2. Document information gathered on the six (6) dimensions outlined in the ASAM Criteria for assessments; and 3. Utilize the decisional flow process as outlined in the ASAM Criteria to determine and document the assessed level of care.

D. The BHE must conduct assessments throughout the course of treatment, review previous assessments and update those assessments whenever there is a change in the person's level of care or functioning. The assessments must occur, at minimum, every six (6) months, unless otherwise indicated in an endorsement Chapter.

E. All methods and procedures used to assess and evaluate an individual must be developmentally and age appropriate, culturally and linguistically appropriate and trauma informed. All methods and procedures used to assess and evaluate an individual must be able to be provided in the preferred language and/or communication method of frequently encountered Limited English Proficiency (LEP) groups of the BHE.

F. The assessment must be documented in the individual’s record and, at minimum, include the following information, if available and applicable:

1. Identification and demographic data;

2. Primary complaint/reason for seeking services, including onset of symptoms and severity of symptoms;

3. Ment al health history, including but not limited to:

a. Suicidal risk and ideation, and b. Homicidal ideation.

4. Substance use and substance use withdrawal history;

5. Physical and dental health status, including but not limited to human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), hepatitis A, B, or C, and other infectious diseases status and risk evaluation;

6. A diagnosis with sufficient supporting criteria, as well as any subsequent changes in diagnosis;

7. A mental status examination(s) for individuals who receive a diagnosis. When completing a mental status exam, personnel must consider other diagnoses or disabilities that may impact motor and speech activity;

8. History of involuntary treatment;

9. Advance directives, including medical and psychiatric;

10. Capacity for self-sufficiency and daily functioning;

11. Cultural factors that may impact treatment, including age, ethnicity, linguistic/communication needs, gender, gender identity, sexual orientation, relational roles, spiritual beliefs, socio-economic status, personal values, level of acculturation and/or assimilation, and coping skills;

12. Education, vocational training, and military service;

13. Family and/or social relationships;

14. Trauma and trauma history;

15. Physical and/or sexual abuse or perpetration and current risk;

16. Legal issues that may impact behavioral health outcomes;

17. Issues specific to older adults such as hearing loss, vision loss, strength; mobility and other aging issues;

18. Issues specific to children such as growth and development, daily activities, legal guardians and need for family involvement and engagement in the child's treatment;

19. Strengths, abilities, skills, and interests; and 20. Barriers to treatment.

G. Assessments must apprise individuals, as applicable, of risk factors associated with acquiring and transmitting HIV/AIDS, Tuberculosis (TB), Hepatitis A, B, or C, and other infectious diseases.

Appropriate testing and pre and post-test counseling must be offered on-site or through referral.

H. Additional assessment requirements may be required for specific endorsements. See endorsement Chapters 4 through 10 of these rules for additional requirements.

2.13 S ervice Planning 2.13.1 Service plan A. If providing clinical services, the BHE shall ensure the development and review of a written service plan for each individual as follows:

1. The service plan must be developed as soon as practicable after admission, but no later than the timeframes identified in the endorsement-specific Chapters of these rules (i.e., Chapters 4 through 10).

2. The service plan must be reviewed and revised in writing when there is a change in the individual’s level of functioning or service needs, and no later than applicable endorsement-specific timeframes. Such revision must include documentation of progress made in relation to planned treatment outcomes, changes in treatment focus, and length of stay adjustments, as applicable.

3. The service plan must:

a. Meet the developmental and cultural needs of the individual;

b. Specify goals based on the initial and/or comprehensive assessment in a manner understandable to the individual;

c. Identify the type, frequency, and duration of services;

d. Be individually directed, including the individual’s strengths and identities; and e. Include involvement of other identified family and/or supportive individuals, when 4. The service plan may include tasks or activities to be performed by the individual, such as an individual doing their own laundry or preparing their own meals/snacks, only when such tasks are therapeutic. Tasks must not be included in the service plan solely for the convenience of the BHE.

5. The service plan must be signed by all parties involved in the development of the plan, including the individual, or the individual’s parent or legal guardian in cases where the individual is a child, or the individual has a court-appointed legal guardian and has not consented to services without the involvement of the legal guardian. Signatures must include at least one of the following: a licensee, licensed addiction counselor (LAC), a certified addiction specialist (CAS), authorized practitioner, or a licensure candidate performing within the scope of their practice.

a. A copy of the service plan must be offered to the individual, or to the individual’s parent or legal guardian, as appropriate.

b. The BHE must include documentation in the individual record in cases where the plan is not signed by the individual or the individual's parent or legal guardian if involved in the development of the plan, and in cases where offering the service plan to a parent or legal guardian is contraindicated. 2.13.2 Treatment Progress Documentation Requirements A. The individual record must include progress notes, documenting a chronological record of treatment, date and type of service, session activity, and progress toward individual-specific B. The minimum frequency of progress note completion may vary by endorsement. See specific endorsement requirements in Chapters 4 through 10 of these rules for details.

C. P rogress notes must include any noted change in physical, behavioral, cognitive, and functional condition and action taken by personnel to address the individual’s changing needs.

D. Progress notes must be signed and dated or electronically approved by personnel, practicing within the scope of their practice, at the time they are written, with at least first initial, last name, and degree and/or professional credentials.

E. Verbal orders must be recorded at the time they are given and authenticated as soon as practical. 2.14 Protection of Individuals from Involuntary Restraint or Seclusion 2.14.1 General Provisions A. The following rules covering seclusion, restraint, and physical management apply to all agencies that use seclusion, restraint, and/or physical management. If a BHE has decided to use seclusion, restraint, and/or physical management, the BHE shall use seclusion, restraint, and/or physical management only in accordance with the rules in this part 2.14.

B. These rules do not supersede any requirements under Sections 26-20-101 through -111, C.R.S.

C. If any provision of this part 2.14 conflicts with any provision concerning the use of seclusion, restraint, and/or physical management on an individual with an intellectual or developmental disability as stated in Article 10.5 of Title 27, C.R.S., Article 10 of Title 25.5, C.R.S. or any rule adopted pursuant to those Articles, the provisions of those Articles or rules prevail.

D. Individuals being detained under Sections 27-65-106 through -110, C.R.S., may be secluded or restrained involuntarily under the conditions in this part; otherwise, there must be a signed informed consent for such an intervention as subject to part 2.11 of this Chapter.

E. A BHE may only use seclusion, restraint, and/or physical management:

1. In cases of emergency, as defined at Section 26-20-102(3), C.R.S., to be a serious, probable, imminent threat of bodily harm to self or others where there is the present ability to affect such bodily harm; and 2. After the failure of less restrictive alternatives, including but not limited to after all attempts to verbally direct or de-escalate the individual have failed; or 3. A fter a determination that such alternatives would be inappropriate or ineffective under F. A BHE that uses seclusion, restraint, and/or physical management pursuant to the provisions of

part 2.14.1.E, may only use such seclusion, restraint, and/or physical management:

1. For the purpose of preventing the continuation or renewal of an emergency;

2. For the period of time necessary to accomplish its purpose; and 3. In the case of physical restraint, with no more force than is necessary to limit the individual’s freedom of movement.

G. Seclusion, restraint, and/or physical management must never be used:

1. As a punishment or disciplinary sanction;

2. As a means of coercion;

3. As part of an involuntary service plan or behavior modification plan;

4. For convenience;

5. For the purpose of retaliation; or 6. For the purpose of protection, unless:

a. The restraint or seclusion is ordered by a court; or b. In an emergency, as provided for in this part 2.14.1.F.1 above.

H. Physical management for individuals under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to part 2.14.13 of this Chapter.

2.14.2 P olicies and Procedures Regarding Seclusion, Restraint, and Physical Management A. The BHE shall have and shall implement written policies and procedures that describe the situations in which the use of seclusion, restraint, and/or physical management are considered appropriate and the personnel who can order their use. The policies and procedures must include the requirements in this part 2.14 and Section 26-20-101 through -111, C.R.S. these policies and procedures must also include:

1. For a BHE that does not authorize the use of seclusion, restraint, and/or physical management of any type, a policy statement noting the prohibition against the use of seclusion, restraint, and/or physical management and the procedures that personnel will 2. For a BHE that utilizes seclusion, restraint, and/or physical management, a policy statement regarding the review process for the use of seclusion, restraint, and/or physical management. The review process must include a provision for terminating the seclusion, restraint, and/or physical management episode when the reviewer does not concur with a. If the reviewer is not an authorized practitioner, then the order must be 3. Personnel shall ensure that no individual endures harm or harassment when secluded 4. A p olicy statement that a BHE shall ensure that the care and treatment are skillfully and humanely administered with full respect for the individual’s dignity, pursuant to Section 27-65-101(1)(a), C.R.S.

5. Protocols for when the use of restraint, seclusion, and/or physical management is appropriate, which include restrictions on the use of these techniques. A BHE may impose more, but not fewer, restrictions on the use of these techniques than is required by this Chapter.

6. Details on the type of physical management interventions that personnel are approved to 7. Details on how seclusion, restraint, and/or physical management will be altered to include any necessary accommodations the individual may need, including but not limited to changing emergency interventions to not restrain hands and ability to communicate for those individuals that speak sign language.

8. If a BHE does not have a 27-65 designation with the BHA and is using seclusion and/or restraint interventions, that BHE’s policies and procedures must include details on transferring an individual to a 27-65 designated facility if after one (1) hour of seclusion and/or restraint interventions have been used and the individual is assessed as continued risk, meeting criteria for an emergency hold under 27-65-106, C.R.S., and needing further intervention(s).

2.14.3 P ersonnel Training A. The BHE shall ensure that all personnel involved in utilizing seclusion, restraint, and/or physical management are trained in the use of seclusion, restraint, and/or physical management as described in this part 2.14.

B. The BHE shall ensure that personnel are trained to explain, where possible, the use of seclusion, restraint, and/or physical management to the individual who is to be secluded, restrained, or physically managed and to the individual’s designated representative, if appropriate.

C. Training must be standardized and evaluated every three (3) years to ensure incorporation of evidence-based best practices for seclusion, restraint, and/or physical management.

D. Training must be provided to personnel within the first month of their orientation period and E. Personnel shall obtain certification in cardiopulmonary resuscitation (CPR), including periodic F. Training must include at minimum, but is not limited to:

1. The safe use of seclusion, restraint, and/or physical management including content related to the risks of positional asphyxia, aspiration, traumatization, and recognize and respond to signs of physical distress of an individual who is secluded, restrained, and/or 2. Address concepts related to prevention and non-physical interventions such as deescalation and mediation;

3. Educate personnel of how their culture, language, biases, values, and perceptions influence their response and escalation of person involved; and 4. U nderstanding and recognizing underlying behavioral health and physical health conditions, medications, and their potential effects as well as how age, developmental level, cultural background, language, history of physical or sexual abuse, and prior experience with seclusion, restraint, and/or physical management will influence an G. Personnel must demonstrate knowledge and application of seclusion, restraint, and physical management training on an annual basis when working with persons over the age of twenty-one (21), and on a semi-annual basis when working with youth twenty (20) years old and younger. 2.14.4 Standards of Care Upon Admission A. At admission, the BHE shall inform both the individual and the individual’s legal representative, as applicable, of the BHE’s policy regarding the use of seclusion, restraint, and physical management during an emergency behavioral health episode for individuals in a treatment program. This must, as is reasonable under the circumstances, be communicated in a language and modality accessible to the individual.

B. Upon an individual’s admission, personnel shall collaborate with the individual and the individual’s legal representative, when applicable, to formulate strategies that may minimize the potential for a behavioral health emergency event that requires interventions of seclusion, restraint, and/or C. A B HE electing to utilize seclusion, restraint, and/or physical management shall assess each 1. Assault and trauma history;

2. Seclusion, restraint, and/or physical management history;

3. Individual’s risk factors for a behavioral emergency, and individually identified strategies 4. The BHE shall ascertain any applicable behavioral health advance directives. 2.14.5 Use of Physical Management A. Physical management for individuals under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to this part 2.14.13.

B. Physical management shall only be used on an emergency basis for a maximum of one (1) minute, when the situation places the individual or others at imminent risk of serious physical harm after all attempts to verbally direct or de-escalate the person have failed.

1. If physical management is used for longer than one (1) minute, the intervention is restraint, pursuant to Section 26-20-102(6), C.R.S., and personnel must follow the restraint order rules pursuant to part 2.14.7 of this Chapter.

C. To ensure the safety of each individual and personnel, each BHE shall designate emergency D. The term “ physical management” does not include briefly holding an individual in order to comfort E. The physical management continuum may include:

1. U tilizing transitional measures;

2. Placing one’s hands on an individual to physically guide and/or physically control the 3. Use of an approved restraint method specified in the BHE’s policies and procedures to maintain safety of the individual;

4. Placing an individual into an approved prolonged restraint method specified in the BHE’s policies and procedures;

5. Physical management may be used to move or escort an individual into seclusion.

a. Seclusion, in itself, is not a form of physical management.

F. Physical management must be documented in the clinical record to include the following:

1. Documentation of the behavioral necessity for physical management and any de- 2. Documentation of the approved physical management method utilized. 2.14.6 Use of Seclusion A. If an order for seclusion is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order seclusion must verify the verbal order in a signed written form in the individual’s record. Signatures must be 2. The physician or other authorized practitioner to order seclusion must be available to personnel for consultation, at least by telephone, throughout the period of the emergency B. Within one (1) hour of the initiation of the original order of seclusion an authorized practitioner, such as a registered nurse or physician assistant, trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the individual, shall conduct a face-to-face assessment of the physical and psychological well-being of the individual including but not limited to:

1. The individual’s physical and psychological status;

2. The individual’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

C. When the one (1) hour assessment described in this part 2.14.6.B is conducted by a registered nurse or a physician assistant, that personnel must consult with the attending physician when the D. R esults of the one (1) hour assessment must determine if continued emergency interventions need to be re-ordered by the authorized practitioner.

1. Assessment results and continuation order, if applicable, must be contained in the clinical E. Seclusion occurs any time an individual is placed alone in a room and not allowed to leave.

F. Seclusion must be used only when other less restrictive methods have failed.

1. Documentation of less restrictive methods and the outcome must be contained in the G. Seclusion must not be used for punishment, for the convenience of personnel, or as a substitute H. Seclusion rooms must be lighted, clean, safe, and have a window for personnel to observe.

I. Seclusion rooms must be a minimum of 100 square feet.

J. Relief periods from seclusion must be offered for reasonable access to toilet facilities. 2.14.7 Use of Restraint A. If an order for restraint is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order restraint must verify the verbal order in a signed written form in the individual’s record. Signatures must be 2. The physician or other authorized practitioner to order restraint must be available to personnel for consultation throughout the period of the emergency safety intervention.

B. An individual in physical restraint must be released from such restraint within fifteen (15) minutes after the initiation of physical restraint, except when precluded for safety reasons pursuant to part 2.14.1 of this section.

C. Within one (1) hour of the initiation of the original order for the emergency safety intervention, an authorized practitioner, such as a registered nurse or physician assistant, trained in the use of emergency safety interventions and permitted to assess the physical and psychological wellbeing of the individual, shall conduct a face-to-face assessment of the physical and psychological well-being of the individual including but not limited to:

1. The individual’s physical and psychological status;

2. The individual’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

D. Wh en the one (1) hour assessment described in this part 2.14.7.C is conducted by a registered nurse or a physician assistant, that personnel must consult with the attending physician when the E. Results of the one (1) hour assessment must determine if continued emergency interventions need to be reordered by the authorized practitioner.

1. Assessment results and continuation order, if applicable, must be contained in the clinical F. The decision to restrain must be based on a current clinical assessment and may also be based on other reliable information including information that was used to support the decision to take the individual into custody for treatment and evaluation. The fact that an individual is being evaluated or treated under Sections 27-65-106 through 27-65-111 [effective July 1, 2024], C.R.S., must not be the sole justification for the use of restraint.

G. Restraint includes chemical restraint, mechanical restraint, and physical restraint.

H. Mechanical restraints may be used only for the purpose of preventing such bodily movement that is likely to result in imminent injury to self or others. Mechanical restraint must not be used solely I. R estraint of an individual by a chemical spray is not permissible.

J. The type of restraint must be appropriate to the type of behavior to be controlled, the physical condition of the individual, the age of the individual and the type of effect restraint may have upon K. Restraint must be applied only if alternative interventions have failed. Justification for immediate use of restraint without first attempting alternative interventions must be documented in the clinical record; however, alternative techniques are not required if the alternatives would be ineffective or unsafe when the individual’s behavior could cause harm to self or others.

L. The term “ restraint” as used in this section, does not include restraints used while the BHE is engaged in transporting an individual from one location to another location when it is within the scope of that BHE's powers and authority to conduct such transportation pursuant to Section 26- 20-101 through -111, C.R.S.

M. No physical or mechanical restraint of an individual may place excess pressure on the chest or back of that individual, cover the individual’s face, or inhibit or impede the individual’s ability to breathe. 2.14.8 Chemical Restraint A. If an order for chemical restraint is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency 1. The physician or other authorized practitioner permitted to order chemical restraint must verify the verbal order in a signed written form in the individual’s record. Signatures must 2. T he physician or other authorized practitioner to order chemical restraint must be available to personnel for consultation, throughout the period of the emergency safety B. An order for a chemical restraint, along with the reasons for its issuance, must be recorded in writing at the time of its issuance;

C. An order for a chemical restraint must be signed at the time of its issuance by such authorized practitioner, who is present at the time of the emergency;

D. An order for a chemical restraint, if authorized by telephone, must be transcribed, and signed at the time of its issuance by personnel with the authority to accept telephone medication orders who is present at the time of the emergency.

E. Personnel trained in the administration of medication shall make notations in the record of the individual as to the effect of the chemical restraint and the individual’s response to the chemical 2.14.9 Explanation to Individual in Seclusion/Restraint A. In any situation in which seclusion/restraint is utilized, information must be given to the secluded/restrained individual, and the individual’s legal representative when applicable, as soon as possible after they have been secluded or restrained. The individual must be given a clear explanation of:

1. T he reasons for use of such intervention;

2. The observation procedure, the desired effect; and 3. The circumstances under which the procedure will be terminated.

B. That the explanation has been given to the individual and the individual’s legal representative, when applicable, must be documented in the clinical record.

C. As soon as possible, upon termination of seclusion and/or restraint, personnel shall debrief with the individual and assess for any traumatic stress that may have been triggered as a result of 2.14.10 Observation & Care of Individuals in Seclusion and/or Restraint A. An individual who is in seclusion/restraint must be observed in-person by trained BHE personnel at no more than ten (10) feet physical distance from the individual.

1. Such observation, along with the behavior of the individual, must be documented every B. Unless contraindicated by the individual's condition, such observation must include consistent C. Ongoing provisions must be made for nursing care, hygiene, diet, and motion of any restrained D. BHE personnel must maintain a continuous line-of sight throughout the episode with the E. For individuals held in mechanical restraints, BHE personnel must observe the individual at least every fifteen (15) minutes to ensure that:

1. T he individual is properly positioned;

2. The individual’s blood circulation is not restricted;

3. The individual’s airway is not obstructed; and 4. The individual’s other physical needs are met, pursuant to this part 2.14.10.

F. For individuals held in mechanical restraints, the BHE shall offer relief periods of at least ten (10) minutes as often as every two (2) hours, so long as relief from the mechanical restraint is determined by personnel to be safe pursuant to part 2.14.1 of this section.

G. Personnel must document relief periods both offered and granted.

H. The individual must have access to food at least every four (4) hours.

I. The individual must have access to fluids and toileting upon request or during offered relief periods but must at minimum be offered every two (2) hours.

1. During such relief periods, personnel shall ensure proper positioning of the individual and J. Personnel must provide assistance for use of necessary toileting methods.

1. Appropriate toileting does not include the use of adult diapers if not typically used by the individual when not restrained or secluded.

2. If the individual typically uses adult diapers, they are to be changed immediately if soiled.

K. Personnel shall maintain the individual’s dignity and safety during relief periods.

L. Cameras and other electronic monitoring devices must not replace face-to-face observations.

M. To the extent that the duties specified in Section 26-20-101 through -111, C.R.S. are more protective of individual rights or are in conflict with the provisions in this part 2.14, the provisions of Section 26-20-101 through -111, C.R.S. shall apply. 2.14.11 Continued Use of Seclusion and/or Restraint A. Personnel must document efforts to assure that the use of seclusion/restraint is as brief as B. The original order of seclusion/restraint of an individual must not exceed one (1) hour without an order for continued seclusion/restraint from an authorized practitioner. A verbal order, including telephone or other electronic orders, may be used if followed by a written order from the C. Seclusion/restraint must not be ordered on an “as needed” basis.

D. A new written order is required every four (4) hours and shall include a documented examination by an authorized practitioner.

E. Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative 1. T he administrative reviewer shall be a different authorized practitioner with the authority and knowledge necessary to review clinical information and reach a determination that the extension of a seclusion and/or restraint episode beyond twenty- four (24) hours is 2. If the administrative reviewer does not concur with the order for continuation of seclusion/restraint, the order shall be discontinued and the authorized practitioner in F. An administrative review must be initiated at the conclusion of each twenty-four (24) hour period 2.14.12 Documentation Requirements A. Each BHE must ensure that an appropriate notation of the use of seclusion, restraint and/or physical management is documented in the record of the individual who was secluded, restrained, and/or physically managed and must be completed before the end of the shift of the personnel involved in the seclusion, restraint and/or physical management episode(s). Each BHE shall document the following in the individual’s record:

1. Specifics of the episode including identified triggers, precipitating events, the individual's specific behavior(s) and the nature of the danger;

2. Type of restraint, if utilized;

3. Specific date and times of initiation and discontinuation of seclusion, restraint and/or physical management and total length of time individual is secluded, restrained, and/or 4. A description of specific non-physical and least restrictive interventions that were attempted prior and the individual’s response;

5. Identification of personnel involved in the initiation and application of the seclusion, restraint and/or physical management;

6. Notification to an authorized practitioner within one (1) hour of the seclusion/restraint 7. Care provided while individual was secluded, restrained, and/or physically managed, a. Observations conducted;

b. Assessments of position, respiration, circulation, and range of motion;

c. Documentation of ongoing 15-minute observation and care checks, as subject to applicable rules, along with relief periods both offered and granted for food, fluid, d. Interventions provided to promote comfort and safety as well as expedite release;

e. The individual’s response to these interventions; and f. The effect of the restraint or seclusion on the individual;

8. Documentation that the individual, and the individual’s legal representative if applicable, was given a clear explanation of the reasons for use of such intervention, the observation procedure, the desired effect, and the circumstances under which the intervention will be terminated including criteria for release and individual understanding of that criteria; and, 9. Documentation that personnel debriefed the incident with the individual and assessed for B. An y administrative reviewer shall document the clinical justification for the continued use of seclusion/restraint in the individual's chart. The justification must include:

1. Documentation that the authorized practitioner ordering the continuous use of seclusion/restraint in excess of four (4) hours has conducted a face-to-face evaluation of 2. Documentation of the ongoing behaviors or findings that warrant the continued use of 3. Documentation of a plan for ongoing efforts to actively address the behaviors that 4. A determination of the clinical appropriateness of the continuation of seclusion/restraint;

5. A summary of the information considered by the reviewer and the result of the administrative review with the date, time and signature of the individual completing the C. Information regarding use of seclusion/restraint must be readily accessible to authorized individuals for review. The BHE shall have the ability to gather data as follows:

1. Each seclusion/restraint episode including date and time the episode started and ended, specific to each individual over the period of one complete calendar year from January 1 2.14.13 Additional Procedures and Requirements for Seclusion/Restraint of a Youth A. Procedures for youth must include the following in addition to the requirements found in part 2.14 of this Chapter, unless otherwise required in this part 2.14.13.

B. This part 2.14.13 does not apply to adult individuals over the age of 21.

C. An emergency safety intervention must be performed in a manner that is safe, proportionate, and appropriate to the severity of the behavior, and the youth’s chronological and developmental age; size; gender; physical, medical, and psychiatric condition; and personal history (including any 1. Physical management is always considered restraint for an individual under age eighteen (18) and must follow the restraint order rules pursuant to this part 2.14 of this Chapter.

D. Orders for seclusion/restraint must be by an authorized practitioner in the BHE to order seclusion/restraint and trained in the use of emergency safety interventions. Federal regulations at 42 C.F.R. Part 441, specifically 441.151 require that inpatient psychiatric services for individuals under age twenty-one (21) be provided under the direction of a physician.

1. If the individual’s treatment team assigned physician is available, only they can order seclusion/restraint. If they are not available, then another team physician may make the order.

E. A physician or other authorized practitioner must order the least restrictive emergency safety intervention that is most likely to be effective in resolving the emergency safety situation based on F. If the order for seclusion/restraint is verbal, the order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order restraint or seclusion must verify the verbal order in a signed written form in the minor’s record. Signatures must be entered into the record no more than twenty-four (24) hours after the event.

2. The physician or other authorized practitioner to order restraint or seclusion must be available to personnel for consultation, at least by telephone, throughout the period of the G. Each order for seclusion/restraint must be limited to no longer than the duration of the emergency H. U nder no circumstances may the total order time exceed:

1. Four (4) hours for persons ages eighteen (18) to twenty-one (21);

2. Two (2) hours for persons ages nine (9) to seventeen (17); or 3. One (1) hour for persons under the age of nine (9).

I. Within one (1) hour of the initiation of the order of the emergency safety intervention, a physician, or other authorized practitioner trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the youth, must conduct a face - to - face assessment of the physical and psychological well-being of the individual including but not limited to:

1. The youth’s physical and psychological status;

2. The youth’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

J. Results of the one (1) hour assessment must be documented in the individual’s record.

K. Notification of parent(s) and/or legal guardian(s), when applicable:

1. The BHE must notify the parent(s) and/or legal guardian(s) of the individual who has been in seclusion or restraint as soon as possible after the initiation of each emergency 2. The BHE shall document in the individual’s record that the parent(s) or legal guardian(s) have been notified of the emergency safety intervention, including date and time of the 2.15 Med ication Administration A. The BHE shall ensure that medications are administered only by licensed or certified personnel allowed to administer medications under their own scopes of practice, or unlicensed personnel who are qualified medication administration persons (QMAPs) acting within their own scope of B. When using QMAPs to administer medication, the BHE shall ensure compliance with 6 CCR 1011-1, Chapter 24 (March 17, 2025), which is hereby incorporated by reference. No later editions or amendments are incorporated. This Colorado Department of Public Health and Environment rule is available at no cost at https://www.coloradosos.gov/CCR/GenerateRulePdf.do?ruleVersionId=11868&fileName=6%20C CR%201011-1%20Chapter%2024. Individuals may inspect or obtain a copy of the rule at the BHA, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours. 2.16 Critical Incident Reporting A. A critical incident includes but is not limited to the following:

1. Breach of confidentiality: any unauthorized disclosure of protected health information as described in HIPAA, 42 C.F.R. Part 2, and/or Section 27-65-101 through - 131, C.R.S.

2. Death: including the death of an individual inside of or outside of the BHE’s physical location while an individual is receiving services or where an individual has attempted to receive services from the BHE within the past thirty (30) calendar days.

3. Elopement: absconding from a mental health hold, certification, emergency/involuntary commitment, or a secure facility where an individual is being held as a result of a court order. This includes any unauthorized absence of a child, when a child cannot be accounted for or when there is reasonable suspicion to believe the child has absconded.

4. Any instance when an individual cannot be located following a search of the BHE, the BHE grounds, and the area surrounding the BHE, and:

a. There are circumstances that place the individual’s health, safety, or welfare at risk; or b. The individual has been missing for eight (8) hours.

5. Medication diversion: any medication diversion as defined in part 1.2 of these rules if the diverted drugs are injectable, the BHE shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known.

6. Medication error: medication error that resulted or could have resulted in harm to the 7. Medical emergency: any suicide attempt/self-injury, other form of serious injury, health emergency, overdose or serious illness which occurred on BHE premises or in the presence of BHE personnel.

8. An y instance involving physical, sexual, or verbal abuse of an individual, as described in Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, 18-3-405, 18-3- 405.3, 18-3-405.5, and 18-9-111 (exempting however, the phrase “intended to harass”), C.R.S. by another individual, personnel, or a visitor to the BHE.

9. Any instance that results in any of the following serious injuries to an individual:

a. Brain or spinal cord injuries;

b. Life-threatening complications of anesthesia or life-threatening transfusion errors c. Second- or third-degree burns involving twenty percent (20%) or more of the body surface area of an adult or more than fifteen percent (15%) of the body surface area of a child.

10. Any instance involving caretaker neglect of an individual, as defined in 26-3.1-101(2.3), C.R.S. or child abuse or neglect as defined in 19-1-103(1), C.R.S.

11. Any instance involving misappropriation of an individual’s property, meaning patterns of loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, an individual’s belongings or money without the individual’s 12. An y occurrence involving the malfunction or intentional or accidental misuse of care equipment that occurs during treatment or diagnosis of an individual and that significantly or adversely affects or, if not averted, would have significantly adversely affected an B. Critical incidents must be reported to the BHA within one (1) business day after the incident.

Critical incidents must also be reported to the BHA within one (1) business day of when the BHE determines that a reportable incident has occurred and the BHA requests such reporting.

C. The BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes and investigation of critical incidents reports in accordance with:

1. BHA policies and procedures, 2. Regulations that protect the confidentiality and individual rights in accordance with Sections 27-65-101 through -131, C.R.S.; HIPAA; and 42 C.F.R. Part 2, 3. Controlled Substance Licensing; Section 27-81-113, C.R.S.; Section 27-80-212, C.R.S., D. The BHA shall have access to relevant documentation required to determine compliance with E. The BHE must:

1. Establish written policies and procedures for reporting and reviewing all critical incidents occurring at the BHE;

2. Submit critical incidents reports to the BHA using state prescribed forms that can be obtained from the BHA’s website at https://bha.colorado.gov/for-providers. This is not in lieu of other reporting mandated by state statute or federal guidelines;

3. Mak e available a report with the investigation findings for review by the BHA, upon 4. Maintain critical incidents reports for a minimum of three (3) years following the incident F. Nothing in this part shall be construed to limit or modify any statutory or common law right, 2.17 Quality Management Program A. Every BHE must have a quality management program (QMP) designed to improve individual safety and well-being. The individual safety component of the program must implement improvements in response to patterns and trends associated with service delivery errors and potential for error. The individual well-being component of the QMP must implement improvements that are not necessarily tied to errors or potential for error but instead to the continuous quality improvement principle that opportunities always exist to enhance service delivery.

B. The BHE must implement the QMP in accordance with a quality management plan that is reviewed and approved annually by the governing body. The plan must have the following elements:

1. Identification of quality management programs a. For the individual safety component of the QMP, the plan must identify:

(1) The types of service delivery errors and potential for error that will be monitored, which must be based, at minimum, on a review of negative individual outcomes that are unanticipated, individual disputes, critical incidents, deficiencies cited by regulatory agencies, occurrences and/or errors, and potential for errors reported by personnel.

(2) A process for personnel to report service delivery error and potential for error within a prescribed period of time and a plan for how personnel will be trained regarding such reporting.

(3) The methods used to collect and analyze data to find patterns and trends. The plan must also include how the governing body, if applicable, and the administrator will be informed of such patterns and trends.

(4) The method(s) used to select quality management projects.

(5) The method(s) for selecting the service delivery practice(s) that will be reviewed.

2. Implementation of the individual well-being component a. The plan must include development of improvement strategies. This may include identifying the personnel that will be involved in designing the intervention, opportunities for individual input, and the administrative approvals needed to finalize the intervention design.

b. The plan must document each improvement strategy including:

(1) A d escription of the intervention design. For individual safety improvements, this must include how information about patterns and trends will be shared with personnel and how the underlying systemic problem(s) that led to the pattern or trend will be addressed.

(2) How personnel will be allocated and/or trained to implement the strategy.

(3) How the strategy will be evaluated for effectiveness.

(4) Timelines for implementation and evaluation of the strategy and how the BHE is tracking the meeting of these milestones.

C. The BHA may audit a BHE’s QMP to determine compliance with part 2.17 of this Chapter.

1. If the BHA determines that an investigation of any incident or outcome is necessary, it may, unless otherwise prohibited by law, investigate and review documents related to the incident or outcome to determine actions taken by the BHE. 2.18 Initial Application Procedure A. Any person or business entity seeking a license to operate a BHE shall initially notify the BHA by submitting a letter of intent. Upon receipt of a letter of intent, the BHA will open a license application file.

B. The applicant must provide the BHA with a complete application including all information and attachments specified in the application form, which is available to access on the BHA’s website, and any additional information requested by the BHA. The appropriate non-refundable fee(s) for the license category requested must be submitted with the application. Applications must be submitted at least ninety (90) calendar days before the anticipated start-up date.

1. A license application may be considered abandoned if the applicant fails to complete the application within twelve (12) months. The BHA may administratively close the application process.

2. After an administrative closure, the applicant may file a new license application along with the corresponding initial license fee.

C. With the submission of an application for a license to operate a BHE, or within ten (10) days after a change in ownership or management of a BHE, each owner and manager shall submit a complete set of the owner's and manager's fingerprints to the Colorado Bureau of Investigation (CBI) for the purpose of conducting a fingerprint-based criminal history record check. The CBI shall forward the fingerprints to the Federal Bureau of Investigation (FBI) for the purpose of conducting fingerprint-based criminal history record checks. Each owner and each manager shall pay the CBI the costs associated with the fingerprint-based criminal history record check. Upon completion of the criminal history record check, the CBI shall forward the results to the BHA. The BHA may acquire a name-based criminal history record check for an applicant who has twice submitted to a fingerprint-based criminal history record check and whose fingerprints are unclassifiable.

D. Ea ch applicant must provide the following information:

1. The legal name of the applicant and all other names used by it to provide services. The BHE has a continuing duty to submit notification to the BHA for all name changes at least thirty (30) calendar days prior to the effective date of the change.

a. Applicants for initial licensure must submit a distinctive license name that does not need to include the services to be provided, but it may not mislead or confuse the public regarding the license or type of services to be provided.

b. Duplication of an existing name is prohibited except between agencies that are affiliated through ownership or controlling interest.

c. Each BHE shall be identified by this distinctive name on stationery, billing materials, and exterior signage that clearly identifies the licensed entity. Exterior signage must conform to the applicable local zoning requirements.

d. If the BHE has a “doing business as” name, it must hold itself out to the public using such name, as it appears on the license.

2. Contact information for the BHE must include a mailing address, telephone number, and e- mail addresses. If applicable, the BHE’s website and facsimile number must be 3. T he identity, address, and telephone number of all persons and business entities with a controlling interest in the BHE, including but not limited to:

a. A non-profit corporation shall list the governing body and officers.

b. A for-profit corporation shall list the names of the officers and stockholders who directly or indirectly own or control five percent or more of the shares of the corporation.

c. A sole proprietor shall include proof of lawful presence in the United States.

d. A partnership shall list the names of all partners.

e. The chief executive officer of the BHE.

f. If the addresses and telephone numbers provided above are the same as the contact information for the BHE itself, the BHE shall also provide an alternate address and telephone number for at least one person for use in the event of an emergency or closure of the BHE.

4. Proof of professional liability insurance. BHEs must maintain such coverage for the duration of the license term and must notify the BHA of any change in the amount, type, or provider of professional liability insurance coverage during the license term.

5. Articles of incorporation, Articles of organization, partnership agreement, or other organizing documents required by the secretary of state to conduct business in Colorado; and by-laws or equivalent documents that govern the rights, duties, and capital contributions of the business entity.

6. T he address(es) of the physical location(s) where services are delivered, as well as, if different, where records are stored for BHA review.

7. A map for each floor of the BHE’s buildings indicating room layout, services to be provided in each of the rooms, the proposed physical extent of the license within each building, and all occupancies contiguous to the BHE regardless if services are being delivered under the terms of the license.

a. If services are delivered in multiple buildings located on a campus, a street map of the campus must be submitted that indicates which buildings and floors are occupied as part of the license.

b. Maps must be submitted to the BHA.

8. A copy of any management agreement pertaining to operation of the entity that sets forth the financial and administrative responsibilities of each party.

9. If an applicant leases one or more building(s) to operate under the license, a copy of the lease or leases must be filed with the license application and show clearly in its context which party to the agreement is to be held responsible for the physical condition of the property.

10. A statement, on the applicant’s letterhead, if available, signed and dated, submitted with the application stating whether any of the actions listed in this part 2.17.D.10.a.(2) of these rules have occurred, regardless of whether the action has been stayed in a judicial appeal or otherwise settled between the parties. The actions are to be reported if they occurred within ten (10) years preceding the date of the application. For initial licensure, the BHA may, based upon information received in the statement, request additional information from the applicant beyond the ten-year time frame.

a. For initial licensure of the BHE, whether one or more individuals or entities identified in the response to part 2.18.D.3 of this Chapter has a controlling or ownership interest in the BHE and has been the subject or party to any of the (1) A civil judgment or criminal conviction resulting from conduct or an offense in the operation, management or ownership of a BHE or other entity related to substandard care or health care fraud. A guilty verdict, a plea of guilty, or a plea of nolo contendere (no contest) accepted by the court is considered a conviction.

(2) A disciplinary action imposed upon the BHE by a governmental entity in another state that registers or licenses agencies including but not limited to, a sanction, probation, civil penalty, or a denial, suspension, revocation, or modification of a license or registration.

(3) Limitation, denial, revocation, or suspension by any federal, state, or local authorities of any health care related license.

(4) The refusal to grant or renew a license for operation of a BHE, or contract for participation or certification for Medicaid, Medicare, or other public health or social services payment program.

b. For a change of ownership of a BHE, whether any of the new owners have been the subject of, or a party to, one of more of the following events:

(1) A ci vil judgment or a criminal conviction in a case brought by the federal, state, or local authorities that resulted from the operation, management, or ownership of a BHE or other entity related to substandard care or health care fraud.

(2) Limitation, denial, revocation, or suspension of a state license or federal certification by another jurisdiction.

11. Any statement regarding the information requested in 2.18.D.10 of this Chapter must include the following, as applicable:

a. If the event is an action by a governmental agency, as described in part 2.18.D.10.b: the name of the agency, its jurisdiction, the case name, and the docket proceeding or case number by which the event is designated, and a copy of the consent decree, order, or decision.

b. If the event is a felony conviction or misdemeanor involving moral turpitude: the court, its jurisdiction, the case name, the case number, a description of the matter or a copy of the indictment or charges, and any plea or verdict entered by the court. For the purposes of this rule, “ crimes of moral turpitude” include the following felony, misdemeanors, or municipal offenses:

(1) Any of the offenses against the person set forth in Title 18, Article 3 of are not limited to, any assault, menacing, or unlawful sexual behavior;

(2) An y of the offenses against property set forth in Title 18, Article 4 of the not limited to, any arson, theft, trespass, or criminal mischief;

(3) Any of the offenses involving fraud set forth in Title 18, Article 5 of the Colorado Revised Statutes;

(4) Computer crime as set forth in Title 18, Article 5.5 of the Colorado Revised Statutes;

(5) Any of the offenses involving the family relations set forth in Title 18,

Article 6, Part 4 (wrongs to children), when committed intentionally and knowingly or recklessly; Part 6 (harboring a minor); or Part 8 (domestic violence), of the Colorado Revised Statutes;

(6) Any of the offenses constituting wrongs to at-risk adults set forth in Title 18, Article 6.5 of the Colorado Revised Statutes;

(7) Any of the offenses relating to morals set forth in Title 18, Article 7 of the not limited to, prostitution, indecent exposure, and criminal invasion of privacy;

(8) Any other offense in any jurisdiction whatsoever that is committed intentionally, knowingly, or recklessly, and involves violence, coercion, threats, cruelty, fraud, deception, or deprivation of legally recognized rights; and, (9) Any conspiracy, solicitation, or criminal attempt to commit any of the above offenses, or participation as an accessory to any of the above offenses.

c. If the event is a civil action or arbitration proceeding: the court or arbiter, the jurisdiction, the case name, the case number, a description of the matter or a copy of the complaint, and a copy of the verdict of the court or arbitration decision.

E. The BHA will not issue or renew a BHE license unless it has received a certificate of compliance as defined in Chapter 1 of these rules for each physical location where services are provided F. Each application must be signed under penalty of perjury by an authorized corporate officer, general partner, member, or sole proprietor of the BHE as appropriate.

G. The BHA shall conduct a preliminary assessment of the application and notify the applicant of any application defects.

1. The applicant shall respond within fourteen (14) calendar days to written notice of any H. License fees must be submitted to the BHA as specified below:

1. An applicant for an initial license as a BHE shall submit the following nonrefundable fee(s) with the application for licensure, as applicable:

a. A base fee of $500, regardless of endorsements or physical locations included as

part of the application for initial licensure. The base fee includes one physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter.

b. A fee of $300 for each additional physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this

Chapter included as part of the application for initial licensure, to be paid only by applicants that are seeking licensure that includes endorsement for outpatient c. A fee of $600 for each physical location in which services are to be provided under a residential/overnight endorsement as defined in part 2.3.A.4 of this

Chapter, to be paid only by applicants seeking such endorsement.

d. Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a fee.

2. A BHE may apply to add an endorsement to its license at any time with the submission of fees outlined in part 2.20.H.1.b and part 2.20.H.1.c.

I. The duration of the initial license will be one (1) year from the date of issuance.

J. The BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a K. The BHA will act on an application within thirty (30) calendar days of receipt of the completed 2.19 Provisional Licenses A. W here an applicant for an initial license fails to fully conform to the applicable statutes and regulations but the BHA determines the applicant is in substantial compliance with these rules and regulations and is temporarily unable to conform to all the minimum standards, a provisional license may be granted. No provisional license may be issued to an applicant if the operations may adversely affect the health, safety, or welfare of individuals, personnel, or other persons. A provisional license will only be issued upon payment of the non-refundable provisional license fee.

1. A provisional license will be valid for ninety (90) days.

2. A second provisional license may be issued if the BHA determines that it is likely compliance can be achieved by the date of expiration of the second provisional license.

3. The second provisional license may be issued for the same duration as the first upon payment of a second non-refundable provisional license fee. The BHA will not issue a third or subsequent provisional license to the applicant.

4. During the term of the provisional license, the BHA shall conduct any review it deems necessary to determine if the applicant meets the requirements for a regular license.

5. If the BHA determines, prior to expiration of the provisional license, that the applicant is in compliance with all applicable rules, it may issue a regular license upon payment of the applicable initial license fee. The regular license will be valid for one (1) year from the date of issuance of the regular license, unless otherwise acted upon pursuant to part 2.24 of this Chapter. 2.20 License Renewal A. A BHE seeking renewal must provide the BHA with a license application, signed under penalty of perjury by an authorized corporate officer, general partner, member, or sole proprietor of the BHE as appropriate, and the appropriate fee at least sixty (60) calendar days prior to the expiration of the existing license. Renewal applications shall contain the information required in part 2.18.D of this Chapter unless the information has been previously submitted and no changes have been made to the information currently held by the BHA.

B. Failure to submit a completed renewal application to the BHA thirty (30) calendar days prior to expiration of the existing license will result in assessment of a late fee in an amount equal to the renewal fee.

C. Failure of the BHE to accurately answer or report any of the information requested by the BHA will be considered good cause to deny the license renewal application.

D. The BHA shall conduct a preliminary assessment of the renewal application and notify the BHE of any application defects.

1. The BHE shall respond within fourteen (14) calendar days to written notice of any E. A BHE submitting a renewal application shall submit the following nonrefundable fees, as 1. A bas e fee of $500, regardless of endorsements or physical locations included as part of the application for licensure renewal. The base fee includes one physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter.

2. A fee of $300 for each additional physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter included as

part of the application for licensure renewal, to be paid only by applicants that are seeking licensure that includes endorsement for outpatient services.

3. A fee of $600 for each physical location in which services are to be provided under a residential/overnight endorsement as defined in part 2.3.A.4 of this Chapter, to be paid only by applicants seeking such endorsement.

4. Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a fee.

F. The duration of the renewal license will be one (1) year from issuance. 2.21 Change of Ownership/Management A. If a BHE undergoes a change in ownership without following the procedures outlined in this part 2.21, their existing license may be terminated. Termination of the license may not occur until after a hearing and in compliance with the provisions and procedures specified in 24-4-101 through - 109, C.R.S.

B. When a BHE initiates a change of ownership, the BHE must submit notification to the BHA within the specified time frame, and the prospective new BHE shall submit an application and supporting documentation for change of ownership along with the requisite fees in part 2.21.G of this Chapter within the same time frame. The time frame for submission of the notification and the application and supporting documentation shall be at least thirty (30) calendar days before a change of ownership involving any BHE.

C. The BHA will consider the following criteria in determining whether there is a change of ownership of a BHE that requires a new license. The transfer of fifty percent (50%) of the ownership interest referred to in this part 2.21 may occur during the course of one transaction or during a series of transactions occurring over a five-year period.

1. Sole proprietors:

a. The transfer of at least fifty percent (50%) of the ownership interest in a BHE from a sole proprietor to another individual, whether or not the transaction affects the Title to real property, shall be considered a change of ownership.

b. Change of ownership does not include forming a corporation from the sole proprietorship with the proprietor as the sole shareholder or forming a limited liability company from sole proprietorship with the proprietor as the sole member.

2. P artnerships:

a. Dissolution of the partnership and conversion into any other legal structure shall be considered a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the ownership to one or more new owners.

b. Change of ownership does not include dissolution of the partnership to form a corporation with the same persons retaining ownership in the new corporation.

3. Corporations:

a. Merger of two or more corporations resulting in the creation of a new corporate entity will be considered a change of ownership if the consolidation includes a transfer of at least fifty percent (50%) of the ownership to one or more new b. Formation of a corporation from a partnership, a sole proprietorship, or a limited liability company will be considered a change of ownership if the change includes a transfer of at least fifty percent (50%) of the ownership to one or more new c. The transfer, purchase, or sale of shares in the corporation such that at least fifty percent (50%) of the ownership of the corporation is shifted to one or more new owners will be considered a change of ownership.

4. L imited liability companies:

a. The transfer of at least fifty percent (50%) of the ownership interest in the company will be considered a change of ownership.

b. The termination or dissolution of the company and the conversion thereof into any other entity will be considered a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the ownership to one or more new owners.

c. Change of ownership does not include transfers of ownership interest between existing members if the transaction does not involve the acquisition of ownership interest by a new member.

5. Non-profits:

a. The transfer of at least fifty percent (50%) of the controlling interest in the nonprofit is considered a change of ownership.

6. Management contracts, leases, or other operational arrangements:

a. If the BHE enters into a lease arrangement or management agreement whereby the owner retains no authority or responsibility for the operation and management of the BHE, the action will be considered a change of ownership that requires a new license.

7. Legal structures:

a. The conversion of a BHE’s legal structure, or the legal structure of a business entity that has an ownership interest in the BHE is a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the BHE’s ownership interest to one or more new owners.

D. Ea ch BHE undergoing a change of ownership shall submit an application as prescribed in 2.18.B through 2.18.F of this Chapter.

E. The existing BHE is responsible for correcting all rule violations and deficiencies in any current plan of action before the change of ownership becomes effective. In the event that such corrective actions cannot be accomplished in the time frame specified, the prospective BHE shall be responsible for all uncorrected rule violations and deficiencies including any current plan of action submitted by the previous BHE unless the prospective BHE submits a revised plan of action, approved by the BHA, before the change of ownership becomes effective.

F. When the BHA issues a license to the new owner, the previous owner must return its license to the BHA within five (5) calendar days of the new owner’s receipt of its license.

G. For a change of ownership, a BHE must submit the following nonrefundable fee(s) with the application for licensure, as applicable:

1. A base fee of $500, regardless of endorsements or physical locations included as part of the application for licensure. The base fee includes one physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter.

2. A fe e of $300 for each additional physical location in which services are to be provided under an outpatient endorsement as defined in part 2.3.A.3 of this Chapter included as

part of the application for licensure, to be paid only by applicants that are seeking licensure that includes endorsement for outpatient services.

3. A fee of $600 for each physical location in which services are to be provided under a residential/overnight endorsement as defined in part 2.3.A.4 of this Chapter, to be paid only by applicants seeking such endorsement.

4. Endorsements for services not listed in parts 2.3.A.3 or 2.3.A.4 shall not require a fee. 2.22 Rule Waivers A. This part establishes procedures with respect to waiver of regulations relating to BHE licensing.

B. Any BHE or applicant that has applied for or been issued a license to operate a BHE has the right to apply for a waiver of any rule or standard set forth in these rules which, in their opinion, poses an undue hardship on the applicant, BHE, or community.

C. Nothing contained in these provisions abrogates the BHE's obligation to meet minimum requirements under local safety, fire, electrical, building, zoning, and similar codes.

D. Nothing herein authorizes a waiver of any statutory requirement under state or federal law, except E. Upon application to the BHA, a waiver may be granted in accordance with this part 2.22. Absent the existence of a current waiver issued pursuant to this part, BHEs are expected to comply at all times with all applicable regulations except in instances where they are granted a provisional license in accordance with part 2.19 of this Chapter. BHEs must comply with all regulations in this

part as well as all regulations in the endorsement parts of these rules (i.e., Chapters 3 through 10) that apply to a BHE unless and until a waiver is granted.

F. W aiver applications must be submitted to the BHA in writing.

1. The BHA will only consider one regulation per waiver.

2. The waiver application must provide the BHA information related to:

a. The regulation the BHE or applicant is requesting to waive;

b. The reason why the waiver is being requested;

c. A proposed alternate compliance plan;

d. Any other information relevant to the waiver request that would inform the BHA’s 3. The waiver application must be signed by an authorized representative of the BHE or applicant, who is the primary contact person and the person responsible for ensuring that accurate and complete information is provided to the BHA.

G. In making its determination, the BHA may consider any information it deems relevant, including 1. Critical incident and complaint investigation reports, licensure or certification survey reports, anticipated impact of the waiver on individual safety and quality of care if any, and findings of these reports related to the BHE and/or the operator or owner thereof.

2. When determining whether a waiver should be granted, the BHA shall prioritize consideration of the impact of the waiver on the health, safety, and welfare of individuals over any alleged undue hardship.

H. The BHA shall act on a waiver application within ninety (90) calendar days of receipt of the completed application. An application will not be deemed complete until the BHE has provided all information and documentation requested by the BHA.

I. The BHA may specify terms and conditions under which any waiver is granted, including which terms and conditions must be met in order for the waiver to remain effective. The term for which each waiver granted will remain effective must be specified at the time of issuance but may not exceed the term of the current license.

1. At any time, upon reasonable cause, the BHA may inspect a BHE with an active waiver to ensure that the terms and conditions of the waiver are being observed, and/or that the continued existence of the waiver is otherwise appropriate.

2. Within thirty (30) calendar days of the termination, expiration, or revocation of a waiver, the BHE shall submit to the BHA an attestation of compliance with the regulation to which the waiver pertained.

J. A w aiver will automatically terminate upon a change of ownership of the BHE, as defined in part 2.21 of this Chapter. However, to prevent such automatic termination, the prospective new owner may submit a waiver application to the BHA prior to the effective date of the change of ownership.

Provided the BHA receives the new application by this date, the waiver will be deemed to remain effective until such time as the BHA acts on the application.

1. Except as otherwise provided in this part 2.22, a waiver may not be granted for a term that exceeds the current license term.

2. If a BHE wishes to maintain a waiver beyond the stated term, it must submit a new waiver application to the BHA not less than ninety (90) calendar days prior to the expiration of the current term of the waiver or with a license renewal.

K. Notwithstanding anything in this part 2.22 to the contrary, the BHA may revoke a waiver if it determines that:

1. The waiver's continuation jeopardizes the health, safety, or welfare of individuals served by the BHE;

2. The waiver application contained false or misleading information;

3. The terms and conditions of the waiver have not been complied with;

4. T he conditions under which a waiver was granted no longer exist or have changed 5. A change in a federal or state statute or regulation prohibits, or is inconsistent with, the L. Notice of the revocation of a waiver must be provided to the BHE in accordance with the Colorado administrative procedures act, Section 24-4-101 through -109, C.R.S.

M. A BHE may appeal the decision of the BHA regarding a waiver application or revocation, as provided in the Colorado administrative procedures act, Section 24-4-101 through - 109, C.R.S. 2.23 Continuing Obligations and BHA Oversight A. Each BHE must have and maintain electronic business communication tools, including but not limited to, internet access and a valid e-mail address. The BHE must use these tools to receive B. The license is only valid while in the possession of the BHE to whom it is issued and may not be subject to sale, assignment, or other transfer, voluntary or involuntary, nor is a license valid for any premises other than those for which it was originally issued.

C. The BHE must provide accurate and truthful information to the BHA during inspections, investigations, and licensing activities.

D. When a BHE is subject to inspection, certification, or review by other agencies, accrediting organizations, or inspecting companies, the BHE shall provide and/or release to the BHA, upon request, any correspondence, reports, or recommendations concerning the BHE that were E. Each BHE must submit notification to the BHA of any change in the information required by part 2.18.D of this Chapter from what was contained in the last submitted license application.

1. Changes to the operation of the BHE may not be implemented without prior approval from the BHA. A BHE shall, at least thirty (30) calendar days in advance, submit notification to the BHA regarding any of the following proposed changes.

a. C hange in license category or classification.

b. Change in the scope of services, including the addition or removal of an endorsement, a service, or a physical location.

c. Change in legal name of the BHE and all other names used by it to provide F. The BHA and any duly authorized representatives thereof have the right to enter upon and into the premises of any licensed BHE or applicant for a BHE license in order to determine the state of compliance with the statutes and regulations and must initially identify themselves to the person in charge of the BHE at the time.

G. Licensure surveys and tiered inspections 1. For each BHE that is eligible, the BHA will either extend the standard licensure survey cycle up to three (3) years or utilize a tiered licensure inspection system.

2. To be eligible, the BHE must meet all the following criteria:

a. Licensed for at least three (3) years;

b. No conditions imposed on the license within three (3) years prior to the date of the survey;

c. No patterns of rule violations, which occurs when a BHE commits the same class of rule violation three or more times in consecutive inspections, as documented in the inspection and survey reports issued by the BHA within the three (3) years prior to the date of the inspection; and, d. No substantiated complaint resulting in the discovery of significant deficiencies that may negatively affect the life, health, or safety of individuals served by the BHE within the three (3) years prior to the date of the survey.

3. The BHA may expand the scope of a tiered inspection to an extended or full survey if the BHA finds rule violations during the tiered inspection process.

H. The BHA may use the following measures to ensure a BHE’s full compliance with the applicable statutory and regulatory criteria.

1. The BHA may conduct an unscheduled or unannounced review of a current BHE based upon, but not limited to, the following criteria:

a. Routine compliance inspection;

b. Reason exists to question the BHE’s continued fitness to conduct or maintain licensed operations;

c. A complaint alleging non-compliance with license requirements;

d. Discovery of previously undisclosed information regarding a BHE or any of its owners, officers, managers, or other personnel if such information affects or has the potential to affect the BHE’s provision of services; or e. The omission of relevant information from documents requested by the BHA or indication of false information submitted to the BHA.

2. P lan of action a. If after review or pursuant to a complaint, it is determined that a BHE is not in compliance with these rules, the BHE shall be notified in writing, within thirty (30) business days of the specific deficiency/deficiencies.

b. After any review, the BHA may request a plan of action from a BHE or require a BHE’s compliance with a BHA directed plan of action.

c. If the BHE does not agree with any or all the findings regarding non-compliance, the BHE has fourteen (14) business days from the receipt of non-compliance notice to dispute the findings by submitting evidence to the BHA.

d. The BHE shall receive a written response within thirty (30) business days of the review of submitted evidence.

e. If the submitted information is sufficient, the BHE shall be determined in f. If the BHE continues to be found out of compliance with these rules, the BHE shall have thirty (30) business days from the date of receipt of the review findings to submit a plan of action.

g. The plan of action must be in the format prescribed by the BHA and included, but not be limited to, the following:

(1) A d escription of how the BHE will correct each identified deficiency.

(a) If deficient practice was cited for specific personnel, the not reoccur for the affected individuals(s) and/or other individuals (2) A description of how the BHE will monitor the corrective action to ensure each deficiency is remedied and will not reoccur, and (3) A completion date that is no later than ninety (90) calendar days from the the BHA. The completion date is the date that the entity deems it can h. A completed plan of action must be:

(1) Signed by the BHE’s director, administrator, or manager, and (2) Submitted to the BHA within thirty (30) calendar days after the date of the BHA’s written notice of deficiencies.

(a) If an extension of time is needed to complete the plan of action, the BHE shall request an extension in writing from the BHA prior to the plan of action due date. The BHA may grant an extension of time.

i. The BHA has discretion to approve, impose, modify, or reject a plan of action.

(1) If the plan of action is accepted, the BHA shall notify the BHE by issuing a written notice of acceptance.

(2) If the plan of action is unacceptable, the BHA shall notify the BHE in writing, and the BHE shall re-submit the changes within the time frame prescribed by the BHA.

(3) If the BHE fails to comply with the requirements or deadlines for submission of a plan or fails to submit requested changes to the plan, the set forth in part 2.24 of this Chapter.

(4) If the BHE fails to implement the actions agreed to by the action date in the approved plan of action, the BHA may impose enforcement sanctions as set forth below.

I. The BHE must provide, upon request, access to or copies of the following to the BHA for the 1. Individual records.

2. Reports and information including but not limited to, staffing reports, census data, statistical information, and other records, as determined by the BHA.

J. Oversight and enforcement activities may include review of endorsements and/or separate physical locations as necessary for the BHA to ensure the health, safety, and welfare of 2.24 Enforcement and Adverse Actions 2.24.1 License, Designation, or Endorsement Denials A. The BHA may deny an application for an initial or renewal license, or an application for endorsement(s) for reasons including but not limited to, the following:

1. The BHE has not fully complied with all local, state, and federal laws and regulations applicable to that license category, endorsement, or classification;

2. The application or accompanying documents contain a false statement of material fact;

3. The BHE fails to respond to BHA requests for additional information in the time frame indicated in the request;

4. The BHE refuses any part of an inspection;

5. The BHE fails to comply with or successfully complete an acceptable plan of action;

6. The results of the background check reveal a felony or misdemeanor conviction of a crime of moral turpitude as described in part 2.18.D.11.b of this Chapter;

7. The BHE has failed to cooperate with the investigation of any local, state, or federal regulatory body or law enforcement agency; or 8. The BHE is not in compliance with regulatory requirements or has a documented pattern of non-compliance that has harmed or has the potential to harm the health or safety of the individual(s) served.

B. I f BHA denies an application for an initial or renewal license, it shall provide the BHE with a written notice by mail to the applicant at the address shown on the application. The notice must explain the basis for the denial and afford the BHE the opportunity to respond.

C. Appeals of licensure denials must be conducted in accordance with the State Administrative Procedure Act, Section 24-4-101 through -109, C.R.S. and 26-1-106, C.R.S. 2.24.2 Revocation or Suspension of a License, Designation, or Endorsement A. The BHA may limit, revoke, or suspend an existing license or endorsement if a BHE fails or refuses to comply with the statutory and/or regulatory requirements applicable to its license and endorsements associated with its license. The BHA may limit the overall BHE license, any endorsements or physical locations, or any combination thereof for failure or refusal to comply.

Failures to comply include, but are not limited to:

1. Making a false statement of material fact about individuals served by the BHE, its personnel, capacity, or other operational components verbally or in any public document or in a matter under investigation by the BHA or another governmental entity, 2. Preventing, interfering with, or attempting to impede in any way the work of a representative or agent of the BHA in investigating or enforcing the applicable statutes or regulations, 3. Falsely advertising or in any way misrepresenting the BHE’s ability to provide services for the individuals served based on its license type or status, 4. Failing to provide reports and documents required by regulation or statute in a timely and complete fashion, 5. Failing to comply with or complete a plan of action in the time or manner specified, 6. Falsifying records or documents, 7. Knowingly using or disseminating misleading, deceptive, or false information, 8. Accepting commissions, rebates, or other forms of remuneration for referrals or other treatment decisions, or 9. Exercising undue influence or coercion over an individual to obtain certain decisions or actions or for financial or personal gain. A relationship other than a professional relationship, including but not limited to a relationship of a sexual nature, between an owner, director, manager, administrator, or other personnel and an individual.

10. Noncompliance with the requirements of Sections 27-50-501 through 27-50-509, C.R.S. and any applicable regulations promulgated pursuant to those statutes.

B. The BHA may revoke or suspend an existing license if one or more individuals or entities identified in the response to part 2.18.D.3 of this Chapter has a controlling or ownership interest in the BHE and:

1. Has been the subject or party to any of the actions described in part 2.18.D.10.a:

2. H as a felony or misdemeanor conviction of a crime of moral turpitude as described in part 2.18.D.11.b of this Chapter.

C. Except in the case of a summary suspension in accordance with 24-4-104(4)(a), C.R.S., suspension or revocation must not occur until after a hearing and in compliance with the provisions and procedures specified in Section 24-4-101 through Section - 109, C.R.S. and

Section 27-50-505, C.R.S. 2.24.3 Conditional Licenses A. If a BHE is found to be out of compliance with applicable BHA, state, or federal law or regulations, the BHA may impose conditions upon a license prior to issuing an initial or renewal license or during an existing license term. If the BHA imposes conditions on a license, the BHE shall immediately comply with all conditions until and unless said conditions are overturned or stayed on appeal.

1. Imposition of conditions on a license does not constitute a modification to the license if the BHE agrees to the conditions. If an agreement is not reached, the BHE may appeal in accordance with part 2.24.5 of this Chapter, Section 24-4-101 through -109, and Section 27-50-505, C.R.S.

B. If conditions are imposed at the same time as an initial or renewal license, the BHE shall pay the applicable initial or renewal license fee plus the conditional fee equal to the amount of their initial or renewal license fee.

C. If conditions are imposed during the license term, the BHE shall pay the conditional fee and the conditions must run concurrently with the existing license term.

D. If the conditions are renewed in whole or in part for the next license term, the BHE shall pay the applicable renewal fee along with the conditional fee in effect at the time of renewal.

E. If the BHA imposes conditions of continuing duration that require only minimal administrative oversight, it may waive the conditional fee after the BHE has complied with the conditions for a full license term.

F. If a BHE holds a conditional license, it shall post a clearly legible copy of the license conditions in a conspicuous public place in the BHE. 2.24.4 Intermediate Restrictions A. The BHA may impose the following intermediate restrictions or conditions on a BHE in accordance with Section 27-50-505 (3), C.R.S.:

1. Retaining a consultant to address corrective measures including deficient practice resulting from systemic failure;

2. Monitoring by the BHA for a specific period;

3. Providing additional training to employees, owners, or operators of the BHE;

4. Complying with a directed written plan to correct the violation; or 5. Paying a civil fine not to exceed two thousand dollars ($2,000) in a calendar year. The assessment of these fines shall follow the procedures set forth in Section 26.5.-5-323, B. T he BHE may appeal any intermediate restriction or condition to the BHA in accordance with the Colorado Administrative Procedures Act Section 24-4-101 through -109, C.R.S. 2.24.5 Right to Appeal A. Any BHE adversely affected or aggrieved by the BHA’s decisions in regard to implementation of these rules, has the right to appeal to the Colorado Department of Personnel and Administration, Office of Administrative Courts, and may subsequently seek judicial review of the BHA’s action in accordance with Section 24-4-101 through -109, C.R.S.

B. The following actions may be submitted to an administrative law judge for an evidentiary hearing: denial of a license, designation, or endorsement; denial of a renewal; provisional license; conditional license; revocation; denial of a waiver; limitation of a license, denial of a modification; and imposition of an intermediate restriction or condition.

C. After written notification from the BHA of intended action, the BHE has twenty-one (21) calendar days to submit a written appeal. The appeal must be received by the BHA within twenty-one (21) days from the date the written notification of action letter was sent by the BHA.

D. In all cases except waiver denials, the BHA will file a notice of charges with the office of administrative courts to begin the administrative process. In waiver denials, if the applicant for the waiver requests an appeal, the request for appeal must be forwarded to the office of administrative courts. Once the appellant’s request is forwarded to the office of administrative courts, the BHA may file a notice of charges.

E. Subsequent to an evidentiary hearing at the office of the administrative courts and the issuance of a final agency decision, a party may seek to appeal the final agency decision through judicial 2.25 BHE Closure A. Each license issued by the BHA will become invalid if the BHE fails to timely renew the license, ceases operation, or there is final BHA action suspending or revoking the license. The license must be returned to the BHA within ten (10) calendar days of the event that invalidated it. 2.25.1 Emergency Closures A. In the event of an emergency affecting the physical space of the BHE that necessitates the removal of individuals and personnel from the BHE, a BHE shall provide the BHA with verbal notice of the event at the time of removal and a written report within fourteen (14) calendar days after the removal explaining the emergent situation and the actions taken by the BHE to provide services that meet the health and safety needs of the individuals. Based on the extenuating circumstances, the BHA may approve the continuation of the license during the time period that it takes to make the physical space appropriate for individuals and personnel to return.

2.25.2 P ermanent Closures A. Each BHE that surrenders its license shall accomplish the following with regard to any individual records that the entity is legally obligated to maintain:

1. Within ten (10) calendar days prior to closure, inform the BHA in writing of the specific plan for storage and retrieval of individual records;

2. Unless noted otherwise within an endorsement Chapter, within ten (10) calendar days of closure, inform all individuals or designated representatives thereof, in writing, how and where to obtain their individual records; and 3. Provide secure storage for any remaining individual records.

B. In the event of a BHE closure, the BHE shall be responsible for appropriate continuity of care for each individual served by the BHE. 2.26 Residential and Overnight Standards A. A BHE providing residential and/or overnight services as defined in part 2.3.A.4 of this Chapter shall meet the standards in this part 2.26.

B. Each physical location in which residential and/or overnight services are provided must meet the following personnel requirements:

1. Each physical location must have appropriate oversight personnel, such as an administrator and/or clinical director, or personnel delegated those same responsibilities, available twenty-four (24) hours per day, seven (7) days per week.

a. O versight personnel when the administrator and/or clinical director are not physically on-site must be in accordance with policies as required at part 2.2.4.A.6 of this Chapter.

2. Each physical location must have at least one person trained in cardio-pulmonary resuscitation (CPR) and first aid on-site and on-duty at all times when individuals are present.

C. Personnel providing services under the residential/overnight endorsement shall be trained in the 1. The recognition and response to common side effects of medications used for behavioral 2. Behavior management and de-escalation techniques, including incidents involving harm 3. Behavioral health and medical emergency response training, consistent with emergency services policies required in parts 2.9.D and 2.9.E of this Chapter.

4. Personnel preparing or serving food shall complete food safety training. At a minimum, this must include that personnel overseeing dietary services shall have knowledge of foodborne disease prevention, including, but not limited to, hygienic practices and food safety techniques pertaining to preparation, food storage, and dishwashing.

D. The BHE shall have policies and procedures specific to the residential/overnight endorsement, services, or physical location, as applicable, including, but not limited to:

1. Policies and procedures to be followed in the event of serious illness, injury, or death of an individual during their stay, including, but not limited to:

a. C riteria for when an individual's injury or illness warrants medical treatment or an in-person medical evaluation.

b. Requirements for notifying the individual’s emergency contact, including immediate notification in the case of an emergency room visit or unscheduled c. Reporting procedures within the BHE.

2. BHEs that provide overnight/residential services shall maintain enough food and water on hand to provide all individuals with three (3) nutritionally balanced meals for four (4) days.

3. Written policies and procedures for the management of individuals’ personal funds and property, including, but not limited to:

a. An inventory of all the individual’s personal belongings must be conducted upon admission, and documented by at least two (2) individuals, one of which must be the individual when the individual is capable and willing to document the inventory. Such inventory must be maintained in the individual record.

b. All inventoried property must be returned to the individual upon discharge, and such return must be documented by at least two (2) individuals, one of which must be the individual when the individual is capable and willing to document the inventory. Such documentation must be included in the individual record.

4. I nfection control policies to address risks associated with housekeeping, dietary services, and linen and laundry services, in addition to the requirements at part 2.4.E of this a. Policies for linen and laundry services must include:

(1) Procedures for preventing contamination between soiled linen and clean linen through either the use of gloves or hand washing.

(2) Procedures for soiled linen to be stored separately from clean linen, in separate enclosed areas.

b. Dietary services must be provided using methods that conform to state or local food safety standards, including, at a minimum:

(1) Food must be prepared, handled, and stored in a sanitary manner, so that it is free from spoilage and/or contamination, and must be safe for human consumption.

(2) Reusable equipment, dishes, cutlery, and other wares used for the preparation, serving, or storage of food must be washed in a safe and sanitary manner, and, in the case of dishwashing machines, in accordance with manufacturer’s instructions.

5. The provision of linen and laundry services, including, but not limited to:

a. Individuals must have access to laundry services for personal clothing, which may be provided through the use of personal laundry facilities, a centralized laundry service, or may be contracted for with an outside provider.

b. A requirement to maintain a sufficient supply of clean linen, including sheets and towels.

6. T he provision of dietary services, including but not limited to:

a. The BHE must ensure enough food and water on hand to provide all individuals with three (3) nutritionally balanced meals for four (4) days.

b. A BHE responsible for providing meals to individuals must:

(1) Provide at least three meals daily, at regular times comparable to normal mealtimes in the community, or in accordance with individual needs, preferences, and plans of care.

(a) Nourishing meal substitutes and between-meal snacks must be provided, in accordance with plans of care, to individuals who want to eat at non-traditional times or outside of scheduled meal service times.

(b) Meals must include a variety of foods, be nutritionally balanced, and sufficient in amount to satisfy appetites of individuals.

(c) Appealing substitutes of similar nutritive value must be available for individuals who choose not to eat food that is initially served or who request an alternative meal.

(2) Offer drinks, including water and other liquids, to individuals with every meal and between meals throughout the day.

(3) Ensure that individuals have independent access to water at all times.

7. If the population served includes individuals assessed to be at risk of imminent harm to self or others, the BHE shall require safety checks be conducted at least every fifteen (15) minutes and at every shift change to identify and remedy hazards and shall maintain documentation of such checks.

8. The type of first aid equipment maintained by the BHE, including a requirement that such equipment be maintained in a readily accessible location, at each physical location providing services under the residential and/or overnight endorsement. First aid equipment must include, but not be limited to, an automated external defibrillator (AED).

a. First aid supplies and equipment must be kept unexpired and in a reliable condition.

9. Smoking policies applicable to individuals, including, but not limited to any prohibitions on smoking, designated areas for smoking, and methods/substances allowed under any smoking policy, such as tobacco, electronic cigarettes, vaporizers, etc.

E. The BHE must ensure there is a minimum of one (1) full bathroom for every six (6) individuals, including a toilet, sink, toilet paper dispenser, mirror, tub and/or shower, and towel rack.

F. B athrooms must be equipped with soap dispensers, or the BHE shall have a procedure in place that prevents individuals from sharing soap.

G. The BHE shall ensure that individuals have access to basic hygiene supplies.

H. In addition to the requirements of part 2.4 of this Chapter, each BHE’s emergency policies must address:

1. When to evacuate the premises, when to shelter in place, and the procedures for doing so;

2. A predetermined means of communicating with individuals, families, staff and other providers;

3. A plan that ensures the availability of, or access to, emergency power for essential functions and all individual required medical devices or auxiliary aids or services;

4. Storage and preservation of medications; and 5. In the event relocation of individuals becomes necessary, written agreements with other health facilities and/or community agencies.

I. The BHE shall have readily available a roster of current individuals, their room assignments and emergency contact information, along with a facility diagram showing room locations.

J. Hot water must not measure more than 120 degrees Fahrenheit at taps which are accessible by K. A BHE serving both adults and children must ensure management of the living space assignments includes physical barriers and personnel oversight of activities to ensure safety. This management must include, but is not limited to:

1. P hysical barriers, such as doors or walls;

2. Personnel stations that separate living space assignments;

3. Other practical arrangements that support the safe management of the individuals 2.27 Fentanyl and Other Opioid Use Disorder Education and Treatment 2.27.1 Statutory Authority and Applicability A. Authority to approve BHEs to provide treatment of substance use disorders, including fentanyl and other opioid use disorders, is provided by Section 18-1.3-401 and 18-1.3-501, C.R.S.

B. BHEs providing services for the treatment of substance use disorders including fentanyl and other opioid use disorders must exist across all endorsed service types. For this reason, all BHEs shall comply with this part 2.27. In addition to this part 2.27, BHEs shall comply with provisions of the applicable endorsed services, as noted below:

1. BHEs providing outpatient and high-intensity outpatient services shall comply with parts 4.3, 4.6, and/or 4.7 of these rules.

2. BHEs providing residential services shall comply with parts 5.1 through 5.4 of these rules and the applicable sub-endorsement(s) of residential services (parts 5.6, 5.8, 5.10, and 5.11 of these rules).

3. BHEs providing withdrawal management services shall comply with parts 4.5, 4.8, 5.1, 5.2, 5.3, 5.7, and 5.12 of these rules.

2.27.2 P lacement in Services A. Individuals receiving fentanyl and other opioid use disorder treatment must be assessed and referred into education and/or treatment by a supervising entity as a condition of probation or parole. The BHE is expected to evaluate whether the supervising entity’s recommendation matches the individual’s assessed clinical need(s). The BHE is expected to address any differences identified with the supervising entity directly and document results in the individual’s B. BHEs shall include a copy of the referral paperwork, demonstrating placement in the fentanyl or other opioid-specific treatment services as required by the supervising entity, in the individual’s C. If a BHE is unable to obtain a copy of the court order and/or written documentation of supervising entity’s recommendation for education and/or treatment, there must be documentation of attempt(s) to obtain the paperwork from the referral source.

D. Individuals receiving fentanyl and other opioid use disorder treatment are expected to complete the required fentanyl education program as part of that process. The BHE must verify that the individual completes this requirement when it is clinically appropriate for the individual, prior to discharging from services. Documentation of this must be kept in the individual’s record.

2.27.3 S upport Systems A. The BHE shall be capable of delivering all necessary medication for opioid use disorder (MOUD) services that are clinically indicated for the individual under applicable law. These services may be provided through direct service provision or active collaboration with other agencies that are able to provide MOUD services.

B. Opioid antagonists 1. Opioid antagonists must:

a. Be discussed and provided upon individual request at the initial assessment.

b. Documentation shall be reflected in the individual record response from individual and if dosages were provided for the individual to keep on their person.

2. BHEs shall:

a. Ensure that opioid antagonists are available on-site at all times, b. Ensure that opioid antagonists are made available to all individuals being served to keep on their person. This may be achieved through providing access to the opioid antagonist directly, or through coordination with another resource;

c. Make reasonable documented attempts and to ensure that all individuals receiving treatment know how to administer the opioid antagonist in case of emergency, and, d. Promote or directly provide information to the individual’s referred support system to allow for the administration of opioid antagonists. 2.27.4 Personnel Training and Competencies A. All personnel interacting with individuals receiving fentanyl and other opioid-specific services shall be trained in the following:

1. Proper use of opioid antagonists, and 2. Recognition and response to signs and symptoms of drug overdose.

B. Additionally, all personnel providing treatment and peer support professionals interacting with individuals receiving fentanyl and other opioid-specific services shall be trained and demonstrate competency in the following topics:

1. S ubstances of misuse and dependence including, but not limited to alcohol, tobacco, and other drugs, and polysubstance abuse;

2. Pharmacology of the medications for opioid use disorder (MOUD), including but not limited to loss of tolerance to opioids, dangerous drug or alcohol interactions with the MOUD, and purpose of the medication’s use;

3. Culturally and linguistically appropriate services, awareness, and responsiveness to current misuse trends for opioid-involved individuals; and 4. Harm-reduction and trauma-informed practices in the treatment of opioid use disorder. 2.27.5 Collaboration and Termination of Court-Ordered Services A. With written permission from individuals who are required to attend services as a condition of probation, agencies shall communicate regular updates to the referring supervising entity for the portion of the treatment episode in which fentanyl and other opioid-specific services are determined to be clinically necessary. This determination of clinical necessity must be made by:

1. A licensee;

2. A candidate;

3. An authorized practitioner; or 4. A certified addiction specialist (CAS).

B. Individuals that no longer meet clinical necessity for fentanyl or other opioid-specific treatment as a condition of probation, pursuant to Section 18-1.3-510(3)(a), C.R.S., but may benefit from aftercare or continued services to address other relevant behavioral health needs may remain in treatment. The BHE is not required to communicate further progress updates to the referring supervising entity unless the individual requests and consents to this communication.

Chapter 3: Behavioral Health Recovery Supports 3.1 Authority and Applicability A. Chapter 3 establishes the standards that BHEs must follow when electing to provide mental health and substance use recovery supports as part of a recovery supports endorsement. The

authority to promulgate these service-specific requirements that apply to BHEs electing to provide this service comes from Sections 27-50-107(3) and 27-50-502(1), C.R.S.

B. All agencies providing recovery support services rendered by peer support professionals shall meet the standards in this Chapter. If the agency requires a BHE license, the agency must comply with Chapter 2.

C. This Chapter does not apply to licensed recovery support services organizations. Regulations for licensed recovery support services organizations are found in Section 21.600.

3.2 S ervice Provision A. Recovery support services include a variety of recovery-focused services and supports for individuals with a behavioral health disorder and/or who are in recovery from a behavioral health disorder. These services are rendered by peer support professionals. These services must include engaging individuals in peer-to-peer relationships that support healing, personal growth, life skills development, self-care, and crisis strategy development to help achieve recovery, wellness, and life goals. These services include:

1. Peer support professional-run drop in centers;

2. Recovery and wellness centers;

3. Employment services;

4. Prevention and early intervention activities;

5. Peer support professional mentoring for children and youth;

6. Warm lines, as defined in Chapter 1 of these rules;

7. Advocacy services;

8. Recovery coaching;

9. Peer support professional-led support groups;

10. Navigating services (resources);

11. Recovery planning services; and 12. Other activities supporting the recovery experience of an individual.

B. A peer support professional may provide services in a variety of settings, if permitted access, that may include but are not limited to:

1. Court-affiliated settings, such as the Department of Corrections, county jails, or community correctional placements;

2. Physical health settings, such as primary care physician offices;

3. Emergency departments;

4. Audio-visual or audio-only telehealth;

5. Agencies serving homeless communities;

6. Peer respite homes;

7. School-based health centers;

8. Home and community-based settings, including salons and other gathering places; and 9. Brick and mortar recovery community organizations, including faith based organizations.

C. Agencies endorsed pursuant to this Chapter 3 must ensure peer support professionals are not required to provide services that compromise the dynamic of a peer-to-peer relationship or that are outside the scope of providing recovery-focused services. Activities that are outside of the scope of a peer support professional include, but are not limited to:

1. P erforming clinical/diagnostic assessments, service planning, or treatment; and 2. Drug and/or alcohol testing, monitoring, and/or collection of toxicology samples.

D. Agencies endorsed pursuant to this Chapter 3 must submit job descriptions of all peer support professional positions in accordance with part 2.6.E of these rules.

E. Peer support professionals must provide individuals with a written disclosure at the time of first contact that includes 1. Their full name;

2. Their contact information;

3. Their qualifications;

4. Their role in work with the individual;

5. Their supervisor's name;

6. Their supervisor's contact information; and 7. The name of the agency that employs the peer support professional. 3.3 Personnel Qualifications and Training A. Peer support professionals providing peer recovery support services must hold a professional peer support certification credential or have successfully completed formal training that covers all content areas outlined in “ core competencies for peer workers in behavioral health services - 2018” (December 13, 2018), established by United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), which is incorporated herein by reference and does not include any later amendments or editions. These standards are available at no cost at https://www.samhsa.gov/ and are also available for public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, B. Training or proof of certification must be documented in personnel files.

C. For peer support professionals with a certification credential, the certification credential must include the following requirements:

1. At least sixty (60) hours of training, including training covering all content areas in “ core competencies for peer workers in behavioral health services – 2018” established by United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), incorporated by reference in subsection A, above;

2. At l east 200 hours of experience as a peer support professional; and 3. Passing a certification exam.

D. Peer support professionals with a certification credential must be in good standing with their certifying body, including compliance with the certifying body’s code of ethics. 3.4 Supervision A. Peer support professionals must be supervised on at least a monthly basis for at least an hour by a licensee or authorized practitioner in good standing with their credentialing body and/or an experienced peer support professional who meets the criteria set forth in Section 3.3 of this

Chapter. Supervisors shall document supervision date, time, duration, and topics discussed.

B. Supervisors of peer support professionals must demonstrate to the BHA that they have received training in 1. The provision of peer support services;

2. The supervision of peer support professionals; and 3. The role of peer support professionals.

C. Supervision of a peer support professional may include co-reflective supervision strategies in which supervisors and supervisees engage in a relationship of mutual learning. 3.5 Documentation Requirements A. Agencies endorsed to provide recovery supports must maintain records of the services provided to individuals by peer support professionals. These records shall include at a minimum the date, time, and duration of the service.

Chapter 4: Behavioral Health Outpatient and High Intensity Outpatient Services 4.1 Authority and Applicability A. Chapter 4 establishes the standards for and applies to agencies electing to provide mental health and substance use outpatient services and high-intensity outpatient services. The authority to promulgate these service-specific requirements that apply to BHEs electing to provide this service comes from Sections 27-50-502(1), 27-50-106, 27-50-301(5), and 27-50-107(3)(b), C.R.S.

B. These rules apply to and are established to create standards for agencies seeking subendorsements to provide behavioral health outpatient services, which includes early intervention, outpatient, intensive outpatient, partial hospitalization, and ambulatory withdrawal management services. Agencies may also choose to provide optional sub-endorsements of minor in possession services, in conjunction with the correlated sub-endorsements in this Chapter. 4.2 Ea rly Intervention Services Standards A. These rules are established to create standards for agencies seeking sub-endorsements to provide early intervention, which includes ASAM Criteria Level 0.5 type services.

B. Agencies providing early intervention services must meet the standards in part 4.2 of these rules. 4.2.1 Service Delivery and Setting A. Early intervention services are generally intended for individuals who are not appropriate for more intensive levels of care, are sufficiently stabilized to complete early intervention services prior to moving to a different level of care, are attending education-only services, or are being screened in a stabilization setting and are provided referrals for appropriate level of care once stabilized.

B. Early intervention services are appropriate for individuals with mental health, substance use, and co-occurring disorders that are of low severity, or are of moderate to high severity, as defined by the DSM-5-TR, but have been stabilized and are awaiting entry into a higher level of care.

C. All services provided must be adapted to the individual’s developmental stage, physical, cultural, D. Early intervention services may be delivered via telehealth in accordance with the standards set in part 2.9 of these rules.

E. If early intervention services are related to court-ordered DUI/DWAI requirements, services must comply with parts 10.1 through 10.9 of these rules, including telehealth provisions.

F. Treatment groups must not exceed twelve (12) individuals receiving services. 4.2.2 Personnel A. The agency must ensure early intervention services are provided by personnel meeting the qualifications in parts 1.3 and 2.5 of these rules.

B. Agencies providing early intervention services must ensure treatment personnel have supervisor consultation within twenty-four (24) hours via in-person or telephone to discuss, at minimum, psychiatric or medical concerns of individuals receiving services as necessary.

1. Personnel must have supervisor consultation available within one (1) hour via in-person or by telehealth to discuss, when warranted crisis and/or emergency situations. 4.2.3 Service Provisions A. Duration of early intervention services may vary dependent upon individual needs.

B. Early intervention services must be provided in accordance with individual screening information as defined in part 2.12.1 of these rules, or the court ordered education requirements for education-only individuals.

1. Continued screening will be conducted when symptomology and risk factors for a diagnosis of mental health, substance use, and/or co-occurring disorder(s), as defined by the DSM-5-TR, are identified by personnel. Referral(s) to match screened treatment needs will be provided to the individual and documented pursuant to part 4.2.4 of these 2. Referral(s) will be provided in collaboration with the individual.

C. E arly intervention services may include brief therapeutic interventions of individual, group, or family counseling, peer support services, medication/psychiatric-only services, follow-up services, and/or regulated education groups mandated to the individual by a supervising entity.

1. An individual is classified as receiving medication/psychiatric - only services when the agency provides a maximum of three (3) services, in addition to services related to medications, within a six (6) month period of time. 4.2.4 Documentation and Timeliness A. Early intervention agencies must complete appropriate screening in accordance with screening guidelines in part 2.12.1 of these rules upon intake of individual into services.

1. Other screening may be used in addition for program and/or individual specific needs.

B. Agencies must complete the screening requirements within two (2) calendar days.

C. Early intervention level services are exempt from assessment and service plan expectations of parts 2.12.2, 2.12.3 and 2.13.1 of these rules, unless the individual attending services is moved to a higher level of care within the same agency.

D. Progress notes must be completed for each early intervention session. Progress notes must be completed to standards identified in part 2.13.2 of these rules, and at a minimum frequency of one (1) note per session.

E. R eferrals to other services must be documented in the individual’s file including:

1. Recommendations of care;

2. Reason for discharge;

3. Recommended programs for individual to enroll in; and 4. Follow-up plan including care coordination and documentation needs.

F. If providing medication/psychiatric-only services, a licensee or authorized practitioner shall complete and document in the individual record at least annually:

1. Clinical rationale supporting a medication/psychiatric-only service status;

2. An updated assessment; and 3. An updated service plan. 4.3 Outpatient Services Standards A. These rules are established to create standards for agencies seeking a sub-endorsement to provide outpatient services, which includes ASAM Criteria Level 1.0 type services.

B. All agencies providing behavioral health outpatient treatment services must meet the standards in this part 4.3. 4.3.1 Service delivery and setting A. Outpatient services are generally intended for individuals who are assessed as not appropriate for more intensive levels of care. Outpatient services may also be a step-down from a higher level of care or offered when an individual is in early stages of change and declines participation in the higher level of care indicated by the assessment.

B. Outpatient services are appropriate for individuals diagnosed with mental health, substancerelated, and co-occurring disorders if the mental health disorders are of moderate severity, or are of high severity, as defined by the DSM-5-TR, but have been stabilized.

C. Al l services provided must be adapted to the individual’s developmental stage, physical, cultural, D. Outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with part 2.9 of these rules.

E. Treatment groups must not exceed twelve (12) individuals receiving services. 4.3.2 Personnel A. Treatment personnel, for the purpose of outpatient services, unless otherwise noted, means the following behavioral health professionals trained in mental health and/or substance use disorder identification and treatment and acting within their scope of practice:

1. Authorized practitioners;

2. Licensees;

3. Certified addiction specialists (CAS);

4. Candidates;

5. Certified addiction technicians (CAT); and a. If utilizing certified addiction technicians (CAT), the agency must ensure that 6. Counselors-in-training and/or interns.

a. If utilizing counselors-in-training and/or interns, the agency must ensure that all able to supervise pursuant to their scope of practice. Counselor-in-training and/or B. Outpatient services may include recovery support services rendered by peer support professionals in accordance with Chapter 3 of these rules.

C. Agencies providing outpatient services must ensure treatment personnel have supervisor consultation available within twenty-four (24) hours via in-person or by telehealth to discuss, when warranted, psychiatric or medical concerns of individuals receiving services.

1. Personnel must have supervisor consultation available within one (1) hour via in-person or telehealth to discuss, when warranted crisis and/or emergency situations. 4.3.3 Service Provisions A. Outpatient services must be conducted in regularly scheduled sessions of no more than eight (8) treatment contact hours per week for adults, and no more than five (5) treatment contact hours per week for children.

1. T reatment contact hours does not include pro-social activities.

2. Treatment contact hours may include medication/psychiatric-only services pursuant to this part 4.3.3.

B. Outpatient treatment services must be provided in accordance with the individual’s service plan.

C. When referral(s) are needed to best meet the individual assessed needs, referral(s) must be provided in collaboration with the individual and their choice(s) for referred services.

D. Medication/psychiatric-only services may be provided when:

1. An individual is classified as receiving medication/psychiatric - only services when the agency provides a maximum of three (3) services, in addition to services related to medications, within a six (6) month period of time. 4.3.4 Documentation and Timeliness A. Outpatient service documentation must follow the provisions set forth in parts 2.10, 2.11, 2.12, and 2.13 of these rules.

B. Upon intake into services, preliminary screening and risk assessment must be completed in compliance with part 2.12.1 of these rules.

C. As soon as is practicable upon admission, but no later than ten (10) calendar days from the date of preliminary screening and risk assessment, the agency must complete an initial assessment in accordance with part 2.12.2 of these rules.

1. If the screening and risk assessment identifies an urgent clinical need, clinical services must be provided, and the initial assessment must be completed within one (1) calendar day of preliminary screening.

D. As soon as is practicable upon admission, but no later than sixty (60) calendar days from the first date of services, the agency must complete a comprehensive assessment in accordance with

part 2.12.3 of these rules. Completion of the comprehensive assessment does not preclude the initiation of services.

E. The individual service plan must be created, in accordance with part 2.13.1 of these rules, within fourteen (14) calendar days after the initial assessment. The service plan must be updated to reflect information from the comprehensive assessment. The agency must update the service plan throughout the course of treatment, review previous goals, and update those goals whenever there is a change in the individual's level of care or functioning, and must occur, at minimum, every six (6) months.

F. O utpatient treatment services must be documented in the individual’s record in accordance with

part 2.13.2 of these rules, and at a minimum frequency of one (1) note per session.

G. If providing medication/psychiatric-only services, a licensee or authorized practitioner shall complete and document in the individual record at least every six (6) months:

1. Clinical rationale supporting a medication/psychiatric-only service status;

2. An updated assessment; and 3. An updated service plan. 4.4 Minor in Possession (MIP): Education and Treatment Services Standards 4.4.1 MIP General Provisions A. Agencies providing Minor in Possession education and treatment must comply with this part 4.4.

B. If providing MIP treatment to individuals under eighteen (18) years of age, agencies must receive the Children and Family endorsement and follow the standards of care in Chapter 8 of these C. Agencies must not place an individual with a MIP citation in DUI/DWAI education or therapy groups unless the youth also has a DUI/DWAI offense.

D. All agency education and treatment personnel must have documented training, supervision and experience in youth development and prevention, intervention, and treatment approaches.

E. Individuals that are sixteen (16) years of age and under must be treated in separate groups than those treating individuals seventeen (17) to twenty (20) years old.

F. A gencies must conduct ongoing assessment of progress in education and/or treatment level of care to determine if individuals are in the appropriate service level. 4.4.2 MIP: First Offense Education and Early Intervention A. MIP education is for individuals who have received their first MIP citation and must be conducted in an outpatient setting and comply with early intervention procedures in part 4.2 of these rules.

B. MIP education must be at least eight (8) hours, completed over no less than a two (2) day period with no more than four (4) hours of education per day.

C. Education topics must include:

1. Current legal consequences for additional MIP citations;

2. Resources or referrals for treatment level services, when indicated;

3. Developmental impact of early onset substance use and subsequent impact on the developing brain;

4. Physiological effect of alcohol and other drug use;

5. Refusal skills; and 6. Avoidance of high-risk situations.

D. For children, agencies must include and document a minimum of two (2) hours of parental or legal guardian involvement, unless contraindicated, and document the determination to not include parental or guardian involvement and reasoning for this determination. 4.4.3 MIP: Second and Subsequent Offense Outpatient Treatment A. In addition to the provisions outlined in this part 4.4.3, agencies providing MIP outpatient treatment must also comply with part 4.3.

B. S econd offense MIP therapy must be conducted in an outpatient setting, must be a minimum of twelve (12) hours in duration over eight (8) weeks, and must not exceed ninety (90) minute sessions, excluding breaks and administrative procedures.

C. Agencies must complete an individualized service plan, with each individual in accordance with parts 2.13.1 and 8.5 of these rules.

D. For children, agencies must include and document a minimum of four (4) hours of parental or legal guardian involvement, unless contraindicated, and document the determination to not include parental or guardian involvement and reasoning for this determination.

E. For third and subsequent minor in possession offenses, agencies shall conduct a comprehensive assessment to determine substance use disorder treatment needs of the individual.

F. Third and subsequent MIP outpatient treatment must be conducted at a minimum of twenty (20) hours of substance use disorder treatment over a minimum thirteen (13) week period, as determined by the assessment. Groups must not exceed ninety (90) minutes in duration.

G. Additional assessed service offerings and referral(s) must be offered to meet the needs of the individual and family members, when determined by the assessment. 4.5 Level 1-Withdrawal Management (Level 1-WM): Ambulatory Withdrawal Management Without Extended On-Site Monitoring Standards A. This part 4.5 is established to create standards for agencies seeking a sub-endorsement to provide outpatient Level 1-Withdrawal Management (Level 1-WM) services in accordance with

Chapter 6 of the ASAM Criteria.

B. Agencies providing Level 1-WM services must meet the standards in this part 4.5. Agencies providing Level 1-WM services may:

1. Also engage in outpatient behavioral health treatment services by meeting the standards for the outpatient sub-endorsement(s) selected by the agency, or 2. Provide only Level 1-WM services and coordinate with other providers for ongoing and concurrent outpatient behavioral health treatment services. 4.5.1 Service delivery and setting A. Level 1-WM is an outpatient withdrawal management service that complements individualized behavioral health treatment services.

B. Individuals may participate in Level 1-WM for a period of time in which it is determined to be medically appropriate. Admission to Level 1-WM services must not hinder the individual’s ability to participate in concurrent behavioral health services. This includes the potential process of admitting to, and discharging from, such withdrawal management services one (1) or more times by the individual.

C. Lev el 1-WM services are generally provided in a clinical or addiction-focused treatment office, medical health care facility, or home health care-type agency.

D. Level 1-WM services offered by agencies that do not provide behavioral health services within their agency structure must be affiliated with agencies or other behavioral health providers as needed to ensure the treatment needs of all individuals served can be met. Documentation of this affiliation must be presented to the BHA, upon request. Referral(s) will be provided in collaboration with the individual and their choice(s) for referred services.

E. Support systems 1. Agencies must:

a. Have the ability to obtain a comprehensive medical history and physical examination at the time of admission to Level 1-WM services;

b. Have twenty-four (24)-hour access to emergency medical consultation services, should services become indicated;

c. Have the ability to provide or assist in accessing transportation services for individuals who lack safe transportation; and d. Have the ability to coordinate services with behavioral health personnel, within the agency or through referral.

F. Diagnostic criteria 1. Individuals participating in Level 1-WM services typically exhibit a mild to moderate withdrawal severity rating on standardized withdrawal severity scales as well as mild/stable psychiatric symptoms for emotional, behavioral, and cognitive conditions.

2. Individuals may also present with a higher withdrawal severity rating on standardized withdrawal severity scales, with protective factors and other support system(s) in place to safely participate in this level of outpatient care.

3. Due to the safety concerns inherent with withdrawal, the following may not be appropriate for Level 1-WM services:

a. Individuals who are experiencing withdrawal from more than one class of substance.

b. Individuals with recent complicated withdrawal symptoms as identified by ASAM Criteria.

c. If the medical personnel determines that an individual meeting one or both of the above criteria can be safely and effectively served in a Level 1-WM setting, the rationale and plan for safe management and services must be documented in the G. Individuals may be more advanced in their readiness to change and need minimal assistance with transportation and other engagement barriers.

H. Individuals may participate in Level 1-WM services without a formal substance use disorder diagnosis if collateral information indicates a high probability of such diagnosis. The agency must ensure further evaluation of this probable diagnosis, either completed within the agency or through referral to a behavioral health provider.

I. A gencies must:

1. Provide safe management and documentation of signs and symptoms of intoxication and withdrawal; and 2. Ensure that discharge planning begins at the time of admission to Level 1-WM services, to allow for necessary care coordination and transition into ongoing or concurrent treatment services to occur successfully based on screening or assessment of needs. 4.5.2 Personnel A. Level 1-WM services are primarily provided by medical professionals who are acting within the scope of their practice and are trained in assessing and managing intoxication and states of withdrawal. This may include, but is not limited to, authorized practitioners. 4.5.3 Service Provisions A. Agencies must develop policies and procedures to address service delivery expectations. These 1. Consultation with specialized clinical and medical professionals for individualized Level 1- WM care;

2. Coordinating an individual’s transition into other levels of care, determined to be completed during their Level 1-WM services. This may include collaboration with emergency behavioral health services, such as Colorado Crisis Services, as appropriate;

3. Conducting or arranging for laboratory and/or toxicology tests to be completed;

4. Responding to individuals who are assessed as being a current threat to themselves or others, including the appropriate use of law enforcement;

5. Communication with intoxicated individuals leaving Level 1-WM services against personnel recommendations, including the use of emergency commitments; and 6. Circumstances under which individuals may be discharged from Level 1-WM services, other than completing withdrawal management or leaving against personnel B. Admission procedures for Level 1-WM services must include at a minimum:

1. Collecting of information regarding the degree of alcohol and/or other drug intoxication as evidenced by breathalyzer, urinalysis, self-report, observation or other evidence-based or best practices;

2. A pregnancy screening for pregnancy-capable individuals;

3. Taking of vital signs; and 4. Administration of a validated clinical withdrawal assessment tool.

C. Therapies offered by the agency must include a range of treatment approaches and support services based on the screening or assessment of the individual’s treatment needs. Treatment services may include but are not limited to:

1. S creening;

2. Assessment;

3. Group and individual counseling;

4. Motivational enhancement;

5. Family therapy;

6. Educational groups;

7. Occupational and recreational therapy;

8. Addiction pharmacology;

9. Mental health and physical health pharmacology, as needed;

10. Medication management;

11. Peer, social and recovery support;

12. Care coordination; and 13. Support for the development of life skills.

D. If the agency does not provide a treatment approach or support service necessary to meet the individual’s treatment needs, the agency must ensure that care coordination occurs.

E. Agencies must provide additional service planning for managing individuals with medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place individuals at additional risk during withdrawal management.

F. Agencies must provide assessments of individual readiness for treatment and services based on the service plan and the assessments and interventions shall be documented in the individual’s G. Medication-assisted treatment (MAT) for withdrawal management 1. Agencies must continue individuals on their medication-assisted treatment regimen and will only remove individuals from medications treating opioid use disorders at the individual’s request or if it is deemed medically appropriate by an authorized practitioner.

2. Agencies must inform individuals receiving services about access to medication-assisted treatment. Upon the individual’s consent, the agency must provide medication-assisted 3. Agencies must obtain a controlled substance license pursuant to section 21.300 of 2 CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled substance from stock medication in order to treat a substance use disorder or to treat the a. A c ontrolled substance license is not required if the agency intends to provide 4.5.4 Documentation and Timeliness A. Upon admission to Level 1-WM services, the agency must complete the following requirements, keeping documentation of timely completion in the individual’s record:

1. Conduct a physical examination of the individual. This may be conducted by an authorized practitioner;

2. Conduct an addiction-focused history of the individual. This may be conducted by an authorized practitioner; and 3. Utilize screening tools in the process of gathering sufficient biopsychosocial and ASAM dimensional criteria as outlined in Chapter 6 of the ASAM Criteria, to inform an individualized, withdrawal management-focused service plan.

B. Implementation of the service plan, including any amendments to the service plan and the individual’s clinical response to the services provided, must be maintained in the individual’s record during the time they remain engaged in Level 1-WM services. This may include withdrawal rating scales or flow sheets that are used, as needed.

C. The service plan and progression tracking may be indicated in progress notes that align with the existing medical model for documentation.

D. Individuals may engage in a pattern of admitting to, and discharging from, Level 1-WM services in a repeated and fluid manner throughout a concurrent behavioral health episode of care.

Documentation specific to these engagement milestones for Level 1-WM services may be reflected in the existing medical model documentation and does not require a formal discharge summary as detailed in part 2.10.A.5 of these rules.

E. Considerations for discharge from Level 1-WM services include, but are not limited to:

1. Resolution of withdrawal symptoms;

2. Symptoms that have not improved or have intensified after engaging in Level 1-WM services and the individual requires a higher service, such as Level 2-withdrawal management (Level 2-WM); or 3. The individual is unable to participate in Level 1-WM and may require a different support system or delivery mechanism.

F. If a higher level of care is required, the Level 1-WM agency must initiate a referral to the appropriate level of care. 4.6 Intensive Outpatient Program (IOP) Services Standards A. T hese rules are established to create standards for agencies seeking a sub-endorsement to provide intensive outpatient program (IOP) services, which includes ASAM Criteria Level 2.1 type B. Agencies providing intensive outpatient program services must meet the standards in this part 4.6. 4.6.1 Service Delivery and Setting A. Individuals receiving this level of service meet diagnostic criteria of acute state moderate severity mental illness, substance use, or co-occurring disorder criteria, as defined in the DSM-5-TR.

Individuals may also meet high severity, as defined in the DSM-5-TR, but are stabilized and/or receiving medication-assisted treatment, as defined in part 1.2 of these rules, or pharmacotherapy, as defined in part 1.2 of these rules.

B. IOP services are intended for individuals who require a higher level of intervention than can be provided in standard outpatient services.

C. All services must be adapted to the individual’s developmental stage and physical and D. Services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with telehealth regulations found in part 2.9 of these rules.

E. Treatment groups must not exceed twelve (12) individuals receiving services.

F. IO

P support systems 1. Agencies providing IOP services must have direct affiliation or close coordination through referral to more and less intensive levels of care. Agencies must also have a documented consultation and/or referral process through internal staff or other affiliation in place for medical, psychiatric, and medication-assisted treatment needs.

a. Referral(s) will be provided in collaboration with the individual and their choice(s) 4.6.2 Personnel A. Treatment personnel, for the purpose of this Chapter, unless otherwise noted, means the following behavioral health professionals trained in mental health, substance use, and/or cooccurring disorder identification and treatment and acting within their scope of practice:

1. Authorized practitioners;

2. Licensees;

3. Certified addiction specialists (CAS);

4. Candidates;

5. Certified addiction technicians (CAT);

a. If utilizing certified addiction technicians (CAT), the agency must ensure that 6. Counselors-in-training and/or interns.

a. If utilizing counselors-in-training and/or interns, the agency must ensure that all able to supervise pursuant to their scope of practice. Counselor-in-training and/or B. A gencies providing IOP must ensure treatment personnel have supervisor consultation available within eight (8) hours via in-person or by telehealth to discuss, when warranted, at minimum, psychiatric or medical concerns of individuals receiving services.

C. Personnel must have supervisor consultation available within one (1) hour via in-person or telehealth to discuss, when warranted crisis/emergency situations.

D. Services may include recovery support services rendered by peer support professionals in E. Agencies providing IOP services must provide training appropriate to the treatment-type focus and best practice standards.

1. Training must include that treatment personnel understand the signs and symptoms of mental health, substance use, and co-occurring disorders and the basics of psychopharmacology. 4.6.3 Service Provisions A. Services must be conducted in regularly scheduled sessions that follow a planned format of treatment services of nine (9) to nineteen (19) contact hours per week for adults and six (6) to nineteen (19) contact hours per week for children under the age of eighteen (18).

B. Services may include individual therapy, group therapy, medication-assisted treatment (MAT) monitoring and/or education, psychiatric medication education and/or monitoring, family therapy, peer professional services, educational/occupational groups, recreational therapy, and other therapies as deemed appropriate by assessment of the individual receiving services. 4.6.4 Documentation and Timeliness A. Agencies providing IOP services must document services pursuant to the standards set in parts 2.10, 2.11, 2.12, and 2.13 of these rules.

B. Upon initiation of services to an individual, preliminary screening and risk assessment must be completed in compliance with part 2.12.1 of these rules.

C. As soon as is practicable upon admission, but no later than ten (10) calendar days from the date of preliminary screening and risk assessment, the agency must complete an initial assessment in accordance with part 2.12.2 of these rules.

1. If the screening and risk assessment identifies an urgent clinical need for treatment of the individual, clinical services must be provided immediately, and the initial assessment must be completed within one (1) calendar day of preliminary screening.

D. As s oon as is practicable upon admission, but no later than sixty (60) calendar days from the first date of services, the agency must complete a comprehensive assessment in accordance with

part 2.12.3 of these rules. The requirement that the comprehensive assessment be completed within sixty (60) days does not preclude the initiation or completion of the comprehensive assessment or the provision of treatment during the intervening sixty (60) day period.

E. Individual service plans must be created, in accordance with part 2.13.1 of these rules, within fourteen (14) calendar days after initial assessment. The service plan must be updated to reflect information from the completed comprehensive assessment. The agency must update the service plan throughout the course of treatment, review previous goals, and update those goals whenever there is a change in the person's level of care or functioning, and must occur, at minimum, every six (6) months.

F. IOP services must be documented in the individual’s record in accordance with part 2.11 and 2.13.2 of these rules and at a minimum frequency of one (1) progress note per session. 4.7 Partial Hospitalization Program (PHP) Services Standards A. These rules are established to create standards for agencies seeking a sub-endorsement to provide partial hospitalization program (PHP) services, which includes ASAM Criteria Level 2.5 type services.

B. A gencies providing partial hospitalization program services must meet the standards in this part 4.7. 4.7.1 Service Delivery and Setting A. PHP services must generally be intended for individuals who require daily monitoring or management to treat mental health, substance use, and co-occurring disorders, as defined by the DSM-5-TR, that can be provided in a structured outpatient setting. Services include direct access to medical, psychiatric, and laboratory services.

B. PHP service sites for children must include access to educational services and coordination with a school system, as appropriate.

C. PHP services are appropriate for individuals with co-occurring mental health and substance use disorders if the disorders are diagnosed as moderate severity or are of higher severity, as defined by the DSM-5-TR, but have been stabilized.

D. All services provided must be adapted to individual’s developmental stage and physical and E. Services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with telehealth regulations found in part 2.9 of these rules.

F. PHP agencies must meet the facility requirements set forth in part 2.6 of these rules or requirements in accordance with facility mandates under other regulatory state and federal entities for licensure in cases such as a medical facility, school, or other.

G. T reatment groups must not exceed twelve (12) individuals receiving services.

H. PHP support systems 1. Agencies providing PHP services must inform individuals receiving treatment how to access emergency services by telephone twenty-four (24) hours per day, seven (7) days per week when the program is not in session. At minimum, agencies must provide emergency services information that includes contact information for services provided by the behavioral health crisis response system created pursuant to Section 27-60-103, 2. Agencies providing PHP services must have direct affiliation or close coordination through referral to more and less intensive levels of care. Agencies providing PHP services must also have a documented consultation and/or referral process through internal staff or other affiliation for medical, psychiatric, and medication-assisted treatment needs.

a. Referral(s) will be provided in collaboration with the individual and their choice(s) 4.7.2 Personnel A. Treatment personnel, for the purpose of PHP services, unless otherwise noted, means the following behavioral health professionals trained in mental health and/or substance use disorder identification and treatment and acting within their scope of practice:

1. Authorized practitioners;

2. Licensees;

3. Certified addiction specialists (CAS);

4. C andidates;

5. Certified addiction technicians (CAT);

a. If utilizing certified addiction technicians (CAT), the agency must ensure that 6. Counselors-in-training and/or interns.

a. If utilizing counselors-in-training and/or interns, the agency must ensure that all able to supervise pursuant to their scope of practice. Counselor-in-training and/or B. Services may include recovery support services rendered by peer support professionals in C. Agencies providing PHP services must ensure treatment personnel have supervisor consultation available within eight (8) hours via in-person or by telehealth and within two (2) calendar days inperson or by telehealth, when warranted, at minimum, to discuss at minimum psychiatric or medical concerns of individuals receiving services.

D. Personnel must have supervisor consultation available within one (1) hour via in-person or telehealth to discuss, when warranted crisis and/or emergency situations.

E. In addition to trainings required as a BHE in part 2.5 of these rules, PHP endorsed agencies must provide training appropriate to their treatment-type focus, as well as best practice standards.

1. T raining for PHP endorsed agencies must include training that treatment personnel understand the signs and symptoms of mental health, substance use, and co-occurring disorders and the basics of psychopharmacology.

2. PHP endorsed agencies must ensure that all personnel providing medical services at the PHP have completed and maintained any training required by the personnel’s applicable government licensing entity in order to work within behavioral health focused services. 4.7.3 Service Provisions A. Mental health - only service provisions 1. Individuals for this level of treatment meet diagnosed acute state severe and persistent mental illness criteria, as defined in the DSM-5-TR, and are not at current risk of harming themselves or others.

2. Services must be provided at a minimum of twenty (20) or more hours a week including a minimum of three (3) hours per day and a minimum of four (4) calendar days per week.

Service frequency and intensity must be modified to meet assessment and service plan objectives.

3. Services may include medical services, individual therapy, group therapy, medication management, educational/occupational groups, peer professional services, recreational therapy, and other therapies as deemed appropriate by assessment of the individual B. S ubstance use disorder and co-occurring service provisions (including ASAM Criteria Level 2.5)

1. Individuals for this level of treatment meet diagnostic criteria for a substance use related disorder as defined in the DSM-5-TR and are at low risk of withdrawal or have minimal remaining withdrawal symptoms.

2. Services must be conducted with a minimum frequency of twenty (20) regularly scheduled treatment contact hours per week.

3. Services may include medical services, individual therapy, group therapy, medication management, medication-assisted treatment monitoring/education, educational/occupational groups, recreational therapy, peer professional services, and other therapies as deemed appropriate by assessment of individual receiving services. 4.7.4 Documentation and Timeliness A. All PHP service documentation requirements must follow the requirements set forth in parts 2.10, 2.11, 2.12, and 2.13 of these rules.

B. Upon entrance into service, preliminary screening and risk assessment must be completed in compliance with part 2.12.1 of these rules.

C. As soon as practicable upon admission, but no later than ten (10) calendar days from the date of preliminary screening and risk assessment, the agency must complete an initial assessment in accordance with part 2.12.2 of these rules 1. If the screening identifies an urgent need, clinical services are provided, and the initial assessment must be completed within one (1) calendar day of preliminary screening.

D. As s oon as practicable upon admission, but no later than sixty (60) calendar days from the first date of services, the agency must complete a comprehensive assessment in accordance with

part 2.12.3 of these rules. The requirement that the comprehensive assessment be completed within sixty (60) days does not preclude the initiation or completion of the comprehensive assessment or the provision of treatment during the intervening sixty (60) day period.

E. The individual service plan must be created, in accordance with part 2.13.1 of these rules, within fourteen (14) calendar days after initial assessment. The service plan must be updated to reflect information from the completed comprehensive assessment. The agency must update the service plan throughout the course of treatment, review previous goals and update those goals whenever there is a change in the person's level of care or functioning, and must occur, at minimum, every fourteen (14) calendar days.

F. PHP services must be documented in the individual’s record in accordance with part 2.11 and 2.13.2 of these rules and at a minimum frequency of one (1) progress note per session and one (1) progress note per week. 4.8 Level 2-Withdrawal Management (Level 2-WM): Ambulatory Withdrawal Management with Extended On-Site Monitoring Services Standards A. T his part 4.8 is established to create standards for agencies seeking a sub-endorsement to provide outpatient Level 2-Withdrawal Management (Level 2-WM) services in accordance with

Chapter 6 of the ASAM Criteria.

B. Agencies providing Level 2-WM services must meet the standards in this part 4.8. Agencies providing Level 2-WM services may:

1. Also engage in outpatient behavioral health services by meeting the standards for the outpatient sub-endorsement(s) selected by the agency; or 2. Provide only Level 2-WM services and coordinate with other providers for ongoing and concurrent outpatient behavioral health treatment services. 4.8.1 Service Delivery and Setting A. Level 2-WM is an outpatient withdrawal management service that complements individualized behavioral health treatment services.

B. Individuals may participate in Level 2-WM for a period of time in which it is determined to be medically appropriate. Admission to Level 2-WM services must not hinder the individual’s ability to participate in concurrent behavioral health services. This includes the potential process of admitting to, and discharging from, such withdrawal management services one (1) or more times by the individual.

C. Level 2-WM services are generally provided in a day hospital-type setting, general health care facility, or an agency providing substance use disorder or mental health treatment.

D. Level 2-WM services offered by agencies that do not provide behavioral health services within their agency structure must be affiliated with BHEs or other necessary providers to ensure the treatment needs of all individuals served can be met. Documentation of this affiliation must be presented to the BHA, upon request. Referral(s) will be provided in collaboration with the individual and their choice(s) for referred services.

E. S upport systems 1. Agencies must:

a. Have the ability to obtain a comprehensive medical history and physical examination at the time of admission to Level 2-WM services;

b. Have twenty-four (24)-hour access to emergency medical consultation services, should emergency services become indicated;

c. Have the ability to provide or assist in accessing transportation services for individuals who lack safe transportation; and d. Have the ability to coordinate services with behavioral health personnel, within the agency or through referral.

F. Diagnostic criteria 1. Individuals participating in Level 2-WM services typically exhibit a moderate withdrawal severity rating on standardized withdrawal severity scales as well as mild/stable psychiatric symptoms for emotional, behavioral, and cognitive conditions.

2. Individuals may also present with a higher withdrawal severity rating on standardized withdrawal severity scales or with higher psychiatric symptom requirements, with sufficient protective factors and other support system(s) in place to safely participate in Level 2-WM services.

3. Due to the safety concerns inherent with withdrawal, individuals with complicated withdrawal severity ratings may not be appropriate for Level 2-WM services.

a. If the medical personnel determines that an individual meeting the above criteria can be safely and effectively served in a Level 2-WM setting, the rationale and plan for safe management and services must be documented in the individual’s 4. Individuals may be more advanced in their readiness to change and may require assistance with transportation or other engagement barriers.

5. Individuals may participate in Level 2-WM services without a formal substance use disorder diagnosis if collateral information indicates a high probability of such diagnosis.

The agency must ensure further evaluation of this probable diagnosis, either completed within the agency or through referral to a behavioral health provider.

G. Agencies must:

1. Provide safe management and documentation of signs and symptoms of intoxication and withdrawal; and 2. Ensure that discharge planning begins at the time of admission to Level 2-WM services, to allow for necessary care coordination and transition into ongoing or concurrent treatment services to occur successfully based on screening or assessment of needs. 4.8.2 Personnel A. Level 2-WM services are primarily provided by medical professionals who are acting within the scope of their practice and are trained in assessing and managing intoxication and states of withdrawal. This may include, but is not limited to:

1. A uthorized practitioners; and 2. Nurses.

B. Level 2-WM is an outpatient service that requires daily monitoring of withdrawal symptoms and assessments of progress. This requires medical personnel to be readily accessible and able to evaluate an individual’s needs and safe placement in Level 2-WM. 4.8.3 Service Provisions A. Agencies must develop policies and procedures to address service delivery expectations. These 1. Consultation with specialized clinical and medical professionals for individualized Level 2- WM care;

2. Coordinating an individual’s transition into other Levels of care determined to be completed during their Level 2-WM services. This may include collaboration with emergency behavioral health services, such as Colorado Crisis Services, as appropriate;

3. Conducting or arranging for laboratory and/or toxicology tests to be completed;

4. Responding to individuals who are assessed as being a current threat to themselves or others, including the appropriate use of law enforcement;

5. Communication with intoxicated individuals leaving Level 2-WM services against personnel recommendations, including the use of emergency commitments; and 6. Circumstances under which individuals may be discharged from Level 2-WM services, other than completing withdrawal management or leaving against personnel B. Admission procedures for Level 2-WM services must include at a minimum:

1. Collection of information regarding the degree of alcohol and/or other drug intoxication as evidenced by breathalyzer, urinalysis, self-report, observation, or other evidence-based or best practices;

2. A pregnancy screening for pregnancy-capable individuals;

3. Taking of vital signs; and 4. Administration of a validated clinical withdrawal assessment tool.

C. Therapies offered by the agency must include a range of treatment approaches and support services based on the screening or assessment of the individual’s treatment needs. Treatment services may include but are not limited to:

1. Screening;

2. Assessment;

3. Group and individual counseling;

4. Motivational enhancement;

5. Family therapy;

6. Educational groups;

7. Occupational and recreational therapy;

8. Addiction pharmacology;

9. Mental health and physical health pharmacology, as needed;

10. Medication management;

11. Peer, social and recovery support;

12. C are coordination; and 13. Support for the development of life skills.

D. If the agency does not provide a treatment approach or support service necessary to meet the individual’s treatment needs, the agency must ensure that care coordination occurs.

E. Agencies must provide additional service planning for managing individuals with medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place individuals at additional risk during withdrawal management.

F. Agencies must provide assessments of individual readiness for treatment and services based on the service plan and the assessments and interventions shall be documented in the individual’s G. Medication-assisted treatment (MAT) for withdrawal management 1. Agencies must continue individuals on their medication-assisted treatment regimen and will only remove individuals from medications treating opioid use disorders at the individual’s request or if it is deemed medically appropriate by an authorized practitioner.

2. Agencies must inform individuals receiving services about access to medication-assisted treatment. Upon the individual’s consent, the agency must provide medication-assisted 3. Agencies must obtain a controlled substance license pursuant to section 21.300 of 2 CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled substance from stock medication in order to treat a substance use disorder or to treat the a. A controlled substance license is not required if the agency intends to provide 4.8.4 Documentation and Timeliness A. Upon admission to Level 2-WM services, the agency must complete the following requirements, keeping documentation of timely completion in the individual’s record:

1. C onduct a physical examination of the individual. This may be conducted by an authorized practitioner;

2. Conduct an addiction-focused history of the individual. This may be conducted by an authorized practitioner; and 3. Utilize screening tools in the process of gathering sufficient biopsychosocial and ASAM dimensional criteria as outlined in Chapter 6 of the ASAM Criteria, to inform an individualized, withdrawal management-focused service plan.

B. Implementation of the service plan, including any amendments to the service plan and the individual’s clinical response to the services provided, must be maintained in the individual’s record during the time they remain engaged in Level 2-WM services. This may include serial medical assessments, withdrawal rating scales and/or flow sheets that are conducted, as needed.

C. The service plan and progression tracking may be indicated in progress notes that align with the existing medical model for documentation.

D. Individuals may engage in a pattern of admitting to, and discharging from, Level 2-WM services in a repeated and fluid manner throughout a concurrent behavioral health episode of care.

Documentation specific to these engagement milestones for Level 2-WM services may be reflected in the existing medical model documentation and does not require a formal discharge summary as detailed in part 2.10.A.5 and 2.10.A.6 of these rules.

E. C onsiderations for discharge from Level 2-WM services include, but are not limited to:

1. Resolution or diminishing of withdrawal symptoms, that allow the individual to be safely served at a lower service level, such as Level 1-WM;

2. Symptoms that have not improved or have intensified after engaging in Level 2-WM services and the individual requires a higher service, such as Level 3-withdrawal management (Level 3-WM); or 3. The individual is unable to participate in Level 2-WM and may require a different support system or delivery mechanism.

F. If a different level of care is required, the agency providing Level 2-WM services must initiate a referral to the appropriate level of care.

Chapter 5: Behavioral Health Residential and Level 3-Withdrawal Management Services 5.1 Authority and Applicability A. Chapter 5 establishes the standards for agencies electing to provide behavioral health residential and/or Level 3-Withdrawal Management (Level 3-WM) services. The authority to promulgate these service-specific requirements that apply to BHEs electing to provide this service comes from Sections 27-50-502(1), 27-50-106, 27-50-301(5), 27-71-105(1), and 27-50-107(3)(b), C.R.S.

B. These rules are established to create standards for agencies seeking an endorsement to provide behavioral health residential and/or Level 3-WM.

C. In a ddition to the overall endorsement associated with this Chapter 5, agencies must hold the relevant sub-endorsement(s) to provide these services, as detailed below. The subendorsements build in alignment with the natural progression of the continuum of care, with parts that detail applicability standards as noted in parts 5.4 through 5.11 of this Chapter.

D. Agencies must elect a treatment type sub-endorsement to provide services to individuals, which may include mental health treatment services, substance use disorder treatment services, or both.

E. Agencies are not required to serve all treatment types within their selected sub-endorsement(s). If the agency does not provide a service needed by an individual, the agency must ensure that care coordination for the needed service occurs.

F. Agencies providing behavioral health residential services must meet the standards in:

1. This part 5.1 through part 5.3 of this Chapter; and 2. The standards required for the sub-endorsement(s) of the agency that are set forth in these rules, including treatment type(s) provided.

G. Agencies providing Level 3-WM services must meet the standards in:

1. This part 5.1 through part 5.2 of this Chapter; and 2. T he standards required for the sub-endorsement(s) of Level 3-WM services provided by the agency as set forth in part 5.6 and/or part 5.11 of this Chapter.

H. The continuum of behavioral health residential and Level 3-WM services are set forth in the following section of this Chapter:

1. Clinically monitored services, part 5.4 of this Chapter, including:

a. Level one mental health transitional living homes: part 5.4 of this Chapter.

2. Clinically managed services, part 5.5 through part 5.9 of this Chapter, including:

a. ASAM 3.1-type services: part 5.5 of this Chapter.

b. Level 3.2-WM services: part 5.6 of this Chapter.

c. ASAM Level 3.3 services: part 5.7 of this Chapter.

d. Level two mental health transitional living homes: part 5.8 of this Chapter.

e. ASAM 3.5-type services: part 5.9 of this Chapter.

3. Medically monitored services, part 5.10 through 5.11 of this Chapter, including:

a. ASAM 3.7-type services, part 5.10 of this Chapter.

b. Level 3.7-WM services, part 5.11 of this Chapter.

I. If the agency provides services to both mental health and substance use disorder treatment types, they must meet the standards of all relevant sub-endorsement(s) set forth in this Chapter as noted above. 5.2 Behavioral Health Residential and Level 3-Withdrawal Management (Level 3-WM) Services Standards A. This part 5.2 applies to all agencies providing behavioral health residential and/or Level 3- Withdrawal Management (Level 3-WM) services.

5.2.1 S ervice Delivery and Setting A. The agency must promote safety and avoid abuse, including psychological abuse, for all individuals served by the agency. The agency must prioritize the living space assignment process to ensure person-centered and trauma-informed services are received by the individual and overall milieu. Factors to be considered in the determination of a safe living space assignment may include, but are not limited to:

1. Age (child, youth or adult);

2. Gender identity;

3. Cultural needs identified during the assessment process;

4. The individual’s sex (male, female, intersex);

5. Individual’s ability to interact safely with others; and 6. The individual’s requests.

B. The agency must have physical barriers such as doors and walls, and personnel oversight of activities to ensure safety for all personnel and individuals served. This management may also include, but is not limited to:

1. Personnel oversight, such as workstations that separate living space assignments;

2. Video or other monitored oversight that promptly notifies personnel of unexpected movement in the milieu; and 3. Other practical arrangements that support the safe management of the individuals 5.2.2 Personnel A. Agencies providing behavioral health residential and/or Level 3-WM services must have on-site personnel twenty-four (24) hours per day, seven (7) days per week.

1. This coverage may include a combination of personnel qualified to provide treatment to individuals receiving services as well as personnel who are trained to provide milieu management services.

2. Personnel qualified to provide treatment may also provide milieu management, as noted below.

3. On-site personnel must be sufficient to address the needs of the individuals served as well as the safety of personnel providing oversight. See the relevant sub-endorsement(s) in this Chapter for specific ratios of individuals served to personnel, if applicable.

B. Minimum agency personnel ratios, percentages and requirements are specific to each physical location where services are being provided. This includes on-call personnel that may assist the site, as needed.

C. The qualifications and credentialing of personnel providing treatment must be reflective of the population(s) receiving services and meet the minimum standards and ratios present in the relevant sub-endorsement(s), as applicable.

D. T reatment personnel 1. For agencies providing clinically managed or medically monitored residential and/or Level 3- WM services, personnel qualified to provide treatment means the following behavioral health professionals acting within their scope of practice and trained in mental health and/or substance use disorder identification and treatment:

a. Authorized practitioners;

b. Licensees;

c. Candidates;

d. Counselors-in-training; and e. Interns.

2. Agencies providing residential substance use disorder, residential co-occurring, and/or Level 3-WM services may also utilize the following as treatment personnel, when a. Certified addiction specialists (CAS); and b. Certified addiction technicians (CAT).

E. Milieu management personnel 1. In addition to the treatment personnel noted in part 5.2.2.D of this Chapter, agencies providing behavioral health residential and/or Level 3-WM services may utilize the following personnel for milieu management:

a. Peer support professionals, and b. Group living workers.

(1) If utilizing group living workers for milieu management, these personnel (a) Be assigned duties and responsibilities that are within their training and scope of practice. They must not perform tasks that are required to be performed by treatment personnel as outlined in part 5.2.2.D; and (b) Be assigned to the clinical director, a licensee, or authorized practitioner for training and oversight of milieu management services provided.

(c) If correctional personnel, such as security or correctional officers, are utilized as group living workers within an agency that provides services in a correctional setting, they must be responsive and accountable to the clinical director or other assigned clinical supervisor to ensure the culture of the program is supported.

2. If utilizing peer support professionals for milieu management, the agency must follow standards for recovery support services rendered by peer support professionals in 3. Agencies that have shifts without credentialed personnel on-site as a result of utilizing CATs, counselors-in-training, interns, peer support professionals, and/or group living workers for milieu management must ensure that consultation with a credentialed person is immediately available. This consultation must be provided by the clinical director, a licensee, or an authorized practitioner.

a. Excluding clinically monitored services, this consultation must include an on-site response by the credentialed personnel within thirty (30) minutes if needed. 5.2.3 Service Provisions A. Agencies providing behavioral health residential and/or Level 3-WM services must offer a range of treatment approaches and support services to meet the individual’s treatment needs, as determined by the screening and/or assessment process. Services offered may include, but are 1. Screening;

2. Comprehensive assessment;

3. Group and individual counseling;

4. Motivational enhancement;

5. Family therapy;

6. Educational groups;

7. Occupational and recreational therapy;

8. Behavioral health pharmacology;

9. Physical health pharmacology;

10. Medication management;

11. Peer, social and recovery support;

12. Care coordination; and 13. Support for the development of life skills.

B. If the agency does not provide a treatment approach or support service necessary to meet the individual’s treatment needs, the agency must ensure that care coordination for the needed service occurs. 5.2.4 Documentation and Timeliness A. See the behavioral health residential and/or Level 3-WM services sub-endorsement(s) as set forth in this Chapter for relevant documentation and timeliness standards. 5.3 Behavioral Health Residential Services A. This part 5.3 applies to all agencies providing behavioral health residential services.

B. This part 5.3 does not apply to agencies providing only Level 3-WM services. 5.3.1 Service Delivery and Setting A. Agencies providing behavioral health residential services must ensure that they can sufficiently provide for the behavioral health needs of all individuals served. These services may occur through direct service provision by agency personnel or through the coordination of services with other agencies endorsed to provide the services an individual requires.

B. A gencies must prioritize the development of necessary living skills to support the individual’s successful integration, or reintegration, into independent or other living situations within their community. This may include services developed for participation by all individuals as well as services tailored to an individual's assessed needs.

C. Services offered by the agency must be regularly scheduled and relevant to the treatment type and population receiving services.

D. Agencies providing behavioral health residential services must:

1. Have direct affiliation or close coordination through referral to more and less intensive levels of behavioral health care;

2. Have the ability to conduct or arrange for laboratory and/or toxicology tests to be completed; and 3. Develop and maintain house rules as noted in part 5.3.3.C of this Chapter. 5.3.2 Personnel A. All personnel must receive training and demonstrate competency in areas relevant to their specific duties and responsibilities prior to working independently in the residential setting.

Training may be provided through formal instruction, self-study courses, or on-the-job training.

Personnel training must include, but is not limited to the following topics:

1. House rules development, implementation, and updating; and 2. How to access and utilize an individual’s psychiatric advanced directive (PAD), when applicable.

a. If the individual does not have a PAD completed, personnel must offer to assist in PAD completion if the individual is interested and it is clinically appropriate. 5.3.3 General Provisions A. Between 10 pm and 6 am, personnel must conduct, and document safety checks of all individuals served. The intervals in which safety checks are completed must be sufficient to provide for the health and safety of the individuals being served.

B. T he agency must ensure that telephone services available on-site include videophones for hearing or speech-impaired individuals served.

C. House rules 1. The agency must establish written house rules and place them in a location where they are always available to individuals and visitors.

2. The agency must develop policies and procedures regarding house rules which includes a list of all possible actions which may be taken by the agency if any rule is knowingly violated by an individual served, and how the agency will document violations and actions taken.

3. House rules must address, at a minimum, the following items:

a. Smoking and tobacco utilization, including the use of electronic cigarettes, vaporizers, and chewing tobacco;

b. Cooking;

c. Visitors;

d. Telephone usage, including frequency and duration of calls;

e. Use of common areas and devices, such as television, radio, and computer;

f. Consumption of alcohol and marijuana; and g. Pets.

(1) Service animals, as determined by the Americans with Disabilities Act (ADA), are not classified as pets. House rules must not limit an individual’s right to have a service animal while served by the agency.

4. House rules must not:

a. Take the place of, or conflict with, any requirements of these rules; or b. Delay, discourage, or prevent an individual’s exercise of their rights.

5. The agency must revisit and update house rules at least annually and allow for collaboration and feedback from individuals.

D. Court ordered referrals for residential services may require a length of stay that is based on a legal requirement and may not be clinically necessary for the duration of that period of time. The agency is expected to evaluate if the supervising entity’s recommendation matches the individual’s assessed clinical needs. The agency must address any differences identified with the supervising entity directly and document the results in the individual’s record.

E. See the behavioral health residential services sub-endorsement(s) as set forth in this Chapter for relevant service provision standards. 5.4 Level One Mental Health Transitional Living Home Services A. T his part 5.4 applies to agencies operating level one mental health transitional living homes. This level of care is defined in Chapter 1 of these rules. 5.4.1 Service Delivery and Setting A. Level one mental health transitional living homes shall comply with the requirements of parts 5.1 through this part 5.4, unless otherwise noted. 5.4.2 Personnel A. To determine level of oversight needed to ensure safety, the agency shall consider, at a minimum, the following items:

1. The acuity and needs of the individuals, and 2. The services outlined in the service plan of an individual.

B. Personnel shall be sufficient in number to help individuals needing or potentially needing assistance, and to account for the risk of accident, hazards, or other challenging events based on the number of individuals in residence.

C. When determining personnel requirements, the agency must consider the needs of the individuals receiving services. Oversight of individuals must include on-site and on-call availability of personnel with appropriate training and expertise based on the needs of the individuals.

D. Personnel must be assigned to complete tasks commensurate with their skills and training.

Personnel that are not licensed or credentialed shall not complete specialized screenings, assessments, therapies, or techniques for which they are not qualified.

E. Only personnel with the appropriate training and expertise may train personnel on specialized techniques beyond general personal care and assistance with activities of daily living as defined in these rules. This includes, but is not limited to, transfers requiring specialized equipment, and assistance with therapeutic diets. Personnel must be evaluated for proficiency in demonstrating the specialized technique before the delivery of a personal service requiring a specialized technique.

1. Documentation regarding training and proficiency in specialized techniques must be included in the personnel files.

F. A nurse who is employed or contracted by the agency may delegate to other personnel in accordance with the Nurse and Nurse Aide Practice Act pursuant to Article 255 of Title 12, C.R.S., if the nurse is the supervising nurse for the personnel.

G. The agency shall ensure that personnel comply with all agency policies and procedures and shall not allow personnel to perform any functions which are outside of their job description, scope of practice, or an individual's service plan.

H. P ersonnel providing non-medical transportation to individuals must meet the following 1. Must be eighteen (18) years of age or older to render services;

2. Has at least one year of driving experience;

3. Possesses a valid driver’s license;

4. Has provided a copy of their current Colorado motor driving vehicle record, with up to the previous seven years of driving history as applicable; and 5. Has completed a Colorado or national-based criminal history record check.

I. Vehicles used during the provision of non-medical transportation must be safe and in good working order. To ensure the safety and proper functioning of the vehicles, vehicles must pass a vehicle safety inspection prior to it being used to render services. Inspection requirements must be outlined in the agency’s policies and procedures, and records of such inspections must be maintained by the agency.

J. The agency shall have policies and procedures for determining when personnel are not permitted to provide non-medical transportation based on violations presented on the driver’s motor vehicle K. An agency that uses a separate agency, organization, or personnel to provide services for the mental health transitional living home or a specific individual shall have a written agreement that sets forth the terms of the arrangement. The agreement must specify, at a minimum, the following items:

1. T he specific services to be provided;

2. The time frame for the provision of such services;

3. The contractor’s obligation to comply with all applicable agency policies and procedures, including personnel qualifications;

4. How such services will be coordinated and overseen by the agency; and 5. The procedure for payment of services provided under the contract.

L. If contract personnel and/or services are used, the agency shall ensure the contractor meets all applicable requirements of these regulations.

M. Notwithstanding the above criteria, the agency shall retain responsibility to ensure the health, safety and welfare of the individuals, and the provision of necessary services, including but not limited to, the minimum necessary services set forth in part 5.5.1.B. 5.4.3 Service Provisions A. The agency shall ensure the provision of accommodations, personnel, and services necessary for the welfare and safety of individuals.

B. The agency shall make available, either directly or indirectly through contracted services, the following services, sufficient to meet the needs of the individuals. These services must include but are not limited to:

1. A physically safe and sanitary environment that includes, but is not limited to, measures to reduce the risk of potential hazards in the physical environment and that accounts for the unique characteristics of the resident population;

a. Wh en a transitional living home utilizes a delayed egress door at an exit point, the exit door must allow full egress in emergencies, and must only be used to assist personnel in maintaining supervision and redirecting individuals back into the care setting.

b. Egress alert devices must only be used to assist personnel in redirecting individuals back into the mental health transitional living home when personnel are alerted to an individual's departure, as opposed to restricting the free movement of individuals.

2. Room and board;

3. Personnel to assist with personal services;

4. Assistance with medication; 5 Life skills training;

a. The agency shall support individuals to maintain and develop skills for independent living through regular, structured individual and group engagement opportunities.

b. Training opportunities must include therapeutic and habilitative activities to facilitate the development of life skills and promote independent living and must support the pursuit of individual’s interests and goals.

c. The agency shall document in the record the individual’s engagement and progress in life skills training and other training opportunities.

d. If requested, the agency shall assist an individual with identifying and accessing outside services and community events.

6. Intensive case management;

a. As appropriate for the needs of the individual, the agency shall:

(1) Convene the individual, their legal representative and/or the persons involved in the individual’s treatment and care, including medical and behavioral health providers, and persons identified by the individual, for the purpose of care planning and coordination, in order to facilitate wellness, self-management, and recovery of the whole person.

(2) Provide proactive and intentional outreach and engagement with the individual and their identified support persons to build necessary trust and support.

(3) Assess for support needs, risk factors and health related social needs and support the individual in accessing care, resources, and services to address health related social needs including but not limited to:

(a) Food security (b) Housing stability and security (c) Personal safety (d) Access to health services including preventative health care (e) Physical health concerns for which the individual is not receiving adequate treatment (f) Ongoing behavioral health care needs b. Intensive case management must involve discharge planning in accordance with the requirements of part 2.10.A.6 of these rules.

7. N on-medical transportation and access to the community a. The agency shall provide for community access through non-medical transportation services. This includes providing accessible transportation when an individual requires adaptive supports.

C. Agencies will arrange for the individual to receive community-based behavioral health services.

D. The agency shall assume responsibility for all services it provides, including those provided by contract.

E. Services provided by or coordinated by the agency may be provided via telehealth at the discretion of the administrator, to the extent that such services meet the needs of the individual, fulfill the requirements set forth in this Chapter, and account for individuals’ preferences for service delivery F. Admission and discharge 1. The agency shall ensure, prior to admission and move-in, that an individual’s needs can be fully met either directly or through coordination with additional providers. The agency's ability to meet individual needs must be based upon a comprehensive pre-admission assessment of an individual's physical, mental, and social needs, which must be documented in, and become part of, the individual’s record. The pre-admission assessment must also include all screening and initial assessment requirements set forth in part 2.12 of these rules.

2. An agency shall not admit any individual who:

a. Needs regular 24-hour medical or nursing care, b. Has an acute physical illness which cannot be safely managed through medication or prescribed therapy 3. The agency shall arrange for the transfer or transition of care for any individual who has an acute physical illness which cannot be safely managed through medication or prescribed therapy, or for an individual who develops a need for 24-hour medical or nursing care 4. Prior to discharging an individual because of increased care needs, which may include, but are not limited to, changes in health status or where an individual becomes an imminent danger to self or others, the agency shall make documented efforts to meet the individual’s needs through other means. The documented efforts must include:

a. T aking all measures necessary to protect the individual and others, including following agency policies and procedures for behavioral and physical health emergencies, as required per parts 2.10.D and 2.10.E of these rules;

b. Reassessing the individual and revising their service plan to identify the individual's current needs and what services the agency will provide or coordinate to meet those needs or address newly assessed risks; and c. Ensuring all personnel are aware of any revisions to the service plan and are properly trained to provide supervision and support consistent with the service 5. The agency shall coordinate a voluntary or involuntary discharge with the individual, the individual's legal representative and/or the persons, including medical and behavioral health providers, who will be responsible for services provided to the individual per the discharge plan.

6. In the event an individual is transferred to another health care provider for additional care, the agency shall arrange to evaluate the individual prior to readmission or shall discharge the individual in accordance with the discharge procedures set forth in this Chapter.

7. When an individual is discharged, it is the responsibility of the agency to develop a discharge plan, and provide care coordination to facilitate, to the extent possible, the individual's transition to an appropriate level of care. Care coordination efforts must be documented and maintained within the individual’s record.

G. P ractitioner assessment 1. The agency shall have policies and procedures that are consistent with state and federal law for promptly contacting the individual’s authorized practitioner for assessment when:

a. The individual experiences a significant change in their baseline status;

b. The individual has known exposure to a communicable disease;

c. The individual develops any condition which would have initially precluded admission to the agency;

d. The individual has any observed or reported unfavorable reactions to e. The individual is affected by a medication error; and/or f. The individual engages in a pattern of refusing medications or medical 2. The agency shall ensure that any of the events in this part 5.4.3.G of this Chapter are 3. As applicable, the individual’s legal representative must be promptly notified any time assessment is indicated per this part. 5.4.4 Documentation and Timeliness A. Comprehensive individual assessment 1. Within ten (10) calendar days of admission, the agency shall complete a comprehensive assessment that meets the requirements set forth in part 2.12 of these rules as well as the requirements of this part 5.4.4.A. The assessment must reflect information requested and received from the individual, the individual's representative if requested by the individual, and an authorized practitioner. Information from the comprehensive assessment must be used to establish an individualized service plan.

2. T he comprehensive assessment must include all the following items:

a. Information from the comprehensive pre-admission assessment described in part 5.4.3.F.1;

b. Information regarding the individual's overall health and physical functioning ability, including supports needed with activities of daily living;

c. Communication ability and any specific needs to facilitate effective communication;

d. Food and dining preferences, unique dietary needs, allergies, and restrictions;

e. Reactions to the environment and others, including changes that may occur at certain times or in certain circumstances;

f. Routines and interests;

g. Safety awareness;

h. Types of physical, mental, and social support required;

i. History of or potential risk of harm to self or others, including aggressive behaviors, and any known approaches to prevent future occurrences including previously developed safety plans.

3. The comprehensive assessment must be documented in writing and kept in the individual's health information record.

4. The comprehensive assessment must be updated for each individual at least every six (6) months and whenever the individual's condition changes from baseline status.

B. Individual service plan 1. An initial service plan, based upon information from the pre-admission assessment described in part 5.4.3.G.1 of this Chapter, must be developed within twenty-four (24) hours of admission and must address, at a minimum, an individual's daily support needs, including assistance with activities of daily living, medication management, behavioral and physical health diagnoses, and support needs.

2. Within fourteen (14) calendar days of completion of the comprehensive assessment, the agency shall develop a comprehensive service plan. In addition to the requirements of

part 2.13.1 of these rules, the service plan must:

a. Be developed with input from the individual and the individual's representative, if applicable;

b. Reflect the most current assessment information;

c. P romote individual choice, mobility, independence and safety;

d. Detail specific personal service needs and preferences along with the supports necessary to meet those needs; personal service needs must consider:

(1) individual prioritized needs for life skills training, and (2) medical and therapeutic care needs;

e. Identify all external service providers along with care coordination arrangements;

f. Identify engagement opportunities that match the individual's personal choices and needs; and g. Outline a plan for ensuring the individual’s behavioral health care needs are met, which may include access to community-based services.

3. The agency shall be responsible for the coordination of individual care services with external service providers identified in the individual service plan.

4. The agency shall be responsible for implementing recommendations made by the external service providers identified in the individual service plan.

5. As applicable, the agency shall ensure that an individual receives nursing and therapeutic supports prescribed by the individual’s authorized practitioner.

6. Only personnel employed or contracted by the agency may provide or assist with nursing or therapeutic services on behalf of the agency.

7. If the agency utilizes delayed egress or egress alert devices, it must be noted within the individual’s service plan.

8. The service plan must be updated for each individual at least every six (6) months and whenever the individual's condition changes from baseline status.

C. Records 1. In addition to the requirements set forth in part 2.11 of these rules, individual records must contain, but not be limited to, the following minimum items:

a. Current practitioner orders;

b. Individualized service plan;

c. Daily progress notes, in accordance with part 2.13.2 of these rules, which must include information on individual status, well-being, and engagement, as well as documentation regarding any out of the ordinary event or issue that affects an individual's physical, behavioral, cognitive and/or functional condition, along with the action taken by personnel to address that individual's changing needs; and d. Documentation of physical and mental health care services received including any on-going services provided by external service providers. 5.5 Clinically Managed Residential Services, Including ASAM 3.1-Type Services A. T his part 5.5 applies to agencies providing ASAM 3.1-type clinically managed behavioral health B. This part 5.5 does not apply to agencies providing only Level 3-WM services.

C. This part 5.5 does not apply to recovery residences, as defined in BHA rule section 21.500 of 2 CCR 502-1. 5.5.1 Service Delivery and Setting A. These services are intended for individuals who may benefit from twenty-four (24) hour structure and supportive services to develop, practice, and integrate coping skills in preparation for reintegration into their community of choice. Group homes, community corrections agencies, or other supportive living environments that provide twenty-four (24) hour on-site personnel, a focus on community re-integration, and treatment services on-site are examples of this level of care.

B. Agencies must ensure individuals receiving services have at least one (1) of the following concerns to address during their residential episode of care:

1. A history of mental health, substance use, or co-occurring disorders;

2. A lack of stable or supportive housing options;

3. Unemployment or education concerns; and/or 4. Social or psychological dysfunction that necessitates this twenty-four (24) hour structure.

C. Agencies must provide services that include (1) motivational enhancement to increase the individual’s level of readiness to change and (2) individual monitoring and support to facilitate the discovery of the individual’s needs. Services must also prioritize continued engagement in treatment services beyond the residential episode of care.

D. The length of stay allows individuals to remain in residential services for a sufficient period of time to familiarize themselves with and integrate the skills obtained into regular use.

E. Support systems 1. Agencies must:

a. Ensure the availability of telehealth or on-site consultation with an authorized b. Ensure the availability of consultation with emergency services twenty-four (24)

c. Have the capacity to arrange for medication-assisted treatment (MAT) and/or psychiatric medications in a timely manner for individuals served.

(1) This may include services provided through coordination and referral but must not exceed twenty-four (24) hours from the time the need is identified to when arrangements are made. 5.5.2 Personnel A. Agencies must maintain an individual-to-personnel ratio not exceeding twenty to one (20:1) at all times, per physical location. This includes nighttime and weekend hours.

5.5.3 S

A. Services must be regularly scheduled and include a minimum of five (5) hours of planned treatment services per week for each individual in care. 5.5.4 Documentation and Timeliness A. Agencies must complete and document the following items in the individual’s record within 1. All required demographic, intake and consent paperwork, as specified in part 2.11 of 2. Screenings, as required in part 2.12.1 of these rules;

3. The initial assessment as required in part 2.12.2 of these rules; and 4. The initial service plan, addressing immediate needs and other relevant concerns B. Screenings and assessments conducted in accordance with this part 5.5.4.A must be used to determine appropriateness for this level of care.

C. As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the agency must complete and document the comprehensive assessment for the individual, as D. As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive assessment is completed, the agency must complete and document an individualized and comprehensive service plan, informed by the comprehensive assessment, as required in part E. If the individual’s comprehensive assessment indicates they may benefit from further evaluation, medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are addressed during the episode of care. The individual record must contain documentation F. Service plan reviews and revisions must be completed and documented in the individual’s record when there is a change in the individual’s level of functioning or service needs, but in no case 1. Monthly for the first six (6) months after admission, and 2. At least quarterly for the remainder of time that the individual remains in residential G. P rogress notes must be present in the individual’s record, in accordance with part 2.13.2 of these rules and must be completed at least weekly for this level of care. 5.5.5 Treatment Type Standards for Residential Services, Including ASAM 3.1-Type Services A. Agencies that provide mental health-only or co-occurring residential services must ensure that individuals served meet at least one (1) of the following criteria:

1. Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a mild to moderate level defined in the DSM-5-TR, or 2. Have sufficient collateral information present that indicates a high probability of a serious mental illness or comorbid diagnoses at a mild to moderate level as defined in the DSM- 5- TR.

B. Agencies that provide co-occurring or substance use disorder-only residential services at an ASAM 3.1-type must ensure the following personnel requirements are met:

1. If utilizing certified addiction technicians (CAT), these personnel do not comprise more 2. If utilizing counselors-in-training and/or interns, these personnel do not comprise more 5.6 C linically Managed Residential Withdrawal Management (ASAM Level 3.2-WM) Services A. This part 5.6 applies to agencies providing withdrawal management services at an ASAM 3.2-WM level of care.

B. This part 5.6 does not apply to agencies providing behavioral health residential services only. 5.6.1 Service Delivery and Setting A. Level 3.2-WM services provide a twenty-four (24) hour setting in which individuals may withdraw from substances while supervised by personnel, responsible for the implementation of medical provider-approved protocols.

B. Agencies must develop policies and procedures to address service delivery expectations. These 1. Consultation with specialized clinical and medical professionals for individualized withdrawal management care;

2. Coordinating an individual’s transition into other levels of care, determined to be completed during the course of Level 3.2-WM services. This may include collaboration with emergency behavioral health services, such as Colorado Crisis Services, as 3. Conducting or arranging for laboratory and/or toxicology tests to be completed;

4. Responding to individuals who are assessed as being a current threat to themselves or others. This must include appropriate use of law enforcement and monitoring any use of individual restraint and/or seclusion in accordance with part 2.14 of these rules;

5. Communication with intoxicated individuals leaving treatment against personnel 6. Circumstances under which individuals must end Level 3.2-WM services, other than completing services or leaving against personnel recommendations.

C. S upport systems 1. Agencies must:

a. Implement protocols that are developed and supported by a physician knowledgeable in addiction medicine;

b. Have protocols in place to address an individual’s evolving treatment and withdrawal needs, including protocols for if the individual’s condition deteriorates and requires medical or nursing care services;

c. Have protocols that clearly determine the nature of medical or nursing care required. These protocols must include how to determine when nursing and/or physician care is warranted, and/or when transfer to a medically monitored facility or acute care hospital is necessary;

d. Ensure that medical evaluation and consultation is available twenty-four (24) hours per/day; and e. Ensure that medications that are self-administered, monitored, or dispensed at the agency are supervised and documented in accordance with agency policy and procedures, state, and federal law.

D. Diagnostic criteria 1. Individuals participating in Level 3.2-WM services are generally intoxicated, under the influence, or in any stage of withdrawal from alcohol and/or other drugs.

2. In addition to the ASAM Criteria guidelines detailed in part 2.12.3.C of these rules, individuals participating in Level 3.2-WM services must meet the diagnostic criteria for substance withdrawal disorder, as indicated in the DSM-5-TR.

3. Upon admission to Level 3.2-WM services, the agency must complete the following minimum requirements:

a. Collect information regarding the degree of alcohol and/or other drug intoxication as evidenced by breathalyzer, urinalysis, self-report, observation or other evidence-based or best practices;

b. A pregnancy screening for pregnancy-capable individuals;

c. Taking of vital signs; and d. Administration of a validated clinical withdrawal assessment tool.

E. The agency must conspicuously post procedures for responding to circumstances and events that warrant entering a divert status. 5.6.2 Personnel A. Personnel must be trained in, and evaluated in knowledge of the following areas before providing services independently, if within their scope of practice and job description:

1. Withdrawal management process;

2. Monitoring vital signs;

3. Conducting assessment and triage, including identifying and properly responding to suicidal ideation;

4. C ollecting urine and breath samples; and 5. Basic counseling and motivational interviewing skills.

B. Agencies providing Level 3.2-WM must ensure all personnel working with children under the age of eighteen (18) are trained and knowledgeable in child development and engaging children in states of intoxication and withdrawal management care.

C. Each work shift at an agency must have a minimum of two (2) personnel, whenever one (1) or more individuals are present. At least one (1) of those persons must be treatment personnel as listed in part 5.2.2.D of this Chapter.

D. The individual-to-personnel ratio must not exceed ten to one (10:1).

E. The agency personnel requirements below are specific to each physical location where Level 3.2- WM services are provided. This includes on-call personnel that may assist as needed.

1. At least fifty percent (50%) of the agency’s personnel providing Level 3.2-WM services must consist of treatment personnel identified in part 5.2.2.D of this Chapter.

a. If utilizing counselors-in-training and/or interns, the agency must ensure that all able to supervise pursuant to their scope of practice. Plans for addiction counselor certification must be available for review.

b. Full-time personnel must obtain at least an addiction technician certification within eighteen (18) months of employment.

2. Uncertified personnel or personnel without a plan for addiction counselor certification must not comprise more than fifty percent (50%) of an agency’s total personnel. This includes group living workers that may be utilized for milieu management.

F. The person overseeing day-to-day operations for agencies providing Level 3.2-WM services must be one of the following:

1. An authorized practitioner, 2. A licensee; or 3. A certified addiction specialist (CAS). 5.6.3 Service Provisions A. Agencies must:

1. Provide safe management and documentation of signs and symptoms of intoxication and withdrawal;

2. Ensure that transition planning begins at the time of admission to Level 3.2-WM services, to allow for necessary care coordination and transition into ongoing or concurrent treatment services to occur successfully;

3. Provide additional service planning for managing individuals with medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place individuals at additional risk during withdrawal management; and 4. P rovide assessments of individual readiness for treatment and services based on the service plan and the assessments and interventions shall be documented in the B. Medication-assisted treatment (MAT) for withdrawal management 1. Agencies must continue individuals on their medication-assisted treatment regimen and will only remove individuals from medications treating opioid use disorders at the individual’s request or if it is deemed medically appropriate by an authorized practitioner.

2. Agencies must inform individuals receiving services about access to medication-assisted treatment. Upon the individual’s consent, the agency must provide medication-assisted 3. Agencies must obtain a controlled substance license pursuant to section 21.300 of 2 CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled substance from stock medication in order to treat a substance use disorder or to treat the a. A controlled substance license is not required if the agency intends to provide C. Discharge from Level 3.2-WM services 1. Agencies must ensure referral and care coordination for continued behavioral health treatment that occurs at the time of discharge from Level 3.2-WM services. This may be made available within the agency’s structure or through referral.

2. Agencies must provide discharge information as required in part 2.10.A.6 of these rules to the individual and document that it was provided.

3. Agencies must provide the following information to individuals at the time of discharge from Level 3.2-WM services:

a. Effects of alcohol and other drugs;

b. Risk factors associated with alcohol and other drug abuse for acquiring and transmitting HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome), Tuberculosis (TB), and other infectious diseases, and for pregnancy;

c. Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C and other infectious diseases, and pregnancy; and d. Availability of harm-reduction and alcohol and other substance use disorder treatment resources. 5.6.4 Documentation and Timeliness A. The following must be addressed within three (3) hours of an individual’s arrival at the agency:

1. Personnel must complete the screening and triage process as indicated in part 2.12.1 of these rules to determine the urgency and appropriateness of care within the agency including the need for emergency or urgent medical or psychiatric services;

2. In c ollaboration with the individual, personnel must develop withdrawal managementfocused initial service plan, tailored to the safe withdrawal of the individual from the substance(s) of concern;

3. In addition to required intake documentation and consents as noted in part 2.11 of these rules, the agency must inventory and secure the individual’s personal belongings. This must be observed and confirmed through documentation by at least two (2) personnel;

4. Personnel must monitor and document vitals in real-time.

B. As soon as clinically feasible, but no later than seventy-two (72) hours following admission of an individual to Level 3.2-WM services, the agency must:

1. Update or amend any intake paperwork or consents that the individual was not able to complete or comprehend due to their state of intoxication upon admission;

2. Complete at least the initial assessment as indicated in part 2.12.2 of these rules, including substance use disorder history and the degree to which the use of substances affects personal and social functioning;

3. Update the individual’s service plan to reflect ongoing treatment needs as identified through the assessment; and 4. Document referral and care coordination activities to support the individual’s transition into beginning or resuming behavioral health treatment services.

C. Observation and monitoring requirements 1. Agencies must conduct routine monitoring of physical and mental status of the individual throughout their time in Level 3.2-WM services. This must include:

a. Vital signs taken and documented in real-time at the following minimum frequency:

(1) Every two (2) hours until vitals remain at the individual’s baseline for at least four (4) consecutive hours, (2) Then every eight (8) hours thereafter until discharge.

(a) Documentation per shift to include all individual monitoring activities. 5.7 Clinically Managed Residential Services, Including ASAM Level 3.3 Services A. This part 5.7 applies to agencies providing behavioral health residential services at an ASAM 3.3 level of care.

B. This part 5.7 does not apply to agencies providing Level 3-WM services only.

C. T his part 5.7 does not apply to services to children under the age of eighteen (18) seeking 5.7.1 Service Delivery and Setting A. These services are intended for individuals who are unlikely to benefit from outpatient services or other residential levels of care due to a temporary or permanent cognitive impairment resulting from an addictive or co-occurring disorder. Therapeutic rehabilitation facilities or traumatic brain injury programs are examples of this level of care.

B. Agencies shall confirm that individuals served have a history of substance use or co-occurring disorders or difficulty with interpersonal relationships, coping skills, or comprehension that necessitates this twenty-four (24) hour structured recovery environment, in combination with highintensity clinical services.

C. If agency personnel determine that an individual served may benefit from deliberately repetitive and/or concrete services, those services shall be delivered on a timeline appropriate to the individual’s assessed cognitive needs.

D. The agency must ensure that treatment is focused on preventing relapse, continued problems and/or continued use, enhancing readiness to change, and promoting the eventual reintegration of the individual into the community.

E. Individuals with a temporary cognitive impairment may be transferred to another level of care after the impairment has resolved. Individuals with chronic cognitive impairment may remain in this level of care for a longer duration, if assessed as continuing to meet their individual needs.

F. Support systems 1. Agencies must:

a. Ensure the availability of telehealth or on-site consultation with an authorized b. Ensure the availability of consultation with emergency services twenty-four (24)

c. Have the capacity to arrange for medication-assisted treatment (MAT) and/or psychiatric medications in a timely manner for individuals served.

(1) This may include services provided through coordination and referral but must not exceed twenty-four (24) hours from identifying the need to complete. 5.7.2 Personnel A. If utilizing certified addiction technicians (CAT), these personnel must not comprise more than twenty-five percent (25%) of the agency’s total personnel; and B. If utilizing counselors-in-training and/or interns, these personnel must not comprise more than twenty-five percent (25%) of the agency’s total personnel.

5.7.3 S

A. Services must be regularly scheduled services and include a minimum of nine (9) hours of B. Services must be delivered in a manner that is matched to the individual’s functioning. These services may be provided in a deliberately repetitive manner or with a timeline appropriate to address the cognitive needs of individuals for whom this level of care is considered a medical necessity. 5.7.4 Documentation A. Agencies must complete and document the following items in the individual’s record within 1. All required demographic, intake and consent paperwork, as specified in part 2.11 of 2. Screenings, as required in part 2.12.1 of these rules;

3. The initial assessment as required in part 2.12.2 of these rules; and 4. The initial service plan, addressing immediate needs and other relevant concerns B. As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the agency must complete and document the comprehensive assessment for the individual, as C. As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive assessment is completed, the agency must complete and document an individualized and comprehensive service plan, informed by the comprehensive assessment, as required in part D. If the individual’s comprehensive assessment indicates they may benefit from further evaluation, medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are addressed during the episode of care. The individual record must contain documentation E. Service plan reviews and revisions must be completed and documented in the individual’s record when there is a change in the individual’s level of functioning or service needs, but in no case 1. Monthly for the first six (6) months after admission, and 2. At least quarterly for the remainder of time that the individual remains in residential F. P rogress notes must be present in the individual’s record, in accordance with part 2.13.2 of these rules. Progress notes must be completed at least daily for this level of care. 5.8 Level Two Mental Health Transitional Living Home Services A. Level two mental health transitional living homes shall comply with the rules in parts 5.1 through 5.4 of this Chapter.

B. Level two mental health transitional living homes shall ensure that 600 minutes (ten hours) of planned treatment services are provided to each individual on a weekly basis.

C. Level two mental health transitional living homes must either:

1. Be designated pursuant to part 11.18 of these rules to provide care and treatment to individuals on short-term and long-term certifications on an outpatient basis; or 2. Establish facility agreements with designated facilities in order to treat individuals on short-term or long-term certifications on an outpatient basis. 5.9 Clinically Managed Residential Services, Including ASAM 3.5-Type Services A. This part 5.9 applies to agencies providing ASAM 3.5-type clinically managed behavioral health B. This part 5.9 does not apply to agencies providing only Level 3-WM services.

5.9.1 S ervice Delivery and Setting A. These services are intended for individuals who have multifaceted treatment needs requiring a twenty-four (24) hour treatment environment, and who are unable to be properly treated at a lower level of residential care. A variable-length therapeutic community or residential treatment center are examples of this level of care.

B. Agencies must confirm that any individuals served have multiple treatment considerations to be addressed during the residential episode of care, which may include, but are not limited to the 1. A history of mental health, substance use or co-occurring disorders.

2. Engagement in behaviors and/or thought processes that contribute to impaired social, interpersonal, and/or vocational functioning, necessitating this highly structured twentyfour (24) hour treatment environment.

C. Services provided by the agency must be directed toward developing and enhancing prosocial behaviors, sustaining recovery, reducing relapse risk when applicable, and the promotion of successful reintegration into the community.

D. Support systems 1. Agencies providing this clinically managed residential service shall:

a. Ensure the availability of telehealth or on-site consultation with an authorized practitioner twenty-four (24) hours per day, seven (7) days per week;

b. Ensure the availability of consultation with emergency services twenty-four (24)

c. H ave the capacity to arrange for medication-assisted treatment (MAT) and/or psychiatric medications in a timely manner that must not exceed twelve (12) hours to complete. 5.9.2 Personnel A. Agencies must:

1. Ensure that each work shift has a minimum of two (2) personnel on-site, whenever one (1) or more individuals are present in the milieu; and 2. Maintain individual-to-personnel ratios not exceeding twenty to one (20:1) at all times, per physical location, unless otherwise noted. This includes nighttime and weekend hours. 5.9.3 Service Provisions A. Services for individuals must be regularly scheduled and include a minimum of ten (10) hours of 5.9.4 Documentation and Timeliness A. Agencies must complete and document the following items in the individual’s record within 1. All required demographic, intake and consent paperwork, as specified in part 2.11 of 2. Screenings, as required in part 2.12.1 of these rules;

3. The initial assessment as required in part 2.12.2 of these rules; and 4. The initial service plan, addressing immediate needs and other relevant concerns B. Screenings and assessments conducted in accordance with 5.9.4.A must be used to determine appropriateness for this level of care.

C. As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the agency must complete and document the comprehensive assessment for the individual, as D. As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive assessment is completed, the agency must complete and document an individualized and comprehensive service plan, informed by the comprehensive assessment, as required in part E. If the individual’s comprehensive assessment indicates they may benefit from further evaluation, medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are addressed during the episode of care. The individual record must contain documentation F. S ervice plan reviews and revisions must be completed and documented in the individual’s record when there is a change in the individual’s level of functioning or service needs, but in no case 1. Monthly for the first six (6) months after admission, and 2. At least quarterly for the remainder of time that the individual remains in residential G. Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these rules. The minimum frequency of progress note completion for this level of care may vary, depending upon the individual’s time in the level of care and/or anticipated length of stay.

1. For the first thirty (30) days of the stay, daily progress notes are required.

2. After the first thirty (30) days where there is an anticipated length of stay of three (3) months or less, providers shall continue required daily progress notes.

3. After the first thirty (30) days when there is an anticipated length of stay of more than three (3) months, providers shall complete progress notes at a minimum of weekly. 5.9.5 Treatment Type Standards for Clinically Managed Behavioral Health Residential Services and ASAM 3.5-Type Services A. A gencies that provide mental health-only or co-occurring residential services must confirm the 1. Individuals served meet at least one (1) of the following criteria:

a. Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a moderate level, per the DSM-5-TR, or b. Have sufficient collateral information to indicate there is a high probability that the individual has a serious mental illness or comorbid diagnoses at a moderate level, as defined in the DSM-5-TR.

B. Agencies that provide co-occurring or substance use disorder-only residential services at an ASAM 3.5-type must ensure the following:

1. If utilizing certified addiction technicians (CAT), these personnel do not comprise more 2. If utilizing counselors-in-training and/or interns, these personnel do not comprise more 5.10 Medically Monitored Residential Services, Including ASAM 3.7-Type Services A. This part 5.10 applies to agencies providing ASAM 3.7-Type medically monitored behavioral health residential services.

B. This part 5.10 does not apply to agencies providing only ASAM Level 3.7-WM services. 5.10.1 Service Delivery and Setting A. Medically monitored residential services are intended for individuals whose medical, emotional, behavioral and/or cognitive problems are severe enough to require twenty-four (24) hour medical monitoring, but do not require the full resources of an acute care general hospital or medically managed inpatient treatment program. These services may be offered in free-standing buildings providing residential services or incorporated into specialty units within general health care or psychiatric hospitals.

B. A gencies must ensure that individuals receiving services receive multiple treatment considerations including but not limited to: a history of mental health, substance use or cooccurring disorders, along with medical, cognitive, or complicated withdrawal management needs that require the structured regimen of twenty-four (24) hour evaluation, observation, and medical monitoring in order to safely provide the necessary behavioral health services.

C. Agencies must ensure treatment is designed for individuals who have functional limitations in the areas of intoxication/withdrawal potential, biomedical conditions, and/or emotional, behavioral, or cognitive conditions. This level of care focuses on the monitoring of the individual’s biomedical needs to promote physical and psychiatric stabilization and allow for continued engagement in a lower level of care once the individual is stabilized.

D. Support systems 1. Agencies must:

a. Ensure the availability of telehealth or on-site consultation with an authorized b. Ensure the availability of consultation with emergency services twenty-four (24) hours per day, seven (7) days per week;

c. Have the capacity to arrange for medication-assisted treatment (MAT) and/or psychiatric medications in a timely manner for individuals served. This must not exceed eight (8) hours from identifying the need to complete;

d. Ensure the availability of additional medical specialty consultation, psychological, laboratory and toxicology services; and (1) These services may be provided through consultation or referral; and e. Ensure that psychiatric services, if not provided, are available on-site through consultation or referral within eight (8) hours by telehealth or twenty-four (24) hours in-person. 5.10.2 Personnel A. Agencies must:

1. Ensure that each work shift has a minimum of two (2) personnel on-site whenever one (1) or more individuals are present in the milieu;

2. Maintain an individual-to-personnel ratio not exceeding twenty to one (20:1) at all times, per physical location. This includes nighttime and weekend hours;

3. Utilize an interdisciplinary team that includes physicians, nurses and mental health professionals licensed or certified pursuant to Article 245 of Title 12, C.R.S. that provide twenty-four (24) hour professionally directed evaluation, care and treatment services including administration of prescribed medications, withdrawal management and integrated treatment of co-occurring medical, emotional, behavioral or cognitive conditions;

4. Be ov erseen by a physician licensed pursuant to Article 240 of Title 12, in order to assure the quality of care; and 5. Have a nurse as defined in part 1.3 of these rules, responsible for monitoring the individual’s progress and/or medication administration twenty-four (24) hours per day, seven (7) days per week. 5.10.3 Service Provisions A. Medically monitored residential services must be regularly scheduled and include a minimum of twenty (20) hours of planned treatment services per week.

B. At the time of admission to the agency, a registered nurse must conduct an alcohol or other drugfocused assessment, if applicable.

C. As soon as clinically feasible, but no later than twenty-four (24) hours after admission to the agency, an authorized practitioner must perform a physical examination of the individual.

1. Physical examinations performed by authorized practitioners must be completed as necessary for the individual throughout the episode of care. 5.10.4 Documentation and Timeliness A. Agencies must complete and document the following items in the individual’s record within 1. All required demographic, intake and consent paperwork, as specified in part 2.11 of 2. Screenings, as required in part 2.12.1 of these rules;

3. The initial assessment as required in part 2.12.2 of these rules; and 4. The initial service plan, addressing immediate needs and other relevant concerns B. Screenings and assessments conducted in accordance with 5.10.4.A of this Chapter must be used to determine appropriateness for this level of care.

C. As soon as possible, but no later than ten (10) calendar days after an individual’s admission, the agency must complete and document the comprehensive assessment for the individual, as D. As soon as possible, but no later than three (3) calendar days after an individual’s comprehensive assessment is completed, the agency must complete and document an individualized and comprehensive service plan, informed by the comprehensive assessment, as required in part E. If the individual’s comprehensive assessment indicates they may benefit from further evaluation, medication, and/or specialty behavioral health care to address mental health, substance usespecific, or co-occurring needs, the agency must ensure their individualized treatment needs are addressed during the episode of care. The individual record must contain documentation F. S ervice plan reviews and revisions must be completed and documented in the individual’s record when there is a change in the individual’s level of functioning or service needs, but in no case 1. Monthly for the first six (6) months after admission, and 2. At least quarterly for the remainder of time that the individual remains in residential G. Progress notes must be present in the individual’s record, in accordance with part 2.13.2 of these rules. Progress notes must be completed at least daily for this level of care. 5.10.5 Treatment Type Standards for Medically Monitored Behavioral Health Residential Services and ASAM 3.7-Type Services A. Agencies that provide mental health-only or co-occurring residential services must ensure the 1. Individuals served meet at least one (1) of the following criteria:

a. Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a severe level, as defined in the DSM-5-TR;

b. Have sufficient collateral information that indicates a high probability that the individual has a serious mental illness or comorbid diagnoses at a severe level, as defined in the DSM-5-TR; or c. Are diagnosed with a serious mental illness (SMI) or comorbid diagnoses at a mild to moderate level, as defined in the DSM-5-TR, with additional biomedical needs that require a higher level of medical oversight.

B. Agencies that provide co-occurring or substance use disorder-only residential services at an ASAM 3.7-type must ensure the following:

1. If utilizing certified addiction technicians (CAT), these personnel do not comprise more 2. If utilizing counselors-in-training and/or interns, these personnel do not comprise more 5.11 Medically Monitored Inpatient Withdrawal Management (ASAM Level 3.7-WM) Services A. This part 5.11 applies to agencies providing withdrawal management services at an ASAM 3.7- WM level of care.

B. This part 5.11 does not apply to agencies providing behavioral health residential services only. 5.11.1 Service Delivery and Setting A. Level 3.7-WM services are available for individuals who require the oversight of medical and nursing professionals in order to complete a safe period of withdrawal. This level of care provides a twenty-four (24)-hour service in which individuals have prompt access to medical evaluations as needed, as well as an interdisciplinary team available to meet the individual’s needs. Services are developed and delivered under the monitoring of a physician. This may be observed as a freestanding withdrawal management center or as a step-down service from an acute care hospital.

1. S ervices must be provided by licensed medical personnel qualified to supervise withdrawal from alcohol and other drugs through the use of medication and/or medical procedures in residential settings which possess a controlled substances license in compliance with Part 2 of Article 80 of Title 27, C.R.S.

B. Agencies must develop policies and procedures to address service delivery expectations. These 1. Consultation with specialized clinical and medical professionals for individualized withdrawal management care;

2. Coordinating an individual’s transition into other levels of care, determined to be completed during the course of Level 3.7-WM services. This may include collaboration with emergency behavioral health services, such as Colorado Crisis Services, as 3. Conducting or arranging for laboratory and/or toxicology tests to be completed;

4. Responding to individuals who are assessed as being a current threat to themselves or others. This must include appropriate use of law enforcement and monitoring any use of individual restraint and/or seclusion in accordance with part 2.14 of these rules;

5. Communication with intoxicated individuals leaving treatment against personnel 6. Circumstances under which individuals must end Level 3.7-WM services, other than completing services or leaving against personnel recommendations.

C. Support systems 1. Agencies must:

a. Implement protocols that are developed and approved by a physician knowledgeable in addiction medicine.

b. Develop and implement specific admission protocol detail for which substances, including both drugs and alcohol, medical withdrawal management services are provided. This protocol must include processes for customary and atypical withdrawal management from each drug delineated in the admission protocol, and must include at minimum, the following elements:

(1) Types of intoxication;

(2) Tolerance levels for the individual's drug of choice;

(3) Degrees of withdrawal;

(4) Possible withdrawal and/or intoxication complications;

(5) Other conditions affecting medical withdrawal management procedures;

(6) Types of medications used;

(7) Recommended dosage levels;

(8) Procedures to follow in the event of withdrawal management complications;

(9) Daily assessments including expected improvements as well as potential problems; and (10) Expected duration of withdrawal management.

c. Ensure that prompt medical evaluation and consultation is available twenty-four (24) hours/day.

d. Ensure that hourly nurse monitoring of the individual’s progress is available, if medically indicated.

e. E nsure that medications that are self-administered, monitored, or dispensed at the facility are supervised and documented in accordance with agency policy and procedures, state, and federal law.

f. Ensure referral and care coordination for continued behavioral health treatment occurs. This may be made available within the agency’s structure or through referral.

D. Diagnostic criteria 1. Individuals participating in Level 3.7-WM services are generally intoxicated, under the influence, or in a severe stage of withdrawal from alcohol and/or other drugs. These individuals may have comorbid medical issues that require additional medical oversight.

2. In addition to the ASAM Criteria guidelines detailed in part 2.12.3.C of these rules, individuals receiving Level 3.7-WM services must meet the diagnostic criteria for substance withdrawal disorder, as indicated in the DSM-5-TR.

3. Upon admission to Level 3.7-WM services, the agency must complete the following minimum requirements:

a. Collect information regarding the degree of alcohol and/or other drug intoxication as evidenced by breathalyzer, urinalysis, self-report, observation or other evidence-based or best practices;

b. A pregnancy screening for pregnancy-capable individuals;

c. Taking of vital signs; and d. Administration of a validated clinical withdrawal assessment tool.

E. The agency must conspicuously post procedures for responding to circumstances and events that warrant entering a divert status. 5.11.2 Personnel A. Personnel must be trained in, and evaluated in knowledge of the following areas before providing services independently:

1. Withdrawal management;

2. Monitoring vital signs;

3. Conducting assessment and triage, including identifying and properly responding to, suicidal ideation;

4. C ollecting urine and breath samples; and 5. Basic counseling and motivational interviewing skills.

B. Agencies providing Level 3.7-WM must ensure all personnel working with children under the age of eighteen (18) are trained and knowledgeable in child development and engaging children in states of intoxication and withdrawal management care.

C. Each work shift must have a minimum of two (2) personnel, whenever one (1) or more individuals are present.

D. Treatment personnel as defined in part 5.3.2.D must be present at a rate that meets the needs of the individuals receiving Level 3.7-WM services.

E. Agencies must employ, at minimum, the following personnel:

1. A medical director who is licensed as a physician or medical doctor pursuant to Article 240 of Title 12, C.R.S., 2. A registered nurse or licensed practical nurse with at least one (1) year of withdrawal management experience; and 3. Treatment personnel as defined in part 5.3.2.D of this Chapter.

F. Personnel oversight 1. The person overseeing day-to-day operations for an agency providing Level 3.7-WM services must be the medical director.

2. The medical director’s responsibilities must include, at minimum:

a. Quarterly reviews and revisions of drug withdrawal management categories and b. Reviews of individual withdrawal management plans;

c. Reviews of individual prescriptions;

d. Direct supervision of individual withdrawal management cases that deviate from standard protocols and/or the individual experiences complications;

e. Five (5) hours of monthly supervision of and consultation with personnel providing withdrawal management services;

f. Development and implementation of back-up systems for physician coverage when medical director(s) are unavailable and/or for emergencies;

g. Review of critical incidents reported in accordance with part 2.16 of these rules;

h. Review of admission, medical exclusion, and medical care policies at least annually.

G. Agencies must ensure twenty-four (24) hour access to clinical personnel by telehealth and accommodations for unscheduled visits in the event of crises or problem situations.

5.11.3 S

A. Agencies must:

1. Provide safe management and documentation of signs and symptoms of intoxication and withdrawal;

2. Ensure that transition planning begins at the time of admission to Level 3.7-WM services, to allow for necessary care coordination and transition into ongoing or concurrent treatment services to occur successfully;

3. Provide additional service planning for managing individuals with medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place individuals at additional risk during withdrawal management; and 4. Provide assessments of individual readiness for treatment and services based on the service plan and the assessments and interventions shall be documented in the B. Medication-assisted treatment (MAT) for withdrawal management 1. Agencies must continue individuals on their medication-assisted treatment regimen and will only remove individuals from medications treating opioid use disorders at the individual’s request or if it is deemed medically appropriate by an authorized practitioner.

2. Agencies must inform individuals receiving services about access to medication-assisted treatment. Upon the individual’s consent, the agency must provide medication-assisted 3. Agencies must obtain a controlled substance license pursuant to section 21.300 of 2 CCR 502-1 from the BHA if they plan to dispense, compound, or administer a controlled substance from stock medication in order to treat a substance use disorder or to treat the a. A controlled substance license is not required if the agency intends to provide C. Discharge from Level 3.7-WM services 1. Agencies must ensure referral and care coordination for continued behavioral health treatment occurs at the time the individual is discharged from Level 3.7-WM services.

This may be made available within the agency’s structure or through referral.

2. A gencies must provide discharge information as required in part 2.11 of these rules to the individual and document that it was provided.

3. In addition to these requirements, agencies must provide the following information to individuals at the time of discharge from Level 3.7-WM services:

a. Effects of alcohol and other drugs;

b. Risk factors associated with alcohol and other drug abuse for acquiring and transmitting HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome), Tuberculosis (TB), and other infectious diseases, and for pregnancy;

c. Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C and other infectious diseases, and pregnancy; and d. Availability of harm-reduction and alcohol and other substance use disorder treatment resources.

D. Agencies must provide medical evaluations completed by authorized practitioners. The medical evaluations must consist of, at minimum:

1. Medical histories including detailed chronologies of substance use disorders;

2. Identification of current physical addiction including drug types;

3. Physical examinations to determine appropriateness for outpatient or inpatient medical withdrawal management; and 4. Appropriate laboratory tests and other evaluations, as indicated.

E. Medication dispensation and administration procedures 1. Agencies using stock-controlled substances in order to treat a substance use disorder or to treat the withdrawal symptoms of a substance use disorder are required to have a controlled substance services license issued by the BHA and comply with the applicable portion(s) of section 21.300 of 2 CCR 502-1 that deal with a controlled substance license.

2. Agencies may utilize buprenorphine for medications for opioid use disorder (MOUD) services without requiring an opioid treatment program endorsement. If an agency intends to utilize controlled substances other than/in addition to buprenorphine for MOUD services, the agency must be endorsed as an opioid treatment program, verified through the Drug Enforcement Administration (DEA), and coordinated with the SAMHSA.

3. Qualified practitioners may prescribe buprenorphine under their own Drug Enforcement Administration (DEA) registration number for individuals admitted to this level of care for withdrawal management or addiction treatment.

4. Agencies must develop and implement policies and procedures for dispensing medications per standard withdrawal management protocols that are in accordance with applicable state and federal statutes and for the following:

a. Individual prescriptions filled and dispensed by a registered pharmacist at a designated pharmacy location;

b. I ndividual prescriptions from medical directors that are filled from stock quantities; and c. Storage and accounting of all medications, including controlled substances. 5.11.4 Documentation and Timeliness A. The following must be addressed within three (3) hours of an individual’s arrival at the agency:

1. Personnel must complete the screening and triage process as indicated in part 2.12.1 of these rules to determine the urgency and appropriateness of care within the agency including the need for emergency or urgent medical or psychiatric services;

2. In collaboration with the individual, personnel must develop a withdrawal managementfocused initial service plan, tailored to the safe withdrawal of the individual from the substance(s) of concern;

3. In addition to required intake documentation and consents as noted in part 2.11 of these rules, the agency must inventory and secure the individual’s personal belongings. This must be observed and confirmed through documentation by at least two (2) personnel;

4. Personnel must monitor and document vitals in real-time.

B. As soon as clinically feasible, but no later than seventy-two (72) hours following admission of an individual into Level 3.7-WM services, the agency must:

1. U pdate or amend any intake paperwork or consents that the individual was not able to complete or comprehend due to their state of intoxication upon admission;

2. Complete at least the initial assessment as indicated in part 2.12.2 of these rules, including substance use disorder history and the degree to which the use of substances affects personal and social functioning;

3. Update the individual’s service plan to reflect ongoing treatment needs as identified through the assessment; and 4. Document referral and care coordination activities to support the individual’s transition into beginning or resuming behavioral health treatment services.

C. The individual record must contain informed consent to receive medical withdrawal management services that includes at minimum:

1. Medications to be used; and 2. Need to consult with primary care physicians.

D. Observation and monitoring requirements 1. Agencies must conduct routine monitoring of physical and mental status of the individual throughout their time in Level 3.7-WM services. This must include:

a. Vital signs taken and documented in real-time at the following minimum frequency:

(1) Every two (2) hours until vitals remain at the individual’s baseline for at least four (4) consecutive hours, (2) Then every eight (8) hours thereafter until discharge.

(a) Documentation per shift to include all individual monitoring activities.

2. If medical personnel determine that an individual requires vital signs to be monitored and documented in real-time at a frequency that is less than the minimum requirement above, the rationale and plan for this variance must be documented in the individual’s record.

Non-medical personnel must not make or document such a determination.

Chapter 6: E mergency and Crisis Behavioral Health Services 6.1 Authority and Applicability A. Chapter 6 establishes the standards for and is applicable to BHEs electing to provide behavioral health crisis and emergency services. The authority to promulgate these service-specific requirements that apply to BHEs electing to provide these services comes from Sections 27-50- 502(1), 27-50-106, and 27-50-107(3)(b), C.R.S. 6.2 General Provisions A. All agencies providing residential services to individuals shall comply with the residential and overnight requirements set forth in part 2.26 of these rules.

B. Each component within the behavioral health crisis response system must provide services in a trauma-informed, culturally responsive manner.

C. Agencies must incorporate peer support professionals in accordance with Chapter 3 of these rules into the services they provide, when clinically appropriate. 6.3 Walk-In Crisis Services 6.3.1 Applicability A. These rules set forth in this section 6.3 are established to create standards for and apply to agencies with an endorsement to provide walk-in crisis services. 6.3.2 General Provisions A. Each walk-in crisis agency must obtain a 27-65 designation and be in compliance with Section 27-60-104, C.R.S.

B. All walk-in crisis agencies are required to obtain a Children and Families endorsement pursuant to Chapter 8 of these rules.

C. Walk-in crisis services must be accessible to all individuals throughout the state of Colorado twenty-four (24) hours per day, seven (7) days per week, and 365 days per year. Every walk-in crisis services agency must have the ability to provide information and referrals to anyone in need, and crisis assessment when indicated, including, if appropriate, access and clinically appropriate transportation to crisis stabilization in a crisis stabilization unit. Walk-in crisis service agencies must collaborate with other agencies endorsed pursuant to this Chapter 6, and community-based organizations.

D. A w alk-in crisis agency must have the capacity to:

1. Screen and triage every individual who presents at the agency, with any presenting problem including acute and chronic substance use and/or intellectual and developmental disability;

2. Coordinate multiple simultaneous requests for services;

3. Work closely with community partners, family members or caregivers; and 4. Work with local hospitals to develop accepted clearance practices to divert the individual in crisis from emergency departments for purpose of verifying medical stability prior to residential or inpatient admission.

E. Walk-in crisis agencies must employ an integrated care model based on evidence-based practices that consider an individual's physical and emotional health.

F. Walk-in crisis agencies shall manage and prevent elopement of individuals on an emergency mental health hold using strategies in conformity with state and federal laws.

G. Walk-in crisis agencies must develop crisis safety plans in collaboration with the individual in crisis and/or their family member(s) or other social supports. Safety plans should include psychiatric advanced directives and referrals/warm hand offs to health and social services and supports, as needed.

H. Follow-up services must be provided to every individual and must include:

1. Follow-up to each individual and authorized caregiver and/or family member(s) by phone or in-person, based on clinical need and individual preferences. The first follow-up must be within twenty-four (24) hours after services were provided. Follow-up attempts must be documented in the individual’s record. Follow-up communications must be compliance with state and federal data protection laws.

2. Follow-up communication may be conducted face-to-face, via telehealth, or via telephone only, based on an individual’s clinical need and preferences. 6.3.3 Service Provisions A. Walk-in crisis services must include screening as defined in part 2.12.1 of these rules, triage, crisis assessment, and referrals to appropriate resources. Individuals in crisis must be screened and triaged within fifteen (15) minutes of arrival.

1. Walk-in crisis agencies are exempt from assessment requirements in Part 2.12.2 and 2.12.3 of these rules. Walk-in crisis agencies shall complete a crisis assessment, in full, on a BHA-created form that is available on BHA’s website, if clinically indicated by the initial screening in part 2.12.1 of these rules.

B. Prior to an individual leaving a walk-in crisis agency, screenings must be reviewed by a crisis professional who is licensed or a candidate receiving supervision from a licensee or authorized 1. Walk-in crisis agencies shall refer all individuals seeking crisis services to appropriate resources based on the level of care indicated by the screening or crisis assessment.

C. Walk-in crisis services must include:

1. Brief intervention, stabilization and de-escalation intended to maintain stability in the community, whenever possible to include such activities as:

a. On-site interventions, including solution-focused crisis counseling, for immediate de-escalation of presenting behavioral health issues.

b. Coordination with other providers involved in the individual’s or individual’s family’s care.

c. Skill development, psychosocial education and initial identification of resources needed to stabilize the presenting situation.

d. Crisis prevention strategies, including resources to cope with presenting emotional symptoms, behaviors, and existing circumstances to avoid future crises.

e. I mmediate coordination with other crisis providers when needed (e.g., crisis stabilization units and respite, psychiatric emergency services).

f. Prioritization of remaining in the community, especially for children. Prioritize crisis response in home and community-based settings, including schools, recreational centers, homeless shelters, and other community centers for children.

g. Lethal means restriction.

h. Peer support to reduce stigma and build connection.

i. Identifying and engaging natural supports.

2. Substance use services:

a. Walk-in crisis agencies shall provide harm reduction interventions, including the administration of opioid receptor antagonists to reverse an overdose, if needed.

b. Evaluation of withdrawal management needs. Walk-in crisis agencies may offer withdrawal management services if endorsed to provide such services.

c. Evaluation of appropriateness for medication-assisted treatment (MAT) and referrals to providers that can initiate treatment as indicated.

3. Physical health screen, if indicated, to inform crisis planning and/or as part of the clearance practice.

a. Physical health screens may be provided by qualified walk-in crisis agency personnel or through coordination or referral to a medical provider.

4. Referrals:

a. Walk-in crisis agency personnel are responsible for referrals and warm hand-offs to health and social services and supports, including withdrawal management and medication-assisted treatment, as needed.

b. Walk-in crisis agency personnel must make documented efforts to schedule follow-up appointments within seven (7) business days of referral. 6.3.4 Personnel Requirements A. A walk-in crisis agency must be staffed twenty-four (24) hours per day, seven (7) days per week, and 365 days per year.

B. A walk-in crisis agency must include a number of trained professionals on their team which may include licensees, authorized practitioners, peer support professionals, case managers, nurses, and other trained crisis personnel.

C. A walk-in crisis agency must employ sufficient personnel to ensure that the provision of services meets the needs of individuals. At minimum, the agency must have two (2) personnel on-site at all times.

D. A walk-in crisis agency must always be staffed by crisis professionals who can lead the crisis assessment and intervention. This may include crisis professionals receiving supervision from a licensee or authorized practitioner.

E. A walk-in crisis services agency must have access to a licensee or authorized practitioner within fifteen (15) minutes via telehealth if one is not available onsite.

F. Every agency endorsed to provide walk-in crisis services must employ or contract with a peer support professional who may lead initial engagement and assist with follow-up services. Any recovery support services rendered by peer support professionals shall be provided in accordance with part 3.1 through 3.5 of these rules.

G. A walk-in crisis agency must include a personnel member trained in working with children, families and their caregivers who experience crisis.

H. A walk-in crisis agency must develop a training plan for personnel to ensure expertise in addressing and responding to individuals with physical or intellectual/developmental disabilities (I/DD), traumatic brain injury, severe mental illness, serious emotional disturbance, substance use disorders, co-occurring disorders, and other cognitive or neurodiverse needs who are in crisis.

I. A walk-in crisis agency may develop contractual relationships with local providers with expertise in working with the populations referenced in part 6.3.4.H of this Chapter above. These providers must be engaged during or immediately after initial face-to-face intervention as needed to support individuals in crisis who do not already have an existing relationship with a provider. Telehealth may be used to secure expertise for individuals served by the mobile crisis response team with a physical or I/DD.

J. Providers seeking crisis professional status must complete training required by the BHA found on the BHA website. Status will be tracked on a yearly basis by the BHA. 6.4 Crisis Stabilization Units 6.4.1 Applicability A. These rules set forth in this section 6.4 are established to create standards for and apply to agencies with an endorsement to operate a crisis stabilization unit (CSU).

6.4.2 S tandards for crisis stabilization services A. Crisis stabilization services must meet the requirements of part 2.12 of these rules, including, but not limited to requirements for screening, initial assessment, and comprehensive assessment, with the following additions:

1. Comprehensive assessments must be completed within twenty-four (24) hours of admission of an individual;

2. Medical and medication treatment in accordance with parts 11.8 and 11.17.13 of these rules and coordination with medical services;

3. Peer support, in accordance with Chapter 3 of these rules, when clinically appropriate;

4. Discharge and service planning in accordance with part 2.10 and 2.13 of these rules;

5. Safety planning:

a. Safety planning is required, and safety plans must be developed in collaboration with the individual and the individual’s family members and/or other social supports, if not clinically contraindicated.

b. Safety plans must include psychiatric advance directives.

6. Care coordination and referral services.

B. Crisis stabilization services must include, at a minimum:

1. Medication management; and 2. Individual and/or group counseling.

C. The agency shall ensure individuals admitted for crisis stabilization services cannot be appropriately treated in a less restrictive setting.

D. The individual must be assessed for continued appropriateness for treatment in the crisis setting at least every three (3) days.

1. When an individual’s assessment indicates the individual should be transferred to a different setting but placement in that setting is delayed due to lack of availability, the agency shall document that in the service plan, and continue reassessing the individual in accordance with part 6.5.2.A above.

2. Assessments for continued stays in the crisis stabilization setting past seven (7) days must include consideration regarding whether the individual would be more appropriately served, and should be transferred to, a different level of care. 6.4.3 Crisis Stabilization Unit Staffing Requirements A. In addition to the walk-in crisis service staffing requirements listed in part 6.3.4 of these rules, crisis stabilization units must have:

1. Access to an authorized practitioner upon admission; and 2. At minimum, one (1) on-site personnel member qualified to administer medications. 6.5 Mobile Crisis Services 6.5.1 Applicability A. The rules set forth in this section 6.5 are established to create standards for and apply to agencies with an endorsement to provide mobile crisis services pursuant to Section 27-60-104, 6.5.2 G eneral Provisions A. Mobile crisis service agencies are intended to provide a timely paired mobile response as described in part 6.5.3.B to a behavioral health crisis in the community. Mobile crisis service agencies must provide referrals and facilitate transitions to other crisis agencies, behavioral health entities, and community-based services as clinically indicated.

B. All agencies providing mobile crisis services or responding to crisis calls shall meet critical incident reporting procedures in accordance with part 2.16 of these rules. 6.5.3 Service Provisions A. Mobile crisis service agencies must have the capacity to:

1. Intervene where the crisis occurs;

2. Coordinate multiple simultaneous requests for services;

3. Work closely with law enforcement, emergency medical services, crisis hotlines, schools, and hospital emergency departments; and 4. Serve priority populations.

B. An agency’s mobile crisis response teams must arrive at the community-based location where a crisis occurs within two (2) hours of accepting a dispatch request for rural and frontier areas as defined in Section 23-76.5-101(6), C.R.S. and within one (1) hour of accepting a dispatch request for urban areas, including dispatch from the statewide hotline/988 either face-to-face or using telehealth operations.

1. The mobile crisis service agency shall develop policies for dispatch criteria related to serving:

a. Populations listed in part 6.5.4.E of this Chapter b. Individuals of all ages c. Individuals demonstrating aggressive behavior d. Individuals who are uninsured or unable to pay for services e. Individuals who may lack Colorado residency or legal immigration status 2. If the statewide hotline/988 requests a mobile crisis response, a mobile crisis service agency shall immediately accept the request which means to affirm the request from the hotline and immediately dispatch the mobile crisis response team. Rejected requests are subject to review from the BHA or their designee.

C. Mobile crisis service agencies must operate twenty-four (24) hours per day, seven (7) days per week, and 365 days per year in providing community-based crisis intervention, screening, crisis assessment on a BHA created form that is available on the BHA’s website, and referrals to appropriate resources.

D. T he mobile crisis service agency must complete screening requirements as defined in part 2.12.1 of these rules. In addition to these screening requirements, the mobile crisis service agency must also attempt to collect the following information:

1. Strengths and resources of the individual experiencing the crisis, their family members, and other social supports 2. Recent inpatient hospitalizations and/or any current relationship with a behavioral health provider 3. Medications prescribed, medications taken recently, current prescriber and information about the individual’s ongoing medication regimen E. The screening process referenced in this section’s subpart D above must also include a rapid determination as to whether the crisis warrants medical or law enforcement response.

F. The mobile crisis service agency must administer a crisis assessment, in full, on a BHA-created crisis assessment form that is available on the BHA’s website if clinically indicated by the initial screening in part 2.12.1 of these rules.

G. Mobile crisis service agencies through mobile crisis response teams shall develop crisis safety plans in collaboration with individuals in crisis and their authorized family members and/or other social supports, unless clinically contraindicated. The safety plan shall be in writing and copies of the plan must be offered to the individual, the individual’s caregiver when applicable, and to other service providers or social supports when authorized by the individual.

1. Safety plans must include any psychiatric advance directives in effect.

2. Safety plans shall also include:

a. Short-term strategies for immediate stabilization b. Long-term strategies to support a return to the pre-crisis level of functioning c. Referrals to services, supports, and resources identified by the mobile crisis team.

H. Mobile crisis teams of a mobile crisis service agency must follow-up with an individual and authorized caregiver and/or family member(s) by phone or in-person, based on clinical need and individual preferences, within twenty-four (24) hours from when services are provided. Follow-up attempts must be documented in the individual’s record.

I. Mobile crisis response teams of a mobile crisis service agency must provide brief intervention, stabilization and de-escalation services intended to maintain stability in the community, whenever possible. This may include but is not limited to:

1. On-s ite interventions, including solution-focused crisis counseling, for immediate deescalation of presenting behavioral health issues.

2. Coordination with other providers involved in the individual’s or family’s care.

3. Skill development, psychosocial education and initial identification of resources needed to stabilize the presenting situation.

4. Crisis prevention strategies and resources to cope with presenting emotional symptoms, behaviors and existing circumstances and avoid future crises.

5. Immediate coordination with other crisis providers, including peer support professional services, when needed. Other crisis providers may include walk-in centers, crisis stabilization units and respite, psychiatric emergency services.

6. Prioritization of remaining in the community, especially for children and young people.

Prioritize crisis response in home and community-based settings, including schools, recreational centers, homeless shelters, and other community centers for children.

7. Provide harm reduction interventions, including the administration of an opioid receptor antagonist to reverse an overdose, when needed.

8. Evaluation of appropriateness for medication-assisted treatment (MAT) and referrals to providers that can initiate treatment as indicated.

J. Mobile crisis response teams of a mobile crisis service agency must provide or coordinate clinically appropriate and accessible transportation to an appropriate level of care as needed following a response. An agency’s mobile crisis team may only provide transportation directly if they are appropriately licensed by their county as a secure transportation provider. 6.5.4 Personnel Requirements A. All mobile crisis service agencies must include a mobile crisis response team.

1. Every mobile crisis response team must include a licensee or authorized practitioner, or 2. Must have a licensee or authorized practitioner immediately available via telehealth.

3. Mobile crisis response teams may also include a number of trained professionals on their teams including emergency medical technicians, community paramedics, peer support professionals, mobile crisis case managers, nurses, and other trained crisis personnel.

B. Every mobile crisis response team must include a crisis professional who can lead the crisis assessment and intervention.

C. Every agency endorsed to provide mobile crisis services must employ or contract with a peer support professional who can be included in the mobile crisis response team as appropriate and available, and who may take the lead on initial engagement and assist with follow-up services.

1. A peer support professional must be available for follow-up services within one (1) business day of the crisis response.

D. Every mobile crisis response team must include a personnel member with specific training and expertise in serving children and their caregivers who experience crisis.

E. Personnel on a mobile crisis response team must be trained in responding to individuals with physical or intellectual/developmental disabilities (I/DD), traumatic brain injury, severe mental illness, serious emotional disturbance, substance use disorders, co-occurring disorders, and other cognitive or neurodiverse needs who are in crisis.

F. Mobile crisis service agencies may develop contractual relationships with local providers with expertise working with the populations referenced in 6.4.4.H of this Chapter. These providers must be engaged during or immediately after initial face-to-face intervention as needed to support individuals in crisis who do not already have an existing relationship with a provider. Telehealth may be used to secure expertise for individuals served by the mobile crisis response team with a physical disability or I/DD.

G. Mob ile crisis service agencies must develop a training plan to ensure expertise in addressing specific population needs as described in part 6.3.4.H of this section. If not utilizing contractual relationships to meet requirements in part 6.5.4.F of this section, the plan must address training for serving populations described in that part. 6.6 Respite Care Services 6.6.1 Applicability A. These rules set forth in this section 6.6 are established to create standards for and apply to agencies with an endorsement to provide residential or community-based respite care services. 6.6.2 General Provisions A. Residential or community-based respite care services provide temporary or short-term care by a licensee, authorized practitioner, candidate or other personnel based on the level of care being provided and is designed for an individual that has experienced a self-defined crisis. Crisis respite is intended to be a flexible intervention or set of services based on the presenting concerns of the individual in a self-defined crisis and must have the capacity to:

1. Provide supports necessary to alleviate the conditions leading to the initial crisis; and 2. Enhance an individuals’ sense of safety and agency in managing their crisis.

B. Residential or community-based respite care services include a range of short-term services twenty-four (24) hours per day, seven (7) days per week, and 365 days per year. Respite care services shall be flexible to ensure that the individual’s daily routine is maintained.

C. Length of stay determinations must be ongoing, transparent to the individual and family to the extent allowable under state and federal privacy laws, and jointly determined by the individual, family, respite provider, and treatment team.

D. In order to be eligible for residential or community-based respite services, an individual that has experienced a behavioral health crisis must:

1. Be referred by personnel within other agencies endorsed pursuant to this Chapter 6;

2. Agree to residential or community-based respite services;

3. Not meet emergency procedure criteria outlined in Section 27-65-106, C.R.S., Care and Treatment for Persons with Mental Illness;

4. Present a minimal risk of significant withdrawal complications;

5. Cooperate with program guidelines; and 6. Be able and willing to participate, with accommodations if needed, in forming a service 6.6.3 S A. Services must be intended to improve/maintain the condition and functional level of the individual and prevent relapse or hospitalization while providing a safe environment to address precipitating factors to the crisis. Services must include structure, support, and care coordination, and may include but not be limited to the following:

1. Comprehensive assessment as described in part 2.12.3 of these rules;

2. Assistance with monitoring, completing, or prompting of activities of daily living (ADLs);

3. Assistance with medical and physical health needs, including medication administration and monitoring;

4. Life skills and environmental maintenance;

5. Assistance/supervision needed by an individual to participate in social, recreational and community activities;

6. Referral to and establishing a stronger connection to community resources;

7. Relationship building;

8. Safety planning;

9. Stigma reduction; and 10. Monitoring of personal hygiene, nutritional support, safety, and environmental maintenance. 6.6.4 Personnel Requirements A. Respite agency personnel shall be multidisciplinary, with the intention of subclinical stabilization, responsive to the unique needs of the individual. Respite agency personnel shall include expertise in meeting the need of children if the agency holds a Children and Families endorsement, which includes but is not limited to:

1. Child and family peer support providers; psychiatrists, psychiatric nurse practitioners, or physicians; and social workers, counselors, and crisis specialists;

2. Have personnel who can assess physical health needs and deliver care for most minor physical health challenges;

3. Have an identified pathway to transfer the child to more medically staffed services, if needed; and 4. Ensure that personnel have child and family expertise and experience, training in traumaresponsive care and cultural responsiveness.

B. Peer support professionals must be utilized in accordance with Chapter 3 of these rules if providing residential or community-based respite services.

C. Every respite agency must include a licensee or authorized practitioner. This licensee or authorized practitioner must be immediately available via telehealth. 6.6.5 Respite Care Settings A. Respite care services may be provided in residential or community-based settings.

1. R esidential respite care services must comply with residential and overnight requirements in accordance with part 2.26 of these rules.

2. Community-based respite care services may be provided in the individual's home or community as a temporary relief from stressful situations or environments, or to provide additional support in the individual’s home environment. 6.7 Acute Treatment Services 6.7.1 Applicability A. These rules set forth in this section 6.7 are established to create standards for and apply to agencies with an endorsement to operate an acute treatment unit (ATU). 6.7.2 Standards for Acute Treatment Services A. Agencies providing acute treatment unit services must be designated pursuant to Chapter 11 of B. The agency shall ensure the admission/discharge criteria and service planning requirements in

part 2.10 and 2.13.1 of these rules, as well as assessment requirements in parts 2.12.2 and 2.12.3 of these rules are met with the following additions:

1. The agency shall ensure individuals admitted for acute treatment services are age eighteen (18) years or older, in need of psychiatric care, and cannot be appropriately treated in a less restrictive setting.

2. The individual shall be assessed for continued appropriateness for treatment in the acute treatment services setting at least every three (3) days. Individual stays may be extended when such extension is determined to be the most appropriate course of treatment based on an updated individual assessment and service plan, as follows:

a. When an individual’s assessment indicates the individual should be transferred to a different setting but placement in that setting is delayed due to lack of availability, the agency shall document that in the service plan, and continue to reassess the individual in accordance with part 6.7.2.B.2.

b. Assessments for continued stays in the acute treatment services setting past ten (10) days shall include consideration regarding whether the individual would be more appropriately served, and should be transferred to, a different level of care.

3. An in dividual may only be admitted into a locked setting if there is no less restrictive appropriate alternative and admitting to a locked facility is in compliance with Chapter 11 4. An individual may be admitted into a 27-65 designated facility on a voluntary basis, as long as the following requirements are met and the individual signs a form that documents the following:

a. The individual is aware the setting is locked.

b. The individual has the ability to exit the setting with personnel assistance.

5. An individual who is an imminent danger to self or others may only be admitted to acute treatment services upon completion of the agency’s comprehensive assessment and determination that the individual’s safety and the safety of others can be maintained.

6. If an individual is admitted and personnel subsequently determine the individual’s behavior cannot be safely and successfully treated in the acute treatment services location, the agency shall make arrangements to transfer the individual to the nearest hospital or other appropriate level of care for further assessment and evaluation.

7. The agency shall have policies that identify when an individual requires a physical health assessment by a qualified licensed practitioner, including, but not limited to:

a. W ithin twenty-four (24) hours of admission;

b. When there is a significant change in the individual’s condition;

c. When the individual has evidence of a possible infection, such as swelling or open sores;

d. When the individual experiences an injury or accident that might cause a change in condition;

e. When the individual has known exposure to a communicable disease; or f. When the individual develops any condition that would have initially precluded admission to the acute treatment service setting.

8. The agency shall ensure the individual’s service plan is created within twenty-four (24) hours after admission. Such service plan shall include any special dietary instructions, physical or cognitive limitations, and a description of the services which the agency will provide to meet the needs identified in the individual’s assessment(s).

a. The individual may request a modification of the services identified in the service plan at any time.

b. The service plan shall include goals of the acute treatment services stay and standards to be met for discharge.

C. The agency shall ensure acute treatment services meet personnel training requirements in accordance with part 2.14.3 of these rules, with the following additions:

1. The agency’s administrator shall have training in assessment skills, nutrition, and identifying and dealing with behavioral health crises and behavior management, and be responsible for the overall direction and supervision of personnel;

2. T he agency’s clinical director shall have training in assessment and identifying and treating individuals who display behaviors that are common to individuals with severe and persistent mental health disorders; and 3. The agency shall ensure the staffing level in each physical location providing acute treatment services is adequate to provide services to meet the needs of the individuals at the location, in accordance with the individuals’ service plans.

D. The agency shall ensure compliance with parts 2.15 and part 11.17.15 of these rules, regarding medication administration, storage, handling, and disposal.

E. The agency shall establish written house rules for the acute treatment services setting which do not violate or contradict rules found in this Chapter 6, and which do not restrict an individual’s rights. Such house rules shall be provided to the individual upon admission and be prominently posted at the location services are provided.

F. Alternate building standards. The following building standards shall apply only to the physical locations in which acute treatment services are provided.

1. The interior environment shall be clean and sanitary, free of hazards to health and safety, a. Layout, finishes, and furnishings must minimize the opportunity for residents to injure themselves or others.

b. I nterior areas, finishes, and furnishings must be maintained in good repair and promote sanitary conditions. All spaces shall have adequate heat, lighting, and ventilation sufficient for its intended use and individual needs.

c. Windows that can be accessed by individuals must have security glazing or other appropriate security features to reduce the possibility of injury or elopement.

d. Items/substances that could be used for self-harm or harm to others, including, but not limited to, sharp knives and cleaning solutions, must be appropriately labeled and stored in a safe manner, inaccessible to individuals.

e. The physical location shall be maintained free of infestations of insects and rodents and all openings to the outside must be screened.

f. An adequate supply of safe, potable water must be available.

g. Hot water shall not be more than 120 degrees Fahrenheit at taps which are accessible by individuals, and there must be a sufficient supply of hot water to meet the needs during peak usage.

G. The agency shall provide a clean, sanitary, and secure exterior environment for the year-round use of individuals, free of hazards to health and safety.

1. Exterior areas must be maintained to prevent hazardous slopes, holes, or other hazards, and must be kept free of high weeds and grass, garbage, and/or rubbish.

2. Secure outdoor areas shall be fenced or enclosed to prevent elopement and protect the safety and security of individuals.

H. T he agency shall ensure the following standards are met regarding the physical operation of the acute treatment services location:

1. The agency’s physical operation shall be in compliance with all applicable:

a. Local zoning, housing, fire, and sanitary codes and ordinances of the city, city and county, or county where the location is situated.

b. State and local plumbing laws and regulations, including that plumbing must be maintained in good repair, free of the possibility of backflow and back siphonage through the use of vacuum breakers and fixed air gaps, in accordance with state and local codes.

c. Sewage disposal requirements, including that sewage must be discharged into a public sewer system or disposed of in a manner approved by the local health department, or local laws if no local health department exists, and the Colorado water quality control commission.

2. The agency shall have common areas adequate to accommodate all individuals, including a designated dining area capable of seating all individuals, and meeting the following accessibility requirements:

a. All common areas and dining areas must be accessible to individuals using an auxiliary aid without requiring transfer from a wheelchair to walker or from a wheelchair to a regular chair.

b. D oors to individual accessible rooms shall be at least thirty-two (32) inches wide.

c. A minimum of two entryways shall be provided for ingress and egress from the building by individuals using a wheelchair.

3. The following requirements must be met for bedrooms:

a. No individual may be assigned to any room other than a regularly designated bedroom. Temporary occupancy of a room not designated as a bedroom is permissible on a limited basis when the use of the assigned bedroom is contraindicated due to circumstances related to individual safety or emergent issues. Justification for such placement, and the length of placement, shall be documented in the individual record.

b. No more than two (2) individuals shall reside in a bedroom.

c. Each bedroom for individuals must have at least 100 square feet for a single individual, or 120 square feet for two residents. Bathroom areas and closets shall not be included in the determination of square footage.

d. Each individual shall have separate storage facilities adequate for personal Articles, such as a closet or locker, available inside their bedroom. Shelves may be provided for folded garments in lieu of hanging garments.

e. Each bedroom must include a comfortable, standard-sized bed with a clean mattress, mattress protector, pillow, rollaway-type beds, cots, folding beds, or bunk beds are not permitted.

f. The bedroom shall have a safe and sanitary method to store the individual’s towel, such as a breakaway towel rack.

g. E xtension cords and multiple-use electrical sockets shall be prohibited in individual bedrooms.

h. The bedroom shall include a chair unless contraindicated, in which case alternate seating shall be provided in close proximity to the bedroom.

4. The following standards must be met for bathrooms:

a. Each floor with bedrooms must have at least one bathroom which can be accessed without entering a bedroom.

b. The physical location of the agency’s operations must have at least one full bathroom accessible to any individual using an auxiliary aid, including properly installed grab bars at each tub and/or shower, and adjacent to each toilet.

c. Bathtubs and shower floors must have non-skid surfaces.

d. Toilet seats shall be constructed of non-absorbent materials and free of cracks.

e. Individuals must have individualized personal care Articles and supplies, such as soap and towels, and such Articles and supplies shall not be shared.

f. Toilet paper must be available at all times in each bathroom.

g. Liquid soap and paper towels must be available at all times in the common bathrooms.

5. The following standards must be met for seclusion rooms:

a. The seclusion room must be constructed to prevent an individual from hiding, escaping, being injured, or dying by suicide, and must be free of all protrusions, sharp corners, hardware, fixtures or other devices, and furnishings which may cause injury to the individual.

b. The seclusion room must maintain a temperature appropriate for the season.

c. The seclusion room must be located in a manner affording direct observation of the individual by personnel.

d. The seclusion room must have a window that allows someone outside the room to see into all of the corners of the room. All windows in the seclusion room must be constructed to prevent breakage and otherwise prevent self-harm.

e. Doors to the seclusion room shall be at least thirty-two (32) inches wide and must open outward.

f. Light fixtures and other electrical outlets in the seclusion room must be limited to those required and necessary, must be recessed, and must be constructed to prevent self-harm. Such fixtures and outlets must be controlled by labeled on/off switches located outside the seclusion room.

6. The agency shall meet the following requirements regarding linen and laundry:

a. The agency may have laundry room(s) with residential-style washer(s) and dryer(s) in an area with adequate square footage and ventilation for the number of washers and/or dryers included in the space.

b. T he laundry room(s) must not be used for storage of soiled or clean linen.

c. There must be a separate enclosed area for receiving and holding soiled linen until ready for pickup or processing, in addition to a separate enclosed area for clean linen storage.

d. There must be hand-washing, or other appropriate hand-sanitizing, facilities in each area where unbagged, soiled linen is handled.

Chapter 7: Emergency and Involuntary Substance Use Disorder Commitment Services 7.1 Authority and Applicability A. Chapter 7 establishes the standards for emergency and involuntary commitment of a person with a substance use disorder. The authority to promulgate these rules necessary to carry out the BHA’s programs for emergency and involuntary commitment of a person with a substance use disorder comes from Section 27-50-107(3), C.R.S. and Section 27-50-502(1), C.R.S. authority for BHA administration of these programs is found in Section 27-50-105(1)(pp), C.R.S. and Section 27-50-105(1)(qq), C.R.S.

B. These rules are established to create standards for agencies seeking an endorsement to provide services to individuals on emergency substance use disorder commitments pursuant to Section 27-81-111, C.R.S. and Section 27-81-112, C.R.S.

C. Al l agencies providing services to individuals on emergency substance use disorder commitments shall meet the standards in this Chapter 7. If the agency requires a BHE license, the agency shall comply with Chapter 2 of these rules. 7.2 Emergency Substance Use Disorder Commitment Services A. Emergency commitment policies and procedures, based on compliance with Section 27-81-111, C.R.S., shall be developed and implemented by the licensed and appropriately endorsed agency providing withdrawal management services pursuant to Chapter 4 (Outpatient and High Intensity Outpatient Services) or Chapter 5 (Residential Services) of these rules. Such policies and procedures shall require agency personnel to:

1. Ascertain if grounds for commitment exist;

2. Assure that individuals and their legal representatives receive copies of the application for emergency commitment forms and are advised verbally and in writing of the right to challenge commitment through the courts; and, 3. Determine when grounds for emergency commitment no longer exist.

B. The treatment agency administrator shall designate, in writing, qualified personnel who meet the criteria established in part 5.6.2.F of these rules, to assume responsibility for accepting, evaluating, informing, and providing treatment to individuals on an emergency commitment.

C. Applications for emergency commitments must be prepared on BHA designated forms available on the BHA website.

D. Daily evaluations shall be completed for the continuance of an emergency commitment. Daily evaluations shall be documented in the individual record.

E. If individuals on an emergency commitment require treatment in other licensed and appropriately endorsed withdrawal management programs, transfers shall be managed by the programs that initially authorized the commitments.

F. When transferring individuals, withdrawal management programs shall use BHA designated transfer forms available on the BHA website. Completed copies shall be given to:

1. Individuals and/or their legal representatives; and, 2. The withdrawal management programs to which individuals are being transferred.

G. When a child is transferred and/or the child's emergency commitment has been discontinued, parents or legal guardians who have given permission for treatment must receive copies of transfer form and emergency commitment form.

H. When it is determined that grounds for an emergency commitment no longer exist, the individual must be transferred to voluntary status and the emergency commitment shall be discontinued and documented. A copy of the emergency commitment form that specifies discontinuation of the emergency commitment must be given to the individual and made part of the individual record as described in part 2.11 of these rules.

I. Discharge summaries, as outlined in part 2.10.A.6 of these rules must be submitted to the BHA, the referring source, and to the referral agency in accordance with state and federal confidentiality laws and regulations. 7.3 Involuntary Substance Use Disorder Commitment Services A. These rules are established to create standards for agencies seeking an endorsement to provide services for individuals on involuntary substance use disorder commitments pursuant to Section 27-81-112, C.R.S. 7.3.1 General Provisions A. Involuntary commitment policies and procedures must be developed and implemented based on and in compliance with Section 27-81-112, C.R.S.

B. The BHA may delegate physical custody of individuals involuntarily committed to an appropriate approved treatment agency pursuant to Section 27-81-112(5), C.R.S.

C. Passes may be issued to individuals on involuntary commitments in residential settings only if they are directly related to treatment. Passes shall not be issued during the initial thirty (30) days of treatment, except in emergencies, as defined in part 1.2 of these rules, and with BHA approval.

D. The following information shall be reported to the BHA using the process outlined on the BHA website:

1. Non-compliance with program requirements shall be reported within three (3) business days;

2. Non-compliance with court orders shall be reported within 24 hours;

3. Failure to appear for admission to treatment shall be reported within 24 hours;

4. Leav ing treatment in violation of court orders shall be reported within 24 hours;

5. Failure to return from passes shall be reported within 24 hours; and, 6. Monthly treatment status reports shall be due by the 15th day of the month.

E. Discharge summaries, as outlined in part 2.10.A.6 of these rules shall be submitted to the BHA, the referring source, and to the referral agency in accordance with state and federal confidentiality laws and regulations.

F. An agency may not grant an individual’s requests for early discharge and/or transfer to other treatment programs without first obtaining BHA approval. 7.3.2 Personnel Requirements A. Primary counselors for individuals on an involuntary commitment, means the following behavioral health professionals trained in substance use disorder identification and treatment and acting within their scope of practice:

1. Authorized practitioner;

2. Licensee;

3. Certified addiction specialist (CAS); or, 4. Candidate personnel.

B. All of the personnel noted in part 7.3.2.A above shall complete at least fourteen (14) hours of training in interviewing techniques related to engaging individuals in treatment.

C. Copies of primary counselor credentials and other relevant documentation shall be maintained in counselor personnel files as described in part 2.5.G of these rules.

Chapter 8: Services for Children and Families 8.1 Authority and Applicability A. Chapter 8 establishes standards for agencies seeking an endorsement to provide services for children and families. Rules include requirements for individual assessment, treatment and patient rights. The authority for these standards comes from Section 27-50-502(1)(a)(I), C.R.S.

authority to promulgate these rules establishing additional competencies related to serving priority populations, including children, comes from Section 27-50-502(6) C.R.S., and for children Sections 27-50-301(3)(c), C.R.S., 27-50-301(5), C.R.S., and 27-50-107(3), C.R.S.

B. These rules are established to create standards for agencies seeking an endorsement to provide psychotherapy services, as defined in part 1.2 of these rules, and services for children and families. Services for children and families include Behavioral Health Early Intervention and Outpatient Services as outlined in part 4.1 through 4.4.3 of these rules, Behavioral Health High- Intensity Outpatient Services as outlined in part 4.6 through 4.7.4 of these rules, Behavioral Health Residential Services as outlined in part 5.1 through 5.3.3 of these rules and part 5.5 through part 5.6 of these rules and part 5.9 through 5.9.5 of these rules and Emergency and Crisis Behavioral Health Services as outlined in part 6.1 through 6.7.2 of these rules.

C. Al l agencies providing psychotherapy services and children and family services must meet the standards in this Chapter 8. If the agency requires a BHE license, the agency shall comply with

Chapter 2 of these rules.

D. An agency with a Children and Families endorsement must also have at least one other endorsement of these rules. 8.2 Behavioral Health Services for Children 8.2.1 Criminal History Record Check A. In addition to criminal background checks required under part 2.6.D of these rules, agencies must, prior to hiring or accepting new personnel, submit to the Federal Bureau of Investigation (FBI) a complete set of fingerprints taken by a qualified law enforcement agency to obtain any criminal record held by the FBI, for each prospective personnel. Payment of the fee for the criminal record check is the responsibility of the agency. No direct contact with children may take place until the background check is cleared by the FBI. 8.3 Rights of Children A. Parents or legal guardians must be contacted without the child’s written or verbal consent, unless notifying the parent or legal guardian would be inappropriate or detrimental to the minor’s care and treatment, as authorized by Section 12-245-203.5(7), C.R.S., if:

1. T he child presents or communicates a danger to self or others, including a person who is identifiable by the person’s association with a specific location or entity.

B. Section 27-65-104(1), C.R.S. allows children who are fifteen (15) years of age or older, with or without the consent of a parent or legal guardian, to knowingly consent to mental health services, which includes the provision of psychotropic medications. 8.3.1 Rights of Children Receiving Outpatient Services A. Agencies must obtain parental or legal guardian consent for children under fifteen (15) years of age, with the following exception:

1. Section 12-245-203.5(2), C.R.S., allows psychotherapy services, as defined in Section 12-245-202(14)(a), C.R.S., to be provided to a child who is twelve (12) years of age or older, with or without the consent of the child’s parent or legal guardian, if the child is knowingly and voluntarily seeking such services and the provision of psychotherapy services is clinically indicated and necessary to the child’s well-being. The following mental health professionals are the only professionals within an agency allowed to provide outpatient psychotherapy services in an outpatient setting to a child who is twelve (12) years of age or older, without the consent of the child’s parent or legal guardian:

a. A professional person as defined in Section 27-65-102(27), C.R.S., which means a person licensed to practice medicine in this state, a psychologist licensed to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist licensed to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the Armed Forces of the United States, the United States Public Health Service, or the United States Department of Veterans Affairs;

b. A m ental health professional licensed pursuant to Article 245, of Title 12, C.R.S., which in accordance with Section 12-245-203.5, C.R.S., includes:

(1) A licensed psychologist or a psychologist candidate pursuant to Section 12-245-301 through -309, C.R.S.;

(2) A licensed clinical social worker or a licensed social worker candidate pursuant to Section 12-245-401 through -410, C.R.S.;

(3) A marriage and family therapist licensed or a licensed marriage and family therapist candidate pursuant Section 12-245-501 through -506, C.R.S.;

(4) A licensed professional counselor or a licensed professional counselor candidate pursuant to Section 12-245-601 through -607, C.R.S.; and, (5) A licensed addiction counselor or an addiction counselor candidate licensed pursuant to Section 12-245-801 through -806, C.R.S.

2. A child may not refuse psychotherapy services when a mental health professional and the child’s parent or legal guardian agree psychotherapy services are in the best interest of the child.

3. If the child voluntarily seeks psychotherapy services on their own behalf pursuant to

Section 12-245-203.5(2)(a), C.R.S.:

a. The mental health professional may notify the child’s parent or legal guardian of the psychotherapy services given or needed, with the child’s consent, unless notifying the parent or legal guardian would be inappropriate or detrimental to the child’s care and treatment.

b. The mental health professional shall engage the child in a discussion about the importance of involving and notifying the child’s parent or legal guardian and shall encourage such notification to help support the child’s care and treatment;

c. Notwithstanding the provisions of Section 12-245-203.5(3)(a), C.R.S., a mental health professional may notify the child’s parent or legal guardian of the psychotherapy services given or needed, without the child’s consent, if, in the professional opinion of the mental health professional, the child is unable to manage the child’s care or treatment.

4. A mental health professional shall fully document in the child’s individual record, when the mental health professional attempts to contact or notify the child’s parent or legal guardian and whether the attempt was successful or unsuccessful, or the reason why, in the mental health professional’s opinion, it would be inappropriate to contact or notify the child’s parent or legal guardian.

a. If the child seeks psychotherapy services on their own behalf pursuant to Section 12-245-203.5(2)(a), C.R.S., documentation must be included in the child’s individual record, along with a written statement signed by the child, indicating the child is voluntarily seeking psychotherapy services.

5. In addition to the individual rights specified in part 2.7 of these rules, children who meet the requirements of part 8.3.1.A.1, without the consent of a parent or legal guardian, have the right to:

a. Consent to release of information 8.3.2 Rights of Children in Hospitalization A. In addition to the individual rights specified in part 2.7 of these rules, and notwithstanding any other provision of law, a child who is fifteen (15) years of age or older, with or without the consent of a parent or legal guardian, has the right to consent to receive behavioral health services to be rendered by an agency, a professional person, or a mental health professional pursuant to

Section 27-65-104(1), C.R.S., in any practice setting;

1. Consent to voluntary hospitalization for mental health services;

2. Object to hospitalization and to have that objection reviewed by the court under the provision of Section 27-65-104(6), C.R.S.; and 3. C onsent to release of information.

B. Children who are under the age of fifteen (15), have the right to object to hospitalization and to have a guardian ad litem appointed pursuant to Section 27-65-104(6)(b),(c), C.R.S. 8.4 Screening and Assessment of Children A. Agencies shall follow screening as required in part 2.12.1 of these rules.

B. Agencies shall follow the requirements of part 2.12.2 and part 2.12.3 of these rules in addition to 1. Comprehensive assessments must include an evaluation of the family's, or legal guardian’s social determinants of health, as well as needs and strengths that may pertain to the child’s treatment. If family or legal guardian basic needs are identified, including, but not limited to, food, clothing, shelter and health, this must be addressed in the individualized and family-oriented service plan and referral made to the identified services and supports, if needed. Such comprehensive assessments will maintain the confidentiality of participants records in accordance with applicable state and federal 2. The comprehensive assessment must explore how the identified family members, natural supports or legal guardians will be involved in whole person and Two (2) - Generational behavioral health services. In the event that any person’s involvement is contraindicated, the clinical rationale must be documented.

3. The comprehensive assessment must also include a trauma assessment specific to children, which can include but is not limited to: an ACEs screen, or a pediatric ACEs screener. This shall be completed with the child utilizing any standardized screening tool.

a. Parent(s) or legal guardian(s) shall be included, unless involvement in the screen is contraindicated, then the clinical rationale must be documented in the individual record. If completing the aces screen, parent(s) and/or legal guardian(s) shall complete this separately.

b. F or clarity and accuracy, a child under the age of twelve (12), must be given the option to answer the questions verbally to the provider.

4. The comprehensive needs and strengths assessment must be incorporated into the service plan, reassessment, and discharge plan, when or where appropriate, and assess and triage for the needs of a child, who are at least seventeen (17) years of age who is expected to require behavioral health services and supports beyond the age of eighteen (18). This may include, but is not limited to:

a. Housing and/or housing stability;

b. Insurance or lack of insurance;

c. Transportation;

d. Employment and/or education;

e. Social supports;

f. Medical/dental needs; and g. Food security and/or insecurity 8.5 Service Planning for Children and Families A. Agencies shall follow part 2.13 of these rules, service planning and reviews, in addition to the 1. The service plan must be developed in collaboration with the child, and the child’s parent or legal guardian and be signed by the child, if the child is over the age of twelve (12), and by the parent or legal guardian. In the event that involvement of the parent or legal guardian is contraindicated, the rationale shall be documented.

a. In all instances where prescription psychiatric medications are to be ordered as a

part of a mental health treatment program, the following information shall be provided, in an accessible manner, to the child and parent(s) or legal guardian(s).

(1) The name(s) of the medication being prescribed.

(2) The usual uses of the medication(s).

(3) The reasons for ordering the medication(s) for the child.

(4) A description of the benefits expected.

(5) The common side effects and common discomforts, if any.

(6) The major risks, if any.

(7) The probable consequences of not taking the medication(s).

(8) Any significant harmful drug or alcohol interactions, or food interactions.

(9) Appropriate treatment alternatives, if any; and, (10) That the child may withdraw agreement to take the medication at any time.

2. A c opy of the service plan shall be provided, upon request, to the child, if they are over the age of twelve (12), and parent or legal guardian. In the event that involvement of the parent or legal guardian would be detrimental to the child’s health, safety, or welfare, the rationale shall be documented.

3. The service plan shall be individualized and use a Two (2)- Generational approach to include family driven goals and objectives that address the child and family services, supports, needs and building on their strengths and natural supports as identified in the assessment.

4. Service plans must be implemented in partnership with children and families. Service plans must support planning and transition to another services and/or setting.

Chapter 9: Women’s and Maternal Behavioral Health Treatment 9.1 Authority and Applicability A. Chapter 9 establishes the standards for agencies electing to provide Women’s and Maternal Behavioral Health Treatment. Authority to promulgate rules establishing requirements for individual assessment, treatment, and patient rights, comes from Sections 27-50-107(3) and 27- 50-502(1)(a)(b), C.R.S. authority to promulgate these rules establishing additional competencies related to serving priority populations comes from Section 27-50-502(6), C.R.S. additionally, the BHA has authority to administer the treatment program for high-risk pregnant women created pursuant to Sections 27-80-112 and 27-80-113, C.R.S. authority for BHA administration of this program is found in Section 27-50-105, C.R.S. authority to promulgate rules required for the administration of this program comes from Section 27-50-107(3)(a), C.R.S.

B. All agencies providing Women’s and Maternal Behavioral Health Treatment services shall meet the standards in this Chapter 9. If the agency requires a BHE license, the agency shall comply with Chapter 2 of these rules.

C. An agency with a Women’s and Maternal Behavioral Health Treatment endorsement shall also have at least one level of care endorsement to provide substance use disorder treatment pursuant to Chapters 4 through 7 of these rules. 9.1.1 General Provisions A. P ersonnel shall have documented training, experience, and access to supervision in womenspecific issues and services. Training and experience may include topics such as:

1. Trauma-informed care;

2. Trauma;

3. Women’s and/or pregnancy-related health during the reproductive years;

4. Infertility;

5. Pregnancy loss;

6. Infant loss;

7. Perinatal mood and anxiety disorders;

8. Stigma and substance use disorder among pregnant and parenting women/ individuals and perinatal substance exposure;

9. Body image/disordered eating;

10. Relationship violence/ healthy relationships;

11. Dyadic attachment/parenting;

12. American Society of Addiction Medicine (ASAM) Criteria for parents or prospective parents receiving addiction treatment concurrently with their children; and, 13. Child welfare reporting requirements and alternatives.

B. Treatment for behavioral health shall be provided to and/or coordinated with family members, unless clinically contraindicated. Clinical contraindications to this provision and referrals for dyadic and/or family treatment must be documented in the individual record.

C. Agencies shall make every attempt to offer any pregnant or postpartum women/individuals’ admission to treatment within forty-eight (48) hours and shall demonstrate compliance with part 9.1.5.D.

D. Agencies providing gender specific women’s and/or pregnancy-related behavioral health treatment may include the following components:

1. Emotional and physical safety of individuals take precedence over all other considerations in the delivery of services, as outlined within trauma-informed principles;

2. Services designed to increase women’s and/or pregnancy-related access to wraparound services, and engagement and retention of individuals (such as peer services, transportation, childcare);

3. Women-only therapeutic environments;

4. Women-specific service needs and topic areas;

5. Program services shall directly address trauma issues currently manifesting in the individual’s life, either through direct service provision or by referral; and, 6. Multiple modalities that meet the specific needs of women (group and individual therapy, case management and opportunities for women to be in treatment with their children where possible).

E. Agency policy and procedures must include the criteria for interventions offered and expected outcomes of services delivered. 9.1.2 Screening A. In addition to the part 2.12.1 of these rules, screening shall include all the following unless clinically contraindicated:

1. S creening and documentation of individual’s need for prenatal/postpartum care (where applicable), primary medical care and family planning services; and 2. Screening and documentation of child safety issues and/or referrals for children in the individual’s home that need behavioral health and/or medical care utilizing an evidencebased instrument or best practice approach. 9.1.3 Treatment A. Service plans shall be established in accordance with part 2.13 of these rules and shall address each of the need areas identified in part 9.1.3.B and 9.1.3.C.

B. When not clinically contraindicated the following topic areas shall be addressed in treatment or through comprehensive care coordination as outlined in part 2.9.G and the following, when 1. Reductions or elimination of substance use;

2. Individual safety;

3. Child safety;

4. Trauma;

5. Parenting, including attachment and co-regulation;

6. Ways in which behavioral health impacts family and relationships across the lifespan;

7. Primary care, medical care, lactation, pelvic health, dental health, reproductive health, and family planning care;

8. Mental health, including parental mental health conditions; and 9. Nutrition assessment in relation to pregnancy, lactation, early childhood, and behavioral health.

C. Any agency that qualifies to provide services pursuant to Sections 25.5-5-202(1)(r), 27-80-112, C.R.S. and 27-80-113, C.R.S., in regard to the Treatment Program for High-Risk Pregnant Women, shall make available, in addition to substance use and addiction counseling and treatment:

1. Needs assessment services;

2. Preventive services;

3. Rehabilitative services;

4. Care coordination;

5. Psychosocial counseling;

6. Intensive health education;

7. Home visits;

8. Transportation;

9. Development of provider training;

10. Child care;

11. Child care navigation; and, 12. Other necessary components of residential or outpatient treatment or care. 9.1.4 Services for Pregnant and Postpartum Women/Individuals A. Pregnant women/individuals shall be given priority admission and/or care coordination to treatment for substance use disorders.

1. A gencies cannot deny services to pregnant and postpartum women/individuals due to sobriety status.

B. Agencies shall develop policies and procedures for service delivery to pregnant and postpartum women/ individuals, which shall include circumstances under which pregnant and postpartum women/individuals may be discharged from treatment.

1. Pregnant women/individuals may not be discharged from treatment solely for failure to maintain abstinence from substance use.

2. Every effort shall be made to retain pregnant and postpartum women/individuals in treatment for the duration of their pregnancies in order to maintain an optimal period of abstinence from substance use.

C. Every attempt shall be made to admit pregnant women/individuals to treatment within forty-eight (48) hours of first contact between the woman/individual and the admitting program.

D. If a pregnant woman/individual is not admitted to treatment within forty-eight (48) hours of first contact, the reason shall be clearly documented in their individual record. If the individual is working with a care coordinator through their managed care entity or managed service organization, the care coordinator shall be informed. Interim services shall be provided consisting of the following at minimum:

1. Referral for prenatal care;

2. Information on the effects of alcohol and drug use on the fetus and perinatal individual;

3. Daily phone contact with the individual for those seeking residential care; and, 4. Education regarding the transmission and prevention of communicable diseases such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), Tuberculosis (TB), and Hepatitis A, B, or C.

E. P regnant and postpartum women/individuals shall be linked to prenatal and postpartum care immediately and barriers to accessing prenatal and postpartum care including, but not limited to transportation to care, must be addressed, and documented in their individual record.

F. If a pregnant or postpartum woman/individual declines prenatal or postpartum care, this shall be documented in the individual record, and offers for care shall continue to be offered at a minimum of one attempted contact monthly and documented. If no contact occurs within six (6) months, the reason shall be documented, and the agency is no longer required to contact.

1. This does not include individuals who have completed their treatment goals or disengaged from treatment.

Chapter 10: Services for Criminal Justice-Involved Individuals 10.1 Authority and Applicability A. Chapter 10 establishes the standards for and applies to BHEs providing services to criminal justice involved individuals, including specific criminal justice programs. The BHA has authority for administration of DUI treatment programs pursuant to Article 2 of Title 42, C.R.S., and Alcohol and Drug Driving Safety Education or Treatment pursuant to Section 42-4-1301.3, C.R.S. and

Section 27-50-105(1)(vv)(ww), C.R.S. authority to promulgate rules required for the administration of this program comes from Section 27-50-107(3)(a), C.R.S. authority to promulgate rules establishing requirements for individual assessment and treatment comes from Section 27-50- 502(1)(a)(I), C.R.S.

B. Services for criminal justice-involved individuals must generally be intended for individuals who are referred into education and/or treatment services as a result of, or in connection to, involvement with the criminal justice system. This does not include juvenile justice system services that are regulated by the responsible state agencies as indicated in Section 19-2.5-1401, C. Services for criminal justice-involved individuals must involve a continuum of education and/or treatment options available to individuals as they proceed through the criminal justice system.

These services must be available across multiple settings, including community-based and locked facility-based settings. Services offered must vary depending upon the needs of the individual and the specific criminal justice program endorsement.

D. These rules are established to create standards for BHEs seeking endorsements to provide education and/or treatment services, as defined in part 10.1.1 of this Chapter, for individuals involved with the criminal justice system. This criminal justice endorsement and all corresponding sub-endorsements may not be held alone, but in addition to appropriate corresponding endorsement(s) and sub-endorsement(s) for the type of services being provided. 10.1.1 Definitions “Contact Hours”, for the purposes of parts 10.5 through 10.9 of this Chapter means the time that an individual participates in Level I Education, Level II Therapeutic Education, and/or Level II Treatment. redit Hours”, for the purposes of parts 10.5 through 10.9 of this Chapter means the time that an individual participates in non-DUI/DWAI specific education or treatment. These hours may be granted towards education and/or treatment requirements for DUI/DWAI services within the parameters set forth in this part 10.5.11.

“Education and/or Treatment” means the programs developed that are structured in such a manner to provide a continuum of education and treatment for each individual as they proceed through the criminal justice system and may include but shall not be limited to, attendance at self-help groups, group counseling, individual counseling, outpatient treatment, inpatient treatment, day care, or treatment in a therapeutic community. Education and treatment are to be accessible by all individuals involved in the criminal justice system, pursuant to Section 16-11.5-102, C.R.S.

“Enhanced Outpatient Services,” or “ EOP,” means services in which an individual receives an increased number of therapeutic contacts and interactions with personnel, intended to expedite stabilization of assessed behavioral health concerns. The goal is to stabilize the individual to allow for more effective engagement in education and other treatment services.

“Program(s)” for the purpose of this Chapter, means the systems of education and treatment services addressing abuse of substances which can be utilized by individuals who are placed on probation, incarcerated with the Department of Corrections, placed on parole, or placed in community corrections, pursuant to Sections 16-11.5-102(1)(b), C.R.S. and 42-4-1301.3, C.R.S. elehealth,” in addition to the requirements of part 1.2 and 2.9 of these rules, telehealth services for the

purpose of this Chapter 10, does not include consistent and regular in-session use of audio-only telehealth services. 10.1.2 Assessment and Placement in Services A. Unless otherwise noted, BHEs endorsed to provide treatment programming to criminal justiceinvolved individuals must receive placement recommendation(s) for each individual served, completed by the referring supervising entity. The BHE is expected to evaluate if the supervising entity’s recommendation matches the individual’s assessed clinical need(s). The BHE is expected to address any differences identified with the supervising entity directly and document results in B. The type of placement recommendation(s) from the supervising entity will vary depending upon the type of supervising entity and the individual’s type of offense leading to the treatment referral.

BHEs must include a copy of the referral paperwork, demonstrating treatment in accordance with the placement initial assessment and treatment recommendation(s) from the supervising entity, in C. If a BHE is unable to obtain a copy of the placement recommendation(s) from the supervising entity there must be documentation of attempt(s) to obtain the paperwork from the referral source, if applicable.

D. BHEs must assess for and prioritize the delivery of services that support the individual’s placement in the community, including reintegration into the community if incarcerated. This must include engagement of the individual’s identified support system throughout the episode of care, as permitted by the individual.

10.1.3 P ersonnel Training A. All BHE personnel providing education and/or treatment services to individuals involved in the criminal justice system must:

1. Be knowledgeable about the criminal justice system, including the sequential intercept model and the processes and phases through which an individual moves in the criminal justice system;

2. Be knowledgeable of the principles of risk, need, and responsivity;

3. Be knowledgeable about the criminal justice system in the state of Colorado, including competency restoration services, as explained in Chapter 12 of these rules, and situations involving individuals determined to be not guilty by reason of insanity (NGRI);

4. Attend at least one (1) training during their active licensing or approval term unique to individuals involved in the criminal justice system.

5. Personnel providing curriculum-driven education and/or treatment services, including but not limited to DUI/DWAI programming, to individuals involved in the criminal justice system must be trained in the curriculum and be qualified to provide such services, as indicated in parts 10.4 through 10.9 of this Chapter.

B. The above training requirements may be satisfied by completing the BHA-developed criminal justice services curriculum on the statewide Learning Management System (LMS), once developed and available in the LMS.

C. BH

Es endorsed to provide programming to DUI/DWAI-involved individuals must maintain proof of completion of the training in personnel files and provide verification to the BHA upon request. 10.1.4 Documentation A. In addition to documentation requirements applicable to the BHE’s license and selected endorsement(s), individual records must include documentation of intentional collaboration and communication with the supervising entity. Collaboration and communication efforts must include, but are not limited to:

1. Ongoing communication and coordination of care with supervising entities;

2. Case consultation;

3. Development of referral processes; and 4. Incorporation of issues related to criminal justice involvement into ongoing service planning processes.

B. Identified RNR principles must be incorporated in the individual’s record and addressed in treatment services, as appropriate.

C. Documentation in the individual record must reflect and demonstrate personnel’s knowledge of the criminal justice system including, for example, the proper use of criminal justice system terminology. Documentation must also demonstrate an understanding of how involvement in the criminal justice system relates to providing care for the individual.

D. Documentation in the individual’s record must reflect how, the individual’s identified support system is engaged throughout the episode of care.

1. If the individual does not permit support system involvement, it is clinically contraindicated, or the individual is unable to identify a support system, the record must reflect efforts to help the individual build a recovery-focused support system. This may include post-treatment referral(s) and peer recovery support services, as applicable.

E. I ndividual records must reflect efforts to deliver services necessary based on the individual’s assessment and service planning process. This must involve documentation of care coordination with other providers, resources, and support systems as necessary.

F. Documentation in the individual’s record must reflect service delivery that is person-centered, trauma-informed, harm reduction focused, physically and programmatically accessible, and culturally and linguistically appropriate for all individuals served.

1. This may include connecting to referrals, and/or providing translation and/or interpreter services for those individuals that need this service to receive treatment.

G. BHEs endorsed to provide programming to criminal justice-involved individuals must provide individuals with a complete copy of the participant materials and workbook associated with the curriculum being used, when applicable.

1. BHEs must supply materials and workbooks associated with curriculum in ways that reasonably accommodate the individual’s needs and facilitate access, utilization, and understanding of the information.

2. BHEs must supply youth with age-appropriate materials/workbooks. 10.2 Enhanced Outpatient Services (EOP) 10.2.1 Applicability A. BHEs endorsed to provide an EOP level of programming to criminal justice-involved individuals must meet all requirements set forth in part 4.3 of these rules in addition to parts 10.1 and 10.2 of this Chapter.

B. BHEs providing EOP level of services must be intended for individuals who are assessed as needing increased services for immediate stabilization, but not appropriate for more intensive levels of care. EOP services are often utilized by individuals who require stabilization prior to engaging in required education or treatment services and a recommendation or referral may be received for this level of care from a supervising entity.

C. BHEs providing EOP level of services are appropriate for individuals with substance-related disorders, mental health disorders, or co-occurring disorders if:

1. The behavioral health disorders are of moderate or high severity, as defined in the DSM- 5- TR;

2. Require additional stabilization; and 3. May be safely managed in this level of care.

D. BHEs providing EOP level of services must be endorsed by the BHA to provide this level of care.

If the BHE refers the individual to another provider to address stabilization needs that are identified through the assessment and service planning process, the referring BHE must be responsible for care coordination and communication of progress updates with the supervising entity.

10.2.2 EO

P Service Provisions A. BHEs providing EOP level of services must provide between three (3) and eight (8) treatment contact hours per week for individuals.

B. BHEs providing EOP level of services must be conducted over a minimum of two (2) calendar days per week.

C. BHEs providing EOP level of services must be provided by personnel as defined in part 4.3.2 of D. The treatment duration in EOP services must be determined by one (1) or more of the following treatment personnel, acting within their scope of practice:

1. Authorized practitioners;

2. Licensees;

3. Certified addiction specialists (CAS); and/or 4. Candidates.

E. Determination of treatment duration must be based on the individual’s assessment, continued screened/assessed needs while attending services, and documented progress towards treatment goals.

1. When a supervising entity recommends a treatment duration or a specific number of hours in EOP services that is not justified by the individual’s assessment, the BHE must address the discrepancy with the supervising entity, provide alternative service recommendations to the supervising entity, and document the result of the collaboration 2. In the instance where this collaboration does not result in alignment with the assessed treatment recommendations, the BHE must follow the supervising entity’s recommendation.

F. Services attended while in EOP level of care must be variable and responsive to the individual’s behavioral health needs as identified in the assessment and service plan, unless otherwise decided per this part 10.2.2.D.

1. EOP services attended must not include education related to the originating offense. 10.3 Intensive Outpatient Services (IOP) 10.3.1 Applicability A. BHEs endorsed to provide an IOP level of programming to criminal justice-involved individuals (including ASAM Criteria Level 2.1) must meet all requirements set forth in part 4.6 of these rules in addition to parts 10.1 and 10.3 of this Chapter. 10.3.2 IOP Service Provisions A. The treatment duration in IOP services must be determined by one (1) or more of the following treatment personnel, acting within their scope of practice:

1. A uthorized practitioners;

2. Licensees;

3. Certified addiction specialists (CAS); and/or 4. Candidates.

B. Determination of treatment duration must be based on the individual’s assessment and documented progress towards treatment goals.

1. When a supervising entity recommends a treatment duration or a specific number of hours in IOP services that is not justified by the individual’s assessment the BHE must address the discrepancy with the supervising entity, provide alternative service recommendations to the supervising entity, and document the results of the collaboration 2. In the instance where this collaboration does not result in alignment with the assessment treatment recommendations, the BHE must follow the supervising entity’s recommendation. 10.4 Criminal Justice Services Programs 10.4.1 Authority and Applicability A. This part 10.4 details standards for and applies to BHEs with an endorsement to provide substance use disorder education and treatment for individuals involved in the criminal justice system programming, pursuant to Section 16-11.5-102, C.R.S., and B. Parts 10.5 through 10.9 of this Chapter detail standards for and apply to BHEs endorsement to provide DUI/DWAI Level I and Level II education and treatment programming, pursuant to Sections 42-4-1301.3(3)(c), C.R.S. and 27-81-106, C.R.S. 10.4.2 General Provisions A. Individuals convicted of misdemeanor or felony offenses who are assessed as needing substance use disorder treatment, as indicated in Section 16-11.5-102, C.R.S. and in accordance with current standardized assessment and placement protocol of the referring supervising entity, must receive court-ordered education, treatment, and care coordination services.

B. All BHEs admitting out of state offenders must identify and notify the interstate compact unit for adult offender supervision pursuant to Section 17-27.1-101, C.R.S.

C. Services must be based on the results of current screening and assessments.

D. BHEs must render treatment to individuals involved in the criminal justice system according to the placement recommendation(s) provided by the referring supervising entity.

E. E ducation, treatment and care coordination services, as indicated by assessment and included in the service plan, must be provided for by the BHE or through referrals.

F. BHEs must have a written memorandum of understanding with community supports or other agencies to provide agreed upon services, as well as any specific data and/or information needed for individualized services. Agreements as to disclosure of information must be in compliance with state and federal law.

G. Education and treatment must be a minimum of nine (9) months or as required by the referring supervising entity.

1. The BHE is expected to address any discrepancies regarding court-ordered length of stay in services with the supervising entity and document in the individual’s record.

H. Frequency and intensity of education and treatment services must be based on assessments and at minimum one (1), two (2) hour session per week.

I. The following content/topics must be presented during treatment:

1. Physiological and psychological effects of alcohol, controlled substances, and other drugs;

2. Signs and symptoms of substance use disorders;

3. Stress management and substance use disorders;

4. Anger management and substance use disorders;

5. Behavioral triggers leading to substance use disorders;

6. D rugs in the workplace; and 7. Legal issues and substance use disorders.

J. BHEs must implement treatment curricula that are written in manual format and are evidencebased or best practices. These materials must be provided in the language and modality of frequently encountered limited English proficiency groups.

K. Education and treatment sessions must not include administrative procedures or breaks in accounting for their duration.

L. BHE personnel working directly with individuals must have documented qualifications and training in forensic populations and criminal justice systems.

M. Drug and alcohol toxicology collection must be observed by trained personnel when requested by the referral source.

N. Records must contain monthly documentation of communication with the criminal justice referral source describing progress toward specific treatment goals. BHEs must be responsible for monitoring and reporting to referring courts or their representatives the individual's progress with ancillary services.

O. BHEs must have written documentation in an individual's record that the individual has received services to assist in continued community placement, or community reintegration, whichever is applicable. 10.5 Driving Under the Influence/Driving While Ability Impaired (DUI/DWAI) Services 10.5.1 Authority and Applicability A. Authority to establish the endorsement of BHEs to provide DUI/DWAI Level I and Level II Education and Treatment programming is provided by Sections 42-4-1301.3(3)(c), C.R.S. and 27- 81-106, C.R.S.

10.5.2 L evels of DUI/DWAI Program Endorsements A. BHEs seeking an endorsement to provide DUI/DWAI education and/or treatment programming in Colorado shall identify in their application the level of services they plan to provide. DUI/DWAI education and treatment services include:

1. Level I Education, part 10.6 of this Chapter, and Level II Therapeutic Education, part 10.7 of this Chapter;

2. Level II Treatment (Tracks A - D), part 10.8 of this Chapter; or 3. Level II Treatment Track F (Level II Four (4) Plus), part 10.9 of this Chapter.

B. Locked correctional facilities may provide DUI/DWAI education services only.

C. BHEs shall not provide DUI/DWAI education or treatment services they are not endorsed to provide. 10.5.3 General DUI/DWAI Services Provisions A. The following provisions are applicable to all levels of DUI/DWAI services:

1. BHEs must develop and implement policies and procedures related to the provision of DUI/DWAI services. Personnel must have access to and be knowledgeable about the BHEs policies, procedures, and state and federal laws and regulations relevant to their respective duties.

B. All BHEs must have:

1. A formalized process for referring individuals to higher or lower levels of care;

2. A process to ensure individual data is accurate and submitted within seven (7) calendar days of service or change in status and entered into the Treatment Management System (TMS), unless prohibited by state or federal law;

3. A process for how the BHE must determine a method of service delivery that best meets the needs of the individual. This process must include but not be limited to:

a. A plan for regular review, evaluation, and modification of service delivery to continue meeting the individual’s needs; and b. A referral process to BHEs and/or other agencies that provide alternate methods of service delivery, if not available through the current BHE.

4. A process addressing how concurrent treatment provider(s) may be utilized or engaged to ensure coordination of individualized services is available to the individual. This must include a plan for data and exchange of information related to the individualized services received;

5. A pr ocess for how granting of DUI/DWAI services credit hours, as noted in this part 10.5.11, must be achieved. This includes providing DUI/DWAI services credit for individuals assessed as needing mental health services to address primary treatment concerns, and/or referral into non-English-speaking treatment options;

6. A process for how individuals will be monitored for drug and alcohol use while participating in education and/or treatment services must occur. This process must include a plan for responding and incorporation of monitoring results into the individual’s 7. Groups for ADDS education and treatment services must be restricted to those arrested, convicted of or receiving deferred prosecutions, pending prosecution, sentences, or judgments for DUI/DWAI.

8. Individuals with DUI/DWAI must not be treated in offender-specific groups with individuals with other offenses unless they need these groups as determined by the assessment and supported by the service plan.

C. Prior to admission of an individual for DUI/DWAI services, the BHE must obtain a current ADDS program screening and referral for placement. This screening and referral may be completed by a supervising entity as a condition of probation, parole, or pretrial services.

1. If a BHE is unable to obtain a copy of the ADDS or other court paperwork at the time the individual is admitted, there must be documentation of attempt(s) to obtain the paperwork from referral source, if applicable.

2. If the court paperwork is unavailable, or the individual is pretrial, the BHE must conduct a screening of the individual using an evidence-based or best practices screening process and instrument, following track placement guidelines as indicated in the legal supplement.

D. Prior to admission, BHEs must complete a screening for:

1. Congruence of level and track assignment with ADDS evaluation, if available. Any deviation or discrepancy must be addressed with the referral source prior to engaging the individual in DUI/DWAI services;

2. The individual’s number of DUI/DWAI-related offenses. If the individual is pre-sentenced with three or more prior convictions of DUI/DWAI-related offenses, or newly sentenced with four or more DUI/DWAI-related offenses, they must be immediately referred to a BHE endorsed to provide Level II Four Plus programming, as defined in part 10.9 of this

Chapter, the referral source must be notified;

3. Youth status for the individual and clinical appropriateness for placement in DUI/DWAI education and/or treatment groups. If the youth is not clinically appropriate for placement in a DUI/DWAI education or treatment group with adults, the BHE must develop an age and developmentally appropriate intervention for the youth. If the BHE is unable to accommodate the youth’s treatment needs, the BHE must refer the youth to another BHE endorsed to provide DUI/DWAI programming and the referral source must be notified;

4. A bility to provide necessary services as identified through the screening or the individual’s court order. If the BHE does not provide the necessary services, the BHE a. Refer the individual back to an ADES with documentation of which service(s) will not be provided within the BHE and identified referrals and suggestions for alternative services; and b. Be responsible for monitoring and reporting to referring courts or their representatives the individual's progress with concurrent services.

E. BHEs must document collaboration with recent or concurrent treatment service providers in accordance with all applicable federal and state confidentiality laws and regulations in the F. Level I Education, Level II Therapeutic Education, and Level II Treatment must not be combined, nor must contact hours completed for one count as contact hours completed in another.

G. Individuals must not be reported as finishing Level I Education or Level II Therapeutic Education until all required content/topics have been completed over the minimum required contact hours and weeks.

H. BHEs must provide individuals with an orientation of the DUI/DWAI program requirements and anticipated timelines for completion. Documentation of the orientation must be maintained in the individual record.

10.5.4 DUI /DWAI Reporting and Data Requirements A. BHEs providing Level I Education, Level II Therapeutic Education, and Level II Treatment must submit information into the Treatment Management System (TMS), including but not limited to DUI/DWAI reporting system (DRS) submissions.

B. BHEs must maintain access to TMS by submitting approval form(s) annually. These form(s) are available on the BHA’s website.

C. Prior to releasing any treatment information, BHEs shall obtain releases of information in accordance with all applicable federal and state confidentiality laws and regulations.

1. Identifying information of the judicial district in which an individual committed a DUI/DWAI offense shall not be put into TMS and/or the individual’s DRS record without a valid release of information for the assigned judicial district. This includes pre-sentenced DUI/DWAI individuals.

D. DRS requirements 1. At admission and throughout the duration of treatment:

a. A DRS record must be entered into TMS for all individuals enrolled in DUI/DWAI education and/or treatment.

b. The admission date for the DRS must be the date of enrollment with the BHE providing DUI/DWAI programming.

c. If the individual discharges from services and readmits, a new DRS with a current date of admission must be input into TMS.

(1) I nformation in the individual’s DRS record must be updated in TMS in a timely manner, not to exceed more than seven (7) calendar days after a service is provided or a change in status.

E. Affidavit of enrollment requirements 1. BHEs must provide individuals assigned to a Level II Treatment Track, as defined in parts 10.8, and 10.9 of this Chapter, Track with a Division of Motor Vehicles affidavit of enrollment upon request, or by the next scheduled session. This form may be found on the BHA’s website.

2. BHEs must provide proof of enrollment and status in Level II Education and Treatment, as defined in parts 10.7 through 10.9 of this Chapter including discharge, to the Colorado Department of Revenue, Division of Motor Vehicles via the Treatment Management System (TMS), within seven (7) calendar days of the service, in accordance with state and federal confidentiality laws, and Sections 42-2-132 and 42-2-114, C.R.S.

F. At discharge of treatment 1. BHEs must provide a copy of the discharge DRS, validated with signature of authorized personnel, to individuals and referral sources upon discharge from education and/or 2. An initial copy of the discharge DRS must be provided to individuals at no charge.

3. T he discharge DRS shall not be withheld from the individual for any reason including, but not limited to, collection of outstanding balances.

4. The discharge DRS must reflect all DUI/DWAI services the individual completed in a given episode of care. This includes any non-DUI/DWAI specific services, or services provided by non-DUI/DWAI endorsed programs, reviewed and granted towards DUI/DWAI credit hours.

5. BHEs must obtain a copy of all validated discharge DRS records for individuals who have completed any prior DUI/DWAI services for DUI/DWAI treatment requirement.

6. If the individual successfully completed DUI/DWAI education services while incarcerated for the current offense, the community-based BHE endorsed to provide DUI/DWAI programming shall not require the individual to repeat the completed education.

7. If the discharge DRS from a previous treatment episode is not available, the BHE must outreach the BHA for a record search. 10.5.5 Training A. Personnel providing DUI/DWAI services must:

1. Receive the “Understanding the ADDS Evaluation” training; and, 2. Be trained in or otherwise knowledgeable of, interlock enhancement counseling (IEC).

B. All personnel accessing the TMS must receive training by authorized BHA representatives.

C. BHEs must maintain proof of completion of training in personnel files and provide verification to the BHA upon request. 10.5.6 Provision of DUI/DWAI Services A. BH Es must use and adhere to a curriculum written in a manual form that is evidence-based or best practices specific to DUI/DWAI, unless otherwise noted.

B. BHEs must assign individuals to a specific group or individual session, unless clinical reason is documented for change in service delivery.

C. Personnel conducting DUI/DWAI education and treatment must meet the minimum qualifications as noted in the specific sub-endorsements for education and treatment in parts 10.6 through 10.9 of this Chapter.

D. Hours of attendance must only be granted for education or treatment contacts and must not include administrative procedures or breaks.

E. If telehealth services do not best meet the needs of the individual and the BHE endorsed to provide DUI/DWAI programming cannot accommodate in-person services, the BHE must refer the individual to a provider that can meet the individual’s needs. 10.5.7 Testing and Monitoring A. BHEs must ensure that testing and/or monitoring of individuals served for alcohol and drug use occurs during the course of services. This testing and monitoring may be completed on-site or through a third-party testing entity.

1. If the BHE elects to collect toxicology samples on-site, the BHE must ensure that samples will be safely collected, packaged, stored, and transferred to the lab for testing, as well as address all points of this part 10.5.8.

2. Drug and alcohol toxicology collection that occurs on-site must be observed by trained 3. If testing is completed by a third-party testing entity, there must be documentation of the BHE’s effort(s) to obtain test results.

B. The testing and/or monitoring schedule and method of collection must be determined by the BHE endorsed to provide DUI/DWAI programming or in collaboration with the supervising entity.

C. Method of testing and/or monitoring may include but is not limited to the following:

1. Urinalysis;

2. Breath analysis;

3. Continuous alcohol monitoring;

4. Mobile/remote breath testing;

5. Direct and indirect biomarker testing; and 6. Drug and other testing as appropriate.

D. With appropriate written consent or assent, the BHE shall coordinate and share testing and/or monitoring results with the supervising entity. 10.5.8 Youth DUI/DWAI Education and Treatment A. BHEs endorsed to provide DUI/DWAI education and treatment programming must have the ability to provide youth DUI/DWAI education and treatment or assist in direct referral and care coordination for the individual to another BHE that is endorsed to provide these DUI/DWAI programs for youth.

B. BH

Es providing DUI/DWAI services to youth under the age of eighteen (18) shall obtain a Children and Families services endorsement in accordance with Chapter 8 of these rules.

C. BHEs must hold youth that receive a DUI/DWAI to the same requirements under ADDS education and treatment services.

D. BHEs must use clinical judgment when determining age-appropriate placement of youth in a DUI/DWAI group, including but not limited to:

1. Providing a separate group for youth, when possible; and 2. Providing individual sessions to meet the developmental needs of the youth if group placement is not clinically indicated or available. 10.5.9 Content of Records for DUI/DWAI Services A. Individual records must be maintained for all levels of DUI/DWAI education and treatment, and in addition to the requirements set forth under part 2.11 of these rules, must contain at least the 1. Court documents regarding classification, referral and placement;

2. Attendance, individualized progress notes, and course completion data;

3. Descriptions of content and topics covered during each session;

4. Relevant reports and records of communication with the supervising entity regarding participation and termination of the episode of care; and 5. Copies of discharge DRS.

B. Additional content of record requirements must be noted within the specific DUI/DWAI endorsements in parts 10.6 through 10.9 of this Chapter. 10.5.10 DUI/DWAI Education and Treatment Credit for Specialized Services Attended A. BHEs endorsed to provide DUI/DWAI programming must consider and be authorized to grant Level I and Level II Education and Treatment credit for services an individual received at non- DUI/DWAI or out-of-state treatment providers. Services considered may include DUI/DWAIspecific education and treatment, substance use disorder education and treatment, mental health or co-occurring disorder services, or other clinically necessary services.

B. The granting of credit hours must be based on the assessed clinical need for services that support reduced engagement in impaired driving behaviors and activities.

C. C redit toward Level I and Level II Education and Treatment requirements are allowed on an hourfor-hour and week-for-week basis. No more than two (2) clinical contact hours per week must be documented for credit. Extra credit hours must not be permitted for individual counseling.

D. If the DUI/DWAI services credit hours being considered occurred previously, the BHE must:

1. Complete a new assessment;

2. If valid written consents or assents in place, obtain and review sufficient documentation of prior education and/or treatment, which includes at a minimum:

a. Admission and discharge date;

b. Description of services completed;

c. Progress on goals;

d. Discharge status; and e. Copy of discharge summary.

E. If the DUI/DWAI services credit hours being considered are concurrent, the BHE must:

1. If valid written consents or assents in place, refer the individual to an additional treatment provider, as indicated by the clinical assessment.

2. Coordinate between the individual and the concurrent treatment provider.

3. Document collaboration and care coordination in the individual’s record and service plan.

F. Credit hours must be assigned only if progress in treatment can be demonstrated in the clinical record review.

G. The granting of any education or treatment credit is subject to the following criteria:

1. Education or treatment must have occurred after the date of the last DUI/DWAI offense.

2. Any hours considered must have been completed in-person or through telehealth.

3. All levels of care are subject to the maximum of two (2) credit hours/week, including higher intensity services such as EOP, IOP, partial hospitalization, and residential.

4. Only partial track credit must be considered for treatment completed exclusively in a noncommunity-based facility, such as while incarcerated.

H. DUI/DWAI services credit hours must not be granted if:

1. The hours were completed in a virtual class and/or webinar format and/or in-person or telehealth support group setting that does not include active facilitation and engagement with one (1) or more of the following treatment personnel, acting within their scope of practice for the behavioral health service being considered for credit hours;

a. A uthorized practitioners;

b. Licensees;

c. Certified addiction specialists (CAS);

d. Candidates;

e. Certified addiction technicians (CAT); and f. Counselors-in-training and/or interns.

2. The hours were completed prior to the last date of DUI/DWAI offense;

3. The individual has a diagnosed substance use disorder and exhibits continued risky substance use related to their DUI/DWAI offense. The determination of risky substance use may include but is not limited to the following considerations: drug/alcohol screening/monitoring, individual self-report, observation by the professional, or another manner documented by the professional.

4. The documented evidence of completed hours or services shows insufficient progress towards goals.

I. Documentation requirements 1. Documentation of rationale for granting or denying of credit hours must be included in the 2. All supporting documentation used for consideration in granting or denying of education and treatment credit must be maintained in the individual’s record.

3. The BHE endorsed to provide DUI/DWAI programming shall enter all hours of education or treatment credit granted in the individual’s DRS.

a. For DUI/DWAI services credit hours achieved prior to current episode of care where a DRS record of that care is not provided, the BHE endorsed to provide DUI/DWAI programming must enter hours in a separate DRS record using the actual admission and discharge dates from the prior provider.

J. If treatment credits are not granted pursuant to part 10.5.11.H of this section, the individual must complete all the court mandated hours of treatment assigned by the referring supervising entity. 10.5.11 Ignition Interlock Enhancement Counseling (IEC)

A. IEC must be made available to all individuals who currently or will have an ignition interlock device installed in their vehicle during the episode of care.

1. If the BHE endorsed to provide DUI/DWAI programming does not provide IEC services, documentation of referral and collaboration with another BHE endorsed to provide DUI/DWAI programming that offers IEC services must be maintained in the individual’s B. BH Es must ask DUI/DWAI-involved individuals about their ignition interlock requirements upon admission and thereafter as needed.

1. Documentation of this inquiry must be maintained in the individual’s record.

C. BHEs must inform all individuals that participation in IEC is voluntary for DUI/DWAI-involved individuals assigned to Level II Treatment Tracks B, C, or D, as defined in part 10.8 of this 1. Participation in IEC is mandatory for DUI/DWAI-involved individuals assigned to Level II Four Plus who have an interlock device installed at any time while participating in Level II Four Plus services and BHEs endorsed to provide Level II Four Plus programming must encourage completion prior to the end of phase 3, as defined in part 10.9.4 of this D. IEC may be completed:

1. In-person; or 2. Utilizing telehealth.

E. IEC must be provided using a BHA-approved curriculum.

1. All BHE personnel providing IEC services must be trained in the curriculum.

F. Progress notes and service plans must reflect an individual’s participation in IEC, whether offered by the BHE or through referral.

G. BHEs must enter ten (10) hours into the individual’s DRS towards Level II Treatment requirements upon successful completion of all IEC requirements.

1. If referred out for IEC services, DRS record entry is completed by the BHE endorsed to provide DUI/DWAI programming that initiated the referral.

2. BHEs may enroll individuals in IEC concurrent to Level II Therapeutic Education or Level II Treatment. 10.6 Level I Education (which includes ASAM Level 0.5)

A. BHEs endorsed to provide Level I Education programming shall meet the requirements in parts 10.1 and 10.5, and 4.2 of these rules in addition to this part 10.6.

B. Level I education may be completed:

1. In-person; or 2. Utilizing telehealth.

C. Level I Education may be provided by a certified addiction technician (CAT), certified addiction specialist (CAS), licensee, authorized practitioner, or a candidate for a mental health professional D. BHEs endorsed to provide Level I Education programming must use and adhere to a curriculum written in a manual form that is evidence-based or are best practices specific to DUI/DWAI.

1. Education about the interlock device and Colorado’s current interlock laws and requirements must be a required topic in the legal session of Level I Education groups.

E. Level I Education must be twelve (12) contact hours of instruction.

1. No more than four (4) contact hours must be conducted in one (1) calendar day.

2. Groups must not exceed twenty (20) individuals receiving services.

3. Missed groups may be made up by attending another education session that covers the missed content.

F. There are no additional content of record or assessment requirements for this level of care.

10.7 L evel II Therapeutic Education (which includes ASAM Level 0.5)

A. BHEs endorsed to provide Level II Therapeutic Education programming shall meet the requirements in parts 10.1 and 10.5 and 4.2 of these rules in addition to this part 10.7.

B. Level II Therapeutic Education may be completed:

1. In-person; or 2. Utilizing telehealth.

C. Level II Therapeutic Education must be provided by a certified addiction technician (CAT), certified addiction specialist (CAS), licensee, authorized practitioner, or a candidate for a mental health professional license.

1. If a counselor-in-training and/or intern is involved in the facilitation of Level II Therapeutic Education, the group may be co-facilitated and documentation signed by a CAS or mental health professional licensed pursuant to Article 245 of Title 12, C.R.S.

D. BHEs endorsed to provide Level II Therapeutic Education programming must use and adhere to a curriculum written in a manual form that is evidence-based or best practices specific to DUI/DWAI.

1. Education about the interlock device and Colorado’s current interlock laws and requirements must be a required topic in the legal session of Level II Therapeutic Education groups.

2. Missed content of the curriculum must be made up in compliance with the requirements of curriculum authors.

E. Level II Therapeutic Education must consist of twenty-four (24) contact hours.

1. No more than two (2) contact hours must be granted per week.

2. Individuals must attend for a minimum of twelve (12) weeks for completion.

3. Groups must not exceed twelve (12) individuals receiving services.

4. Must not be combined with Level II Treatment unless clinical rationale is documented.

The combined time in Level II Therapeutic Education and Level II Treatment must not be less than the minimum number of weeks required for the assigned Level II Treatment Track.

F. The BHE must provide the screening(s) required in part 2.12.1 of these rules to DUI/DWAIinvolved individuals assigned to education-only services upon admission. The BHE must arrange for care coordination needs of the individual, if clinically indicated in the screening results.

G. BH

Es endorsed to provide Level II Therapeutic Education and Treatment programming are subject to the full requirements of Chapter 2 of these rules.

H. If the individual transitions between BHEs endorsed to provide DUI/DWAI programming during the course of services, the discharging BHE must provide the individual with a discharge DRS reflecting partial completion of treatment requirements and the supervising entity must be notified. 10.8 Level II DUI/DWAI Outpatient Treatment (which includes ASAM Level 1.0, Treatment Tracks A through D)

A. BHEs endorsed to provide Level II Outpatient Treatment programming shall meet the requirements in parts 10.1 and 10.5, and 4.3 of these rules in addition to this part 10.8.

B. Treatment must be completed:

1. In-person; or 2. Utilizing telehealth.

C. Treatment may be provided by a CAS, licensee, authorized practitioner, or a candidate for a mental health professional license.

1. If a CAT, counselor-in-training, and/or intern is involved in facilitation of treatment, the group must be co-facilitated and documentation co-signed by a CAS, licensee, or authorized practitioner pursuant to Article 245 of Title 12, C.R.S.

D. Treatment must consist of services that:

1. Are evidence-based or best practice curriculum specific to DUI/DWAI;

2. Are necessary behavioral health services, as determined by the individual’s assessment and service plan; or 3. Are a combination of (1) and (2) noted above.

E. The BHE endorsed to provide DUI/DWAI programming is responsible for recording clinical contact hours in the TMS database.

1. A maximum of two (2) clinical contact hours of DUI/DWAI treatment credit may be granted per week of participation.

2. Services provided in any level of care may count towards the individual’s assigned track 3. Clinical contact hours or weekly requirements must only be assigned in the DRS if progress in treatment can be demonstrated in a clinical record review.

4. Clinical contact hours attended must be conducted over the minimum number of weeks associated with the treatment Track assigned.

5. Make-up sessions for missed treatment sessions are not permitted.

F. If a Track has not been assigned by an ADES or the BHE is unable to obtain documentation of Track placement, the BHE must assign a Track based on the BHA Track placement guidelines located within the legal supplement.

G. T rack requirements 1. Track A individuals whose breath or blood alcohol content was below the statutorily defined PDD level, did not refuse breath or blood testing and who have one (1) offense for DUI/DWAI. Track A is a minimum forty-two (42) telehealth or in-person hours of group and/or individual treatment conducted over twenty-one (21) or more weeks.

2. Track B individuals whose breath or blood alcohol content was at or above the statutorily defined PDD level or refused breath or blood testing and who have one (1) offense for DUI/DWAI. Track B is a minimum of fifty-two (52) telehealth or in-person hours of group and/or individual treatment conducted over twenty-six (26) or more weeks.

3. Track C individuals whose breath or blood alcohol content was below the statutorily defined PDD level, did not refuse breath or blood testing, and who have two (2) or more offenses for DUI/DWAI. Track C is a minimum of sixty-eight (68) telehealth or in-person hours of group and/or individual treatment conducted over thirty-four (34) or more weeks.

4. Track D individuals whose breath or blood alcohol content was at or above the statutorily defined PDD level or refused breath or blood testing, and who have two (2) or more offenses for DUI/DWAI. Track D is a minimum of eighty-six (86) telehealth or in-person hours of group and/or individual treatment conducted over forty-three (43) or more 5. Track F; refer to this part 10.9, Level II Four Plus Treatment.

H. Level II treatment must be conducted only after Level II Therapeutic Education has been completed unless there is documented assessment and clinical rationale to do otherwise.

I. The assessment must be updated at the onset of treatment, and as required in Chapter 2 of these rules thereafter.

J. Using the initial service plan as a basis, a revised service plan and subsequent reviews must be developed for individuals in treatment in accordance with part 2.13.1 of these rules.

K. Treatment group sessions must not be less than two (2) hours of therapeutic contact, and the two hours must not include administrative procedures and breaks.

L. Treatment groups must not exceed twelve (12) individuals receiving treatment.

M. Individual treatment sessions must not be less than one (1) hour of therapeutic contact, and administrative procedures and breaks must not count towards the duration.

N. I ndividuals are expected to attend group one (1) time per week. Clinical rationale for any changes in frequency of group attendance (fewer or more) must be documented. At minimum, a BHE shall require individuals to attend at least one (1) group or individual session per month.

O. Credit toward clinical contact hours for treatment provided by an agency outside of a BHE endorsed to provide DUI/DWAI programming may be granted in accordance with this part 10.5.11. 10.9 Level II Four Plus Treatment (Track F) 10.9.1 General provisions A. BHEs endorsed to provide Level II Four Plus services shall meet the requirements in part 4.3 of these rules and parts 10.1, 10.5 of this Chapter, and this part 10.9.

B. BHEs endorsed to provide DUI/DWAI Level II Four Plus programming shall:

1. Have an active BHE license issued by the BHA, pursuant to Chapter 2 of these rules.

2. Have provided Level II DUI/DWAI treatment services for at least twelve (12) months.

C. BHEs endorsed to provide DUI/DWAI Level II Four Plus programming must:

1. Document active collaboration with referral sources and concurrent treatment entities to meet individualized cross-system needs; and 2. Be a ble to provide or refer to clinically relevant in-person services. 10.9.2 Training A. In addition to meeting training requirements in part 2.5 of these rules and this part 10.5.6, the BHE endorsed to provide Level II Four Plus programming must ensure that personnel involved in the provision of Level II Four Plus services attend no less than two (2) BHA-provided sessions during their active approval or licensing term that address the provision of Level II Four Plus B. BHEs must maintain documentation of all training sessions attended in personnel records and provide verification to the BHA, upon request. 10.9.3 Service Provisions A. Level II Four Plus must be completed as in-person services.

1. Telehealth may only be utilized if clinically indicated for the individual, or if the individual is unable to attend in-person. Documentation must be present in the individual record stating why telehealth was utilized.

B. There must not be a designated “Level II Four Plus Treatment Group,” as all services must be individualized and based on the individual’s assessment.

C. Length of stay in Level II Four Plus must be determined by competency and phase progression with a minimum of one-hundred eighty (180) clinical contact hours received in no less than eighteen (18) months.

1. T he number of clinical contact hours attended will vary throughout an individual’s treatment episode, depending upon the current phase and individual’s treatment needs and progress.

2. Contact hours must not include DUI/DWAI education unless clinically indicated for the 10.9.4 Level II Four Plus Competencies and Phases A. Level II Four Plus must be structured and provided as follows:

1. The individual must demonstrate proficiency in all of the competencies contained within each phase prior to progressing into the next (higher) phase.

2. The BHE endorsed to provide Level II Four Plus programming must document that each individual was provided a copy of the phases and competencies as part of the orientation phase of treatment.

3. Individual progress towards Level II Four Plus completion must be a combination of treatment and phase competency progress.

4. The BHE endorsed to provide Level II Four Plus programming must review each individual’s phase and competency achievements at a minimum every sixty (60) days in collaboration with available members of the individual’s multidisciplinary team.

a. For the purposes of Level II Four (4) Plus Treatment, multidisciplinary team means a team consisting of at least the endorsed DUI/DWAI program and the supervising entity. The MDT may include other professionals relevant to the individual’s assessed treatment needs. Available members of the MDT must be consulted by the agency in Level II Four Plus phase progression, service planning, changes in levels of treatment, and discharge process.

B. All individuals in Level II Four Plus who have an interlock device installed in their vehicle must complete IEC.

1. The BHE endorsed to provide Level II Four Plus programming must make every effort to ensure the individual completes IEC prior to the end of phase 3. 10.9.5 Level II Four Plus Care Coordination A. The BHE endorsed to provide Level II Four Plus programming must establish and regularly maintain collaborative relationships with other agencies, treatment providers, referral sources, or any other entities involved in the individual’s multidisciplinary team.

B. BHEs endorsed to provide Level II Four Plus treatment must provide care coordination, where applicable, to ensure individual service needs are addressed. 10.9.6 Level II Four Plus Assessments A. All Level II Four Plus services must be driven by an evidence-based or best practices assessment process and resulting individualized service plan.

B. Lev el II Four Plus assessments must include incorporation of standardized screening tools specifically designed to evaluate individuals in each of the following areas:

1. Cognitive functioning;

2. Traumatic brain injury;

3. Adverse childhood experiences (ACEs);

4. Grief and loss;

5. Co-occurring mental health issues; and 6. Polysubstance use concerns.

C. Level II Four Plus assessment must inform the determination of what combination of services the individual must complete that are non-DUI/DWAI Therapeutic Education and Treatment strategies. These services include, but are not limited to:

1. Individual counseling;

2. Group therapy, unless clinically contraindicated;

3. Family/other supportive therapy, if applicable;

4. Medication-assisted treatment, if applicable;

5. Residential treatment, if applicable;

6. DUI/DWAI Level II Therapeutic Education or Level II Treatment, if applicable;

7. Other education or treatment as indicated by the initial and ongoing clinical assessment.

D. BHEs endorsed to provide Level II Four Plus programming must ensure that personnel completing the assessment are properly credentialed and hold a valid certification to use the specific assessment instrument. Certification must be attained from entities or professionals authorized to provide such training regarding the instrument.

E. Clinically indicated services may be offered within the BHE or via external referral.

1. If at any time during the treatment episode a need is identified that the BHE endorsed to provide Level II Four Plus programming does not provide, the program must refer the individual to an appropriately licensed and/or credentialed facility or professional.

2. The BHE endorsed to provide Level II Four Plus programming must document evidence of communication with the other agency regarding assessment results, service plans, the individual’s participation, and progress. 10.9.7 Level II Four Plus Service Planning and Reviews A. Level II Four Plus service planning and reviews must be administered in accordance with part 2.13.1 of these rules and this Chapter 10.

B. BH

Es endorsed to provide Level II Four Plus Treatment must conduct service plan, phase, and competency reviews at a minimum of every sixty (60) days. Reviews must be conducted in collaboration with available members of the individual’s multidisciplinary team, in accordance with state and federal confidentiality laws.

C. All services determined to be necessary for the individual must be incorporated into the service plan, whether offered by the BHE endorsed to provide Level II Four Plus programming or another provider. 10.9.8 Level II Four Plus Discharge Planning and Process A. Level II Four Plus discharge planning must be administered in accordance with part 2.10 of these rules and must include a warm handoff when possible. A validated copy of the discharge DRS must be provided to the individual and receiving BHE endorsed to provide Level II Four Plus programming, when applicable, and as appropriate under state and federal confidentiality laws.

B. Consideration must be given to an individual’s needs for post-discharge clinical needs and peer recovery support services.

Chapter 11: Designation of Facilities for the Care and Treatment of Persons with Mental Health Disorders (Title 27, Article 65, C.R.S.) 11.1 Authority A. C hapter 11 establishes standards for and is applicable to facilities that are designated pursuant to

Article 65 of Title 27, C.R.S. the authority to promulgate these rules establishing minimum standards for the Care and Treatment of Persons with Mental Health Disorders comes from Sections 27-50-107(3) and 27-65-128, C.R.S.

B. Facilities designated pursuant to this Chapter 11 shall be subject to the following rule compliance timeline:

1. Upon these rules going into effect, the BHA shall take immediate action on rule violations that impact the health, safety, and welfare of persons receiving services provided by a designated facility.

2. All designated facilities shall be in full compliance of these rules by July 1, 2024.

C. On an annual basis, the BHA will review the effectiveness of these rules and produce a written report of the results of this review to the state board of human services. This review will include engagement with stakeholders and may include, but is not limited to, analysis of grievance data and trends in enforcement actions taken by the BHA. The BHA will provide this report annually to SBHS by September 1 starting September 1, 2024. The BHA will present information in the report to SBHS at the board's next session following submission of the written report unless the board and the BHA agree that presentation of the report occur at a different session of the board. If it is determined based on this review that changes to these rules are advised, the BHA shall propose these changes to the state board of human services for promulgation in accordance with Section 26-1-107, C.R.S.

11.2 D efinitions “Bedridden” means a form of immobility that can present as the inability to ambulate or move about independently or with the assistance of an auxiliary aid, and also requires assistance in turning and repositioning in bed. Such immobility may be due to medical orders or due to incapacitation.

“Behavioral Health Crisis Response Team”, as defined in Section 27-65-102(4), C.R.S., means a mobile team that responds to people in the community who are in a behavioral health crisis and includes at least one licensed or bachelor-degree-level behavioral health worker. A "Behavioral Health Crisis Response Team" includes, but is not limited to, a co-responder model, mobile crisis response unit, or a community response team.

“Certified Peace Officer”, as defined in Section 27-65-102(6), C.R.S., means any certified peace officer as described in Section 16-2.5-102, C.R.S.

“Child”, for the purposes of this Chapter 11, means the same as “ Minor”.

“Colorado Crisis Services” means the statewide behavioral health crisis response system offering individuals mental health, substance use or emotional crisis help, information and referrals.

"Court-Ordered Evaluation" means an evaluation ordered by a court pursuant to Section 27-65-106, iscrimination” for the purposes of this Chapter 11, has the same meaning as 27-65-117, C.R.S.

"Emergency Medical Services Facility" means a general hospital with an emergency department or a freestanding emergency department, as defined in Section 25-1.5-114(5), C.R.S.

“Emergency Medical Service Provider” means a person who holds a valid emergency medical service provider certificate or license issued by the Health Department as provided in Article 3.5 of Title 25, “Emergency Medical Treatment and Labor Act (EMTALA)”, means the federal Emergency Medical Treatment and Labor Act of 1986, found at 42 U.S.C. § 1395dd (2020).

“Facility” for the purposes of this Chapter 11 means:

A. Pursuant to Section 27-65-102(15), C.R.S., a public hospital or a licensed private hospital, Behavioral Health Entity, institution, or residential child care facility that provides treatment for persons with mental health disorders.

B. Any facility, as defined in part 1.2 of these rules, or unit(s) designated by the BHA pursuant to Title 27, Article 65, C.R.S. and this Chapter.

“Facility Personnel” or “ Community- Based Personnel” means:

A. A professional person as defined in this Chapter;

B. A registered professional nurse as defined in Section 12-255-104(11), C.R.S.;

C. A licensed marriage and family therapist, as defined in Section 12-245-501(3), C.R.S., licensed professional counselor, as defined in Section 12-245-601(2), C.R.S., or licensed addiction counselor, as defined in Section 12-245-801(10), C.R.S.; or, D. A licensed clinical social worker licensed as defined in Section 12-245-401(7), C.R.S.

“Gravely Disabled” means a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for the person’s essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of the person’s essential needs that could result in substantial bodily harm. A person of any age may be “Gravely Disabled”, but the term does not include an person whose decision-making capabilities are limited solely by the person’s developmental disability. mmediate Screening” means the determination of whether a person meets criteria for an emergency mental health hold.

“Imminent Danger” means a situation in which a person’s risk status is believed to immediately indicate actions that could lead to a person’s harm of self or others.

“Independent Professional Person” means a professional who evaluates a minor’s condition as an independent decision-maker and whose recommendations are based on the standard of what is in the best interest of the minor. The professional person may be associated with the admitting facility if the professional person is free to independently evaluate the minor’s condition and need for treatment and has the authority to refuse admission to any minor who does not satisfy the statutory standards specified in Section 27-65-104(2), C.R.S.

“Individual” for the purposes of this Chapter 11, has the same meaning as respondent as defined in

Section 27-65-102(29), C.R.S.

“Intervening Professional”, a person who is statutorily permitted to enact an emergency mental health hold, means a person who is of the following:

A. A professional person as defined in Section 27-65-102(27), C.R.S.;

B. A physician assistant licensed pursuant to Section 12-240-113, C.R.S.;

C. An a dvanced practice registered nurse, as defined in Section 12-255-104(1), C.R.S.;

D. A registered professional nurse, as defined in Section 12-255-104(11), C.R.S., who has specific mental health training as identified by the BHA;

E. A clinical social worker licensed pursuant to Part 4 of Article 245 of Title 12, C.R.S.;

F. A marriage and family therapist licensed pursuant to Part 5 of Article 245 of Title 12, C.R.S.;

G. A professional counselor licensed pursuant to Part 6 of Article 245 of Title 12, C.R.S.;

H. An addiction counselor licensed pursuant to Part 8 of Article 245 of Title 12, C.R.S.

“Involuntary Medication” means psychiatric medication administered without a person's consent.

“Involuntary Transportation Form” means the report and application allowing for immediate transport of a person, in need of an immediate screening for treatment, to a clinically appropriate facility.

“Involuntary Transportation Hold” means the ability to transport a person in need of an immediate screening to determine if the person meets criteria for seventy-two (72) hour treatment and evaluation.

The involuntary transportation hold does not extend or replace the timing or procedures related to a seventy-two (72) hour treatment and evaluation hold or a person’s ability to voluntarily apply for mental health services.

"Lay Person" means a person identified by another person who is detained on an involuntary emergency mental health hold pursuant to Section 27-65-106, C.R.S., certified for short-term treatment pursuant to

Section 27-65-109, C.R.S., or certified for long-term care and treatment pursuant to Section 27-65-110, C.R.S., who is authorized to participate in activities related to the person’s involuntary emergency mental health hold, short-term treatment, or long-term treatment, including court appearances, discharge planning, and grievances. The person may rescind the lay person’s authorization at any time.

"Mental H ealth Disorder" includes one or more substantial disorders of the cognitive, volitional, or emotional processes that grossly impairs judgment or capacity to recognize reality or to control behavior.

An intellectual or developmental disability is insufficient to either justify or exclude a finding of a mental health disorder pursuant to the provisions of Article 65 of Title 27, C.R.S.

"Minor", for this Chapter 11, means a person under eighteen (18) years of age; except that the term does not include a person who is fifteen (15) years of age or older who is living separately and apart from the person’s parent or legal guardian and is managing the person’s own financial affairs, regardless of the person’s source of income, or who is married and living separately and apart from the person’s parent or legal guardian.

“Objects to Hospitalization” means that a minor, with the necessary assistance of hospital staff, has written the minor’s objections to continued hospitalization and has been given an opportunity to affirm or disaffirm such objections forty-eight (48) hours after the objections are first written.

"Patient Representative" means a person designated by a mental health facility to process patient complaints or grievances or to represent patients who are minors pursuant to Section 27-65-104(4), etitioner”, pursuant to Section 27-65-102(25), C.R.S., means any person who files any petition in any proceeding in the interest of any person who allegedly has a mental health disorder or is allegedly gravely disabled.

"Physician", for the purposes of this Chapter 11, means a person licensed to practice medicine in this state pursuant to Article 240 of Title 12, C.R.S.

“Placement Facility” means a public or private behavioral health provider that has a written agreement with a designated facility to provide care and treatment to any individual undergoing mental health evaluation or treatment by a designated facility. A placement facility may be but is not limited to, a general hospital, nursing care facility, adult residential facility or licensed residential child care facility.

"Professional Person" has the same meaning as described in Section 27-65-102(27), C.R.S.

“Protection and Advocacy for Individuals with Mental Illness Act (PAIMI Act)”, means the federal Protection and Advocacy for Persons with Mental Illness Act of 1986, Pub. L. No. 99-319 (1986).

“Psychiatric Medication” is a medication being used to treat psychiatric illness for the individual including, but not limited to, anti-psychotics, antidepressants, and other medications that may have other medical uses but are accepted within the medical profession for psychiatric use as well.

“Qualified Medication Administration Person” or “ QMAP” means a person who passed a competency evaluation administered by the Department of Public Health and Environment before July 1, 2017, or passed a competency evaluation administered by an approved training entity on or after July 1, 2017, and whose name appears on the Department of Public Health and Environment’s list of persons who have passed the requisite competency evaluation.

“R esidential Child Care Facility” has the same meaning as set forth in Section 26-6-903(29) C.R.S. a residential child care facility may be eligible for designation by the commissioner pursuant to Article 65 of “Respondent”, for the purposes of Chapter 11, has the same meaning as described in Section 27-65- 102(29), C.R.S.

"Secure Transportation Provider” means a provider licensed pursuant to Section 25-3.5-310, C.R.S. to provide public or private secure transportation services.

“Secure Treatment Facility” for the purposes of these rules, means the state operated mental health hospitals.

“Subsequent Hold” means additional, up to 72-hour hold, when appropriate placement options could not be found during the initial hold period and the person continues to meet criteria for an emergency mental health hold.

“Therapy or Treatments Using Special Procedures” for the purposes of this part 11.10, means a therapy that requires informed consent specific to additional requirements of the treatment, including but not limited to electroconvulsive therapy, feeding tubes for eating disorder treatment, and behavior modifications using transcranial magnetic stimulation.

“Transitional Measures” means physical guidance, prompting techniques of short duration, or an initial temporary approved physical positioning of an individual at the onset or in response to a re-escalation during a physical management, for the purpose of quickly and effectively gaining physical control of that individual in order to prevent harm to self or others. 11.3 27 -65 Designation Requirement A. These rules are established to create standards for agencies seeking a 27-65 designation to provide involuntary treatment services pursuant to Article 65 of Title 27, C.R.S.

B. All agencies providing involuntary treatment services pursuant to Article 65 of Title 27, C.R.S. shall meet the standards in this Chapter 11. If the facility requires a BHE license, the facility shall also comply with Chapter 2 and the other Chapters specific to any endorsements held by the facility. If the facility requires approval as a behavioral health safety net provider, the facility shall also comply with Chapter 12.

C. Any facility licensed by a state agency to include the Colorado Department of Public Health and Environment or the division of child welfare within the Colorado Department of Human Services providing involuntary mental health services whether inpatient or outpatient, shall seek a 27-65 D. In order to provide involuntary services described in this Chapter 11, a facility, other than an emergency medical services facility, must receive a designation based on their compliance with the service standards described in this Chapter.

E. A designated facility must also comply with regulations specific to the involuntary services it provides, which may include:

1. Involuntary short-term and long-term care and treatment designation (part 11.16 of this

Chapter); and/or, 2. Involuntary outpatient care and treatment (part 11.17 of this Chapter). 11.3.1 27 -65 Designation General Standards A. The 27-65 designated facility shall only provide services for which it holds/has a 27-65 designation, approval, and/or another BHA license.

B. Facility designation applies only to the physical location(s) listed on the 27-65 designation certificate from BHA and not to any other non-designated physical locations operated by the facility.

1. Psychiatric units within a medical hospital and units that are separate from a main building must be designated separately for involuntary services.

2. Locations serving individuals under certification on an outpatient basis pursuant to

Section 27-65-111, C.R.S. must also be designated.

C. The 27-65 designated facility shall ensure all operations, locations, and services, including contracted services or personnel, comply with laws, regulations, and standards as required by 2 CCR 502-1.

D. Any 27-65 designated facility, must develop, implement, and every three (3) years review the following policies and procedures, unless such a facility has an active BHE license or safety net approval and has implemented policies and procedures listed below that address 27-65 designated services:

1. The governing body shall have policies and procedures regarding administrative and/or clinical oversight of the 27-65 designated services and requirements.

2. Personnel needed for services and ratios;

3. Training schedules and demonstration of training for personnel;

4. Emergency and crisis protocol;

5. Record protection, sharing, and retention protocol;

6. Disclosure of intervention, treatment, and/or medication;

7. Policies and procedures regarding the use/non-use of seclusion, restraint, and/or physical management pursuant to part 11.9 of this Chapter;

8. Continuity and transfer of care upon admittance and discharge from the facility;

9. The change to voluntary status process for an individual at the facility;

10. Communication of rights of individuals;

11. Facility rules and how they are communicated to individuals receiving services, including visitation expectations;

12. How the facility will manage and maintain the statutory rights individuals have to keep and use their own clothes and possessions, including cell phones and money;

13. Critical incident reporting; and 14. Facility process for removal and reinstatement of individual rights.

E. Any additional details regarding applicable policies and procedures in this Chapter must be followed in addition to those in this part. 11.3.2 Critical Incident Reporting A. A critical incident includes but is not limited to the following:

1. Breach of confidentiality: any unauthorized disclosure of protected health information as described in HIPAA, incorporated in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated in part 1.2 of these rules; and/or Sections 27-65-101 through -131, C.R.S.

2. D eath: including the death of an individual inside of or outside of the facility’s physical location while an individual is receiving services or where an individual has attempted to receive services from the facility within the past thirty (30) calendar days.

3. Elopement: absconding from a mental health hold, certification, emergency/involuntary commitment, or a secure facility where an individual is being held as a result of a court order. This includes any unauthorized absence of a minor, when a minor cannot be accounted for or when there is reasonable suspicion to believe the minor has absconded.

4. Any instance in which an individual cannot be located following a search of the facility, the facility grounds, and the area surrounding the facility, and:

a. There are circumstances that place the individual’s health, safety, or welfare at risk; or, b. The individual has been missing for eight (8) hours.

5. Medication diversion: any medication diversion as defined in part 1.2 of these rules. If the diverted drugs are injectable, the facility shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known.

6. Medication error: medication error that resulted or could have resulted in harm to the 7. Medical emergency: any suicide attempt/self-injury, other form of serious injury, health emergency, overdose or serious illness of an individual which occurred on facility premises or in the presence of facility personnel.

8. Any instance involving physical, sexual, or verbal abuse of an individual, as described in Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, or 18-3-405, 18-3- 405.3, 18-3-405.5, and 18-9-111 (exempting, however, the phrase “intended to harass”), C.R.S. by another individual, personnel, or a visitor to the facility.

9. Any instance that results in any of the following serious injuries to an individual:

a. Brain or spinal cord injuries;

b. Life-threatening complications of anesthesia or life-threatening transfusion errors c. Second- or third-degree burns involving twenty percent (20%) of more of the body surface area of an adult or more fifteen percent (15%) or more of the body surface area of a minor.

10. Any instance involving caretaker neglect of an individual, as defined in Section 26-3.1- 101(2.3), C.R.S.

11. An y instance involving misappropriation of an individual’s property, meaning patterns of loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, an individual’s belongings or money without the individual’s 12. Any occurrence involving the malfunction or intentional or accidental misuse of care equipment that occurs during treatment or diagnosis of an individual and that significantly or adversely affects or, if not averted, would have significantly adversely affected an B. Critical incidents must be reported to the BHA within one (1) business day after the incident.

Critical incidents must also be reported to the BHA within one (1) business day of when the facility determines that a reportable incident has occurred and the BHA requests such reporting.

Critical incidents must be reported to the BHA within one (1) business day on a BHA-created form posted on the BHA website.

C. The BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes and investigation of critical incidents reports in accordance with:

1. BHA policies and procedures, 2. Regulations that protect the confidentiality and individual rights in accordance with Sections 27-65-101 through -131, C.R.S.; HIPAA, as incorporated by reference in part 1.2 of these rules; and, 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules, 3. C ontrolled substance licensing, Section 27-81-113, C.R.S., Section 27-80-212, C.R.S., D. The BHA shall have access to relevant documentation required to determine compliance with E. The facility must:

1. Establish written policies and procedures for reporting and reviewing all critical incidents 2. Submit critical incidents reports to the BHA using state prescribed forms that can be obtained from the BHA’s website. This is not in lieu of other reporting mandated by state statute or federal guidelines;

3. Make available a report with the investigation findings for review by the BHA, upon 4. Maintain critical incidents reports for a minimum of three (3) years following the incident F. Nothing in this part shall be construed to limit or modify any statutory or common law right, 11.4 27-65 Designation Approval Procedures 11.4.1 Application Process A. Entities applying for 27-65 designation shall submit an application to the BHA on a state approved form, available on the BHA website.

B. Facilities providing twenty-four (24) hour inpatient or acute crisis care, must apply for a separate 27-65 designation based on the unique physical address of each site. If two or more buildings or units share a physical address, each building or unit must be designated separately for 27-65 C. T he BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a D. The BHA will act on an application within ninety (90) calendar days of receipt of the completed application. The applicant may be approved for 27-65 designation, granted provisional approval, or the application may be denied.

E. An applicant that is found to be in compliance with these rules shall be approved as a facility designated to provide mental health services effective for up to a one (1) year period.

F. A basis for denial of a 27-65 designation application includes a health care or residential child care facility’s withdrawal, revocation, loss of its license to operate.

G. If the application for 27-65 designation is denied, the reason(s) for denial listing deficiencies in the application shall be provided in a certified letter to the address of the applicant as shown on the application or as subsequently furnished in writing by the applicant. If an applicant disagrees with the decision, the applicant, if within sixty (60) days of receiving notice of the decision, may request a hearing to review the denial pursuant to Sections 24-4-105 and 24-4-106, C.R.S. (see

part 2.24.5 of these rules); or upon remedying the noted deficiencies, may re-apply for 27-65 designation in accordance with this part 11.4. 11.4.2 Provisional 27-65 Designation A. Provisional approval may be granted for a period not to exceed ninety (90) calendar days if, after initial inspection and review of an application:

1. The applicant is in substantial compliance with these rules and is temporarily unable to conform to all the minimum standards required under these rules. No provisional 27-65 designation shall be issued to an applicant if the operation of the facility may adversely affect individual health, safety, or welfare;

2. Compliance will be achieved within the ninety (90) day duration of the provisional license;

3. The applicant has a reasonable plan or schedule in writing for achieving compliance and provides a written copy of the plan to the BHA.

B. The applicant shall provide proof that attempts are being made to conform and comply with C. A second provisional approval for a period not to exceed ninety (90) calendar days may be granted under the same criteria if necessary to achieve compliance.

D. If the applicant is not able to come into compliance within one hundred and eighty (180) calendar days from the date of initial provisional license granted, the application may be denied with a right to request a hearing as described in part 11.4.1.G of this rule. 11.4.3 27 -65 Re-Designation A. A facility seeking 27-65 designation renewal shall provide the Department with a completed 27-65 designation application at least sixty (60) calendar days prior to the expiration of the existing 27- 65 designation.

B. 27-65 designation renewal applications received by the BHA after the current 27-65 designation expiration date has passed shall be returned to the facility by certified first class mail and/or through electronic means with written notification that the 27-65 designation is no longer in effect.

Applicants may reapply for an initial 27-65 designation in accordance with part 11.4.1 of these C. 27-65 designation renewal applications that are received by the BHA fewer than sixty (60) calendar days prior to the expiration of their existing 27-65 designation is a basis from which the BHA may deny the renewal application. If the BHA denies the renewal application for being untimely, the BHA will provide the facility with notice of the decision by certified first class mail. If the facility disagrees with the decision, it may request a hearing as described in part 11.4.1.G of this rule. Alternatively, any facility that submits its renewal application fewer than sixty (60) calendar days prior to the expiration of the current 27-65 designation and does not receive a new 27-65 designation prior to that date and/or notice that the BHA decided to deny the renewal application may reapply for an initial 27-65 designation in accordance with part 11.4.1 of these D. F ailure of a facility seeking renewal of a designation to accurately answer or report any information requested by the BHA shall be considered good cause to deny the 27-65 designation renewal application.

E. Facilities designated to provide care and treatment to persons with mental health disorders pursuant to Section 27-65-101 through -131, C.R.S., shall receive an annual review for compliance.

F. Facilities shall be notified in writing of non-compliance areas and the need for a plan of action as outlined in part 2.23.H.2 of these rules. A probationary 27-65 designation may be granted.

G. A facility in compliance with applicable BHA rules and state and federal regulations shall be granted 27-65 designation effective through the expiration date, for a period not to exceed one (1) year. 11.4.4 Conditional 27-65 Designation A. A conditional 27-65 designation may be granted to a facility out of compliance with applicable BHA or state and federal regulations prior to issuance of a renewal designation or during a current designation period. The facility will be notified in writing of non-compliance areas and the need for a plan of action (see part 2.23.H.2 of these rules).

B. A conditional 27-65 designation will replace the current 27-65 designation for a period not to exceed ninety (90) calendar days.

C. Administrative and treatment activities may be limited by a conditional 27-65 designation as set forth in the conditional designation while the facility addresses corrective actions.

D. A c onditional 27-65 designation may be re-issued for an additional period not to exceed ninety (90) calendar days if substantial progress continues to be made and it is likely that compliance can be achieved by the date of expiration of the second conditional license.

E. If the facility fails to comply with or complete a plan of action in the time or manner specified, or is unwilling to consent to the conditional 27-65 designation, the modification to a conditional 27-65 designation shall be treated as a revocation of the 27-65 designation and the facility shall be notified by certified mail of the deficiencies and reason for action, the BHA may then institute proceedings to effect the revocation per Section 24-4-104(3), C.R.S. 11.4.5 Change in Designation A. If a facility makes a change in its designation status or decides to drop its 27-65 designation, it shall notify the BHA in writing no later than thirty (30) calendar days prior to the desired effective date. The facility shall submit a written plan for the transfer of care for the persons with mental health disorders if the facility will no longer treat those individuals. This plan shall be submitted no later than ten (10) business days prior to the effective date.

11.4.6 R ule Waivers A. Rule waivers may be applied for as described in part 2.22 of these rules. 11.4.7 Enforcement and Adverse Actions A. 27-65 designated facilities are subject to enforcement measures outlined in part 2.24 of these rules and intermediate restrictions as outlined in part 2.24.4 of these rules.

B. Appeals of adverse actions shall be conducted in accordance with the state administrative procedure act, Section 24-4-101 through -109, C.R.S. 11.5 Data Reporting Requirements for All 27-65 Designated Facilities [Effective July 1, 2024]

A. Each facility designated for 27-65 services by the BHA, pursuant to Article 65 of Title 27, C.R.S., shall file an annual report with the BHA. The report shall be submitted in the format and timeframe required by the BHA. This data shall include individuals on emergency mental health holds and/or individuals on short-term or long-term certifications that are being treated in placement facilities under the auspices of the 27-65 designated facility.

B. For each 27-65 designated facility, the annual report shall include:

1. Facility name;

2. County, and address of the facility; and 3. Type of facility as defined in Section 27-65-102(15), C.R.S.

C. The facility must maintain confidentiality over the data sets. The reports generated from these data sets are also confidential; but the BHA may release aggregated information contained in the reports so long as the total number of individuals in any aggregate data group (including county or facility name) is greater than thirty (30). If the total number in such a data group is less than or equal to thirty (30), the BHA may release this information by redacting such number.

11.5.1 D ata Reporting General Standards A. Facilities must submit their annual data report to the BHA by July 1 of each year for the most recent, complete calendar year covering January 1 through December 31. The report must meet the requirements in this part 11.5 of these rules.

B. The BHA will annually request from the Department of Public Health and Environment a list of licensed facilities that may provide emergency services pursuant to Article 65 of Title 27, C.R.S. the facility list shall include, but is not limited to:

1. General hospitals;

2. Hospital units;

3. Psychiatric hospitals; and, 4. Community clinics.

C. If a facility on the list provided by the Department of Public Health and Environment does not report to the BHA, the BHA will contact the facility to confirm that the facility did not provide involuntary care to a person pursuant to Title 27, Article 65, C.R.S. during the reporting cycle.

1. If a facility is found to have provided involuntary care to a person pursuant to Title 27,

Article 65, C.R.S. and did not submit an annual report, an annual report will be requested.

2. If a facility refuses to provide the statutorily required report, the BHA may submit a complaint to the office of the ombudsman for behavioral health access to care.

D. T he facility must maintain confidentiality over the data sets. The reports generated from these data sets are also confidential; but the BHA may release aggregated information contained in the reports so long as the total number of persons in any aggregate data group (including county or facility name) is greater than thirty (30). If the total number in such a data group is less than or equal to thirty (30), the BHA may release this information by redacting such number.

E. The data report requirements, by service type, shall include the following types below in this part 11.5. 11.5.2 Seventy-Two (72) Hour Treatment and Evaluation (Emergency Mental Health Holds)

A. The facility is required to maintain a data set sufficient to report the following disaggregated numbers to the BHA annually by July 1, for the most recent, complete calendar year covering January 1 through December 31 and shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules ; and Section 27-65-101 through-131, C.R.S.:

1. For each individual on an involuntary emergency mental health hold, the facility shall report the individual’s:

a. Client ID;

b. Date of birth;

c. Gender;

d. Race and ethnicity; and e. County of residence.

2. Who initiated the involuntary emergency mental health hold? (Each hold can only meet the requirements of one category listed below):

a. Certified peace officer;

b. Court; or c. Intervening professional.

3. If applicable, what kind of intervening professional initiated the involuntary emergency mental health hold?

a. P rofessional person;

b. Physician assistant;

c. Advanced practice registered nurse;

d. Registered professional nurse;

e. Licensed clinical social worker;

f. Licensed marriage and family therapist;

g. Professional counselor; or h. Licensed addiction counselor.

4. The reason(s) for the involuntary emergency mental health hold (each hold can meet the requirements of multiple categories listed below):

a. Danger to self;

b. Danger to others; or c. Gravely disabled.

5. Disposition of the involuntary emergency mental health hold (each hold can only meet the a. Released without need for further mental health services;

b. Referred for further mental health care and treatment on a voluntary basis;

c. Certified for short-term treatment pursuant to Section 27-65-109, C.R.S.;

d. Transferred to another designated facility while still on the seventy-two (72) hour hold; or e. Placed on a subsequent hold due to placement issues.

6. The length of time the individual had to wait for placement in a facility.

7. The challenges encountered while finding placement for the individual, which may include but is not limited to:

a. Medical complications;

b. Historical aggression/combativeness;

c. Intellectual and developmental disorders;

d. Infectious disease;

e. No bed available; and/or f. Other important barriers to placement.

8. If applicable, the reason(s) for the subsequent involuntary emergency mental health hold, which may include but is not limited to:

a. Medical complications;

b. Historical aggression/combativeness;

c. Intellectual and developmental disorders;

d. I nfectious disease;

e. No bed available; and/or f. Other circumstances that prompted subsequent involuntary emergency mental health hold.

9. The total number of involuntary transportation holds received by the facility, as well as total numbers by outcome of the required screening, including at least:

a. Total number of involuntary transportation hold screenings resulting in the placement of an involuntary emergency mental health hold;

b. Total number of involuntary transportation hold screenings resulting in a referral for further mental health care and treatment on a voluntary basis; and c. Total number of involuntary transportation hold screenings resulting in a release without need for further mental health services. 11.5.3 Short and Long-Term Certifications A. The facility is required to maintain a data set sufficient to report the following disaggregate numbers to the BHA annually by July 1, for the most recent, complete calendar year covering January 1 through December 31 and shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through-131, C.R.S.:

1. For each individual, who was on a certification, the facility shall report the individual’s:

a. Client ID;

b. Date of birth;

c. Gender;

d. Race and ethnicity; and e. County of residence.

2. Type of certification (each certification can only meet the requirements of one category listed below):

a. S hort-term;

b. Extended short-term;

c. Long-term; or d. Extended long-term.

3. Status of certification:

a. Inpatient; or b. Outpatient.

4. Who initiated the certification (each certification can only meet the requirements of one category listed below):

a. Court order; or b. Professional person.

5. Reason(s) for the certification (each certification can meet the requirements of multiple categories listed below):

a. Danger to self;

b. Danger to others; or c. Gravely disabled.

6. Start date of certification.

7. End date of certification.

8. Start time of certification.

9. End time of certification.

10. The services that were provided during the certification.

11. Outcome of the certification (each certification can only meet the requirements of one category listed below):

a. Certification extended;

b. Successfully discharged and referred for further mental health care and treatment on a voluntary basis;

c. Voluntarily discharged;

d. Transferred for continued involuntary treatment;

e. Unable to locate individual for treatment;

f. Discontinued with treatment compliance concerns;

g. Unable to transfer to another facility;

h. Discontinued due to lack of payment to treatment providers; or i. Other circumstances of the outcome of the certification.

12. Employment status:

a. Unemployed;

b. Employed (full time);

c. Employed (part time);

d. Student;

e. Military service; or f. Disability.

13. Housing status:

a. Independent living;

b. Lives with parent/guardian/caregiver;

c. Unhoused;

d. Shelter;

e. Temporary housing;

f. Halfway house;

g. Alternative care facility;

h. Nursing home;

i. Group home; or j. Residential child care facility. 11.5.4 Voluntary Individuals A. The facility is required to maintain a data set sufficient to report the following disaggregate numbers to the BHA annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, a record of each individual who accessed mental health treatment voluntarily pursuant to Section 27-65-103, C.R.S., each individual’s record and data report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27- 65-101 through-131, C.R.S.:

1. Client ID;

2. Date of birth;

3. Gender;

4. Race and ethnicity; and 5. County of residence. 11.5.5 Involuntary Medications A. In addition to the reporting of involuntary medications pursuant to part 11.8.5, the facility is required to maintain data sets sufficient to report the following disaggregate numbers to the Department annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, a record of each individual who was given involuntary psychiatric medication pursuant to Section 27-65-106, C.R.S., each individual’s record and data report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R.

Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through- 131, C.R.S.:

1. C lient ID;

2. Date the procedure was initiated;

3. Date of birth;

4. Gender;

5. Race and ethnicity;

6. Type of order:

a. Emergency; or b. Court-ordered.

7. Type of medication (specified use of involuntary medication):

a. Antipsychotics - typical;

b. Antipsychotics - atypical;

c. Antidepressants;

d. Mood stabilizers; or e. Anxiolytics/hypnotics. 11.5.6 Involuntary Treatment A. The facility is required to maintain data sets sufficient to report the following disaggregate numbers to the Department annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, a record of each individual who underwent involuntary treatments pursuant to Section 27-65-106, C.R.S., each individual’s record and data report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R.

Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through- 131, C.R.S.:

1. Client ID;

2. Date of birth;

3. Gender;

4. Race and ethnicity; and 5. Type of treatment:

a. Seclusion;

b. Restraint; or c. Both seclusion and restraint.

6. Date, time, and length of seclusion and/or restraint episode per individual. 11.5.7 Electroconvulsive Therapy (ECT) Procedures A. The facility is required to maintain data sets sufficient to report the following disaggregate numbers to the Department annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, a record of each individual who underwent electroconvulsive therapy, each individual's record and data report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through-131, C.R.S.:

1. Client ID;

2. Date of birth;

3. Gender;

4. Race and ethnicity;

5. Date, time, and length of ECT; and 6. Status:

a. Voluntary ECT; or b. Involuntary ECT. 11.5.8 Imposition of Legal Disability or Deprivation of a Right A. The facility is required to maintain data sets sufficient to report the following disaggregate numbers to the BHA annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, a record of each individual with an imposition of legal disability or deprivation of a right during treatment pursuant to Section 27-65-127, C.R.S., each individual’s record and data report shall include as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and

Section 27-65-101 through-131, C.R.S.:

1. C lient ID;

2. Date of birth;

3. Gender;

4. Race and ethnicity; and 5. Specific right deprived. 11.5.9 Data Requirements for Emergency Medical Services Facilities [Effective July 1, 2024]

A. The data reporting required in this section is subject to limitations set forth in HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through-131, C.R.S.

B. An emergency medical services facility, as defined in part 11.2 of these rules, providing care to an individual pursuant to Article 65 of Title 27, C.R.S. is required to maintain a data set sufficient to report the following disaggregate numbers to the BHA annually pursuant to Section 27-65- 106(9), C.R.S., in the format and timeframe required by the BHA as provided on the BHA website.

C. For each facility, the annual report shall include:

1. The name, county, and address of each facility site where the service was provided.

2. Gender;

3. Race and ethnicity;

4. County of residence;

5. If the individual arrived at the facility through an emergency transportation hold;

6. A record of each individual who had an involuntary emergency mental health hold resolved (this includes release without need for further mental health services, referral for voluntary treatment, or transferred to from the facility) at the facility;

7. The outcome of each individual involuntary emergency mental health hold resolved at the facility (each hold can only meet the requirements of one category listed below):

a. Released without the need for further mental health services;

b. Referred for voluntary treatment; or c. T ransferred to a 27-65 designated facility for continued involuntary services.

8. Who initiated the involuntary emergency mental health hold (each hold can only meet the a. Certified peace officer;

b. Court; or c. Intervening professional.

9. The reason for the involuntary emergency mental health hold (each hold can meet requirements of multiple categories below):

a. Dangerous to self;

b. Dangerous to others; or c. Gravely disabled. 11.6 Personnel Requirements for 27-65 Designated Facilities 11.6.1 Safety A. Any personnel who are physically or mentally unable to adequately and safely perform duties that are essential functions may not be assigned duties as a direct care personnel or volunteer at a 27-65 designated facility. Facilities shall outline criteria in their policies and procedures for determining whether a person is able to safely perform duties in its policies and procedures.

B. The facility shall not employ or allow any personnel who are under the influence of a controlled substance, as defined in Sections 18-18-203 through -207, C.R.S. or who are under the influence of alcohol in the workplace. This does not apply to personnel using controlled substances under the direction of a physician and in accordance with their health care provider’s instructions, as long as it does not pose a safety risk to the person, other personnel, or individuals.

C. The facility shall employ sufficient personnel to ensure that the provision of services meets the needs of individuals. The facility shall:

1. Ensure that each shift has a minimum of two (2) personnel, whenever one (1) or more individuals are present in the milieu;

2. Mai ntain individual-to-personnel ratios not exceeding a one to six (1:6) trained staff member(s) to individual ratio at all times; and 3. Inpatient staffing ratios do not apply to outpatient certification services.

D. If the facility is a hospital, the facility must comply with staffing requirements pursuant to Section 25-3-128, C.R.S. in lieu of compliance with part 11.6.1.C.

E. The facility shall ensure that, at minimum, one of the following qualified personnel is available to administer medications at all times:

1. Licensed practical nurse, registered nurse, advanced practice registered nurse, physician, physician’s assistant, pharmacist, or qualified medication administration 11.6.2 Leadership Personnel Requirements and Responsibilities A. Facility director 1. The facility director is responsible for the following:

a. Overall direction and responsibility for the individuals, program, facility, and fiscal management;

b. Overall direction and responsibility for supervision of personnel;

c. The selection and training of a capable personnel member who can assume responsibility for management of the facility in the director’s absence; and d. The establishment of relationships and maintaining contact with allied facilities, services, and mental health resources within the community.

2. Qualifications of a facility director:

a. The facility director shall have, at minimum, received a bachelor’s degree from an accredited college or university and have three (3) years of verified experience in position; or, b. The facility director shall have, at minimum, received a master’s degree from an accredited college or university and have two (2) years of verified experience in position.

3. Assistant or acting facility director:

a. In each facility, there shall be a specifically designated personnel member capable of acting as a substitute for the facility director during their absence. The duties and responsibilities of the acting facility director shall be clearly defined within the facility’s policies and procedures in order to avoid confusion and conflict among other personnel and individuals.

b. If the facility director is regularly absent from the facility for more than fifty percent (50%) of their working hours, an assistant or acting director shall be appointed who meets the qualifications outlined in part 11.6.2.A.2 of this section.

B. Clinical director 1. The clinical director is responsible for assuring that there is adequate training and supervision for personnel, that multidisciplinary personnel members are practicing within their scope, and that ethical standards are upheld.

2. Q ualifications of a clinical director:

a. The clinical director shall possess a master’s degree or doctoral degree in a mental health related field or a bachelor’s degree in a mental health related field plus five (5) years of related work experience.

b. The clinical director shall possess a valid clinical license to practice medicine and/or behavioral health services in the state of Colorado. 11.6.3 Personnel Training Requirements for 27-65 Designated Facilities A. In addition to trainings identified in part 2.5.I of these rules, facilities designated for 27-65 services under these rules shall develop policies and procedures for personnel training curriculum and schedules in order to meet the following requirements. Facilities may choose to use an annual certification of competency in lieu of training which shall be stored in the personnel file; the facility shall develop appropriate policies, procedures and testing to assure and demonstrate personnel competency. Training shall be conducted in a trauma-informed, culturally, and linguistically competent manner.

B. All personnel supervising or providing direct care and treatment for individuals with mental health disorders shall receive annual training or annual facility certification of competency on the provisions of these rules and the requirements of Section 27-65-101 through -131, C.R.S.

C. Al l personnel who order or administer involuntary medications (including prescribers, nursing personnel, and QMAPs) shall receive annual training or annual facility certification of competency on Chapter 11 of these rules and the legal rationale underlying involuntary medication of D. All supervisory and direct care personnel shall receive annual training or annual facility certification of competency in the recognition and response to common side effects of psychiatric medications. These personnel shall be trained to respond to emergency drug reactions in accordance with the facility's policies.

E. All personnel who administer seclusion, restraint, and physical management techniques shall receive training and/or certification at minimum pursuant to this part 11.9.3.

F. All program administrators and program supervisory personnel shall receive annual training or annual facility certification of competency on alternative or representative medical decision making, including, but not limited to advance directives, medical durable powers of attorney, and G. Specific personnel of placement facilities, as determined by the 27-65 designated facility and its policies and procedures, shall receive annual facility training or annual certification of competency on the provisions of these rules and the requirements of Section 27-65-101 through-131, C.R.S. the 27-65 designated facility is responsible for ensuring that this annual training occurs at placement facilities and documenting all relevant placement facility training. 11.7 Individual Records 11.7.1 General Procedures for Individual Records A. The professional person and/or the facility providing an evaluation, care, and/or treatment shall keep records detailing all care and treatment received by the individual, and the records must be made available, upon the individual’s written authorization, to the individual’s attorney or the individuals personal physician in accordance with federal and state laws. The records are permanent records and must be retained in accordance with Section 27-65-123(4), C.R.S.

B. E xcept as provided in this part 11.7.1.B, all information obtained and records prepared in the course of providing any services to any individual pursuant to any provision of Article 65 of Title 27, C.R.S., are confidential and privileged matter. The information and records may be disclosed only:

1. In communications between qualified professional personnel in the provision of services or appropriate referrals;

2. When the individual designates other persons to whom information or records may be released; but, if an individual is a ward or conservatee and the ward’s or conservatee’s guardian or conservator designates, in writing, persons to whom records or information may be disclosed, the designation is valid in lieu of the designation by the recipient; except that nothing in this section compels a physician, psychologist, social worker, nurse, attorney, or other professional personnel to reveal information that has been given to the individual in confidence by members of an individual’s family or other informants;

3. To the extent necessary to make claims on behalf of a recipient of aid, insurance, or medical assistance to which recipient may be entitled;

4. If the BHA has promulgated rules for the conduct of research, such rules must include, but are not limited to, the requirement that all researchers must sign an oath of confidentiality. All identifying information concerning individuals, including names, addresses, telephone numbers, and social security numbers, must not be disclosed for research purposes;

5. T o the courts, as necessary for the administration of Article 65 of Title 27, C.R.S.;

6. To persons authorized by an order of court after notice and opportunity for hearing to the individual to whom the record or information pertains and the custodian of the record or information pursuant to the Colorado rules of civil procedure;

7. To family members upon admission of an individual with a mental health disorder for inpatient or residential care and treatment. The only information that may be released pursuant to this part 11.7.1.B.7 is the location and fact of admission of the person with a mental health disorder who is receiving care and treatment. The disclosure of location is governed by HIPAA and 42 C.F.R. Part 2 and the procedures in Section 27-65-124, C.R.S. and is subject to review pursuant to Section 27-65-124, C.R.S.; and/or, 8. To family members or a lay person actively participating in the care and treatment of a person with a mental health disorder, regardless of the length of the participation. This disclosure is governed by HIPAA, as incorporated by reference in part 1.2 of these rules; and 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and the procedures in Section 27-65-124 (2) and is subject to review pursuant to Section 27-65- 124, C.R.S. The information released pursuant to this subpart is limited to one (1) or more of the following:

a. T he diagnosis;

b. The prognosis;

c. The need for hospitalization and anticipated length of stay;

d. The discharge plan;

e. The medication administered and side effects of the medication; and f. The short-term and long-term treatment goals.

9. In accordance with state and federal law, to the facility designated pursuant to the federal “Protection and Advocacy for Mentally Ill Individuals Act”, 42 U.S.C. Sec. 10801 et seq., and as the governor's protection and advocacy system for Colorado.

C. Nothing in part 11.7.2 of these rules precludes the release of information to a parent or legal guardian concerning the minor.

1. Nothing in Article 65 of Title 27, C.R.S., renders privileged or confidential any information, except written medical records and information that is privileged pursuant to Section 13- 90-107, C.R.S., concerning observed behavior that constitutes a criminal offense committed upon the premises of any facility providing services pursuant to Article 65 or any criminal offense committed against any individual while performing or receiving services pursuant to Article 65 of Title 27, C.R.S.

2. This section does not apply to physicians or psychologists eligible to testify concerning a criminal defendant’s mental condition pursuant to Section 16-8-103.6, C.R.S.

D. Al l facilities shall maintain and retain permanent records, including all applications as required pursuant to Section 27-65-106(3), C.R.S.

1. Outpatient or ambulatory care facilities shall retain all records for a minimum of seven (7) years after discharge from the facility for individuals who were eighteen (18) years of age or older when admitted to the facility, or until twenty-five (25) years of age for individuals who were under eighteen (18) years of age when admitted to the facility.

2. Inpatient or hospital care facilities shall retain all records for a minimum of ten (10) years after discharge from the facility for individuals who were eighteen (18) years of age or older when admitted to the facility, or until twenty-eight (28) years of age for individuals who were under eighteen (18) years of age when admitted to the facility.

3. Nothing in this section prohibits or limits the sharing of information by a state institution of higher education police department to authorized university administrators pursuant to

Section 23-5-141, C.R.S. 11.7.2 Request for Release of Information Procedures A. This section provides for the release of information only and is not deemed to authorize the release of the written medical record without authorization by the individual or as otherwise provided by law.

1. When a family member requests the location and fact of admission of a person with a mental health disorder pursuant to Section 27-65-123(1)(g), C.R.S., the treating professional person or the professional person’s designee, who must be a professional person, shall decide and document the rationale in the individual’s record to whether to release or withhold such information. The location must be released if consistent with HIPAA, as incorporated by reference in part 1.2 of these rules, and 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules, unless the treating professional person or the professional person’s designee determines, after an interview with the individual, that release of the information to a particular family member would not be in the best interests of the individual.

a. An y decision to withhold information requested pursuant to Section 27-65-123(1), C.R.S., is subject to administrative review pursuant to this section upon request of a family member or the individual.

2. The treating facility shall make a record of the information given to a family member.

3. For the purposes of request for release of information in this section, an adult person having a similar relationship to an individual with a mental health disorder as a spouse, lay person, parent, child, or sibling of an individual with a mental health disorder may also request the location and fact of admission concerning an individual with a mental health 4. When a family member requests information concerning an individual with a mental health disorder, the treatment professional person or the professional person’s designee, shall determine whether the individual is capable of making a rational decision in weighing the individual’s confidentiality interests and the care and treatment interests implicated by the release of information. The treating professional person or the professional person’s designee shall then determine whether the individual consents or objects to the release of information.

B. For purposes of this section, the treating professional person’s designee shall be a professional C. I nformation must be released or withheld in the following circumstances:

1. If the treating professional person or the professional person’s designee makes a finding that the individual is capable of making a rational decision concerning the individual’s interests and the individual consents to the release of information, the treating professional person or the professional person’s designee shall order the release of the information unless the professional person or the professional person’s designee determines that the release would not be in the best interest of the individual with a mental health disorder.

2. If the treating professional person or the professional person’s designee makes a finding that the individual with a mental health disorder is capable of making a rational decision concerning the individual’s interests and the individual objects to the release of information, the treating professional person or the professional person’s designee shall not order the release of information.

3. If the treating professional person or the professional person’s designee makes a finding that the individual with a mental health disorder is not capable of making a rational decision concerning the individual’s interests, the treating professional person or the professional person’s designee may order the release of the information if the professional person or the professional person’s designee determines that the release would be in the best interests of the individual.

4. An y determination of individual capacity:

a. Must be used only for the limited purpose of this section.

b. A decision by a treating professional person or the professional person’s designee concerning the capability of an individual with a mental health disorder is subject to administrative review upon the request of the individual.

c. A decision by a treating professional or the professional person’s designee to order the release or withholding of information is subject to administrative review upon the request of either a family member or the individual with a mental health d. The director of the treating facility shall make a record of any information given to a family member.

D. Procedures for administrative and judicial review of information release/withholding when requested:

1. When administrative review is requested, the director of the facility providing care and treatment to an individual with a mental health disorder, shall cause an objective and impartial review of the decision to withhold or release information.

2. The director of the facility shall conduct the review if the director is a professional person.

a. If the director is not available or if the director cannot provide an objective and impartial review, the review must be conducted by a professional person designated by the facility director.

3. T he review must include, but is not limited to, an interview with the individual with a mental health disorder.

4. The facility providing care and treatment shall document the review of the decision 5. If an individual with a mental health disorder objects to the release or withholding of information, the individual and the individual's attorney, if any, must be provided with information concerning the procedures for administrative review of a decision to release or withhold information. The individual must be informed of any information proposed to be withheld or released, and to whom, and be given a reasonable opportunity to initiate the administrative review process before information concerning the individual’s care and treatment is released.

6. A family member whose request for information is denied must be provided with information concerning the procedures for administrative review of a decision to release or withhold information.

7. An individual with a mental health disorder may file a written request for review by a court, under Section 27-65-124, C.R.S., of a decision made upon administrative review to release information to a family member requested and proposed to be released.

8. If judicial review is requested by the individual, under Section 27-65-124, C.R.S., the court shall hear the matter within ten (10) days after the request, per Section 27-65-124, C.R.S., and the court shall give notice to the individual with a mental health disorder and the individual's attorney, the treating professional person, and the person who made the decision upon administrative review of the time and place of the hearing.

a. T he hearing must be conducted in the same manner as other civil proceedings before the court per Section 27-65-124, C.R.S.

9. Unless specifically stated in an order by the court, an individual does not forfeit any legal right or suffer legal disability by reason of the provisions of Article 65 of Title 27, C.R.S.

10. In order to allow an individual with a mental health disorder an opportunity to seek judicial review, the treating facility or the treating professional person or the professional person's designee shall not release information requested until five (5) days after the determination upon administrative review of the director or the director's designee is received by the individual.

11. Once judicial review is requested, the treating facility or the treating professional person or the professional person's designee shall not release information except by court order.

12. If the individual with a mental health disorder indicates an intention not to appeal a determination upon administrative review that is adverse to the individual concerning the release of information, the information may be released less than five (5) days after the determination upon review is received by the individual. 11.7.3 Documentation in Individual Records A. 27 -65 designated involuntary emergency services facilities shall be exempt from completing a comprehensive assessment as described in part 2.12.3 of these rules, an initial assessment as described in part 2.12.2 of these rules and a service plan as described in part 2.13.1 of these B. Screening shall follow requirements as outlined in part 2.12.1 of these rules and must also contain the following:

1. Substance use in the past 24 hours:

a. What, how much, when;

2. Current medications; and 3. Psychiatric advance directives, psychiatric and/or medical assessment documentation.

C. Crisis assessments must be completed in full on a BHA-created form, available on the BHA website, within 24 hours of admission when determining involuntary hold.

1. The elements from this form can be integrated into a facility’s electronic health record system.

D. The BHA-created standardized evaluation form pursuant to 27-65-106(6)(b), C.R.S., available on the BHA website must be documented in full in the individual record.

E. If the treating professional person at the designated facility pursues short-term or long-term certification of an individual, all corresponding court documents must also be part of the individual F. Safety planning documentation must contain the following:

1. Emergency services facilities will develop crisis safety plans with individuals who are detained or assessed/evaluated and are not placed on emergency mental health holds prior to discharge or transfer.

2. Safety planning must be done in collaboration with the individual in crisis and their family members and/or other social supports (if desired by the individual).

G. Discharge instructions and care coordination instructions must contain the following in both the individual’s clinical record and available as instructions for the individual:

1. A s ummary of why the individual was detained or evaluated for an emergency mental health hold;

2. Detailed information as to why the evaluating professional determined the individual no longer meets the criteria for an emergency mental health hold pursuant to Section 27-65- 106, C.R.S. or certification pursuant to Section 27-65-109, C.R.S.;

3. Whether the individual may receive services on a voluntary basis pursuant to parts 11.14.2.I through 11.14.2.l of these rules;

4. If the individual’s medications were changed or the individual was newly prescribed medications during the emergency mental health hold, a clinically appropriate supply of medications, as determined by the judgment of a licensed health-care provider, for the individual until the individual can access another provider or follow-up appointment.

Facility must assist in care coordination for the follow-up appointment, if needed;

5. A safety plan for the individual and, if applicable, the individual’s lay person where indicated by the individual’s mental health disorder or mental or emotional state;

6. Notification to the individual’s primary care provider, if applicable and/or known;

7. A referral to appropriate services, if such services exist in the community, if the individual is discharged without food, housing, or economic security. Any referrals and linkages must be documented in the individual’s record;

8. The phone number to call or text the Colorado Crisis Services hotline and information on the availability of peer support services;

9. Information on how to establish a psychiatric or medical advance directive if one is not presented;

10. Medications that were changed during the emergency mental health hold, including previously prescribed upon admission, and which medications, if any, were changed or discontinued at the time of discharge;

11. A list of any screening or diagnostic tests conducted during the emergency mental health hold, if requested;

12. A summary of therapeutic treatments provided during the emergency mental health hold; if requested;

13. Any laboratory work, including blood samples or imaging that was completed or attempted, if requested;

14. The person’s vital signs upon discharge from the emergency mental health hold, if requested;

15. A copy of any psychiatric advance directive presented to the facility, if applicable; and 16. How to contact the discharging facility if needed.

H. The facility shall document in the individual's record whether the individual accepted the discharge instructions.

I. The facility shall provide the discharge instructions to the individual's parent or legal guardian if the individual is under eighteen (18) years of age, and to the individual's lay person, when possible and if consistent with state and federal law.

J. U pon discharge, the facility shall discuss with the individual, the individual's parent or legal guardian, or the individual's lay person the statewide care coordination infrastructure established in Section 27-60-204, C.R.S. to facilitate a follow-up appointment for the individual within seven (7) calendar days after the discharge. Facilities shall comply with part 11.7.3.J of this Chapter, when the statewide care coordination infrastructure created in Section 27-60-204, C.R.S. is fully operational, as determined by the BHA. The BHA shall immediately notify facilities when the statewide care coordination infrastructure is available to assist individuals with discharge.

K. The facility shall, at a minimum, attempt to follow-up with the individual, the individual's parent or legal guardian, or the individual's lay person within forty-eight (48) hours after discharge.

L. The facility is encouraged to utilize peer support professionals, as defined in Section 27-60- 108(2)(b), C.R.S., when performing follow-up care with individuals and in developing a continuing care plan pursuant to this part 11.7.3.G.1 through 3. The facility may facilitate follow-up care through contracts with community-based behavioral health providers or the Colorado Behavioral Health Crisis Hotline. If the facility facilitates follow-up care through a third-party contract, the facility shall obtain authorization from the individual to provide follow-up care, any denial of authorization from the individual shall be documented in the individual record.

M. If the individual is enrolled in Medicaid, the facility is not required to meet the requirements of this

part 11.7.3.J through 11.7.3.M and instead, the facility shall notify the individual's relevant Managed Care Entity, as defined in Section 25.5-5-403(4), C.R.S., of the individual's discharge and need for ongoing follow-up care prior to the individual's discharge.

N. If the facility contracts with a Behavioral Health Entity and/or a safety net provider, as defined in

Section 27-50-101(7), C.R.S., to provide behavioral health services to an individual on or following an emergency mental health hold, the facility shall work with the Behavioral Health Entity and/or safety net provider in order to meet the requirements of this part 11.7.3.J through 11.7.3.M.

O. The facility shall encourage the individual to designate a family member, friend, or other persons as a lay person to participate in the individual's discharge planning and shall notify the individual that the individual is able to rescind the authorization of a lay person at any time. If the individual designates a lay person and has provided necessary authorization, the facility shall attempt to involve the lay person in the individual's discharge planning. The facility shall notify the lay person that the individual is being discharged or transferred.

P. I nvoluntary emergency services facilities must ensure that an individual and authorized caregiver and/or family member(s) receive follow-up by phone or telehealth within forty-eight (48) hours, conducted by any member of the responding team or by an associated hospital follow-up program. Purpose of the follow-up appointment shall be documented in the individual’s clinical 11.8 Psychiatric Medications 11.8.1 Informed Consent A. In all instances where prescription medications are to be ordered as a part of a mental health treatment program, the following information in these part 11.8.1.A through 11.8.1.D shall be provided, consistent with federal and state law, to the individual and legal guardian(s) and communicated both written and verbally. For individuals, between the ages of fifteen (15) and eighteen (18), the following information may be provided to the individuals’ parent(s) or legal guardian(s). When an individual has designated another to act concerning medication issues pursuant to a medical durable power of attorney, advanced directive, or proxy, the information shall be provided to that person also. The facility shall have policies and procedures for documenting in the clinical record that the required information was given to the individual, parent, or guardian and consent obtained before initial administration of medication(s).

1. T he name(s) of the medication being prescribed;

2. The usual uses of the medication(s);

3. The reasons for ordering the medication(s) for this individual;

4. A description of the benefits expected;

5. The common side effects and common discomforts, if any;

6. The major risks, if any;

7. The probable consequences of not taking the medication(s);

8. Any significant harmful drug or alcohol interactions, or food interactions;

9. Appropriate treatment alternatives, if any;

10. That the individual may withdraw agreement to take the medication at any time; and 11. Ensure that medication will not interfere or negatively interact with any of the individual’s other prescribed medication(s).

B. If an individual has established an advance directive concerning psychiatric medication and the advance directive is still in effect, the physician or advanced practice registered nurse shall follow the directive unless contraindicated in a psychiatric emergency. The rationale for overriding an advance directive shall be clearly documented in the individual’s clinical record.

C. The provider with prescriptive authority or their designee shall offer to answer inquiries regarding the medication(s).

D. No individual shall be threatened with or subjected to adverse consequences by facility personnel solely because of a failure to accept psychiatric medication voluntarily. 11.8.2 Prescribing, Handling, & Administration of Psychiatric Medication(s)

A. All psychiatric medication(s) shall be administered on the written order of a professional person authorized by statute to order such medications. Verbal medication orders may be given according to facility policies.

B. The facility shall have written policies and procedures regarding part 11.8.1 of these rules for informed consent, and the following:

1. D ocumentation of the administration of medication, medication variances/errors, and adverse medication reactions related to medication administration;

2. Notification to a professional person authorized by statute to order such medications in case of medication errors and/or medication reactions/events;

3. Discontinuance of medication;

4. Disposal of medications;

5. Acceptance of verbal, fax, or electronically transmitted medication orders; and 6. Medication shortages and substitutions.

C. Facilities shall ensure all clinical staff are aware of and have access to the medication formulary.

D. Facilities shall ensure their providers have access to the medications on the medication formulary when prescribing medications to treat behavioral health disorders.

E. Facilities shall note in the individual’s clinical record all prescription medications administered to the individual by a facility including:

1. The name and dosage of medication;

2. The reason for ordering the medication;

3. The time, date and dosage when medication(s) is administered;

4. The name and credentials of the person who administered the medication;

5. The name of the prescribing physician or advanced practice registered nurse to order such medication; and 6. If the medication is administered as an emergency medication or a court-ordered 11.8.3 Involuntary Psychiatric Medications A. These rules for involuntary psychiatric medications do not apply to refusal of non-psychiatric medications or medical emergencies. If an individual refuses medications intended to treat general medical conditions and that refusal is likely to cause or precipitate a medical emergency, those professionals who are authorized to order and administer medications may take action in accordance with generally accepted medical practice in an emergency situation.

B. Psychiatric emergency conditions: individuals who are detained pursuant to Sections 27-65-106, - 107, -108.5, -109, or -110, C.R.S., and refuse psychiatric medication may be administered psychiatric medication(s) ordered up to twenty-four (24) hours without consent under a psychiatric emergency condition. The least intrusive means should be used to address the psychiatric emergency.

C. An emergency condition exists if:

1. The individual is determined to be in immediate and substantial danger of harming self or others, as evidenced by symptoms which have in the past reliably predicted dangerousness in that particular individual; or, 2. By a recent overt act, including, but not limited to, a credible threat of bodily harm, an assault on another person or self-destructive behavior that demonstrates an immediate and substantial threat to self or others.

D. A reasonable attempt to obtain voluntary acceptance of psychiatric medication shall be made prior to the use of involuntary medication.

E. Continuation of a psychiatric emergency:

1. If the psychiatric emergency has abated because of the effect of psychiatric medications and the authorized practitioner is of the opinion that psychiatric medication is necessary to keep the emergency in abeyance beyond seventy-two (72) hours, then within that seventy-two (72) hours the following steps shall be taken:

a. T he facility shall send a written request for a court hearing for an order to administer the medication involuntarily;

b. A documented concurring consultation with another authorized practitioner shall be obtained. The consultation shall include an examination of the individual and a review of the clinical record including an assessment as to whether the psychiatric emergency condition continues to exist; and c. If a concurring consultation is not obtained within seventy-two (72) hours, then emergency psychiatric medication shall be discontinued until such concurring consultation is obtained and documented, except in cases where life threatening consequences could result from an abrupt medication discontinuation. Under these circumstances, the individual shall be safely taken off the medication according to standards of medical practice, with corresponding clinical documentation.

2. In no case shall an individual receive emergency psychiatric medication(s) involuntarily for a period exceeding ten (10) days without an order from a court of competent jurisdiction, including continuation orders from the court.

3. The individual shall be notified of the right to contact their attorney and/or the court of competent jurisdiction at the time the written request for court-ordered medication is made. This notification shall be documented in the clinical record. If an individual chooses to exercise this right, the 27-65 designated facility shall aid the individual, if necessary, in accomplishing the foregoing.

F. The specific facts outlining behaviors supporting the finding of the emergency condition shall be detailed in the clinical record. Every twenty-four (24) hours thereafter until such time a final court order is issued, the emergency is resolved, or the individual accepts psychiatric medications voluntarily, the facility shall document the behaviors that substantiated the need to continue the emergency medication, and the physician shall reorder the psychiatric medications.

G. D uring the course of emergency medication administration, the individual shall be offered the medication on a voluntary basis each time the medication is given. If the individual voluntarily consents to take the medication(s), and the attending physician determines that the individual will likely continue to accept the medication on a voluntary basis and no longer requires involuntary medications, this shall be documented in the record and the involuntary medication procedures shall be terminated.

H. If the individual again refuses to voluntarily accept medication(s) and their clinical condition returns to an emergency situation, pursuant to part 11.8.3.C of these rules, the emergency psychiatric medication procedures may be re-instituted. 11.8.4 Non-Emergency Involuntary Medications (Court Ordered Medications)

A. In non-emergency situations in which an individual, who is detained pursuant to Sections 27-65- 106, -107, -108.5, -109, -110, or -111, C.R.S., would benefit from the administration of a psychiatric medication, but the individual does not consent, the facility shall petition the court to obtain permission to administer such medication. The following conditions must be documented in the petition:

1. The individual is incompetent to effectively participate in the treatment decision;

2. Treatment by psychiatric medication is necessary to prevent a significant and likely longterm deterioration in the individual's mental condition or to prevent the likelihood of the individual causing serious harm to self or others;

3. A less intrusive appropriate treatment alternative is not available; and 4. The individual's need for treatment by psychiatric medication is sufficiently compelling to override any bonafide and legitimate interest of the individual in refusing treatment.

B. The petition shall specify what class or name of psychiatric medication is being recommended as potentially beneficial to the individual.

C. No psychiatric medications shall be administered without the individual's consent until a court order is received authorizing involuntary use, except under emergency conditions under part 11.8 11.8.5 Involuntary Medication Data Reporting A. In addition to the involuntary medication data reporting requirements pursuant to 11.5.5, the 27- 65 designated facility shall maintain a log of all cases where involuntary medications were administered.

B. The record must contain, at a minimum, the following:

1. Individual's name and identifying number;

2. Specified use of involuntary medication;

3. Physician or other professional authorized by law ordering involuntary medication;

4. Date/time each involuntary medication was administered and reason for use of involuntary medication;

5. Date/time involuntary medication was discontinued; and 6. Reason for discontinuation of involuntary medication(s).

C. If the facility uses a medication administration record or another mechanism which meets the criteria listed in this part 11.8.5.B, can correlate this information as required in this part 11.8.5.D, and places the information in the clinical record, that mechanism may be used in lieu of a separate log.

D. T he facility shall have the ability to determine, at a minimum:

1. The aggregate number of individuals receiving emergency and involuntary psychiatric medications during a specified period of time; and 2. The start and stop dates for each individual's involuntary medication treatment.

E. If the facility is licensed as a BHE, the facility must incorporate the use of this data into the quality improvement program in accordance with part 2.17 of these rules. 11.9 Seclusion, Restraint, and Physical Management 11.9.1 General Provisions A. The following rules covering seclusion, restraint, and physical management apply to all facilities that use seclusion, restraint, and/or physical management. If a facility has decided to use seclusion, restraint, and/or physical management, the facility shall use seclusion, restraint, and/or physical management only in accordance with the rules in this part 11.9.

B. These rules do not supersede any requirements under Section 26-20-101 through-111, C.R.S.

C. If any provision of this part 11.9 conflicts with any provision concerning the use of seclusion, restraint, and/or physical management on an individual with an intellectual or developmental disability as stated in Article 10.5 of Title 27, C.R.S., Article 10 of Title 25.5, C.R.S. or any rule adopted pursuant to those Articles, the provisions of those Articles or rules prevail.

D. Individuals being detained under Sections 27-65-106 through -110, C.R.S., may be secluded or restrained involuntarily under the conditions in this part; otherwise, there must be a signed informed consent for such an intervention as subject to part 2.11 of this rule.

E. A facility may only use seclusion, restraint, and/or physical management:

1. In cases of emergency, as defined at Section 26-20-102(3), C.R.S., to be a serious, probable, imminent threat of bodily harm to self or others where there is the present ability to affect such bodily harm; and, 2. After less restrictive alternatives, including but not limited to after all attempts to verbally direct or de-escalate the individual have failed; or 3. After a determination that such alternatives would be inappropriate or ineffective under F. A fa cility that uses seclusion, restraint, and/or physical management pursuant to the provisions of

part 11.9.1.E of this section, may only use such seclusion, restraint, and/or physical management:

1. For the purpose of preventing the continuation or renewal of an emergency;

2. For the period of time necessary to accomplish its purpose; and 3. In the case of physical restraint, with no more force than is necessary to limit the individual's freedom of movement.

G. In addition to the circumstances described in this part 11.9.1.F, a facility that is designated by the commissioner of the BHA in the State Department to provide treatment pursuant to Sections 27- 65-106, 27-65-109, or 27-65-110, C.R.S., to an individual with a mental health disorder, as defined in Section 27-65-102(22), C.R.S., may use seclusion to restrain an individual with a mental health disorder when the seclusion is necessary to eliminate a continuous and serious disruption of the treatment environment.

H. Seclusion, restraint, and/or physical management must never be used:

1. As a punishment or disciplinary sanction, 2. As a means of coercion, 3. As part of an involuntary service plan or behavior modification plan, 4. F or convenience, 5. For the purpose of retaliation, or 6. For the purpose of protection, unless:

a. The restraint or seclusion is ordered by a court; or b. In an emergency, as provided for in this part 11.9.1.F.1 above.

I. Physical management for individuals under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to part 11.9.13 of this Chapter. 11.9.2 Policies and Procedures Regarding Seclusion, Restraint, and Physical Management A. Facilities shall have and shall implement written policies and procedures that describe the situations in which the use of seclusion, restraint, and/or physical management are considered appropriate in the facilities and personnel who can order their use. The policies and procedures must include the requirements in this part 11.9 and Section 26-20-101 through -111, C.R.S. these policies and procedures must also include:

1. For a facility that does not authorize the use of seclusion, restraint, and/or physical management of any type, a policy statement noting the prohibition against the use of seclusion, restraint, and/or physical management and the procedures that personnel will 2. For a facility that utilizes seclusion, restraint, and/or physical management, a policy statement regarding the review process for the use of seclusion, restraint, and/or physical management. The review process must include a provision for terminating the seclusion, restraint, and/or physical management episode when the reviewer does not concur with a. If the reviewer is not an authorized practitioner, then the order must be 3. Personnel shall ensure that no individual endures harm or harassment when secluded 4. A policy statement that a facility shall ensure that the care and treatment are skillfully and humanely administered with full respect for the individual’s dignity, pursuant to Section 27-65-101(1)(a), C.R.S.

5. Protocols for when the use of restraint, seclusion, and/or physical management is appropriate, and the restrictions on the use of these techniques, the facility may impose more, but not fewer, restrictions on the use of these techniques than is required by this 6. Details on the type of physical management interventions that personnel are approved to 7. Details on how seclusion, restraint, and/or physical management will be altered to include any necessary accommodations the individual may need, including but not limited to, changing emergency interventions to not restrain hands and ability to communicate for those individuals that speak sign language. 11.9.3 Personnel Training A. The facility shall ensure that all personnel involved in utilizing seclusion, restraint, and/or physical management are trained in the use of seclusion, restraint, and/or physical management as described in this part 11.9.

B. The facility shall ensure that personnel are trained to explain, where possible, the use of seclusion, restraint, and/or physical management to the individual who is to be secluded, restrained, or physically managed and to the individual’s designated representative, if C. Training must be standardized and evaluated every three (3) years to ensure incorporation of evidence-based best practices for seclusion, restraint, and/or physical management.

D. Training must be provided to personnel within the first month of their orientation period and E. Personnel shall obtain certification in cardiopulmonary resuscitation (CPR), including periodic F. Training must include at minimum, but is not limited to:

1. The safe use of seclusion, restraint, and/or physical management including content related to the risks of positional asphyxia, aspiration, traumatization, and recognize and respond to signs of physical distress of an individual who is secluded, restrained, and/or 2. Address concepts related to prevention and non-physical interventions such as deescalation and mediation;

3. Educate personnel of how their culture, language, biases, values, and perceptions influence their response and escalation of person involved; and 4. U nderstanding and recognizing underlying behavioral health and physical health conditions, medications, and their potential effects as well as how age, developmental level, cultural background, language, history of physical or sexual abuse, and prior experience with seclusion, restraint, and/or physical management will influence an G. Personnel must demonstrate knowledge and application of seclusion, restraint, and physical management training on an annual basis when working with persons over the age of twenty-one (21), and on a semi-annual basis when working with youth twenty (20) years old and younger. 11.9.4 Standards of Care Upon Admission A. At admission, the facility shall inform both the individual and the individual’s legal representative, as applicable, of the facility’s policy regarding the use of seclusion, restraint, and physical management during an emergency behavioral health episode for individuals in a treatment program. This must, as is reasonable under the circumstances, be communicated, if feasible, in a language and modality accessible to the individual.

B. Upon an individual’s admission, personnel shall collaborate with the individual and the individual’s legal representative, when applicable, to formulate strategies that may minimize the potential for a behavioral health emergency event that requires interventions of seclusion, restraint, and/or C. A fa cility electing to utilize seclusion, restraint, and/or physical management shall assess each 1. Assault and trauma history;

2. Seclusion, restraint, and/or physical management history;

3. Individual’s risk factors for a behavioral emergency, and individually identified strategies 4. The facility shall ascertain any applicable behavioral health advance directives. 11.9.5 Use of Physical Management A. Physical management for individuals under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to part 11.9.13 of this Chapter.

B. Physical management shall only be used on an emergency basis for a maximum of one (1) minute, when the situation places the individual or others at imminent risk of serious physical harm after all attempts to verbally direct or de-escalate the person have failed.

1. If physical management is used for longer than one (1) minute, the intervention is restraint, pursuant to Section 26-20-102(6), C.R.S., and personnel must follow the restraint order rules pursuant to part 11.9.7 of this Chapter.

C. To ensure the safety of each individual and personnel, each facility shall designate emergency D. The term “ physical management” does not include briefly holding an individual in order to comfort E. T he physical management continuum may include:

1. Utilizing transitional measures;

2. Placing one’s hands on an individual to physically guide and/or physically control the 3. Use of an approved restraint method specified in the facility’s policies and procedures to maintain safety of the individual;

4. Placing an individual into an approved prolonged restraint method specified in the facility’s policies and procedures; or 5. Physical management may be used to move or escort an individual into seclusion.

a. Seclusion, in itself, is not a form of physical management.

F. Physical management must be documented in the clinical record to include the following:

1. Documentation of the behavioral necessity for physical management and any de- 2. Documentation of the approved physical management method utilized. 11.9.6 Use of Seclusion A. If an order for seclusion is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order seclusion must verify the verbal order in a signed written form in the individual’s record. Signatures must be 2. The physician or other authorized practitioner to order seclusion must be available to personnel for consultation, at least by telephone, throughout the period of the emergency B. Within one (1) hour of the initiation of the original order of seclusion an authorized practitioner, such as a registered nurse or physician assistant, trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the individual, shall conduct a face-to-face assessment of the physical and psychological well-being of the individual including but not limited to:

1. The individual’s physical and psychological status;

2. The individual’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

C. When the one (1) hour assessment described in this part 11.9.6.B is conducted by a registered nurse or a physician assistant, that personnel must consult with the attending physician when the D. Results of the one (1) hour assessment must determine if continued emergency interventions need to be re-ordered by the authorized practitioner.

1. Assessment results and continuation order, if applicable, must be contained in the clinical E. Seclusion occurs any time an individual is placed alone in a room and not allowed to leave.

F. Seclusion must be used only when other less restrictive methods have failed.

1. Documentation of less restrictive methods and the outcome must be contained in the G. Seclusion must not be used for punishment, for the convenience of personnel, or as a substitute H. Seclusion rooms must be lighted, clean, safe, and have a window for personnel to observe.

I. Seclusion rooms must be a minimum of one hundred (100) square feet, unless the facility is licensed as a hospital and the seclusion room size is in compliance with applicable CDPHE J. Relief periods from seclusion must be offered for reasonable access to toilet facilities. 11.9.7 Use of Restraint A. If an order for restraint is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order restraint must verify the verbal order in a signed written form in the individual’s record. Signatures must be 2. The physician or other authorized practitioner to order restraint must be available to personnel for consultation throughout the period of the emergency safety intervention.

B. An individual in physical restraint must be released from such restraint within fifteen (15) minutes after the initiation of physical restraint, except when precluded for safety reasons pursuant to part 11.9.1 of this section.

C. Within one (1) hour of the initiation of the original order for the emergency safety intervention, an authorized practitioner, such as a registered nurse or physician assistant, trained in the use of emergency safety interventions and permitted to assess the physical and psychological wellbeing of the individual, shall conduct a face-to-face assessment of the physical and psychological well-being of the individual including but not limited to:

1. T he individual’s physical and psychological status;

2. The individual’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

D. When the one (1) hour assessment described in this part 11.9.7.C is conducted by a registered nurse or a physician assistant, that personnel must consult with the attending physician when the E. Results of the one (1) hour assessment must determine if continued emergency interventions need to be reordered by the authorized practitioner.

1. Assessment results and continuation order, if applicable, must be contained in the clinical F. The decision to restrain must be based on a current clinical assessment and may also be based on other reliable information including information that was used to support the decision to take the individual into custody for treatment and evaluation. The fact that an individual is being evaluated or treated under Sections 27-65-106 through 27-65-111 [effective July 1, 2024], C.R.S., must not be the sole justification for the use of restraint.

G. Restraint includes chemical restraint, mechanical restraint, and physical restraint.

H. Mechanical restraints may be used only for the purpose of preventing such bodily movement that is likely to result in imminent injury to self or others. Mechanical restraint must not be used solely I. R estraint of an individual by a chemical spray is not permissible.

J. The type of restraint must be appropriate to the type of behavior to be controlled, the physical condition of the individual, the age of the individual, and the type of effect restraint may have upon the individual.

K. Restraint must be applied only if alternative interventions have failed. Justification for immediate use of restraint without first attempting alternative interventions must be documented in the clinical record; however, alternative techniques are not required if the alternatives would be ineffective or unsafe when the individual’s behavior could cause harm to self or others.

L. The term “ restraint” as used in this section, does not include restraints used while the facility is engaged in transporting an individual from one facility location to another facility location when it is within the scope of that facility’s powers and authority to conduct such transportation pursuant to Section 26-20-101 through -111, C.R.S.

M. No physical or mechanical restraint of an individual may place excess pressure on the chest or back of that individual, cover the individual’s face, or inhibit or impede the individual’s ability to breathe. 11.9.8 Chemical Restraint A. If an order for chemical restraint is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency 1. T he physician or other authorized practitioner permitted to order chemical restraint must verify the verbal order in a signed written form in the individual’s record. Signatures must 2. The physician or other authorized practitioner to order chemical restraint must be available to personnel for consultation, throughout the period of the emergency safety B. An order for a chemical restraint, along with the reasons for its issuance, must be recorded in writing at the time of its issuance.

C. An order for a chemical restraint must be signed at the time of its issuance by such authorized practitioner, who is present at the time of the emergency.

D. An order for a chemical restraint, if authorized by telephone, must be transcribed and signed at the time of its issuance by personnel with the authority to accept telephone medication orders who is present at the time of the emergency.

E. Personnel trained in the administration of medication shall make notations in the record of the individual as to the effect of the chemical restraint and the individual’s response to the chemical 11.9.9 E xplanation to Individual in Seclusion/Restraint A. In any situation in which seclusion/restraint is utilized, information must be given to the secluded/restrained individual, and the individual’s legal representative when applicable, as soon as possible after they have been secluded or restrained. The individual must be given a clear explanation of:

1. The reasons for use of such intervention;

2. The observation procedure, the desired effect; and 3. The circumstances under which the procedure will be terminated.

B. That the explanation has been given to the individual and the individual’s legal representative, when applicable, must be documented in the clinical record.

C. As soon as possible, upon termination of seclusion and/or restraint, personnel shall debrief with the individual and assess for any traumatic stress that may have been triggered as a result of 11.9.10 Observation & Care of Individuals in Seclusion and/or Restraint A. An individual who is in seclusion/restraint must be observed in-person by trained facility personnel at no more than ten (10) feet physical distance from the individual.

1. Such observation, along with the behavior of the individual, must be documented every B. Unless contraindicated by the individual's condition, such observation must include consistent C. Ongoing provisions must be made for nursing care, hygiene, diet, and motion of any restrained D. Facility personnel must maintain a continuous line-of sight throughout the episode with the E. F or individuals held in mechanical restraints, facility personnel must observe the individual at least every fifteen (15) minutes to ensure that:

1. The individual is properly positioned;

2. The individual’s blood circulation is not restricted;

3. The individual’s airway is not obstructed; and 4. The individual’s other physical needs are met, pursuant to this part 11.9.10.

F. For individuals held in mechanical restraints, the facility shall offer relief periods of at least ten (10) minutes as often as every two (2) hours, so long as relief from the mechanical restraint is determined by personnel to be safe pursuant to part 11.9.1 of this section.

G. Personnel must document relief periods both offered and granted.

H. The individual must have access to food at least every four (4) hours.

I. The individual must have access to fluids and toileting upon request or during offered relief periods but must at minimum be offered every two (2) hours.

1. During such relief periods, personnel shall ensure proper positioning of the individual and J. Personnel must provide assistance for use of necessary toileting methods.

1. Appropriate toileting does not include the use of adult diapers if not typically used by the individual when not restrained or secluded.

2. If the individual typically uses adult diapers they are to be changed immediately if soiled.

K. Personnel shall maintain the individual’s dignity and safety during relief periods.

L. Cameras and other electronic monitoring devices must not replace face-to-face observations.

M. To the extent that the duties specified in Section 26-20-101 through -111, C.R.S. are more protective of individual’s rights or are in conflict with the provisions in this part 11.9, the provisions of Section 26-20-101 through -111, C.R.S. shall apply. 11.9.11 Continued Use of Seclusion and/or Restraint A. Personnel must document efforts to assure that the use of seclusion/restraint are as brief as B. The original order of seclusion/restraint of an individual must not exceed one (1) hour without an order for continued seclusion/restraint from an authorized practitioner. A verbal order, including telephone or other electronic orders, may be used if followed by a written order from the C. Seclusion/restraint must not be ordered on an “as needed” basis.

D. A ne w written order is required every four (4) hours and shall include a documented examination by an authorized practitioner.

E. Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative 1. The administrative reviewer shall be a different authorized practitioner with the authority and knowledge necessary to review clinical information and reach a determination that the extension of a seclusion and/or restraint episode beyond twenty- four (24) hours is 2. If the administrative reviewer does not concur with the order for continuation of seclusion/restraint, the order must be discontinued and the authorized practitioner in F. An administrative review must be initiated at the conclusion of each twenty-four (24) hour period 11.9.12 Documentation Requirements A. Each facility must ensure that an appropriate notation of the use of seclusion, restraint and/or physical management is documented in the record of the individual who was secluded, restrained, and/or physically managed and must be completed before the end of the shift of the personnel involved in the seclusion, restraint and/or physical management episode(s). Each facility shall document the following in the individual’s record:

1. S pecifics of the episode including identified triggers, precipitating events, the individual's specific behavior(s) and the nature of the danger;

2. Type of restraint, if utilized;

3. Specific date and times of initiation and discontinuation of seclusion, restraint and/or physical management and total length of time individual is secluded, restrained, and/or 4. A description of specific non-physical and least restrictive interventions that were attempted prior and the individual’s response;

5. Identification of personnel involved in the initiation and application of the seclusion, restraint and/or physical management;

6. Notification to an authorized practitioner within one (1) hour of the seclusion/restraint 7. Care provided while the individual was secluded, restrained, and/or physically managed, a. Observations conducted;

b. Assessments of position, respiration, circulation, and range of motion;

c. Documentation of ongoing 15-minute observation and care checks, as subject to applicable rules, along with relief periods both offered and granted for food, fluid, d. Interventions provided to promote comfort and safety as well as expedite release;

e. The individual’s response to these interventions; and f. The effect of the restraint or seclusion on the individual;

8. Documentation that the individual, and the individual’s legal representative if applicable, was given a clear explanation of the reasons for use of such intervention, the observation procedure, the desired effect, and the circumstances under which the intervention will be terminated including criteria for release and individual understanding of that criteria; and, 9. D ocumentation that personnel debriefed the incident with the individual and assessed for B. Any administrative reviewer shall document the clinical justification for the continued use of seclusion/restraint in the individual's chart. The justification must include:

1. Documentation that the authorized practitioner ordering the continuous use of seclusion/restraint in excess of four (4) hours has conducted a face-to-face evaluation of 2. Documentation of the ongoing behaviors or findings that warrant the continued use of 3. Documentation of a plan for ongoing efforts to actively address the behaviors that 4. A determination of the clinical appropriateness of the continuation of seclusion/restraint;

5. A summary of the information considered by the reviewer and the result of the administrative review with the date, time and signature of the person completing the C. Information regarding use of seclusion/restraint must be readily accessible to authorized persons for review. The facility shall have the ability to gather data as follows:

1. Each seclusion/restraint episode including date and time the episode started and ended, specific to each individual over the period of one complete calendar year from January 1 11.9.13 Additional Procedures and Requirements for Seclusion/Restraint of a Youth A. Procedures for youth must include the following in addition to the requirements found in this part 11.9, unless otherwise required in this part 11.9.13.

B. This part 11.9.13 does not apply to adult individuals over the age of twenty-one (21).

C. An emergency safety intervention must be performed in a manner that is safe, proportionate, and appropriate to the severity of the behavior, and the youth’s chronological and developmental age; size; gender; physical, medical, and psychiatric condition; and personal history (including any 1. Physical management is always considered restraint for an individual under age eighteen (18) and must follow the restraint order rules pursuant to this part 11.9 of this Chapter.

D. O rders for seclusion/restraint must be by an authorized practitioner in the facility to order seclusion/restraint and trained in the use of emergency safety interventions. Federal regulations at 42 C.F.R. Part 441.151, the federal regulations issued by the United States Secretary of Health and Human Services found at 42 C.F.R. Part 441.151 (Feb. 2023), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD 20857 or at https://www.ecfr.gov/current/Title-42. These regulations are also available for public inspection and copying at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours. This requires that inpatient psychiatric services for individuals under age twenty-one (21) be provided under the direction of a physician.

1. If the individual’s treatment team assigned physician is available, only they can order seclusion/restraint. If they are not available, then another team physician may make the order.

E. A physician or other authorized practitioner must order the least restrictive emergency safety intervention that is most likely to be effective in resolving the emergency safety situation based on F. If the order for seclusion/restraint is verbal, the order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The physician or other authorized practitioner permitted to order restraint or seclusion must verify the verbal order in a signed written form in the youth’s record. Signatures must be entered into the record no more than twenty-four (24) hours after the event.

2. The physician or other authorized practitioner to order restraint or seclusion must be available to personnel for consultation, at least by telephone, throughout the period of the G. Each order for seclusion/restraint must be limited to no longer than the duration of the emergency H. Under no circumstances may the total order time exceed:

1. Four (4) hours for persons ages eighteen (18) to twenty-one (21);

2. Two (2) hours for persons ages nine (9) to seventeen (17); or 3. One (1) hour for persons under the age of nine (9).

I. Within one (1) hour of the initiation of the order of the emergency safety intervention a physician, or other authorized practitioner trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the youth, must conduct a face - to - face assessment of the physical and psychological well-being of the individual including but not limited to:

1. The youth’s physical and psychological status;

2. The youth’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

J. R esults of the one (1) hour assessment must be documented in the individual’s record.

K. Notification of parent(s) and/or legal guardian(s), when applicable:

1. The facility must notify the parent(s) and/or legal guardian(s) of the individual who has been in seclusion or restraint as soon as possible after the initiation of each emergency 2. The facility shall document in the individual’s record that the parent(s) or legal guardian(s) have been notified of the emergency safety intervention, including date and time of the 11.10 Therapy or Treatment Using Special Procedures 11.10.1 Informed Consent for Therapy/Treatment Using Special Procedures A. Therapies using stimuli such as electroconvulsive therapy (ECT), use of feeding tubes for eating disorder treatment, and transcranial magnetic stimulation (TMS), require special procedures for consent and shall be governed by this part 11.10 of these rules.

B. Prior to the administration of a therapy listed in part 11.10.1.A of these rules, written informed consent shall be obtained and documented in the clinical record reflecting agreement by both the individual being treated and their legal guardian, if one has been appointed or alternative decision maker if one exists.

1. If the individual undergoing treatment using special procedures is a minor, fifteen (15) years of age or older, the clinical record shall reflect informed consent by both the minor and their guardian(s).

a. If the minor is unable to consent to the special procedure due to their mental illness, as determined by an evaluation of capacity, this shall be documented in (1) The tool used to determine capacity shall be administered by an authorized practitioner within their scope of practice and be maintained in (2) An evidence-based standardized tool for assessing decision-making capacity shall be utilized.

2. If the minor is fourteen (14) years of age or younger, written informed consent from the parent, legal custodian or legal guardian shall be obtained in addition to the requirements listed in part 11.10.1.E, and maintained in the clinical record.

C. In the case of electroconvulsive therapy (ECT), a consent form shall be used, and procedures set forth in Sections 13-20-401 through 13-20-403, C.R.S. shall be followed. An informed consent for ECT means:

1. It is freely and knowingly given and expressed in writing; and 2. The consent agreement entered into by the individual or other person(s) shall not include exculpatory language through which the individual or other person(s) is made to waive, or appear to waive, any of their legal rights, or to release the facility or any other party from liability for negligence.

D. Electroconvulsive treatment (ECT) may be performed on a minor who is sixteen (16) years of age or older, but under eighteen (18) years of age only if two individuals licensed to practice medicine in Colorado and specializing in psychiatry approve the treatment, and the parent or guardian of the minor consents to the treatment.

1. The minor aged sixteen (16) to eighteen (18) must have a diagnosis consistent with ECT best practices.

E. ECT may be performed on a minor who is fifteen (15) years of age or younger when:

1. Two individuals licensed to practice medicine in Colorado, and specializing in psychiatry, approve the treatment. One (1) of the individuals must also specialize in child and adolescent psychiatry;

2. Other less invasive treatments have failed;

3. ECT is performed by at least one (1) physician, or physician’s designee, who is trained and credentialed in ECT; and 4. The minor’s parent, legal custodian, or legal guardian consents to the treatment; or a. A court issues an order for treatment pursuant 27-65-113, C.R.S.

F. Electroconvulsive treatment (ECT) requires a concurring consultation by a licensed psychiatrist prior to administration of the treatment. Such consultation shall be noted in the clinical record.

G. The facility shall document that the following has been explained to the individual:

1. The reason for such treatment information;

2. The nature of the procedures to be used in such treatment, including their probable frequency and duration;

3. The probable degree and duration of improvement or remission expected with or without such treatment;

4. The nature, degree, duration, and probability of the side effects and significant risks of such treatment, commonly known by the medical profession, the possible degree and duration of memory loss, the possibility of permanent irrevocable memory loss, and the remote possibility of death;

5. The reasonable alternative treatments, if any, and why the professional person is recommending the specific treatment;

6. That the individual has the right to refuse or accept the proposed treatment and has the right to revoke their consent for any reason at any time, either orally or in writing;

7. That there is a difference of opinion within the medical profession on the use of some treatments;

8. An offer to answer any inquiries concerning the recommended special procedures; and 9. The number of treatments expected over a specified period of time to achieve maximum benefit.

H. Informed consent for the special procedure shall be renewed each time the prescribed course of treatments determined through clinical assessment have been completed I. Feeding tubes for eating disorder treatment may be used within a designated facility when:

1. Informed written consent is required pursuant to this Section 11.10 from both patient and patient’s parent, legal guardian, or custodian if the patient is fifteen (15) years of age or older; or a. If the patient, fifteen (15) years of age or older, does not consent or objects to continued use of an involuntary feeding tube, patient may seek review pursuant to Section 27-65-104(6) C.R.S.

2. If the patient is fourteen (14) years of age or younger, only written informed consent from the parent, legal guardian, or custodian is required. 11.10.2 Involuntary Treatment Using Special Procedures A. In the event the individual or the legal guardian refuses to or cannot consent, treatments referenced in part 11.10.1.A of these rules using special procedures shall be administered only under the following circumstances:

1. With a prior court order for the treatments using special procedure; or, 2. In an emergency in which the life of the individual is in immediate danger because of the individual's condition. In an emergency situation in which the individual is unable to grant informed consent and sufficient time does not exist to petition the court for an order prior to the administration of the specific therapy, the individual's physician, in consultation with the director of the facility or their designee, may, after careful and informed deliberation and under procedures adopted by the facility, order a special procedure without consent.

B. Policies and procedures:

1. Each designated facility shall adopt written policies and procedures for administration of special procedures in accordance with these rules and applicable statutes. 11.11 Continuity of Care & Transfer of Care 11.11.1 Continuity of Care A. Each facility shall adopt and implement a written policy for continuity of care. The policy shall include at a minimum the following:

1. Access to all necessary care and services within the facility, and coordination with any other current mental health care providers or other systems of care or support as 2. Coordination of care with the individual's previous mental health care providers or medical providers as appropriate, including retrieval of psychiatric and medical records;

3. C oordination of the individual's care with family members, guardians, and other interested parties as appropriate and in a manner that reflects the individual's culture; and/or 4. The facility shall facilitate access to proper medical care and shall be responsible for coordinating mental health treatment with medical treatment provided to the individual. 11.11.2 Transfer of Care: Non-Emergent A. The individual shall only be transferred to another 27-65 designated or placement facility when adequate arrangements for care by the receiving facility have been made and documented in the clinical record. Transfer coordination shall include at least one discharge planning conference, face-to-face or by telephone, with participants from both facilities and the individual and their guardian, whenever possible.

B. At least twenty-four (24) hours advance notice of transfer shall be given to individuals under certification, unless knowingly waived in writing by the individual and guardian, if applicable and as appropriate, except in cases of a medical emergency. Notice of such transfer shall also be provided to the court of competent jurisdiction and the individual's attorney.

C. The transferring facility shall ask the individual to indicate two (2) persons to whom notification of transfer should be given and shall notify such persons within twenty-four (24) hours of notification to the individual. Such notification shall be made by the transferring facility with the appropriate written authorization. Actions taken under part 11.11 of these rules, shall be documented in the 11.12 Requirements for Placement Facilities A. Facilities with a 27-65 designation may provide mental health services directly or through the use of a placement facility contract. Whenever a placement facility is used there must be a written agreement with the 27-65 designated facility. In either case, the 27-65 designated facility is responsible for assuring an appropriate treatment setting for individuals and services provided in accordance with these rules. Whenever a placement facility is used, the 27-65 designated facility shall be responsible for the care provided by the placement facility as well as placement facility compliance with these rules. Policies and procedures must be in place outlining the 27-65 designated facility’s responsibilities and procedures for oversight of placement facilities as outlined in this section.

B. Emergency departments are not eligible to be placement facilities. Only the following Colorado licensed facilities are eligible to be placement facilities:

1. Nursing homes;

2. Residential child care facilities providing mental health services;

3. Non-psychiatric hospitals providing inpatient medical services;

4. Alternative care facilities; and 5. Mental health transitional living homes.

C. All agreements between 27-65 designated facilities and placement facilities and all supplemental agreements and amendments shall be submitted in writing to the BHA no later than ten (10) business days after the effective date of the agreement or amendment.

D. W henever a 27-65 designated facility uses a placement facility, the agreement shall include:

1. An annual training plan for placement facility personnel that provides at a minimum training regarding mental health disorders, these rules, Article 65 of Title 27, C.R.S., and appropriate, safe behavioral interventions. The implementation of the training plan shall be monitored regularly by the 27-65 designated facility;

2. A requirement that supervision of direct care personnel be provided by: professional persons licensed in Colorado to practice medicine or licensed Colorado psychologists employed by or under contract with the designated facility; designated professional persons licensed in Colorado to practice medicine; or licensed Colorado psychologists employed by the placement facility to be responsible for direct care supervision provided that the placement facility and the designated facility are operated by the same corporate facility;

3. A requirement that assures the necessary availability and supervision of placement facility personnel in order to carry out the contract; and 4. A requirement that the placement facility adheres to these rules through the placement facility agreement.

E. Placement facility agreements shall be executed and signed at least every two years and submitted to the BHA when the 27-65 designated facility submits its application for continued F. A placement facility can be used by a 27-65 designated facility, at its discretion under the provisions of these regulations, in order to provide care to any individual undergoing mental health evaluation or treatment. 27-65 designated facilities shall not place individuals in a placement facility unless all of the applicable provisions of these rules are met and placement in such facilities are appropriate to the clinical needs of each individual. When a placement facility is required, the least restrictive facility possible and available must be used, consistent with the clinical needs of the individual.

G. A placement facility shall not provide services beyond the scope of its license. 11.13 Procedures for Involuntary Transportation Holds A. This Section 11.13 is meant to provide a summary of the obligations and standards set forth in

Section 27-65-101 through -131, C.R.S., with regard to involuntary transportation holds. This

section is only enforceable with regard to designated facilities.

B. An individual may be placed on an involuntary transportation hold pursuant to Section 27-65-107, C.R.S. if the certified peace officer or emergency medical services provider believes the individual is experiencing a behavioral health crisis or is gravely disabled, and as a result, without professional intervention, the individual may be a danger to self or others.

1. The certified peace officer or emergency medical services provider may then take the individual into protective custody and transport the individual to an outpatient mental health facility, or a facility designated by the commissioner or other clinically appropriate facility designated by the commissioner.

2. If such a service is not available, the individual may be taken to an emergency medical services facility.

C. The involuntary transportation form to be completed in full (on the BHA-provided M 0.5 form available on the BHA website) prior to transportation shall include:

1. The circumstances under which the individual’s condition was called to the certified peace officer’s or emergency medical services (EMS) provider’s attention and further stating sufficient facts obtained from personal observations or obtained from others whom the certified peace officer or emergency medical services provider reasonably believes to be reliable, to establish that the individual is experiencing a behavioral health crisis or is gravely disabled and, as a result it is believed that without professional intervention the individual may be a danger to the individual’s self or others;

2. The name of the individual and date and time the individual was placed on the involuntary transportation hold;

3. The name of the facility to which the individual will be transported; and 4. The signature of the certified peace officer or EMS provider placing the involuntary D. A copy of the involuntary transportation form must be given to the individual who was placed on the involuntary transportation hold.

E. A copy of the involuntary transportation form must be given to the facility and made part of the individual’s medical record.

F. An individual may not be placed on a transportation hold if an intervening professional or certified peace officer has assessed the individual during the same emergency event and determined the individual does not meet the criteria for an emergency mental health hold.

G. If a behavioral health crisis response team is known to be available in a timely manner, the certified peace officer or emergency medical services provider shall access the behavioral health crisis response team prior to transporting an individual involuntarily.

H. Individuals may not be transported involuntarily for longer than six (6) hours.

I. Once the individual is presented to an outpatient mental health facility or facility designated by the commissioner, an intervening professional shall screen the individual immediately. If an intervening professional is not immediately available, the individual must be screened within immediately, but no more than eight (8) hours pursuant to Section 27-65-107(4)(a)(I), C.R.S., after the individual’s arrival at the facility to determine if the individual meets criteria for an emergency mental health hold.

J. Once the screening is completed and if the individual meets criteria, the intervening professional shall first pursue voluntary treatment and evaluation. If the individual refuses or the intervening professional has reasonable grounds to believe the individual will not remain voluntarily, the intervening professional may place the individual under an emergency mental health hold pursuant to Section 27-65-106, C.R.S. 11.13.1 Individual Rights for Involuntary Transportation A. The following rights must be explained to the individual prior to transporting them involuntarily and provided in written form:

1. To not be detained under an emergency transportation hold pursuant to this Section for longer than fourteen (14) hours, to not be transported for longer than six (6) hours, and to receive a screening within eight (8) hours after being presented to the receiving facility.

Section 27-65-107(4)(a)(I), C.R.S., does not prohibit a facility from holding the individual as authorized by state and federal law, including the federal “ Emergency Medical Treatment and Labor Act,” 42 U.S.C. Sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the individual’s ability to make an informed decision to refuse care and the provider determines that further care is indicated.

2. To request a phone call to an interested party prior to being transported. If the certified peace officer or EMS provider believes access to a phone poses a physical danger to the individual or someone else, the receiving facility shall make the call on the individual’s behalf immediately upon arrival at the receiving facility.

3. T o wear the individual’s own clothes and keep and use personal possessions that the individual had in the individual’s possession at the time of detainment. A facility may temporarily restrict an individual’s access to personal clothing or personal possessions until a safety assessment is completed. If the facility restricts an individual’s access to personal clothing or personal possessions, the facility shall have a discussion with the individual about why the individual’s personal clothing or personal possessions are being restricted. A licensed medical professional or a licensed mental health professional shall conduct a safety assessment as soon as possible. The licensed professional shall document in the individual’s medical record the specific reasons why it is not safe for the individual to possess the individual’s personal clothing or personal possessions.

4. To keep and use the individual’s cell phone, unless access to the cell phone causes the individual to destabilize or creates a danger to the individual’s self or others, as determined by a provider, facility personnel, or security personnel involved in the individual’s care.

5. To have appropriate access to adequate water and food and to have the individual’s nutritional needs met in a manner that is consistent with recognized dietary practices.

6. To be treated fairly, with respect and recognition of the individual’s dignity and individuality.

7. To file a grievance with the BHA, the Department of Public Health and Environment (CDPHE), or the Office of the Ombudsman for Behavioral Health Access to Care established pursuant to Section 27-80-303, C.R.S.

B. An individual’s rights may only be denied if access to the item, program, or service causes the individual to destabilize or creates a danger to the individual’s self or others, as determined by a licensed mental health provider or professional person involved in the individual’s care or transportation. Denial of any right must be entered into the individual’s treatment record or BHAapproved form, available on the BHA website. Information pertaining to a denial of rights contained in the individual’s treatment record must be made available, upon request, to the individual, the individuals attorney, or the individual’s lay person.

11.13.2 I ndividual Rights for Receiving Individuals on Involuntary Transportation Holds A. An individual detained pursuant to this section at an outpatient mental health facility or facility designated by the commissioner, must receive a copy of a form with the individual rights described in this part 11.13.1 on it if they were not provided a copy of the rights prior to transport.

1. If an individual detained pursuant to this part 11.13 is transported to an emergency medical services facility, the involuntary transportation hold expires upon the facility receiving the person for screening by an intervening professional.

B. The receiving emergency medical services facility must offer to make a phone call on the individual’s behalf if the transporting EMS professional or certified peace officer determined that access to a phone prior to transport could pose a physical danger to the individual’s self or others.

C. A facility may temporarily restrict an individual's access to personal clothing or personal possessions until a safety assessment is completed. If the facility restricts an individual's access to personal clothing or personal possessions, the facility shall have a discussion with the individual about why the individual's personal clothing or personal possessions are being restricted and document this in the clinical record.

D. T he individual may keep and use their cell phone, unless access to the cell phone causes the individual to destabilize or creates a danger to the individual's self or others, as determined by a provider, facility personnel, or security personnel involved in the individual's care. If a cell phone is restricted, the reason for this must be explained to the individual and documented in the clinical 1. An individual's rights may only be denied if access to the item, program, or service causes the individual to destabilize or creates a danger to the individual's self or others, as determined by a licensed provider involved in the individual's care or transportation.

Denial of any right must be entered into the individual’s treatment record or BHAapproved form, available on the BHA website. Information pertaining to a denial of rights contained in the individual's treatment record must be made available, upon request, to the individual, the individual's attorney, or the individual's lay person.

a. If an individual speaks sign language and their rights to their cell phone has been denied, when communicating outside the facility they must have access to communication devices that provide written/video/closed caption.

2. Once the screening is completed and if the individual meets criteria, the intervening professional shall first pursue voluntary treatment and evaluation. If the individual refuses or the intervening professional has reasonable grounds to believe the individual will not remain voluntarily, the intervening professional may place the individual under an emergency mental health hold pursuant to Section 27-65-106, C.R.S.

E. If the individual is placed on an emergency mental health hold, they must be advised of and provided with a copy of the associated individual rights as described in part 11.14.3 of this 11.14 Pr ocedures for Emergency Mental Health Holds 11.14.1 General Procedures A. This section 11.14 is meant to provide a summary of the obligations and standards set forth in

Section 27-65-101 through -131, C.R.S., with regard to emergency mental health holds. This

section is only enforceable with regard to designated facilities.

B. An individual may be placed on an emergency mental health hold for seventy-two (72) hours pursuant to Section 27-65-106, C.R.S., if the individual has a mental health disorder and, as a result of the mental health disorder, is an imminent danger to the individual’s self or others or is gravely disabled.

1. The certified peace officer may take the individual into protective custody and transport the individual to a facility designated by the commissioner for an emergency mental health hold. If such a facility is not available, the certified peace officer may transport the individual to an emergency medical services facility. The certified peace officer may request assistance from a behavioral health crisis response team for assistance in deescalating and preparing the individual for transportation, or an emergency medical services provider in transporting the individual; or, 2. When an intervening professional reasonably believes that an individual appears to have a mental health disorder and, as a result of the mental health disorder, appears to be an imminent danger to the individual's self or others or appears to be gravely disabled, the intervening professional may cause the individual to be taken into protective custody and transported to a facility designated by the commissioner for an emergency mental health hold. If such a facility is not available, the certified peace officer may transport the individual to an emergency medical services facility. The intervening professional may request assistance from a certified peace officer, a secure transportation provider, or a behavioral health crisis response team for assistance in detaining and transporting the individual, or assistance from an emergency medical services provider in transporting the C. The emergency mental health hold form, available on the BHA website, shall be completed by an intervening professional or certified peace officer and include the following:

1. The circumstances under which the individual’s condition was brought to the attention of the intervening professional or certified peace officer;

2. A description of facts, either through direct observation by the intervening professional or peace officer or obtained from others believed to be reliable, establishing that the individual has a mental health disorder, and as a result of the mental health disorder, is an imminent danger to self or others, is gravely disabled, or is in need of immediate evaluation for treatment;

3. Date/time the individual was placed on the emergency mental health hold; and 4. Who brought the individual’s condition to the attention of the intervening professional or certified peace officer.

D. A copy of the emergency mental health hold form must be given to the individual who was placed on the emergency mental health hold.

E. A copy of the emergency mental health hold form must be given to the facility and made part of F. Once the individual is receiving care and treatment in a designated involuntary short-term treatment facility, the individual shall receive treatment and care for the duration of their emergency mental health hold.

G. T he individual must be released before seventy-two hours have elapsed if, in the opinion of the professional person overseeing treatment, the individual no longer requires evaluation and H. At the expiration of the emergency mental health hold, the individual must be:

1. Released;

2. Referred for further care and treatment on a voluntary basis; or 3. Certified for short-term treatment pursuant to Section 27-65-109, C.R.S. 11.14.2 Court Orders for Screening & Evaluation A. Pursuant to Section 27-65-106(1)(c), C.R.S., any individual may petition the court in the county in which the individual resides or is physically present requesting an evaluation of the individual’s condition and alleging that the individual appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the individual’s self or others or appears to be gravely disabled.

B. A court may order that an individual be taken into custody and placed in a designated facility for seventy-two (72) hour treatment and evaluation.

C. Pursuant to Section 26-65-106(4)(a), C.R.S., the petition for a court-ordered evaluation must contain the following:

1. N ame and address of the petitioner, and the petitioner’s interest in this case;

2. Name of the individual for whom evaluation is sought, and if known, the address, age, gender, marital status, occupation, and any animals or dependent children in the individual’s care;

3. Allegations of fact indicating the individual may have a mental health disorder and, as a result of the mental health disorder, is a danger to self or others or is gravely disabled;

4. The name and address of every person responsible for the care, support, and maintenance of the individual, if available; and 5. The name, address, and telephone number of the attorney, if any, who has most recently represented the individual. If there is not attorney, there shall be a statement as to whether, to the best knowledge of the petitioner, the individual meets criteria established by the legal aid agency operating in the county or city and county for it to represent the D. Upon receipt of a petition, the court shall identify a facility designated by the commissioner, an intervening professional, or a certified peace officer to provide screening of the individual to determine whether probable cause exists to believe the allegations.

E. Following the screening, the facility, intervening professional, or certified peace officer designated by the court shall file a report with the court and may initiate an emergency mental health hold at the time of screening. The report must include a recommendation as to whether probable cause exists to believe that the individual has a mental health disorder and is a danger to self or others or is gravely disabled. The report must also specify whether the individual will voluntarily receive evaluation or treatment.

F. A c opy of the confidential screening report must be provided to the individual and the individual’s attorney or personal representative.

G. If the court determines that the individual has a mental health disorder and is a danger to self or others or is gravely disabled, and efforts have failed to obtain cooperation from the individual to receive treatment voluntarily, the court must issue an order for a certified peace officer or secure transportation provider to take the individual into custody and transport the individual to a designated facility for seventy-two (72) hour evaluation and treatment.

1. At the time the individual is taken into custody, a copy of the petition and the order for evaluation must be given to the individual and promptly to the one lay person designated by the individual and to the person in charge of the facility named in the order or the individual’s lay person designee. If the individual refuses to accept a copy of the petition and the order for evaluation, such refusal must be documented in the petition and the order for evaluation.

H. When an individual is transported to an emergency medical services facility or a facility designated by the commissioner, the facility may detain the individual under an emergency mental health hold for evaluation for a period not to exceed seventy-two (72) hours from the time the emergency mental health hold was placed or ordered. Nothing in this section prohibits an emergency medical services facility from involuntarily holding the individual in order to stabilize the individual as required pursuant to the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. Sec. 1395dd, or if the treating professional determines that the individual's physical or mental health disorder impairs the individual's ability to make an informed decision to refuse care and the provider determines that further care is indicated.

1. If, in the opinion of the person in charge of the evaluation, the individual can be properly cared for without being detained, the individual shall be provided services on a voluntary 2. If the person in charge of the evaluation determines the individual should be released, the person in charge of the evaluation may terminate the emergency mental health hold.

I. Each individual detained for an emergency mental health hold pursuant to part 11.14 of this

Chapter, shall receive an evaluation as soon as possible after the individual is presented to the facility and shall receive such treatment and care as the individual’s condition requires for the full period that the individual is held.

J. The evaluation may include an assessment to determine if the individual continues to meet the criteria for an emergency mental health hold and requires further mental health care in a facility designated by the commissioner. The evaluation must state whether the individual should be:

1. Released;

2. Referred for further care and treatment on a voluntary basis; or 3. Certified for short-term treatment pursuant to Section 27-65-109, C.R.S.

K. Each evaluation must be completed using a standardized form approved by the commissioner available on the BHA website (the elements from this form can be integrated into a facility’s electronic health record system) and may be completed by a professional person; a licensed advanced practice registered nurse with training in psychiatric nursing; or a licensed physician assistant, a licensed clinical social worker, a licensed professional counselor, or a licensed marriage and family therapist who has two years of experience in behavioral health safety and risk assessment working in a health-care setting.

1. If the professional person conducting the evaluation does not hold two (2) years’ experience, they may conduct the evaluation and a professional person that holds the required experience must review, provide clinical consultation as needed, and provide their signature to the evaluation.

L. If the personnel conducting an evaluation pursuant to part 11.14 of this Chapter is not a professional person and the evaluating personnel recommends the detained individual be certified for short-term treatment pursuant to Section 27-65-109, C.R.S., the evaluating personnel shall notify the facility of the recommendation. A certification may only be initiated by a professional person.

M. If an individual is evaluated at an emergency medical services facility and the evaluating professional determines that the individual continues to meet the criteria for an emergency mental health hold pursuant to part 11.14 of this Chapter, the emergency medical services facility shall immediately notify the BHA if the facility cannot locate appropriate placement. Once notified, the BHA shall support the emergency medical services facility in locating an appropriate placement option on an inpatient or outpatient basis, whichever is clinically appropriate.

N. If an appropriate placement option cannot be located pursuant to this part 11.14.2.N and the individual continues to meet the criteria for an emergency mental health hold pursuant to part 11.14 of these rules and the individual has been medically stabilized, the emergency medical services facility may place the individual under a subsequent emergency mental health hold.

1. If the facility places the individual under a subsequent emergency mental health hold, the facility shall immediately notify the BHA, the individual's lay person, and the court, and the court shall immediately appoint an attorney to represent the individual.

2. The facility may notify the court where the individual resides by mail.

a. Once the court is notified, the emergency medical services facility is not required to take any further action to provide the individual with an attorney unless specified in part 11.14.3 of this Chapter.

3. The emergency medical services facility shall notify the BHA after each emergency mental health hold is placed.

4. If the individual has been recently transferred from an emergency medical services facility to a facility designated by the commissioner and the designated facility is able to demonstrate that the facility is unable to complete the evaluation before the initial emergency mental health hold is set to expire, the designated facility may place the individual under a subsequent emergency mental health hold and shall immediately notify the BHA and lay person.

O. The BHA shall maintain data on the characteristics of each individual placed on a subsequent emergency mental health hold pursuant to this part 11.14.2. The BHA may contract with facilities coordinating care or with providers serving within the safety net system developed pursuant to

Section 27-63-105, C.R.S., to meet the requirements of this part 11.14.

11.14.3 I ndividual Rights for Emergency Mental Health Holds A. The following rights apply to anyone receiving evaluation, care, or treatment pursuant to Article 65 of Title 27, C.R.S. and must be explained to the individual and provided in written form:

1. Nothing in Article 65 of Title 27, C.R.S., limits the right of any individual to make a voluntary application at any time to any public or private facility or professional person for mental health services, including but not limited to evaluation, care, and/or treatment, either by direct application in-person or by referral from any other public or private facility or professional person.

a. Subject to Section 15-14-316(4), C.R.S., a ward, as defined in Section 15-14- 102(15), C.R.S., may be admitted to a hospital or institutional care and treatment for a mental health disorder with the guardian’s consent for as long as the ward agrees to such care and treatment. The guardian shall immediately notify in writing the court, that appointed the guardian, of the admission.

b. Medical and legal status of all voluntary individuals receiving treatment for mental health disorders in inpatient or custodial facilities must be reviewed at least once every six (6) months.

c. V oluntary individuals are afforded all rights and privileges customarily granted by hospitals to individuals they serve.

d. Any individual receiving an evaluation or treatment pursuant to Article 65 of Title 27, C.R.S., is entitled to medical and psychiatric care and treatment, with regard to services listed in Section 27-65-101, C.R.S., and services listed in rules authorized by Section 27-66-102, C.R.S., suited to meet the individual’s specific needs, delivered in such a way as to keep the individual in the least restrictive environment, and delivered in such a way as to include the opportunity for participation of family members in the individuals program of care and treatment when appropriate.

2. To be told the reason for the individual’s detainment and the limitations of the individual’s detainment, including a description of the individual’s right to refuse medication, unless the individual requires emergency medications, and that the detainment does not mean all treatment during detainment is mandatory;

3. To request a change to voluntary status;

4. To be treated fairly, with respect and recognition of the individual’s dignity and individuality, by all employees of the facility with whom the individual comes in contact;

5. To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression;

6. T o retain and consult with an attorney at any time;

a. Except that, unless specified in this part 11.14.2.N of this Chapter, the facility is not required to retain an attorney on behalf of the individual but must allow the individual to contact an attorney;

7. To continue the practice of religion;

8. Within twenty-four (24) hours after the individual's request, to see and receive the services of a patient representative who has no direct or indirect clinical, administrative, or financial responsibility for the individual;

9. To have reasonable access to telephones or other communication devices and to make and to receive calls or communications in private;

a. Facility personnel shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility personnel;

10. To wear the individual’s own clothes, keep and use the individual’s own personal possessions (including but not limited to personal medical devices and/or auxiliary aids), and keep and be allowed to spend a reasonable sum of the individual’s own money.

a. A facility may temporarily restrict an individual’s access to personal clothing or personal possessions, until a safety assessment is completed.

b. If the facility restricts an individual’s access to personal clothing or personal possessions, the facility shall have a discussion with the individual about why the individual’s personal clothing or personal possessions are being restricted.

c. A licensed medical professional or a licensed mental health professional shall conduct a safety assessment as soon as possible. The licensed professional shall document in the individual’s medical record the specific reasons why it is not safe for the individual to possess the individual’s personal clothing or personal possessions.

d. The facility shall periodically conduct additional safety assessments to determine whether the individual may possess the individual's personal clothing or personal possessions, with the goal of restoring the individual’s rights established pursuant to this section.

11. To have the individual's information and records disclosed to family members and a lay person pursuant to Section 27-65-123, C.R.S.;

12. To have the individual's treatment records remain confidential, except as required by law;

13. To not be fingerprinted, unless required by law;

14. To have appropriate access to adequate water, hygiene products, and food and to have the individual's nutritional needs met in a manner that is consistent with recognized dietary practices;

15. To have appropriate access to non-psychiatric medications necessary to maintain an individual's health, including but not limited to pain medications that may be controlled substances, as ordered and/or overseen by a physician or other authorized medical practitioner of record;

16. T o keep and use the individual's cell phone, unless access to the cell phone causes the individual to destabilize or creates a danger to the individual's self or others, as determined by a provider, facility personnel member, or security personnel involved in the individual’s care;

17. To not be photographed, except upon admission for identification and administrative purposes. Any photographs must be confidential and must not be released by the facility except pursuant to a court order. Nonmedical photographs must not be taken or used without appropriate consent or authorization;

18. To have personal privacy to the extent possible during the course of treatment;

19. To have frequent and convenient opportunities to meet with visitors in accordance with the facility’s current visitor guidelines. Each individual may see the individual’s attorney, clergyperson, or physician at any time;

20. An individual’s rights may only be denied if the item, program, or service causes the individual to destabilize or creates a danger to the individual’s self or others, as determined by a licensed provider involved in the individual’s care. Denial of any right must in all cases be entered into the individual’s treatment record. Information pertaining to a denial of rights contained in the individual’s treatment record must be made available, upon request, to the individual, or the individual’s attorney; and, 21. An y person receiving evaluation, care, or treatment pursuant to Article 65 of Title 27, C.R.S., must be given the opportunity to exercise the persons right to register and to vote in primary and general elections.

a. The facility or facility providing evaluation, care, or treatment shall assist the individual, upon the individual’s request, to obtain voter registration forms and mail ballots and to comply with any other prerequisite for voting. 11.14.4 Additional Considerations A. The facility shall develop written policies that include the procedures for managing individual funds or property that include at minimum:

1. A written inventory of all personal belongings shall be conducted upon admission. This inventory shall be signed and reviewed by facility personnel and the individual and shall be maintained in the individual’s clinical record.

2. A process for storing all inventoried items in a secure location during the individual’s stay in the facility.

3. A process for returning all inventoried property to the individual upon discharge or sending the property with the individual if they are transferred to another facility for care and treatment. The individual and facility personnel shall sign the inventory form indicating that all items were returned or that all items were present in the bag for transport.

B. For the purpose of Article 65 of Title 27, C.R.S., the treatment by prayer in the practice of religion of any church that teaches reliance on spiritual means alone for healing is considered a form of C. An y individual receiving an evaluation or treatment pursuant to Article 65 of Title 27, C.R.S., may petition the court pursuant to Section 13-45-102, C.R.S., for release to a less restrictive setting within or without a treating facility or release from a treating facility when adequate medical and psychiatric care and treatment are not administered;

1. If at any time during an emergency mental health hold of an individual who is confined involuntarily the facility personnel requests the individual to sign in voluntarily and the individual elects to do so, the following advisement shall be given orally and in writing and an appropriate notation shall be made in the individual’s medical record by the professional person or the professional person’s designee (this does not apply to an individual on an emergency mental health hold in an emergency medical services facility):

“NOTICE

The decision to sign in voluntarily should be made by you alone and should be free from any force or pressure implied or otherwise. If you do not feel that you are able to make a truly voluntary decision, you may continue to be held at the hospital involuntarily. As an involuntary individual, you will have the right to protest your confinement and request a hearing before a judge.”

11.14.5 I ndividual Rights for Receiving Individuals on Emergency Mental Health Holds A. Each person receiving evaluation, care, or treatment pursuant to any provision of Article 65 of Title 27, C.R.S., has the individual rights specified in part 11.14.3 of this Chapter and shall be provided with a written copy and advised of such rights by the facility.

B. A facility may temporarily restrict an individual's access to personal clothing or personal possessions until a safety assessment is completed. If the facility restricts an individual's access to personal clothing or personal possessions, the facility shall have a discussion with the individual about why the individual's personal clothing or personal possessions are being restricted and document this in the chart.

C. The individual may keep and use their cell phone, unless access to the cell phone causes the individual to destabilize or creates a danger to the individual's self or others, as determined by a provider, facility personnel member, or security personnel involved in the individual's care. If a cell phone is restricted, the reason for this must be explained to the individual and documented in the chart.

D. An individual's rights may only be denied if access to the item, program, or service causes the individual to destabilize or creates a danger to the individual's self or others, as determined by a licensed provider involved in the individual's care or transportation. Denial of any right must be entered into the individual's treatment record or BHA-approved form available on the BHA website. Information pertaining to a denial of rights contained in the individual's treatment record must be made available, upon request, to the individual, the individual's attorney, or the individual's lay person.

1. O nce the screening is completed and if the individual continues to meet criteria for an emergency mental health hold, the intervening professional shall first pursue voluntary treatment and evaluation. If the individual refuses or the intervening professional has reasonable grounds to believe the individual will not remain voluntarily, the intervening professional may keep the individual under an emergency mental health hold pursuant to

Section 27-65-106, C.R.S. 11.14.6 Procedures for Subsequent Emergency Mental Health Holds A. If the facility places the individual under a subsequent emergency mental health hold, the facility shall immediately notify the BHA, the individual's lay person, and the court, and the court shall immediately appoint an attorney to represent the individual. The facility may notify the court where the individual resides by mail. 11.14.7 Procedures for Individuals Who Meet Criteria for an Emergency Mental Health Hold but Require Inpatient Medical Treatment Prior to Placement A. If an individual meets criteria for an emergency mental health hold but requires medical treatment prior to being placed psychiatrically, they may receive treatment on a medical unit of the same hospital under the following conditions:

1. Unless the medical unit is designated for 27-65 services by the BHA, the hospital must follow the hospital’s policies and procedures for ensuring individual safety while receiving medical services.

2. R easonable efforts shall be made to ensure ligature risk is minimized in the individual’s room on the medical unit; these efforts shall be documented in the individual’s clinical 11.15 Additional Procedures for Minors A. This section 11.15 is meant to provide a summary of the obligations and standards set forth in

Section 27-65-101 through -131, C.R.S., with regard to minors. This section is only enforceable with regard to designated facilities. 11.15.1 Consent and Rights of a Minor A. Notwithstanding any other provision of law, a minor who is fifteen (15) years of age or older, whether with or without the consent of a parent or legal guardian, may consent to receive mental health services to be rendered by a facility, a professional person, or mental health professional licensed pursuant to Parts 3, 4, 5, 6, or 8 of Article 245 of Title 12, C.R.S., in any practice setting.

1. Such consent is not subject to disaffirmance because of age.

2. The professional person or licensed mental health professional rendering mental health services to a minor may, with or without the consent of the minor, advise the minor’s parent or legal guardian of the services given or needed.

B. Any individual receiving evaluation or treatment pursuant to any of the provisions of Article 65 of Title 27, C.R.S., is entitled to a written copy of all the corresponding designated service individual’s rights enumerated and a minor child shall receive written notice of the minor’s rights as provided. The list of rights must be prominently posted in all evaluation and treatment facilities.

Minor’s rights include:

1. To refuse to sign the admission consent form; and, 2. T o revoke consent of treatment at a later date;

a. If minor’s consent is revoked after admission, a review of the minor’s need for hospitalization must be initiated immediately 3. Nothing in part 11.15 of these rules limits a minor’s right to seek release from the facility pursuant to any other provision of law.

4. Services shall be suited to meet the individual’s needs, delivered in such a way as to keep the individual in the least restrictive environment, and delivered in such a way as to include the opportunity for participation of family members in the individual’s program of care and treatment, when appropriate. 11.15.2 Hospitalization Treatment Procedures for Minors A. The following treatment procedures apply to any minor receiving evaluation, care, or treatment pursuant to Article 65 of Title 27, C.R.S. and must be explained to the individual and provided in written form:

1. A minor who is fifteen (15) years of age or older or a minor’s parent or legal guardian, on the minor’s behalf, may make a voluntary application for hospitalization.

2. An application for hospitalization on behalf of a minor who is under fifteen (15) years of age and who is a ward of the Department must not be made unless a guardian ad litem has been appointed for the minor or a petition for the same has been filed with the court by the facility having custody of the minor; except that such an application for hospitalization may be made under emergency circumstances requiring immediate hospitalization, in which case the facility shall file:

a. A p etition for appointment of a guardian ad litem within seventy-two (72) hours after application for admission is made, b. And the court shall immediately appoint a guardian ad litem.

c. Procedures for hospitalization of a minor may proceed pursuant to this section once a petition for appointment of a guardian ad litem has been filed, if necessary.

3. Whenever an application for hospitalization is made, an independent professional person shall interview the minor and conduct a careful investigation into the minor’s background, using all available sources, including, but not limited to, the minor’s parents or legal guardian, the minor’s school, and any other social service facilities.

4. Prior to admitting a minor for hospitalization, the independent professional person shall make the following findings:

a. That the minor has a mental health disorder and is in need of hospitalization;

b. That a less restrictive treatment alternative is inappropriate or unavailable; and, c. That hospitalization is likely to be beneficial, improve condition and/or prevent further regression.

5. An interview and investigation by an independent professional person is not required for a minor who is fifteen (15) years of age or older and who, upon the recommendation of the minor’s treatment professional person, seeks voluntary hospitalization with the consent of the minor’s parent or legal guardian.

6. A need for voluntary continued hospitalization must be formally reviewed every two (2) months and must fulfill the requirements of Section 19-1-115(8), C.R.S., when the minor is fifteen (15) years of age or older and consenting to hospitalization.

a. R eview must be conducted by an independent professional person who is not a member of the minor’s treatment team; or if the minor, minor’s physician, and the minor’s parent or legal guardian do not object to the need for continued hospitalization, the review required may be conducted internally by hospital b. The independent professional person shall determine whether the minor continues to meet the criteria specified in part 11.15.2.A.1 through part 11.15.2.A.4 of this Chapter and whether continued hospitalization is appropriate and shall, at a minimum, conduct an investigation pursuant to this part 11.15.2.A.1 through part 11.15.2.A.4 of these rules.

c. Ten (10) days prior to the review, the patient representative at the mental health facility shall notify the minor of the date of the review and shall assist the minor in articulating to the independent professional person the minor’s wishes concerning continued hospitalization.

7. Every six (6) months the review required pursuant to part 11.15.2.A.6 of this Chapter of this section shall be conducted by an independent professional person who is not a member of the minor’s treating team and who has not previously reviewed the minor pursuant to part 11.15.2.A.6 of this Chapter. 11.15.3 Objection to Hospitalization Process for Minors A. When a minor does not consent to or objects to continued hospitalization, the need for such continued hospitalization must, within ten (10) days, be reviewed pursuant to part 11.15.2.A.6 of this Chapter by an independent professional person who is not a member of the minor’s treatment team and who has not previously reviewed the minor pursuant to part 11.15.3.A of this 1. The minor shall be informed of the results of the review within three (3) days after the review’s completion.

a. If the conclusion reached by the professional person is that the minor no longer meets the standards for hospitalization specified in part 11.15.2.A.1 through part 11.15.2.A.4 of this Chapter, the minor shall be discharged with clinically indicated discharge planning and notice to parent, guardian, or caregiver, as appropriate.

B. If twenty-four (24) hours after being informed of the results of the review specified in part 11.15.3.A of this Chapter, a minor continues to affirm the objection to hospitalization, the facility director or the director’s duly appointed representative shall advise the minor that the minor has the right to retain and consult with an attorney at any time and that the director or the director’s duly appointed representative shall file, within three (3) days after the request of the minor, a statement requesting an attorney for the minor or, if the minor is under fifteen (15) years of age, a guardian ad litem. The minor, the minor’s attorney (if any) and the minor’s parent, legal guardian, or guardian ad litem (if any) shall be given written notice that a hearing upon the recommendation for continued hospitalization may be had before the court or a jury upon written request directed to the court pursuant to part 11.15.3.D of this Chapter.

C. W henever the statement requesting an attorney is filed with the court, the court shall ascertain whether the minor has retained an attorney, and, if the minor has not, the court shall, within three (3) days, appoint an attorney to represent the minor, or if the minor is under fifteen (15) years of age, a guardian ad litem. Upon receipt of a petition filed by the guardian ad litem, the court shall appoint an attorney to represent the minor under fifteen years of age.

D. The minor or the minor’s attorney or guardian ad litem may, at any time after the minor has continued to affirm the minor’s objection to hospitalization pursuant to part 11.15.3.B of this

Chapter, file a written request that the recommendation for continued hospitalization be reviewed by the court or that the treatment be on an outpatient basis. If review is requested, the court shall hear the matter within ten (10) days after the request, and the court shall give notice of the time and place of the hearing to the minor; the minor’s attorney (if any), the minor’s parents or legal guardian; the minor’s guardian ad litem (if any), the independent professional person, and the minor's treatment team. The hearing must be held in accordance with Section 27-65-113, C.R.S.; except that the court or jury shall determine that the minor is in need of care and treatment if the court or jury makes the following findings:

1. T hat the minor has a mental health disorder and is in need of hospitalization;

2. That a less restrictive treatment alternative is inappropriate or unavailable; and, 3. That hospitalization is likely to be beneficial.

E. At the conclusion of the hearing, the court may enter an order confirming the recommendation for continued hospitalization, discharge the minor, or enter any other appropriate order.

F. A minor may not again object to hospitalization pursuant to this part 11.15.3 until ninety (90) days after conclusion of proceedings.

G. In addition to the rights specified in Section 27-65-119, C.R.S. for individuals receiving evaluation, care, or treatment, a written notice specifying the rights of minor children under this section must be given to each minor upon admission to hospitalization.

H. A minor who no longer meets the standards for hospitalization specified in this part 11.15 must be discharged. 11.16 Involuntary Short-Term and Long-Term Care and Treatment Designation (Inpatient Services) 11.16.1 Applicability A. The involuntary short-term and long-term care and treatment designation allows facilities to provide care and treatment to individuals on involuntary mental health holds, short-term certifications, and long-term certifications on an inpatient basis.

B. Facilities designated for involuntary short-term and long-term services must be in compliance with the following rules:

1. Parts 2.7 through 2.13 and parts 2.23 through 2.25 of these rules with the following exception:

a. Part 2.7.A.3 of these rules 2. Parts 11.1 through 11.15 and 11.16 of this Chapter.

C. Facilities that may become designated to provide involuntary short-term and long-term care and treatment include acute treatment units (ATU). Crisis stabilization units (CSU), residential child care facilities, and hospitals. ATUs must become designated to meet the requirements of their service endorsement.

D. T his section 11.16 is meant, in part, to provide a summary of the obligations and standards set forth in Section 27-65-101 through -131, C.R.S., with regard to involuntary short-term care and treatment. This section is only enforceable with regard to designated facilities. 11.16.2 Procedures for Emergency Mental Health Holds A. With every emergency mental health hold and petition to court for involuntary treatment resulting in a change of legal status, the facility shall advise an individual of their rights set forth in part 11.16.5 of this Chapter, and there shall be evidence of such advisement in the individual’s clinical B. Procedures for emergency mental health holds may be found in part 11.14 of this Chapter. 11.16.3 Procedures for Short-Term Certifications on an Inpatient Basis A. An individual may be certified for not more than three (3) months for short-term treatment under the following conditions:

1. The professional personnel of the facility detaining the individual on an emergency mental health hold has evaluated the individual and has found that the individual has a mental health disorder and, as a result of the mental health disorder, is a danger to the individual’s self or others or is gravely disabled;

2. The individual has been advised of the availability of, but has not accepted, voluntary treatment; but, if reasonable grounds exist to believe that the individual will not remain in a voluntary treatment program, the individual’s acceptance of voluntary treatment does not preclude certification;

3. The facility or community provider that will provide short-term treatment has been designated by the commissioner to provide such treatment; and, 4. The individual, the individual’s legal guardian, and the individual’s lay person, if applicable, have been advised of the individual’s right to an attorney and right to contest the certification for short-term treatment. [effective July 1, 2024]

B. The facility is responsible for ensuring the individual receive all court paperwork (or ensuring the attorney has provided it).

C. The facility or court shall ask the individual to designate a lay person whom the individual wishes to be informed regarding certification. If the individual is incapable of making such a designation at the time the certification is delivered, the individual must be asked to designate a lay person as soon as the individual is capable.

D. In addition to the certification, the individual must be given a written notice that a hearing upon the individual’s certification for short-term treatment may be had before the court or a jury upon written request directed to the court pursuant to Section 27-65-109(6), C.R.S.

E. T he notice of certification must be signed by a professional person who participated in the evaluation. The notice of certification must:

1. State facts sufficient to establish reasonable grounds to believe that the individual has a mental health disorder and, as a result of the mental health disorder, is a danger to the individual’s self or others or is gravely disabled;

2. Be filed with the court within forty-eight (48) hours, excluding Saturdays, Sundays, and court holidays, after the date of the certification;

3. Be filed with the court in the county in which the individual resided or was physically present immediately prior to being taken into custody;

4. Provide recommendations if the certification should take place on an inpatient or outpatient basis [effective July 1, 2024]; and 5. Within twenty-four (24) hours after the date of certification, copies of the certification must be personally delivered from the evaluating facility to the individual, the BHA, and a copy must be kept by the evaluating facility as part of the individual’s record, if applicable.

F. Upon certification of the individual, the facility designated for short-term treatment has custody of G. T he individual or the individual’s attorney may at any time file a written request that the certification for short-term treatment or the treatment be reviewed by the court or that the treatment be on an outpatient basis.

1. If the individual requests the review, the court shall hear the matter within ten (10) days after the request, and the court shall give notice to the individual and the individual’s attorney and the certifying and treating professional person of the time and place of the hearing.

2. The hearing must be held in accordance with Section 27-65-113, C.R.S.

3. At the conclusion of the hearing, the court may enter or confirm the certification for shortterm treatment, discharge the individual, or enter any other appropriate order.

a. Upon the release of any individual in accordance with Section 27-65-112, C.R.S., the facility shall notify the clerk of the court within five (5) days after the release.

4. If the professional person in charge of the evaluation and treatment believes that a period longer than three (3) months is necessary to treat the individual, the professional person shall file with the court an extended certification at least thirty (30) days prior to the expiration date of the original certification.

5. An extended certification for treatment must not be for a period of more than three (3) months.

6. The individual is entitled to a hearing on the extended certification under the same conditions as an original certification. The attorney initially representing the individual shall continue to represent the individual unless the court appoints another attorney.

H. An individual certified for short-term treatment may be discharged upon the signature of the treating medical professional and the medical director of the facility.

I. A fa cility or program shall make the individual’s discharge instructions available to the individual, the individual's attorney, and the individual’s legal guardian, if applicable, within seven (7) days after discharge, if requested.

1. A facility or program that is transferring an individual to a different treatment facility or to an outpatient provider shall provide all treatment records to the facility or provider accepting the individual at least twenty-four (24) hours prior to the transfer. 11.16.4 Procedures for Long-Term Certifications on an Inpatient Basis A. The facility is responsible for ensuring the individual receives all court paperwork (or ensuring the attorney has provided it).

B. Whenever an individual has received an extended certification for treatment pursuant to Section 27-65-109(10), C.R.S., the professional person in charge of the certification for short-term treatment or the BHA may file a petition with the court at least thirty (30) days prior to the expiration date of the extended certification for long-term care and treatment of the individual under the following conditions:

1. The professional personnel of the facility or facility providing short-term treatment has analyzed the individual’s condition and has found that the individual has a mental health disorder and, as a result of the mental health disorder, is a danger to the individual’s self or others or is gravely disabled;

2. T he individual has been advised of the availability of, but has not accepted, voluntary treatment; but, if reasonable grounds exist to believe that the individual will not remain in a voluntary treatment program, the individual’s acceptance of voluntary treatment does not preclude an order pursuant to this section; and 3. The facility that will provide long-term care and treatment has been designated by the commissioner to provide the care and treatment.

C. Every petition for long-term care and treatment must include a request for a hearing before the court filed thirty (30) calendar days prior to the expiration of six (6) months after the date of original certification and provide a recommendation as to whether the certification for long-term care and treatment should take place on an inpatient or outpatient basis.

1. A copy of the petition must be delivered personally to the individual for whom long-term care and treatment is sought and electronically delivered to the individual’s attorney of record simultaneously with the filing.

D. Within ten (10) days after receipt of the petition, the individual or the individual’s attorney may request a hearing before the court or a jury trial by filing a written request with the court.

E. The court or jury shall determine whether the conditions of this part 11.16.4, are met and whether the individual has a mental health disorder and, as a result of the mental health disorder, is a danger to the individual’s self or others or is gravely disabled.

F. The court shall issue an order of long-term care and treatment for a term not to exceed six (6) months, discharge the individual for whom long-term care and treatment was sought, or enter any other appropriate order.

G. An or der for long-term care and treatment must grant physical custody of the individual to the BHA for placement with a facility or facility designated by the commissioner to provide long-term care and treatment. The BHA may delegate the physical custody of the individual to a facility designated by the commissioner and the requirement for the provision of services and care coordination.

H. When a petition contains a request that a specific legal disability be imposed or that a specific legal right be deprived, the court may order the disability imposed or the right deprived if the court or a jury has determined that the individual has a mental health disorder or is gravely disabled and that, as a result, the individual is unable to competently exercise the specific legal right or perform the function for which the disability is sought to be imposed.

1. Any interested person may ask leave of the court to intervene as a co petitioner for the

purpose of seeking the imposition of a legal disability or the deprivation of a legal right.

I. An original order of long-term care and treatment or any extension of such order expires on the date specified, unless further extended as provided in this part 11.16.4.

J. If an extension is being sought, the professional person in charge of the evaluation and treatment shall certify to the court at least thirty (30) days prior to the expiration date of the order in force that an extension of the order is necessary for the care and treatment of the individual subject to the order in force, and a copy of the certification must be simultaneously delivered to the individual and electronically delivered to the individual’s attorney of record.

1. At least twenty (20) days before the expiration of the order, the court shall give written notice to the individual and the individual’s attorney of record that a hearing upon the extension may be had before the court or a jury upon written request to the court within ten (10) days after receipt of the notice.

2. If a hearing is not requested by the individual within such time, the court may proceed ex parte.

3. If a hearing is timely requested, the hearing must be held before the expiration date of the order in force.

4. If the court or jury finds that the conditions of this part 11.16 continue to be met and that the individual has a mental health disorder and, as a result of the mental health disorder, is a danger to others or to the individual’s self or is gravely disabled, the court shall issue an extension of the order.

5. Any extension must not exceed six (6) months, but there may be as many extensions as the court orders pursuant to this section.

K. An individual certified for long-term care and treatment may be discharged from the facility upon the signature of the treating professional person and medical director of the facility, and the facility shall notify the BHA prior to the individual’s discharge.

1. The facility shall make the individual’s discharge instructions available to the individual, the individual’s attorney, the individual’s lay person, and the individual’s legal guardian, if applicable, within one (1) week after discharge, if requested.

L. A facility that is transferring an individual to a different facility or to an outpatient program shall provide all treatment records to the facility or provider accepting the individual at least twenty-four (24) hours prior to the transfer.

11.16.5 I ndividual Rights for Short-Term and Long-Term Care Treatment A. The facility shall furnish all persons receiving evaluation, care, or treatment under any provisions of Article 65 of Title 27, C.R.S., with a written copy of the rights listed under part 11.14.3 of this

Chapter (translated into a language or modality accessible that the individual understands if feasible) upon admission. If the individual is not able to read the rights, the individual shall be read the rights in a language that the individual understands, if feasible, or provided access to a modality to assist in understanding. Minors must receive a separate written notice of individual rights as outlined in Section 27-65-104, C.R.S.

B. The facility shall post the following list of rights (in the predominant languages of the community in which it operates and explained, if feasible, in a language or modality accessible to the individual) in prominent places frequented by individuals and their families receiving services and the facility shall assist the individual in exercising the below rights, in addition to the rights found in part 11.14.3 of this Chapter:

1. To meet with or call a personal clinician, spiritual advisor, counselor, crisis hotline, family member, workplace, childcare provider, or school at all reasonable times;

2. T o receive and send sealed correspondence, as well as to be given the assistance of facility personnel if the individual is unable to write, prepare, or mail correspondence.

Facility personnel shall not open, delay, intercept, read, or censor mail or other communications or use mail or other communications as a method to enforce compliance with facility personnel;

a. To have access to letter-writing materials, including postage, and to have personnel members of the facility assist the individual if the individual is unable to write, prepare, and mail correspondence;

3. To have the individual’s behavioral health orders for scope of treatment or psychiatric advance directive reviewed and considered by the court as the preferred treatment option for involuntary administration of medications unless, by clear and convincing evidence, the individual’s directive does not qualify as effective participation in behavioral health decision making;

4. To have frequent and convenient opportunities to meet with visitors and to see the individual’s attorney, clergyperson, or physician at any time;

a. The facility may not deny visits by the individual’s attorney, religious representative or physician at any reasonable time.

b. The facility will provide privacy to maintain confidentiality of communication between an individual and spouse or significant other, family member(s), personnel, attorney, physician, certified public accountant and religious representative, except that if disclosure is required by law, then such privacy may be terminated;

5. To have personal privacy to the extent possible during the course of treatment; and, 6. To have access to a representative within the facility who provides assistance to file a grievance.

7. An individual may be photographed upon admission for identification and the administrative purposes of the facility. The photographs are confidential and must not be released by the facility except pursuant to court order.

a. Nonmedical photographs shall not be taken or used without appropriate consent or authorization.

C. Facilities providing care and treatment to minors shall post the minor’s rights information of

section 11.15.1, in addition to the following list of rights (in languages and modality appropriate for understanding) in prominent places frequented by individuals and their families receiving 11.16.6 I ndividual Rights Restrictions for Short-Term and Long-Term Care Treatment A. As set forth in Section 27-65-119, C.R.S., an individual’s statutory rights, and rights listed in parts 11.14.3 and 11.16.5 of this Chapter, may be limited or denied if access to the right would endanger the safety of the individual or another person in close proximity and may only be denied by a person involved in the individual’s care.

1. A person involved in the individual’s care means a person that is either providing care directly to the individual or directing the care of the individual.”

B. Any individual whose rights are denied or violated pursuant to this section has the right to file a complaint against the facility with the BHA and the Department of Public Health and Environment.

C. Except as otherwise provided in part 11.16.6.A of this Chapter, each denial of an individual’s right shall be made on a case-by-case basis and the reason for denying the right shall be documented in the individual record and shall be made available, upon request, to the individual, the individual’s legal guardian, or the individual’s attorney.

D. Except as otherwise provided in part 11.16.6.A of this Chapter, restrictions on rights in parts 11.14.3.A.9, 11.14.3.A.10, 11.14.3.A.15, 11.14.3.A.17, and 11.14.3.A.19 and part 11.16.5.B.1 of this Chapter, shall be evaluated for therapeutic necessity on an ongoing basis and the rationale for continuing the restriction shall be documented at least every seven (7) calendar days.

E. A facility shall not intentionally retaliate or discriminate against a person or employee for contacting or providing information to any official or to an employee or any state protection and advocacy facility, or for initiating, participating in, or testifying in a grievance procedure or in an action for any remedy authorized pursuant to this this section.

1. Under Section 27-65-119(6), C.R.S., any facility that violates this commits an unclassified misdemeanor and shall be fined not more than one thousand dollars. 11.16.7 Individual Rights Restrictions in Secure Treatment Facilities A. A facility, through a professional person treating individuals in a secure treatment setting may limit or deny rights listed in this Chapter for good cause based upon the safety and security needs of the personnel and other individuals in the facility. Safety and security policies applicable to the unit shall be incorporated into the individual’s service plan. The following procedures shall be adhered to:

1. The BHA shall approve of safety and security policies for each facility unit that places any limit on the rights set forth in part 11.16 of this Chapter, as well as the policy and criteria for placement of an individual committed under Article 65 of Title 27, C.R.S., in secure treatment facilities.

2. T he safety and security policies for each facility unit shall be posted in the unit. The secure facility personnel shall provide a copy of the unit policy upon an individual’s 3. Any good cause restriction of rights based upon the safety and security policy of the facility unit shall be noted in the individual’s record. The order for restriction shall be signed by the professional person providing care and treatment and shall be reviewed at least every thirty (30) days.

4. No safety or security policy may limit an individual’s ability to send or receive sealed correspondence. However, to prevent the introduction of contraband into the secure treatment facility, the policy may require that the individual open the correspondence in the presence of unit personnel.

5. No safety or security policy may limit an individual’s right to see their attorney, clergy, or physician at reasonable times. However, the safety and security policy may provide that advance notice be given to the secure treatment facility for such visits so that the secure facility can adequately personnel for the private visit and take any measures necessary to ensure the safety of the visit.

6. For the purposes of this rule, placement of individuals in secure treatment facilities on units that are locked at night:

a. I ndividuals transferred to a secure treatment facility from the Department of Corrections, who are serving sentences in the Department of Corrections, may be placed on units in which the bedroom doors are locked during sleeping hours.

b. Individuals who are newly admitted to a secure treatment facility may be placed on units in which the bedroom doors are locked during sleeping hours, for a time period not to exceed sixty (60) calendar days. After sixty (60) calendar days, these individuals will not be placed on a unit with locked doors during sleeping hours unless an individualized assessment is made, and the treatment team determines that the individual is imminently dangerous to self or to others; this must be documented in the individual’s record.

c. Sleeping hours shall begin no earlier than 9:00 p.m., end no later than 8:00 a.m., and shall not exceed 8-1/2 hours.

d. Individuals shall be provided an effective means of calling for assistance when in a locked room during sleeping hours. The secure treatment facility shall provide personnel to promptly assist an individual with their individual needs including, but not limited to, personnel assigned to a day hall where personnel will be able to hear and respond to individuals who knock on their room doors. An intercom call system may also be used. Personnel shall monitor each individual’s wellbeing through visual observation checks every fifteen (15) minutes.

e. As set forth in Section 27-65-127, C.R.S., an individual's rights may be limited or denied under court order by an imposition of legal disability or deprivation of a right.

f. Information pertaining to the denial of any right shall be made available, upon request, to the individual or their attorney. 11.16.8 Admissions Requirements & Disclosures A. The facility shall develop written admission criteria based on the facility’s ability to meet the individual’s needs. Admission criteria shall be based upon a comprehensive assessment of the individual’s mental health, physical health, substance use, and capacity for self- care. The assessment shall determine the level of intervention and supervision required, including medication management, behavioral health services and stabilization prior to return to the community.

B. Ac ute treatment units shall not admit individuals with a mental health disorder into a locked setting unless there is no less restrictive alternative and unless they are otherwise in compliance with the requirements of Article 65 of Title 27, Colorado Revised Statutes.

C. Individuals may be admitted to a locked setting as a voluntary or involuntary individual. If voluntary, the individual shall sign a form that documents the following information:

1. The individual is aware that the facility is locked.

2. The individual may exit the facility with personnel assistance and/or permission.

3. The individual may leave the facility at any point in time, unless they present as a danger to self or others, or is gravely disabled as defined in Section 27-65-102(17), C.R.S.

4. An individual who is imminently suicidal or homicidal shall only be admitted to the locked facility, upon completion of the facility’s assessment and the facility’s determination that the individual’s safety and the safety of others can be maintained by the facility. If an individual is admitted and facility personnel determine that their behavior cannot be safely and successfully treated at the ATU, then personnel shall make arrangements to transfer the individual to the nearest hospital for further assessment and disposition.

D. A fa cility shall not admit or keep any individual who meets the following exclusion criteria:

1. Is consistently incontinent unless the individual or personnel is capable of preventing such incontinence from becoming a health hazard.

2. Is under the age of eighteen (18) unless the facility has a separate locked unit dedicated to minors.

3. Is bedridden with limited potential for improvement.

4. Has a communicable disease or infection that is:

a. Reportable under the Colorado Department of Public Health and Environment's regulations (6 CCR 1009-1 (01/14/2025) and 6 CCR 1009-2 (05/15/2023)) which are hereby incorporated by reference. No later editions or amendments are incorporated. The rules are available at no cost from the Colorado Secretary of State website. The 6 CCR 1009-1 (01/14/2025) regulation is available at https://www.coloradosos.gov/CCR/GenerateRulePdf.do?ruleVersionId=11781&fil eName=6%20CCR%201009-1. The 6 CCR 1009-2 (05/15/2023) regulation is available at https://www.coloradosos.gov/CCR/GenerateRulePdf.do?ruleVersionId=10788&fil eName=6%20CCR%201009-2. Individuals may inspect a copy at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours); and b. Potentially transmittable in a facility unless the individual is receiving medical or 5. Has acute withdrawal symptoms, is at risk of withdrawal symptoms, or is incapacitated due to a substance use disorder and facility does not have appropriate capacity/endorsements to address issues of withdrawal.

E. The facility shall maintain a current list of individuals and their assigned room. 11.16.9 Required Disclosures to Individuals Upon Admission A. There shall be written evidence of consent to treat, and the following upon admission to the individual or individual’s legal representative, as appropriate. Acknowledgements shall specify the understanding between the parties regarding, at a minimum:

1. Charges;

2. Services included in the rates and charges;

3. Types of services provided by the facility, those services which are not provided, and 4. Transportation services;

5. Therapeutic diets;

6. A physically safe and sanitary environment;

7. Personal services;

8. Protective oversight;

9. Presence and purpose of any video monitoring;

10. Social and recreational activities;

11. A provision that the facility must give individuals thirty (30) calendar days’ notice of closure;

12. Management of personal funds and property;

13. Facility rules, established pursuant to part 11.16.11 of this Chapter;

14. Staffing levels based on individual needs; and 15. Types of daily activities, including examples of such activities that will be provided. 11.16.10 Environment and Safety A. All individuals being treated under these regulations shall receive such treatment in a clean and safe environment with opportunities for privacy.

B. A facility shall only place an individual in a bedroom with video monitoring due to good cause and safety or security reasons which must be noted in the individual record. Individuals shall be notified in writing when placed in bedrooms with video monitoring capabilities.

C. Each facility shall maintain reasonable security capabilities to guard against the risk of unauthorized departures. The least restrictive method to prevent an unauthorized departure shall D. An unlocked facility may place an individual in seclusion to prevent an unauthorized departure when such departure carries an imminent risk of danger for the individual or for others. Under those circumstances, the seclusion procedures in part 11.9 of these rules shall be followed. 11.16.11 Facility rules A. The facility shall establish written policies, which shall list all possible actions that may be taken by the facility if any policy is knowingly violated by an individual. Facility policies may not violate or contravene any rule herein, or in any way discourage or hinder an individual’s rights.

B. T he facility shall prominently post its policies in writing, which shall be available at all times to individuals. Such policies shall address at least the following:

1. Smoking;

2. Cooking;

3. Visitors;

4. Telephone usage including frequency and duration of calls;

5. Use of common areas, including the use of television, radio;

6. Consumption of alcohol and/or illicit drugs;

7. Dress; and 8. Pets, which shall not be allowed in the facility; however, in no event shall such rules prohibit service or guide animals. 11.16.12 Employment of Individuals Receiving Services in 27-65 Designated Facilities A. All labor, employment or jobs involving facility operation and maintenance which are of an economic benefit to the facility, shall be treated as work and shall be compensated according to applicable minimum wage or prevailing wage rates.

B. Maintaining a minimum standard of cleanliness and personal hygiene and personal housekeeping, such as making one's bed or cleaning one's area, shall not be treated as work and shall not be compensated.

C. Individuals shall not be forced in any way to perform work.

D. Privileges or release from a designated facility shall not be conditioned upon the performance of work.

E. Vocational programs and training programs must comply with all applicable federal and state F. Vocational programs are not subject to the provisions in part 11.16.12.A of this section unless the program is of economic benefit to the facility.

G. All work assignments, together with a specific consent form, and the hourly compensation received, shall be noted in the individual’s record. 11.16.13 Medical/Dental Care A. The facility shall ensure the availability of emergency medical and dental care to meet the individual needs of each individual. The obligation to ensure the availability of emergency medical services shall not be construed as the obligation to pay for such services; however, the facility shall secure these services regardless of source of payment. The facility shall have and adhere to a written plan for providing emergency medical and dental care to include at least:

1. A qu alified licensed independent practitioner responsible for the completion of physical examinations within twenty-four (24) hours of admission. Subsequent physical examinations shall be completed at least annually, and as frequently as needed. This information shall be included in the clinical record.

a. If the individual refuses to complete a physical examination, documentation must be held in the clinical record of facility efforts.

2. The availability of a qualified licensed independent practitioner or emergency medical facility on a twenty-four (24) hour, seven (7) days a week basis.

3. Emergency medical or dental treatment, when indicated, shall be accessed immediately upon determination that an emergency exists.

4. Whenever indicated, an individual shall be referred to an appropriate specialist for either further assessment or treatment. The facility shall be responsible for securing an appropriate assessment to determine the need for further specialty consultation. This B. Each designated facility must maintain a facility placement agreement with one or more medical hospitals pursuant to part 11.12 of this Chapter.

C. If an individual on an emergency mental health hold or certification requires inpatient medical care at a hospital, the designated facility shall be responsible for the care and treatment provided by the medical hospital per part 11.12 of this Chapter.

D. The designated facility shall communicate with the hospital upon the individual being admitted to the medical unit regarding the individual’s psychiatric treatment needs, safety considerations, and managing ligature risk while the individual is hospitalized medically consistent with state and federal law. 11.16.14 Physical Health Assessment Policy A. The facility shall develop policies and procedures that identify when a physical health assessment by a qualified licensed independent practitioner will be required, including the following indicators:

1. Within twenty-four (24) hours of admission;

2. A significant change in the individual’s condition;

3. Evidence of possible infection (open sores, etc.);

4. Injury or accident sustained by the individual that might cause a change in the individual’s condition;

5. Known exposure of the individual to a communicable disease; or 6. Development of any condition that would have initially precluded admission to the facility. 11.16.15 Medication Storage, Disposition, and Disposal A. All personal medication must be surrendered to the facility to be logged in and stored by the facility. Individuals are not allowed to self-administer medication in the facility.

B. Personal medication shall be returned to the individual or individual’s legal representative, upon discharge or death, except that return of medication to the individual may be withheld if specified in the individual’s service if a physician or other authorized medical practitioner has determined that the individual lacks the decisional capacity to possess or administer such medication safely.

C. Med ications shall be labeled with the individual’s full name, pursuant to Article 280 of Title 12, D. Any medication container that has a detached, excessively soiled, or damaged label shall be returned to the issuing pharmacy for re-labeling or disposed of appropriately.

E. All medication shall be stored in a manner that ensures the safety of all individuals.

F. Medication shall be stored in a central location, including refrigerators, and shall be kept under lock and shall be stored in separate or compartmentalized packages, containers, or shelves for each individual in order to prevent intermingling of medication.

G. Individuals shall not have access to medication that is kept in a central location.

H. Medications that require refrigeration shall be stored separately in locked containers in the refrigerator. If medication is stored in a refrigerator dedicated to that purpose, and the refrigerator is in a locked room, then the medications do not need to be stored in locked containers.

I. Prescription and over the counter medication shall not be kept in stock or bulk quantities unless such medication is administered by a licensed medical practitioner.

J. Medication disposal procedures include:

1. The return of medication shall be documented by the facility.

2. Medication that has a specific expiration date shall not be administered after that date 11.16.16 Medication Administration A. The facility must ensure that medications are administered only by licensed or certified personnel allowed to administer medications under their own scopes of practice, or an unlicensed personnel who are qualified medication administration persons (QMAPs) acting within their own scope of B. When using QMAPs to administer medication, the facility shall ensure compliance with 6 CCR 1011-1 Chapter 24 (July 19, 2017), which is hereby incorporated by reference. No later editions or amendments are incorporated. The rule is available at no cost from the Colorado Secretary of State at https://www.sos.state.co.us. Individuals may inspect a copy at the Behavioral Health Administration, 710 S. Ash Street, Unit C140, Denver, CO 80246, during regular business hours.

C. Facilities shall follow psychiatric medication standards as outlined in part 11.8.2 of this Chapter and the following:

1. Only a licensed nurse may accept telephone orders for medication from a physician or other authorized practitioner. All telephone orders shall be evidenced by a written and signed order and documented in the individual’s record and the facility’s medication administration record.

2. These rules apply to medications and treatment which do not conflict with state law and regulations pertaining to acute treatment units and which are within the scope of services provided by the facility, as outlined in the individual agreement or the facility rules.

3. The facility shall be responsible for complying with professional person or advanced practice registered nurse orders associated with the administration of medication or treatment. The facility shall implement a system that obtains clarification from the physician, as necessary and documents that the physician:

a. Has been asked whether refusal of the medication or treatment should result in physician notification.

b. Has been notified, where such notification is appropriate.

c. Has provided documentation of such notification shall be made in the individual’s d. C oordinates with external providers or accepts responsibility to perform the care using facility personnel.

e. Trains personnel regarding the parameters of the ordered care as appropriate.

f. Documents the delivery of the care, including refusal by the individual, of the medication or treatment. 11.16.17 Administration of Oxygen A. Individuals may administer oxygen, if the individual is able to manage the administration themself and personnel shall assist with the administration as needed for safety, when prescribed by a physician and if the facility follows appropriate safety requirements regarding oxygen herein.

B. Oxygen tanks shall be secured upright at all times to prevent falling over and secured in a manner to prevent tanks from being dropped or from striking violently against each other.

C. Tank valves shall be closed except when in use.

D. Transferring oxygen from one container to another shall be conducted in a well-ventilated room with the door shut. Transfer shall be conducted by trained personnel or by the individual for whom the oxygen is being transferred, if the individual is capable of performing this task safely. When the transfer is being conducted, no person, except for a person conducting such transfer, shall be present in the room.

E. Tanks and other oxygen containers shall not be exposed to electrical sparks, cigarettes, or open flames.

F. Tanks shall not be placed against electrical panels or live electrical cords where the cylinder can become part of an electric circuit.

G. T anks shall not be rolled on their side or dragged.

H. Smoking shall be prohibited in rooms where oxygen is used or stored. Rooms in which oxygen is used shall be posted with a conspicuous “ no smoking” sign.

I. Tanks shall not be stored near radiators or other heat sources. If stored outdoors, tanks shall be protected from weather extremes and damp ground to prevent corrosion. 11.16.18 Serious Illness, Serious Injury, or Death A. Facility policy shall describe the procedures to be followed by the facility in the event of serious illness, serious injury, or death of individuals receiving services, including incident reporting B. The policy shall include a requirement that the facility notify an emergency contact, if one has been provided, when the individual’s injury or illness warrants medical treatment or face-to-face medical evaluation. In the case of an emergency room visit or unscheduled hospitalization, a facility must notify an emergency contact immediately. 11.16.19 Service Provisions for Short-Term and Long-Term Care Treatment A. Facilities providing short-term and long-term care treatment shall have detailed policies and procedures specific to therapeutic programming provided to individuals while in the facility’s care.

B. P rogramming shall be trauma-informed, person-centered, and appropriate for the individual’s diagnosis.

C. Programming shall be documented in the individual’s treatment plan.

D. Programming shall be facilitated by appropriate personnel for the type of therapeutic treatment E. Programming can include the following, but is not limited to:

1. Intensive case management;

2. Assertive community treatment;

3. Peer recovery support services;

4. Individual therapy;

5. Group therapy;

6. Therapeutic activities;

7. Educational and vocational training or activities;

8. Housing and transportation assistance; and/or 9. Transitional assistance. 11.16.20 Content of Records A. Records shall be kept in conformity with part 2.11 of these rules, applicable federal and state laws, and the following:

1. Demographic and medical information;

2. A cover sheet to contain the following information;

a. Individual’s full name, including maiden name if applicable;

b. Individual’s sex, date of birth, gender identity, marital status and social security number, where needed for Medicaid or employment purposes;

c. Individual’s current address of residence;

d. Date of admission;

e. Name, address and telephone number of relatives or legal representative(s), or other person(s) to be notified in an emergency;

f. Name, address and telephone number of individual’s primary physician, and case manager if applicable, and an indication of religious preference, if any, for use in emergency;

g. I ndividual’s diagnoses, at the time of admission;

h. Current record of the individual’s allergies;

3. Medication administration record; and 4. Physician’s orders.

B. Initial and comprehensive assessments shall comply with the requirements of parts 2.12.2 and 2.12.3 of these rules and must be completed within twenty-four (24) hours of admission.

C. Service plans shall comply with the requirements of part 2.13.1 of these rules, and the following:

1. The service plan shall contain specific criteria required for discharge from treatment or to progress to less restrictive treatment alternatives.

2. If an individual is discharged during an emergency mental health hold without certification by the facility, and a service plan has not been completed, then pertinent information shall be included in the discharge summary.

3. A physician or other legal prescriber shall be responsible for the component of the plan requiring medication management services.

4. For individuals certified to short-term or long-term treatment, the service plan shall be reviewed, and revised, if necessary, at least monthly by the personnel responsible for the plan, the treating professional person, any additional personnel involved in care as the facility determines is necessary for the review, the individual, and the legal guardian. This review shall be documented in the record and include progress toward meeting the criteria for termination of treatment and the need for continued involuntary treatment if the individual is certified. If the monthly review is delayed, the reason for such delay shall be noted in the record and the review shall be completed as promptly as possible.

D. T reatment progress notes shall include the following:

1. Documentation of all treatment procedures including, but not limited to: brief physical restraint, seclusion, mechanical restraint, medications voluntary and involuntary, and other therapies or interventions.

2. Information regarding the serious injury of or by the individual and the circumstances and outcome.

3. Documentation of all transfers, whether permanent or temporary, and reasons for transfer.

4. Legal status and all legal documents related to treatment under Section 27-65-101 through -131, C.R.S.

5. Consultations and/or case reviews.

6. Pertinent information from outside facilities or persons or from the individual.

7. Correspondence to and from relevant facilities and persons.

8. Consent forms as appropriate for alternative treatments or voluntary treatment.

9. Use or non-use of psychiatric and medical advance directives.

E. Discharge information provided to the individual shall include the requirements of part 2.10.A.6.

Of these rules, and the following:

1. Specific recommendations regarding prevention of re-hospitalization based on the individual’s unique challenges and needs.

F. Discharge summaries shall comply with the requirements of part 2.10.A.6 of these rules, this part 11.16.20, and the following:

1. Documentation that notice of discharge was provided to the individual or individual’s legal representatives as follows:

a. At least twenty-four (24) hours in advance of discharge or transfer, in accordance with the rules governing the care and treatment of persons with a mental health disorder in parts 11.14 and 11.16 of this Chapter.

b. In cases of a medical or psychiatric emergency, the emergency contact shall be notified as soon as possible.

2. Documentation of discharge coordination with the individual, and, with permission, the individual’s family, legal representative, or appropriate facility.

3. For transfers between facilities, documentation of appropriate clinical information and coordination of services between the two facilities, including mode of transportation.

4. Information if the discharge is being made against the advice of the treating professional 11.16.21 Management of Personal Funds and Personal Property A. The facility shall comply with part 2.26.D.3 of these rules related to management of personal funds and personal property. 11.16.22 Transportation of Individuals A. Whenever transportation of an individual is required, the treating personnel of the facility shall assess the individual for danger to self or others and potential for escape. Whenever clinically and safely appropriate, the individual may be transported by other means such as ambulance, care van, private vehicle, and restraints shall not be used, unless consistent with state and federal law, authorized as necessary, and ordered by the treating professional person. If the treating personnel assesses the individual as dangerous to self or others or as an escape risk, the personnel may request transportation by a secure transportation provider or the local sheriff's department. 11.16.23 Se cure Transportation Providers A. Facilities may utilize a secure transportation provider.

B. “Class A” secure transportation services are licensed pursuant to CDPHE regulations to use physical restraint during secure transport based on associated regulations.

C. “Class B” secure transportation services are not licensed pursuant to CDPHE regulations to use physical restraint during secure transport.

D. For individuals receiving involuntary care in a 27-65 designated facility, when transportation to a medical appointment outside of the 27-65 designated facility is required, a personnel from the 27- 65 designated facility who is trained in facility transportation policies and procedures shall accompany and remain with the individual for the duration of the appointment at the outside facility. The individual may be left in an emergency medical services facility’s care without a designated facility personnel only if the individual is in a secure area (such as a psychiatric emergency department) and/or if there is trained security personnel present with the individual at all times; these provisions for safety/security must be noted in the designated facility’s individual chart. 11.16.24 Secure Transport Requests A. Any requests for transportation from the sheriff's department shall be filed with the court of appropriate jurisdiction and shall include:

1. Statements from the treating Colorado licensed physician or psychologist supporting the need for transportation by the sheriff's department;

2. Recommendations concerning the use of mechanical restraints and the impact that handcuffs or shackles would have on the individual;

3. Recommendations for soft restraints, not handcuffs or shackles, if the findings of the assessment support the use of mechanical restraint;

4. Recommendations concerning the placement and management of the individual during the time they will be absent from the 27-65 designated facility due to court hearings;

5. Recommendations of considerations for management of the individual based on the individual's age, physical abilities, culture, medical and psychiatric status and/or stability.

B. Notice of the request for transportation by the sheriff's department shall be given to the individual and their attorney at least twenty-four (24) hours prior to the time it is filed with the court. This notice shall not be required during the time an emergency mental health hold is in effect or in an emergency situation with an individual under certification or when the individual signs a waiver which has been clearly explained.

C. R equesting transportation by the sheriff's department does not require a finding of danger to self or others or an escape risk if the sheriff's department is willing to transport the individual without the use of mechanical restraints. 11.16.25 Termination of Certification for Short-Term and Long-Term Treatment A. Prior to July 1, 2024, an original or extended certification for short-term treatment issues pursuant to Section 27-65-109, C.R.S., or an order or extension for certification for long-term care and treatment pursuant to Section 27-65-110, C.R.S., terminates as soon as the professional person in charge of treatment of the individual determines the individual has received sufficient benefit from the treatment for the individual to end involuntary treatment. Beginning July 1, 2024, an original or extended certification for short-term treatment issues pursuant to Section 27-65-109, C.R.S., or an order or extension for certification for long-term care and treatment pursuant to

Section 27-65-110, C.R.S., terminates as soon as the professional person in charge of treatment of the individual and the BHA determine the individual has received sufficient benefit from the treatment for the individual to end involuntary treatment.

B. W henever a certification or extended certification is terminated, the professional person in charge of providing treatment shall notify the court in writing within five (5) days after the termination.

C. Before termination, an individual who leaves a facility may be returned to the facility by order of the court without a hearing or by the superintendent or director of the facility without a court order.

D. After termination, an individual may be returned to the facility only in accordance with Article 65 of E. Facilities designated for involuntary care and treatment of individuals are required to notify the BHA whenever an individual certification is terminated. 27-65 designated facilities must submit required documentation directly to the BHA using the prescribed BHA method available on BHA’s website. 11.17 Involuntary Outpatient Care & Treatment Designation 11.17.1 Applicability A. The involuntary outpatient care and treatment designation allows facilities to provide care and treatment to individuals on short-term and long-term certifications on an outpatient basis.

B. Facilities designated for involuntary outpatient care and treatment must be in compliance with the following rules:

1. Parts 2.7 through 2.13 and parts 2.23 through 2.25 of these rules with the following exception a. Part 2.7.A.3 of these rules 2. Parts 11.1 through 11.15 and 11.17 of this Chapter.

C. This section 11.17 is meant, in part, to provide a summary of the obligations and standards set forth in Section 27-65-101 through -131, C.R.S., with regard to involuntary outpatient care and treatment. This section is only enforceable with regard to designated facilities. 11.17.2 Procedures for Certification to Outpatient Treatment A. An individual who has been treated as an inpatient under a short-term or long-term certification for mental health treatment at a designated facility may be treated on an outpatient basis if the following conditions are met:

1. A pr ofessional person who has evaluated the individual and who is on the personnel of the inpatient designated facility determines that while the individual continues to meet the requirements for certification, professional judgment is that with appropriate treatment modalities in place the individual is unlikely to act dangerously in the community.

2. Certification on an outpatient basis is the appropriate disposition suited to the individual's needs.

3. The designated facility that will hold the certification on an outpatient basis has documentation of the results of a physical examination within the last year, or documented attempts to obtain information.

B. In addition to the requirements in Chapter 4 of these rules, the outpatient treatment provider shall develop a service plan for the individual receiving treatment on an outpatient basis with the goal of the individual finding and sustaining recovery. The service plan must include measures to keep the individual or others safe, as informed by the individual's need for certification. The service plan may include, but is not limited to:

1. Intensive case management;

2. Assertive community treatment;

3. Peer recovery support services;

4. Individual or group therapy;

5. Day or partial-day programming activities;

6. Intensive outpatient programs;

7. Educational and vocational training or activities; and 8. Housing and transportation assistance.

C. The individual, the individual's legal guardian, the individual’s patient representative or the individual's lay person, or any party at any court hearing may contest an individual's treatment regimen, including court-ordered medications, at any court hearing related to the individual's certification for treatment.

D. Primary oversight of outpatient certifications at designated facilities must be provided by a professional person. The professional person assigned to the individual’s case must also be available for clinical supervision and/or consultation to personnel providing clinical services to the individual at the designated facility in which the individual is receiving outpatient certification E. Primary clinical services at the designated facility, including but not limited to individual therapy, must be provided by a licensee or authorized practitioner receiving clinical supervision and/or consultation from the assigned professional person. 11.17.3 Enforcement of Outpatient Certification [Effective July 1, 2024]

A. The facility responsible for providing services to an individual on a certification on an outpatient

basis shall proactively reach out to the individual to engage the individual in treatment on a weekly basis and including visits to the individual’s known places or residence. Documentation of all visits and attempts must be included in the clinical record.

B. If the individual refuses treatment or court-ordered medication and is decompensating psychiatrically, the court may order a certified peace officer or secure transportation provider to transport the individual to an appropriate, least restrictive designated facility in collaboration with the BHA and the provider holding the certification.

1. The individual does not need to be imminently dangerous to the individual's self or others for the facility to request, and the court to order, transportation to a facility for the individual to receive treatment and court-ordered medications.

C. The facility responsible for providing services to an individual on a certification on an outpatient

basis shall provide the court information on the facility's proactive outreach to the individual and the professional person's and psychiatric advanced practice registered nurse's basis for medical opinion.

D. If an individual is placed in a more restrictive setting, the individual has the right to judicial review within ten (10) days after filing a written request.

E. In addition to any other limitation on liability, an agency or facility providing care to an individual placed on short-term or long-term certification on an outpatient basis is only liable for harm subsequently caused by or to an individual who:

1. Has been terminated from certification despite meeting statutory criteria for certification pursuant to Sections 27-65-109 or 27-65-110, C.R.S.; and, 2. Provided services to the individual not within the scope of the individual's professional license or was reckless or grossly negligent in providing services.

3. A provider is not liable if an individual's certification is terminated, despite meeting criteria for certification, if the provider is unable to locate the individual despite proactive and reasonable outreach.

F. An individual certified for short-term treatment on an outpatient basis may be discharged upon the signature of the approved professional person overseeing the individual's treatment, and the professional person shall notify the BHA prior to the discharge.

G. A facility or program shall make the individual’s discharge instructions available to the individual, the individual's attorney, and the individual’s legal guardian, if applicable, within seven (7) days after discharge, if requested.

1. A facility or program that is transferring an individual to a different treatment facility or to an outpatient provider shall provide all treatment records to the facility or provider accepting the individual at least twenty-four (24) hours prior to the transfer.

H. T he individual, their legal guardian, the patient representative or lay person, or any party may object to the individual’s treatment, including court-ordered medications, at any court hearing related to the individual’s certification to treatment. 11.17.4 Individual Rights for Involuntary Outpatient Treatment [Effective July 1, 2024]

A. The facility shall provide all individuals receiving evaluation, care, or treatment on a certified outpatient basis, with a written copy of the rights listed under part 11.14.3 of this Chapter, in addition to this part 11.17.4.B (translated into a language that the individual understands if feasible) upon admission and upon each renewal of certification. If the individual is not able to read the rights, the individual shall be read the rights in a language that they understand.

B. The facility shall post the following list of rights (in languages predominantly used by the population of individuals served), in addition to those enumerated in part 11.14.3 of this Chapter in prominent places frequented by individuals and their families receiving services:

1. To request a change to voluntary status. A change to voluntary status may be denied by the supervising professional person or an advanced practice registered nurse with training in psychiatric nursing responsible for the individual’s treatment if the professional person or advanced practice registered nurse with training in psychiatric nursing determines reasonable grounds exist to believe that the individual will not remain in a voluntary treatment program;

a. If a discrepancy exists for the determination of voluntary status between the professional person and the advanced practice nurse with training in psychiatric nursing, the determination for the individual to change to voluntary status must defer to the assessment from the professional person.

2. To be treated fairly, with respect and recognition of the individual's dignity and individuality, by all employees of the treatment facility with whom the individual comes in contact;

3. To appropriate treatment, which must be administered skillfully, safely, and humanely. An individual shall receive treatment suited to the individual's needs that must be determined in collaboration with the individual;

4. To not be discriminated against on the basis of age, race, ethnicity, religion, culture, spoken language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity, or gender expression;

5. To retain and consult with an attorney at any time;

6. Within forty-eight (48) hours after the individual's request, to see and receive the services of a patient representative, including a peer specialist;

7. To have the individual's behavioral health orders for scope of treatment or psychiatric advance directive reviewed and considered by the court as the preferred treatment option for involuntary administration of medications unless, by clear and convincing evidence, the individual's directive does not qualify as effective participation in behavioral health decision-making;

8. To have the individual's information and records disclosed to adult family members and a lay person pursuant to Section 27-65-123, C.R.S.;

9. To have access to a representative within the facility who provides assistance to file a grievance; and 10. To have the right to file a motion with the court at any time to contest the certification.

c. As s et forth in Section 27-65-127, C.R.S., an individual's rights, as set forth in Section 27-65-101 through -131, C.R.S. and this Chapter, may be limited or denied under court order by an imposition of legal disability or deprivation of a right.

d. Information pertaining to the denial of any right shall be made available, upon request, to the individual or their attorney. 11.17.5 Service Planning [Effective July 1, 2024]

A. Service plans shall comply with the requirements of part 2.13.1 of this Chapter, and the following:

1. The service plan shall contain specific criteria required for discharge from treatment or to progress to less restrictive treatment alternatives;

2. A physician or other legal prescriber shall be responsible for the component of the plan requiring medication management services; and, 3. For individuals certified to short-term or long-term treatment, the service plan shall be reviewed, and revised, if necessary, at least monthly by the personnel responsible for the plan, the treating professional person, the individual and the legal guardian. This review shall be documented in the record and include progress toward meeting the criteria for termination of treatment and the need for continued involuntary treatment if the individual is certified. If the monthly review is delayed, the reason for such delay shall be noted in the record and the review shall be completed as promptly as possible.

4. T he service plan may include, but is not limited to:

a. Intensive case management services;

b. Assertive community treatment;

c. Peer recovery services;

d. Individual and/or group therapy;

e. Day or partial-day programming activities;

f. Intensive outpatient programs;

g. Educational and/or vocational training and activities; or h. Housing and transportation assistance

Chapter 12: Behavioral Health Safety Net Provider Approval 12.1 Authority and Applicability A. Chapter 12 establishes standards for behavioral health safety net providers, including comprehensive community behavioral health providers and essential behavioral health safety net providers, and the behavioral health safety net approval process. The statutory authority to promulgate these rules is set forth in Sections 27-50-107(3)(c), 27-50-301(5), 27-50-304(7), and 27-50-502(1) through (5), C.R.S. Chapter 12 additionally establishes standards for additional competencies related to serving priority populations where behavioral health safety net providers may be eligible for enhanced rates. The statutory authority to promulgate these rules is set forth in Section 27-50-502(6), C.R.S.

B. To be eligible for enhanced service delivery payments set forth in Section 27-50-502(2),(3), C.R.S., a behavioral health safety net provider must be approved by the BHA. This approval does not guarantee enhanced service delivery payments.

C. Approved behavioral health safety net providers shall be subject to the following rule compliance timeline:

1. U pon these rules going into effect, the BHA shall take immediate action pursuant to

Section 27-50-505, C.R.S. on rule violations that impact the health, safety, and welfare of individuals receiving services provided by an approved safety net provider.

2. All approved safety net providers shall be in full compliance of these rules by July 1, 2024.

D. Provider participation in the behavioral health safety net system is voluntary. The rules in this

Chapter must be followed, as applicable, by all entities and persons that are seeking to be or are approved behavioral health safety net providers to be eligible for public funding as part of the state of Colorado’s Behavioral Health Safety Net System created pursuant to Section 27-50-301 through -304, C.R.S. 12.2 Approval A. Approval by the BHA as a behavioral health safety net provider shall be predicated upon the 1. Evidence of current licensure in good standing by the BHA, Department of Public Health and Environment, Department of Regulatory Agencies, and/or other state agency where applicable, unless otherwise exempt from licensing by state or federal rule or statute.

a. Behavioral health providers, including but not limited to federally qualified health centers, that are exempt from licensure but require federal recognition shall provide documentation to demonstrate current recognition.

2. Compliance with the requirements of this Chapter 12.

a. Part 12.4 of this Chapter shall apply only to essential behavioral health safety net providers.

b. Part 12.5 of this Chapter shall apply only to comprehensive community behavioral health providers. 12.3 Safety Net Standards 12.3.1 General Requirements A. The behavioral health safety net provider shall ensure all operations, locations, and services, including contracted services and/or personnel, comply with applicable federal and state laws, regulations, and standards.

B. The behavioral health safety net provider shall provide services in conformity with endorsementspecific requirements as found in Chapters 3 through 10 of these rules, for all services delivered by the provider as part of the behavioral health safety net provider’s approval. This must include:

1. Appropriate personnel, including but not limited to authorized practitioners, licensees, peer support professionals, and others, with qualifications, responsibilities and experience that correspond to the size and capacity of the provider.

C. When determining personnel needs, the behavioral health safety net provider must consider how they will comply with the no refusal requirements set forth in part 12.4.3.D for essential behavioral health safety net providers and part 12.5.3.D. For comprehensive community behavioral health providers.

D. T he behavioral health safety net provider shall provide services in alignment with the following competencies of the behavioral health safety net system:

1. Proactively engaging priority populations, with adequate care coordination throughout the care continuum;

2. Incorporating and demonstrating trauma-informed care practices throughout the care experience;

3. Promoting person-centered care and cultural and linguistic competence;

4. Utilizing evidence-based and evidence-informed programming to promote quality services; and 5. Demonstrating competency in de-escalation techniques. 12.3.2 Policies and Procedures A. The behavioral health safety net provider’s policies and procedures must demonstrate how the agency will provide care in alignment with the required competencies of behavioral health safety net providers set forth in part 12.3.1 of this Chapter.

B. The behavioral health safety net provider shall have written policies and procedures that address:

1. The rights of individuals seeking or receiving care a. The policy must ensure that each individual or, when applicable, the individual’s designated representative, has the right to:

(1) Participate in all decisions involving the individual’s care or treatment;

(2) Be informed about whether the agency is participating in teaching programs, and to provide informed consent prior to being included in any clinical trials relating to the individual’s care;

(3) Refuse any drug, test, procedure, service or treatment and to be informed of risks and benefits of this action;

(4) Receive care and treatment, in compliance with state statute, that is free from discrimination on the basis of physical or mental disability, race, ethnicity, socio-economic status, religion, gender expression, gender identity, sexuality, culture, and/or languages spoken; recognizes an individual's dignity, cultural values and religious beliefs; as well as provides for personal privacy to the extent possible during the course of (5) Be informed of, at a minimum, the first names and credentials of the personnel that are providing services to the individual. Full names and qualifications of the service providers must be provided upon request to the individual or the individual’s designated representative or when required by DORA;

(6) G ive informed consent for all treatment and services. Personnel must obtain informed consent for treatment they provide to the individual;

(7) Register grievances with the agency and the BHA and be informed of the procedures for registering these grievances including contact information;

(8) Be free of abuse and neglect;

(9) Be free from the improper application of restraints or seclusion;

(10) Expect that the agency in which the individual is admitted can meet the identified and reasonably anticipated care, treatment, and service needs of the individual;

(11) Receive care from the agency in accordance with the individual’s needs;

(12) Have the confidentiality of their individual records maintained as required by applicable federal and state law;

(13) Receive care in a safe setting;

(14) Be notified if referrals to other providers are to entities in which the agency has a direct or indirect financial benefit, including a benefit that has financial value, but is not a direct monetary payment;

(15) Formulate medical and psychiatric advance directives and have the agency comply with such directives in compliance with applicable state statute.

2. When admitting, discharging, triaging, and denying services to individuals:

a. Essential behavioral health safety net providers must ensure their policies and procedures align with the requirements of parts 12.4.2 and 12.4.3 of this Chapter b. Comprehensive community behavioral health providers must ensure their policies and procedures align with the requirements of parts 12.5.2 and 12.5.3 of this Chapter 3. How an agency will respond in a crisis to promote the safety of individuals, personnel and community members, including when an individual demonstrates physical aggression or agitation.

4. How telehealth services are deployed, how individual preference for in-person services are addressed, and when based on diagnosis or other need, telehealth services are not 5 Safety of personnel and individuals when delivering services in-home and in-community.

6. Personnel training requirements, which must include training in:

a. De-escalation techniques;

b. Culturally and linguistically appropriate service delivery in accordance with the requirements of part 12.3.4 of this Chapter;

c. Trauma-informed care practices and service delivery.

7. P ersonnel background checks a. The agency must obtain, prior to hire or contract of new personnel, unless the personnel is a volunteer whose service does not involve unsupervised direct contact with individuals receiving services, a name-based criminal history record check for each prospective personnel or volunteer.

(1) If the prospective personnel has lived in Colorado for more than three (3) years at the time of application, the agency shall obtain a name-based criminal history report conducted by the Colorado Bureau of Investigation (CBI).

(2) If the prospective personnel has lived in Colorado for three (3) years or less at the time of application, the agency shall obtain a name-based criminal history report for each state in which the prospective personnel has lived during the past three (3) years, conducted by the respective states’ bureaus of investigation or equivalent state-level law enforcement agency, or a national criminal history report conducted by the federal bureau of investigation.

b. The agency shall bear the cost of obtaining a name-based criminal history record check for each prospective personnel.

c. If an agency contracts with a staffing agency for the provision of services, it shall require that the staffing agency meet the requirements of this part 12.3.2.B.7.

d. When determining whether a prospective personnel is eligible for hire if the criminal history record check reveals the person has a conviction or plea of guilty, active deferred judgment, or nolo contendere, the agency shall have a policy that includes:

(1) Written criteria and procedures for evaluating which convictions or complaints make prospective personnel unacceptable for hire, or for existing personnel, unacceptable for retention, including:

(a) Factors to be considered when determining whether a prospective personnel is eligible for hire or contract when their name-based criminal history record check reveals a conviction or plea of guilty, active deferred judgment, or nolo contendere, 1. The nature and seriousness of the offense;

2. The nature of the position and how the offense relates to or may impact the duties of the position; experience in the criminal justice system is not necessarily a disqualifier and, in certain circumstances, an agency may determine that some lived experiences would benefit a particular position;

3. The length of time since the conviction or plea;

4. W hether such conviction is isolated or part of a pattern;

5. Whether there are mitigating or aggravating circumstances involved.

8. Clinical supervision a. The agency must ensure that all personnel providing behavioral health services, with the exception of peer support professionals, receive clinical supervision, as defined in this part 12.3.2.B.8.

b. The agency will develop policies and procedures for supervision that address the (1) Supervisee’s mandatory disclosure statement that clearly states they are under supervision and by whom;

(2) Requirements for regular evaluation of the supervisee’s progress with a rubric that is tied to the responsibilities assigned;

(3) Documentation and frequency of supervisor reviews and feedback provided;

(4) Maximum number of supervisees a supervisor oversees; and (5) How supervision/consultation is covered by personnel with comparable credentials when the usual supervisor is not available.

c. Clinical supervisors must at minimum:

(1) Meet the standard qualifications for clinical supervision as defined by their professional practice board.

(2) Deliver clinical supervision within the supervisor’s professional practice license and ethical standards for:

(a) Those that are licensed or seeking professional licensure; or (b) When supervising personnel that are not seeking or not eligible for professional licensure, such as group living workers, the supervisor must follow standards in the Colorado Mental Health Practice Act, as defined in Article 245 of Title 12, C.R.S.

(3) Dedicate time between the supervisor and supervisee to instruct, model, and encourage self-reflection by the personnel receiving supervision regarding acquisition of clinical and administrative skills. Clinical supervisor will determine skills through observation, evaluation, feedback, and mutual problem-solving.

(4) Address ethics and ethical dilemmas as aligned with the appropriate professional practice board.

(5) Provide professional direction based on experience, expertise, and/or for ethical or safety concerns.

(6) Ensure that safety and crisis management plans are followed and that clinical supervisors are available to personnel for assistance in crisis situations and processing of the crisis event afterwards.

(7) D ocument date, duration, and the content of supervision session for their supervisee(s), which may include a professional development plan. All documents pertaining to clinical supervision must be provided to the supervisee and the BHA upon request.

d. Personnel-specific clinical supervision requirements (1) Licensees and authorized practitioners will be provided with clinical supervision and/or consultation at minimum upon request of the licensee or authorized practitioner or at times of individual emergency.

(2) Candidates will be provided with clinical supervision at a rate that will meet their licensing requirements for the license they are pursuing or at a minimum of one (1) hour every two (2) weeks, whichever provides a higher level of clinical supervision.

(3) All clinical documentation completed by a counselor-in-training and/or intern still in pursuit of their clinical degree must be reviewed and cosigned by a clinical supervisor able to supervise pursuant to their scope of practice.

(4) Personnel not seeking or not eligible for licensure, but that are providing clinical services, will be provided clinical supervision at a frequency that ensures treatment to individuals is appropriate, safe, and in line with assessment treatment needs and the individual’s treatment goals.

9. Critical incident reporting a. A critical incident includes but is not limited to the following:

(1) Breach of confidentiality: any unauthorized disclosure of protected health information as described in HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules, and/or Section 27-65-101 through -131, C.R.S.

(2) Death: including the death of an individual inside of or outside of the agency’s physical location while an individual is receiving services or where an individual has attempted to receive services from the agency within the past thirty (30) calendar days.

(3) Elopement: absconding from a mental health hold, certification, emergency/involuntary commitment, or a secure facility where an individual is being held as a result of a court order. This includes any unauthorized absence of a child, when a child cannot be accounted for or when there is reasonable suspicion to believe the child has absconded.

(4) An y instance when an individual cannot be located following a search of the agency, the agency grounds, and the area surrounding the agency, and:

(a) There are circumstances that place the individual’s health, safety, or welfare at risk; or (b) The individual has been missing for eight (8) hours.

(5) Medication diversion: any medication diversion as defined in part 1.2 of these rules. If the diverted drugs are injectable, the agency shall also report the full name and date of birth of any individual who diverted the injectable drugs, if known.

(6) Medication error: medication error that resulted or could have resulted in harm to the individual.

(7) Medical emergency: any suicide attempt/self-injury, other form of serious injury, health emergency, overdose, or serious illness which occurred on agency premises or in the presence of agency personnel.

(8) Any instance involving physical, sexual, or verbal abuse of an individual, as described in Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3- 402, 18-3-404, 18-3-405, 18-3-405.3, 18-3-405.5, and 18-9-111 (exempting, however, the phrase “intended to harass”), C.R.S. by another individual, personnel, or a visitor to the agency.

(9) Any instance that results in any of the following serious injuries to an (a) Brain or spinal cord injuries;

(b) Life-threatening complications of anesthesia or life-threatening transfusion errors or reactions; or, (c) Second- or third-degree burns involving twenty (20%) percent of more of the body surface area of an adult or more fifteen (15%) percent or more of the body surface area of a child.

(10) Any instance involving caretaker neglect of an individual, as defined in

Section 26-3.1-101(2.3), C.R.S.

(11) Any instance involving misappropriation of an individual’s property, meaning patterns of loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, an individual’s belongings or money without the individual’s consent.

(12) Any occurrence involving the malfunction or intentional or accidental misuse of care equipment that occurs during treatment or diagnosis of an individual and that significantly or adversely affects or, if not averted, would have significantly adversely affected an individual.

b. Critical incidents must be reported to the BHA within one (1) business day after the incident. Critical incidents must also be reported to the BHA within one (1) business day of when the agency determines that a reportable incident has occurred and the BHA requests such reporting.

c. T he BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes and investigation of critical incidents reports in accordance with:

(1) BHA policies and procedures, (2) Regulations that protect the confidentiality and individual rights in accordance with Section 27-65-101 through -131, C.R.S.; HIPAA; as incorporated by reference in part 1.2 of these rules; and, 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules, (3) Controlled substance licensing; Section 27-81-113; Section 27-80-212, C.R.S., and Section 18-18-503, C.R.S.

d. The BHA shall have access to relevant documentation required to determine e. The agency must:

(1) Establish written policies and procedures for reporting and reviewing all critical incidents occurring at the agency;

(2) Submit critical incident reports to the BHA using state prescribed forms available on the BHA website. This is not in lieu of other reporting mandated by state statute or federal guidelines;

(3) Make available a report with the investigation findings for review by the BHA, upon request; and, (4) Maintain critical incident reports for a minimum of three (3) years following the incident.

f. Nothing in this part shall be construed to limit or modify any statutory or common law right, privilege, confidentiality, or immunity. 12.3.3 Care Coordination A. Behavioral health safety net providers shall work with the individual to identify the individual’s service and support needs and preferences and shall carry out care coordination as defined in

part 1.1 of these rules to facilitate access to those services and supports.

B. Care coordination must, to the extent possible, be carried out in accordance with the individual's expressed preferences and with involvement of the individual's family, parent, legal representative, advocate, caregiver, and other supports identified by the individual.

C. Care coordination activities may include, as appropriate for the needs and preferences of the 1. Development of person and family-centered service plans that:

a. Promote integrated whole person care across the spectrum of health services.

b. Address each individual’s priorities, goals, and the barriers they face.

c. Address access to acute and chronic physical and behavioral health care, peer support networks, social services including income supports, health insurance, housing, educational systems, and employment opportunities as necessary to facilitate wellness and recovery of the whole person in alignment with an individual’s assessed needs and expressed goals.

2. F acilitating access to needed resources and services to carry out the service plan. This may include, but is not limited to:

a. Conducting application assistance, referrals, and warm hand-offs to access resources and care;

b. Providing accessible, culturally and linguistically appropriate resources and information, including access to resource directories such as OWNPATH;

c. Coordinating with partners to provide specialized services, risk stratification, discharge planning, transition planning, prior authorization, insurance appeal, and medication reconciliation;

d. Identifying the information, social service, and health care systems that an individual will need to access in order to navigate systems, manage their care, and achieve whole person health; e Equipping the individual with information through means that are accessible and appropriate for the individual based on their needs and preferences and as required by federal and state statute;

f. Collaborating with other systems and entities providing care coordination services to the individual;

(1) If care coordination activities necessary to meet the individual’s needs and fulfill the service plan are being carried out by an alternate entity, the behavioral health safety net provider shall document the responsibilities of each entity within the record and update the record in response to changes in the individual's needs and/or preferences, and the alternate entity’s involvement.

g. Providing outreach, planning, problem-solving, advocacy, education, and selfmanagement support;

3. Deliberate and coordinated planning to prevent disengagement from services, identifying and mitigating risks for individuals, including identifying and implementing prevention strategies to proactively mitigate risk, and connecting individuals to supports to promote ongoing maintenance and prevention.

a. Risks may include, but are not limited to, risk of grave disability, risk of danger to self or others, risk of institutionalization, risk of incarceration, risk of overdose, risk of housing and income instability including loss of benefits, and risk for out of home placement for a youth.

b. Risk assessment must involve the individual and their service providers, be done on an ongoing basis, and be addressed within the service plan.

c. Wh en a risk for disengagement is identified, the service plan must address prevention of and response to an individual disengaging from services including missing appointments.

4. Monitoring an individual’s progress, engagement, and satisfaction with treatment and recovery in alignment with outcomes identified by the individual. 12.3.4 Culturally and Linguistically Appropriate Services A. To ensure the provision of culturally and linguistically appropriate services, the behavioral health safety net provider shall:

1. Ensure all methods and procedures used to assess and evaluate an individual are able to be provided in the preferred language and/or communication method of frequently encountered limited English proficiency (LEP) groups.

2. Develop and maintain general knowledge about the racial, ethnic, and cultural groups in the service area, including each group's diverse cultural health beliefs and practices, preferred languages, health literacy, and other needs in order to inform the provision of culturally and linguistically appropriate services and improve access and quality of services for these groups.

3. Collect and maintain updated information to help understand the composition of the communities in the service area, including the primary spoken languages in order to inform the provision of culturally and linguistically appropriate services and improve access for these communities.

4. Be able to provide oral and written notice to individuals with limited English proficiency in the preferred language and/or communication method of frequently encountered limited English proficiency (LEP) groups of the agency to inform them of their right to receive language assistance services and how to do so. Language assistance services must be free of charge to the individual, be accurate and timely, and protect the privacy and independence of the individual receiving services.

5. Provide documents or messages vital to an individual’s ability to access services (for example, registration forms, sliding scale fee discount schedule, after-hours coverage, signage) in languages common in the community served, taking account of literacy and developmental levels and the need for alternative formats. Such materials shall be provided at intake.

6. Provide interpretation and translation services in a manner that meets the needs of the a. In order to ensure complete, accurate, impartial, and confidential communication, family, friends, or other individuals shall not be required, suggested, or used as interpreters. An individual shall not be required to provide their own interpreter.

Behavioral health safety net providers shall not rely on an adult accompanying an individual with limited English proficiency (LEP) to interpret or choose to facilitate communication except:

(1) In an em ergency involving an imminent threat to the safety or welfare of an individual or the public, where there is no qualified interpreter for the individual with limited English proficiency immediately available.

(2) Where the individual with limited English proficiency specifically requests that the accompanying adult interpret or facilitate communication, the accompanying adult agrees to provide such assistance, and reliance on that adult for such assistance is appropriate under the circumstances.

(a) Personnel should suggest that a trained interpreter be present in these instances to ensure accurate interpretation and should document the offer and declination in the individual’s record.

(3) Minor children must not be used as interpreters, nor be allowed to interpret for their parents when the minor is the individual receiving services, unless there is an emergency involving an imminent threat to the safety or welfare of an individual or the public when no other interpreter is available.

b. To the extent interpreters are used, and an interpreter is not provided by the individual, the interpreters must be trained to function in a medical and/or behavioral health setting, adhere to accepted interpreter ethics principles, including individual confidentiality and be able to interpret effectively, accurately, and impartially.

7. P rovide auxiliary aids and services needed for effective communication, that are Americans with Disabilities Act (ADA) compliant and responsive to the needs of individuals with disabilities (e.g., sign language interpreters, videophones).

8. Implement strategies to recruit, support, and promote personnel that is representative of the demographic characteristics, including primary spoken languages of the communities in the agency’s service area.

9. Behavioral health safety net providers are responsible for training personnel on interpretation and translation services available to facilitate services. This includes training personnel on the procedures to access and use such services. 12.4 Essential Behavioral Health Safety Net Providers 12.4.1 Requirements A. Essential behavioral health safety net providers shall provide at least one of the following 1. Emergency and/or crisis behavioral health services;

2. Behavioral health outpatient services;

3. Behavioral health high-intensity outpatient services;

4. Behavioral health residential services;

5. Withdrawal management services;

6. Behavioral health inpatient services;

7. Integrated care services;

8. Hospital alternatives; and/or 9. Additional services that the BHA determines are necessary in a region or throughout the state.

B. For services which a BHA endorsement exists in Chapters 3 through 10 of these rules, services shall be provided in conformity with the rules of the endorsement.

C. When providing services to children and families, essential behavioral health safety net providers shall provide services to children and families in conformity with the standards set forth in Chapter 8 of these rules.

D. T he essential behavioral health safety net provider shall provide clinical services during times that ensure accessibility and meet the needs of the individual population to be served, including evening and/or weekend hours.

1. These extended hours may include services provided via telehealth, if appropriate.

E. Essential behavioral health safety net providers offering outpatient behavioral health services must have in-person service offerings in addition to any telehealth services the agency may elect to provide. 12.4.2 Priority Populations A. Essential behavioral health safety net providers must serve all priority populations as defined in

Section 27-50-101(17), C.R.S., unless:

1. The agency’s approval limits the agency’s scope and responsibility to a specific subset of priority population(s); and 2. The provisions in the agency’s contract with the BHA or its designee limit the agency’s scope and responsibility to a specific subset of priority populations.

B. When an essential behavioral health safety net provider is approved to serve a subset of priority populations, the agency shall ensure that corresponding admission and exclusion criteria are:

1. Outlined in the agency’s policy developed pursuant to part 12.3.2.B.2 of this Chapter;

2. Approved by the BHA or its designee;

3. Publicly available on the provider's website; and 4. Applied uniformly.

C. The essential behavioral health safety net provider shall have personnel with scope of practice and training to meet the needs of priority populations within the scope of the services and priority populations that the essential behavioral health safety net provider is approved to provide. 12.4.3 Screening, Triage, and Care Coordination in Alignment with No Refusal Requirements A. When an individual attempts to initiate treatment with an essential behavioral health safety net provider, the essential behavioral health safety net provider shall complete an initial screening and triage process to identify the needs of the individual, and to determine the urgency and appropriateness of care with the essential behavioral health safety net provider.

B. S creenings must collect at least the following information from an individual seeking services:

1. Identifying information;

2. Primary complaint/reason for seeking services;

3. Current behavioral health symptoms, including severity, duration, mental status, and 4. Medical concerns/chronic health issues, including pregnancy and postpartum status; and, 5. Evaluation of imminent risk, including:

a. Suicide risk;

b. Danger to self or others;

c. Urgent or critical medical conditions, including withdrawal or overdose risk; or d. Other immediate risks, including threats from another person.

6. Preliminary determination of level of care needed;

7. Health-related social needs and associated risk factors related to social determinants of health, including but not limited to:

a. Food security;

b. Housing stability and security;

c. Personal safety;

d. Access to health services including preventative health care;

e. Physical health concerns for which the individual is not receiving adequate 8. Whether an individual is part of an identified priority population and which one.

C. The essential behavioral health safety net provider shall use these standard criteria for determining whether an agency’s clinical scope of practice or treatment capacity are appropriate to meet the needs of the individual, or if the agency will instead provide care coordination to support the individual in accessing alternate services. These criteria are:

1. The individual’s presenting problem or behavioral health diagnosis is outside the scope of practice of the agency and its personnel, including the age range with which the agency works, or the modalities and interventions in which personnel are trained in.

2. The agency is approved pursuant to part 12.4.2 of this Chapter to serve a subset of priority populations, and the individual does not fall within the priority population(s).

3. The individual presents with the need for a level of care the agency does not provide.

4. The agency cannot provide services within an appropriate time frame per the individual’s needs and the agency’s capacity.

D. In ac cordance with Section 27-50-301(4), C.R.S., unless it is determined, pursuant to the criteria in part 12.4.3.c of this Chapter, that an individual’s needs fall outside the scope and capacity of the essential behavioral health safety net provider, the essential behavioral health safety net provider shall not refuse to treat an individual based on the individual's:

1. Insurance coverage, lack of insurance coverage, or ability to pay;

2. Clinical acuity level related to the individual's behavioral health condition or conditions, including whether the individual has been certified for short-term treatment or long-term care and treatment pursuant to Article 65 of Title 27, C.R.S.;

3. Readiness to transition out of the Colorado Mental Health Hospital at Pueblo, the Colorado Mental Health Hospital at Fort Logan, or any other mental health institute or licensed facility providing inpatient psychiatric services or acute care hospital providing stabilization because the individual no longer requires inpatient care and treatment;

4. Involvement in the criminal or juvenile justice system;

5. Current involvement in the child welfare system;

6. Co-occurring mental health and substance use disorders, physical disability, or intellectual or developmental disability, irrespective of primary diagnosis, co-occurring conditions, or if an individual requires assistance with activities of daily living or instrumental activities of daily living, as defined in Section 12-270-104(6), C.R.S.;

a. E ssential behavioral health safety net providers shall not deny services to individuals who exhibit inappropriate sexual behaviors.

7. Displays of aggressive behavior, or history of aggressive behavior, as a symptom of a diagnosed mental health disorder or substance use disorder;

8. Clinical presentation or behavioral presentation in any previous interaction with a provider;

9. Place of residence; or 10. Disability, age, race, creed, color, sex, sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or tribal affiliation.

E. If the individual’s needs exceed the treatment capacity or clinical scope of practice needed to serve the individual, the essential behavioral health safety net provider shall provide a warm handoff to a provider or entity able to provide care for the individual that is within its scope of service, which may include the BHA or its designee.

1. Essential behavioral health safety net providers must also provide warm handoffs for individuals who have health-related social needs that require alternative services outside the scope of the behavioral health safety net system, such as services for housing, food insecurity, and transportation. The essential behavioral health safety net provider shall connect the individual to appropriate resources to initiate those services.

2. When referring an individual to an alternative provider, entity, or service, geographic location and the individual’s ability to access the service location shall be considered.

F. T he essential behavioral health safety net provider shall track the following information for all priority population individuals who were referred to alternative services pursuant to this part. This information must be maintained in a single report that must be made available upon request by the BHA or its designee. This report shall include:

1. Individual demographics, including to which priority population the individual belongs;

2. Standardized descriptions of the needs of the individual that could not be met and require the individual to be referred to another provider;

3. The outcome and timeliness of the referral, i.e., the date of the referral and response from the receiving agency; and 4. Whether the individual was discharged from a higher level of care to a lower level of care and, if so, what level of care the referring provider was seeking to discharge the individual from.

G. These processes must apply at the time of initial screening, and any time reassessment indicates the individual’s needs have changed and fall outside of the scope of the agency.

1. When an essential behavioral health safety net provider initiates a transition in care for an individual or family under the care of the agency, whether the transition is to an alternate agency or an alternate level of care within the agency, the essential behavioral health safety net provider must notify the individual or family via a live conversation and then ensure that appropriate steps are taken to transition the individual or family.

2. R equirements to not refuse care based on these criteria apply to essential behavioral health safety net providers as a whole. Refusal does not include transferring an individual to an alternative level of care within an essential behavioral health safety net provider or identifying new personnel to support the individual. 12.4.4 Governance A. Overall responsibility for the administration of an essential behavioral health safety net provider shall be vested in a director who is a physician or a member of one of the licensed mental health professions unless the essential behavioral health safety net provider is only providing recovery support services. If the director is not a licensed physician or licensed mental health professional, the essential behavioral health safety net provider shall employ or contract with at least one (1) authorized practitioner or licensee to advise the director on clinical decisions.

B. Each essential behavioral health safety net provider from which services may be purchased shall:

1. Be under the control and direction of a county or local board of health, a board of directors or board of trustees of a corporation, a for-profit or not-for-profit organization, a regional mental health board, tribal organization, or a political subdivision of the state;

2. Enter into a contract developed pursuant to Section 27-50-203, C.R.S. and accept publicly funded individuals. 12.5 Comprehensive Community Behavioral Health Providers 12.5.1 Requirements A. Comprehensive community behavioral health providers shall, either directly or through formal agreement with behavioral health providers in the community or region, ensure the provision of all of the following services:

1. E mergency and Crisis Behavioral Health Services in conformity with Chapter 6 of these rules;

2. Mental Health and Substance Use Outpatient Services in conformity with Chapter 4 of 3. Behavioral Health High-Intensity Outpatient Services in conformity with Chapter 4 of 4. Care Management pursuant to part 12.5.7 of this Chapter;

5. Outreach, Education, and Engagement Services pursuant to part 12.5.8 of this Chapter;

6. Mental Health and Substance Use Recovery Supports in conformity with Chapter 3 of 7. Outpatient Competency Restoration pursuant to part 12.5.9 of this Chapter.

8. Screening, assessment, and diagnosis, including risk assessment, crisis planning, and monitoring to key health indicators, in accordance with endorsement specific requirements and part 12.5.3 of this Chapter.

B. When providing these services directly, the comprehensive community behavioral health provider shall provide the services in conformity with endorsement specific requirements for the services, found in Chapters 3 through 10 of these rules.

C. When providing these services through formal agreement with another agency, the comprehensive provider shall ensure that the agency providing the services holds the appropriate license(s) and accompanying endorsements in good standing for those services, unless the agency is otherwise exempt from licensure requirements.

D. Comprehensive community behavioral health providers shall provide services to children and families in conformity with the requirements of Chapter eight (8) of these rules.

E. In addition to the requirements set forth in the endorsement Chapters three (3) through ten (10), comprehensive community behavioral health providers shall comply with the following 1. Outpatient requirements a. The comprehensive community behavioral health provider’s requirement to provide outpatient services does not include the requirement to provide minor in possession (MIP) services.

b. The comprehensive community behavioral health provider shall provide outpatient clinical services during times that ensure accessibility and meet the needs of the individual population to be served, including evening and/or weekend hours.

c. As necessary and appropriate for the needs of individuals, comprehensive community behavioral health providers shall provide services in the home and community and shall utilize telehealth methods to deliver care.

d. If an individual presents with an emergency or crisis need, appropriate action is taken immediately, and subsequent outpatient follow-up is promptly coordinated and delivered.

e. If an individual currently receiving services from a comprehensive community behavioral health provider presents with an urgent need, clinical services, including medication management, are provided within one (1) business day of the time the request is made.

f. Comprehensive community behavioral health providers must be designated to provide services to individuals on involuntary outpatient certifications pursuant to

part 11.18 of these rules.

2. Crisis/emergency a. The comprehensive community behavioral health provider shall provide crisis management services that are available and accessible twenty-four (24) hours a day. These services may include:

(1) Walk-in crisis services; or (2) Mobile crisis services. 12.5.2 Priority Populations A. The comprehensive community behavioral health provider shall:

1. Serve all priority populations; and 2. Have personnel with appropriate training and scope of practice to serve all priority populations. 12.5.3 Screening, Triage, and Care Coordination in Alignment with No Refusal Requirements A. When an individual attempts to initiate treatment with a comprehensive community behavioral health provider, the comprehensive community behavioral health provider shall complete an initial screening and triage process to determine urgency and appropriateness of care with the comprehensive community behavioral health provider and the service needs of the individual.

B. Screenings must collect at least the following information from an individual seeking services:

1. Identifying information;

2. Primary complaint/reason for seeking services;

3. Current behavioral health symptoms, including severity, duration, mental status, and 4. Medical concerns/chronic health issues, including pregnancy and postpartum status; and, 5. Evaluation of imminent risk, including:

a. Suicide risk;

b. Danger to self or others;

c. Urgent or critical medical conditions, including withdrawal or overdose risk; or d. Other immediate risks, including threats from another person.

6. Health-related social needs and risk factors related to social determinants of health, including but not limited to:

a. Food security;

b. H ousing stability and security;

c. Personal safety;

d. Access to health services including preventative health care; or e. Physical health concerns for which the individual is not receiving adequate C. The comprehensive community behavioral health provider shall use these standard criteria for determining whether a comprehensive community behavioral health provider clinical scope of practice or treatment capacity are appropriate to meet the needs of the individual, or if the comprehensive community behavioral health provider will instead provide care coordination to support the individual in accessing alternate services in the following circumstances:

1. The individual presents with the need for a level of care the comprehensive community behavioral health provider does not provide.

2. The comprehensive community behavioral health provider cannot provide services within an appropriate time frame per the individual’s needs and the agency’s capacity.

D. In accordance with Section 27-50-301(4), C.R.S., unless it is determined, pursuant to the criteria in part 12.5.3.C of this Chapter, that an individual’s needs fall outside the scope and capacity of the comprehensive community behavioral health provider, the comprehensive community behavioral health provider shall not refuse to treat an individual based on the individual's:

1. Insurance coverage, lack of insurance coverage, or ability to pay;

2. Clinical acuity level related to the individual's behavioral health condition or conditions, including whether the individual has been certified for short-term treatment or long-term care and treatment pursuant to Article 65 of Title 27, C.R.S.;

3. Readiness to transition out of the Colorado Mental Health Hospital at Pueblo, the Colorado Mental Health Hospital at Fort Logan, or any other mental health institute or licensed facility providing inpatient psychiatric services or acute care hospital providing stabilization because the individual no longer requires inpatient care and treatment;

4. Involvement in the criminal or juvenile justice system;

5. Current involvement in the child welfare system;

6. Co-oc curring mental health and substance use disorders, physical disability, or intellectual or developmental disability, irrespective of primary diagnosis, co-occurring conditions, or if an individual requires assistance with activities of daily living or instrumental activities of daily living, as defined in Section 12-270-104(6), C.R.S.;

a. Comprehensive community behavioral health providers shall not deny services to individuals who exhibit inappropriate sexual behaviors.

7. Displays of aggressive behavior, or history of aggressive behavior, as a symptom of a diagnosed mental health disorder or substance use disorder;

8. Clinical presentation or behavioral presentation in any previous interaction with a provider;

9. Place of residence; or 10. Disability, age, race, creed, color, sex, sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or tribal affiliation.

E. If the individual's needs exceed the treatment capacity or clinical scope of practice of a comprehensive community behavioral health provider, based on the standard criteria in part 12.5.3.c of this Chapter, the comprehensive community behavioral health provider must ensure that the individual has access to interim behavioral health services until the individual is connected to the most appropriate agency for ongoing care. This may include use of providers within the network of the BHA or its designee, or the regional managed care entity.

F. T he comprehensive community behavioral health provider shall obtain approval from the BHA or its designee under which the agency is operating, or the regional managed care entity for Medicaid individuals, prior to referring a priority population individual to alternative behavioral health treatment services.

1. Only an individual assessed to be experiencing a behavioral health crisis may be referred to external emergency or crisis services without prior approval from the BHA or its designee.

a. If an individual is referred to an external provider for crisis or emergency behavioral health services, the agency shall work with the receiving provider to coordinate follow-up care for the individual upon discharge.

G. If a referral of a priority population individual is approved by the BHA or its designee, the comprehensive behavioral health provider must provide a warm hand off by assisting the client in identifying a new provider, which may involve using the state’s care coordination and navigation infrastructure.

H. For individuals who have health-related social needs that require alternative services outside the scope of the safety net system, such as services for housing, food insecurity, and transportation, the comprehensive community behavioral health provider will connect the individual to appropriate resources to initiate those services. Approval by the BHA or its designee is not required in this instance.

I. The comprehensive community behavioral health provider shall track the following information for all priority population individuals who were referred to external behavioral health services pursuant to this part 12.5.3 of this Chapter. This information must be maintained in a single report that must be made available upon request by the BHA or it’s designee. This report shall include:

1. I ndividual demographics, including to which priority population the individual belongs;

2. Standardized descriptions of the needs of the individual that could not be met and require the individual to be referred to another provider;

3. The outcome and timeliness of referral, i.e., the date of the referral and response from the receiving agency; and 4. Whether the individual was discharged from a higher level of care to a lower level of care and, if so, what level of care the referring provider was seeking to discharge the individual from.

J. These processes must apply at the time of initial screening, and any time reassessment indicates the individual’s needs have changed and fall outside of the scope of the agency.

1. When an agency initiates a transition in care for an individual or family under the care of the agency, whether the transition is to an alternate agency or an alternate level of care within the agency, the agency must notify the individual or family face to face, on a telephone call, or two-way video conference and then ensure that appropriate steps are taken to transition the individual or family.

2. Requirements to not refuse care based on these criteria apply to the comprehensive community behavioral health provider as a whole. Refusal does not include transferring an individual to an alternative level of care within the comprehensive community behavioral health provider or assigning new personnel to support the individual.

12.5.4 A ccess Plan A. Comprehensive community behavioral health providers shall establish an access plan as part of their quality management program.

B. Access plans must be designed to improve treatment access and/or outcomes for one (1) or more priority populations through an evidenced-based approach.

C. Comprehensive community behavioral health providers shall implement strategies from the access plan to decrease the disparities in access and outcomes for priority populations.

D. Development, implementation, and evaluation of the access plan must include the collection and/or analysis of available data related to populations and areas served by the agency to evaluate outcomes for priority populations. Goals and outcome measures should be identified in conjunction with individuals, families, and advocates who represent the identified priority populations. These outcome measures may include but are not limited to:

1. Individual or family-reported measures such as satisfaction, achievement of goals, ability to thrive, or quality of life;

2. System-reported outcomes such as access and engagement in care, preventable hospitalizations and/or hospital readmission, rate of follow-up with individuals and families, level of individual or family engagement, number of substantiated complaints or appeals, and timeliness of transitions to appropriate levels of care; or 3. Utilization measures such as number of individuals or families served, characteristics of individuals who do not engage in services, number of screenings completed, or number of referrals provided. 12.5.5 Governance A. Each comprehensive community behavioral health provider shall:

1. Be under the control and direction of a county or local board of health, a board of directors or board of trustees of a corporation, a for-profit or not-for-profit organization, a regional mental health board, tribal organization, or a political subdivision of the state;

2. Enter into a contract developed pursuant to Section 27-50-203, C.R.S. and accept publicly funded individuals.

B. Treatment programs of the comprehensive community behavioral health provider must be vested in a director who is a physician or a member of one of the licensed mental health professions.

The director is not required to provide oversight or direction for recovery services. If the director is not an authorized practitioner or licensee, the agency shall contract with at least one (1) authorized practitioner or licensee to advise the director on clinical decisions.

C. The governing board of the comprehensive community behavioral health provider must either:

1. Be composed of at least 51% voting members that have lived experience with accessing services for mental health and/or substance use disorders, which may include parents of children with mental health and/or substance use disorders who have supported their children in accessing services for mental health and/or substance use disorders; or 2. I nclude at least two (2) voting members that have lived experience with accessing services for mental health and/or substance use disorders, which may include parents of children with mental health and/or substance use disorders who have supported their children in accessing services for mental health and/or substance use disorders.

a. In addition, the governing body shall demonstrate how it collects, considers, and implements input and feedback from individuals and families currently receiving services in governing body decisions. 12.5.6 Fee Schedule for Services Provided A. The comprehensive community behavioral health provider shall waive charges or charge for services on a sliding scale based on income and require that the agency not restrict access or services because of an individual's financial limitations.

B. The comprehensive community behavioral health provider must ensure no individuals are denied behavioral health care services, including but not limited to crisis management services, because of an individual’s inability to pay for such service.

1. Any fees or payments required by the comprehensive community behavioral health providers for such services must be reduced or waived to enable the comprehensive community behavioral health providers if necessary to fulfill this requirement.

C. The comprehensive community behavioral health provider shall have a published sliding fee discount schedule(s) that includes all services the comprehensive community behavioral health provider proposes to offer pursuant to these criteria. Such fee schedule must be included on the comprehensive community behavioral health provider’s website, posted in the comprehensive community behavioral health provider’s waiting room, and readily accessible to individuals and families. The sliding fee discount schedule must be communicated in languages/formats and/or communication methods of frequently encountered limited English proficiency (LEP) groups of the comprehensive community behavioral health provider.

D. T he fee schedules, to the extent relevant, conform to federal and state statutory or administrative requirements that may be applicable to existing agencies; absent applicable state or federal requirements, the schedule is based on locally prevailing rates or charges and includes reasonable costs of operation.

E. The comprehensive community behavioral health provider has written policies and procedures describing eligibility for and implementation of the sliding fee discount schedule. Those policies are applied equally to all individuals seeking services. 12.5.7 Care Management A. In addition to the requirements of part 12.3.3, comprehensive community behavioral health providers shall be equipped to provide outreach-focused high intensity supports to individuals who may have complex needs, be involved in multiple systems, and/or require additional support to achieve whole person health.

B. Care management may include, as necessary to address the assessed needs of an individual, and in alignment with the expressed preferences of the individual:

1. Convening persons involved in the individual’s services, including health care and community-based service providers, family members and other persons identified by the individual, to work collaboratively with the individual for the purpose of service planning and coordination, in order to facilitate wellness, self-management, and recovery of the whole person.

a. This must occur when the individual is assessed to be at rising risk of adverse outcomes, or when the individual experiences a significant change in status, which may include a behavioral health crisis, change in health or housing status, etc.

b. This may include team meetings or other structured discussions.

2. Facilitating access to necessary services and supports identified within the individual’s service plan created pursuant to part 12.3.3 of this Chapter through supports including a. Application assistance;

b. Community-based outreach to the individual;

c. Self-management support including educating the individual about their behavioral health conditions and daily living skills including but not limited to medication use, personal hygiene, transportation use, shopping, and budgeting;

d. Accompanying the individual within the community or other setting to access services which the individual may not be able to access independently.

3. Supporting an individual to develop psychiatric advance directives, with the support of appropriate medical and behavioral health professionals, so the individual's preferences for behavioral health treatment and recovery supports are known in the event of a behavioral health crisis.

4. Providing support and outreach during care transitions.

a. T he agency shall have policies and procedures in place supporting discharge planning and transitions between levels of care, including individuals who have presented to or have been treated at an emergency department (ED) or hospital for behavioral health needs.

b. The comprehensive community behavioral health provider shall be proactive in identifying impending care transitions and shall implement these procedures any time that the comprehensive community behavioral health provider is made aware that a care transition is occurring.

c. Policies and procedures must address how the comprehensive community behavioral health provider will provide services to individuals and families to support successful care transitions, ensure continuity of services, and minimize the time between discharge and follow-up. These services may include:

(1) Peer support;

(2) Medication management including completing medication reconciliation and educating individuals, families or persons the individual identifies as their caretaker, about changes to the individual’s medications or service plan;

(3) Individual education to support self-management, including education regarding warning signs for increasing support needs; and (4) Outreach to promote engagement in follow-up care.

d. Whenever possible, the comprehensive community behavioral health provider shall work with the discharging facility ahead of discharge to facilitate a seamless transition, in accordance with care coordination requirements in 12.3.3 in this e. The comprehensive community behavioral health provider shall make and document reasonable attempts to contact individuals who are discharged from a facility within 24 hours of discharge. This may include community-based outreach as applicable to the needs of the individual.

f. Policies and procedures must address transfer of medical records for services received as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through -131, C.R.S.

C. Documentation 1. Care management provided to an individual pursuant to this part 12.5.7 must be 2. The service plan must identify person-centered goals related to mitigating risks and managing assessed needs. The service plan must identify relevant outcome measures and timeframes for assessing progress towards goals.

a. The comprehensive community behavioral health provider must document goal progress within the individual’s record.

D. Personnel and training 1. C omprehensive community behavioral health providers shall have written policies and procedures outlining the initial and ongoing training for personnel delivering the services outlined in this part 12.5.7.

a. Training must include training specific to the particular needs of the populations served by the personnel, including the provision of person-centered, traumainformed, harm reduction-focused, physically and programmatically accessible, and culturally and linguistically appropriate services.

b. The training requirements of personnel may vary based on the populations served by that personnel.

c. The written policies and procedures must identify the frequency of ongoing training.

2. Comprehensive community behavioral health providers shall clearly document trainings in the personnel file and ensure that personnel provide services only to populations for which they are properly trained.

3. Personnel providing care coordination must have clearly defined scopes of work that do not exceed their level of training and scope of practice. 12.5.8 Outreach, Education, and Engagement Services A. General service provisions 1. Comprehensive community behavioral health providers must complete an assessment of the community behavioral health treatment needs of the population they serve.

2. If the agency is completing, or has completed, a community behavioral health assessment for another government entity or project, or through a third-party, those assessments may be used for the purpose of this part 12.5.8.A.1.

3. Assessments of community behavioral health treatment needs of applicable service and populations in need by the BHA or a designee of the BHA may be used for the purpose of this part 12.5.8.A.1.

a. If using previously completed assessment(s) for the purpose of this part 12.5.8.A.1, community behavioral health needs assessment must not be older than three (3) years.

B. The community behavioral health treatment needs assessment must include, but is not limited to, 1. Feedback from community stakeholders that address social determinants of health;

2. Define the community the agency serves by gathering information including, but not limited to, demographics of the community, data on access to care, client grievances and complaints, social determinants of health, and priority population data; and 3. Assess unmet needs in behavioral health treatment levels of care in the community.

C. C omprehensive community behavioral health providers must re-assess at least once every three (3) years to adapt to the changing needs of the community they serve.

D. Comprehensive community behavioral health providers must develop a strategic plan to provide outreach, education, and engagement services. The strategic plan shall include the following:

1. Identified priority population(s) and/or treatment needs, 2. Plans for outreach, education, and engagement services in the community to meet the priority population demographic. Plans must include:

a. How outreach, education, and engagement services will support efforts toward screening, early intervention, and treatment.

b. Off-site events and intentional engagement with priority populations, that may involve but is not limited to:

(1) Broad community involvement;

(2) Community partners that address social determinants of health in serving priority populations in assessed area;

(3) Local law enforcement;

(4) Local public health departments; and.

(5) Cultural centers/organizations.

c. How planned outreach, education, and engagement services can improve behavioral health outcomes.

d. How data will be gathered and analyzed to measure outreach, education, and engagement service outcomes as permitted by HIPAA, as incorporated by reference in part 1.2 of these rules; 42 C.F.R. Part 2, as incorporated by reference in part 1.2 of these rules; and Section 27-65-101 through -131, C.R.S.

E. Comprehensive community behavioral health providers must engage in outreach, education, and engagement services according to the strategic plan developed pursuant to part 12.5.8.D of this

section.

F. Comprehensive community behavioral health providers must gather, analyze, and interpret data received from efforts to measure outreach, education, and engagement service efforts into an outcome report as permitted by HIPAA, 42 C.F.R. Part 2; and Section 27-65-101, et. Seq.

G. At the time of license renewal, or at any other additional time requested by the BHA, comprehensive community behavioral health providers must submit the outcomes report and an updated strategic plan for the following licensure year including a summary of outreach, education, and engagement efforts of the previous year and developed goals created from those efforts. 12.5.9 Outpatient Competency Restoration Services A. A pplication process 1. Comprehensive community behavioral health providers must complete the application process with outpatient competency restoration services program within the Office of Civil and Forensic Mental Health (OCFMH) and appear on the OCFMH approved outpatient competency restoration list prior to BHA approval.

B. Qualification and training 1. Comprehensive community behavioral health providers must ensure that all personnel providing restoration services meet all qualifications as an approved provider of outpatient competency restoration services within OCFMH.

2. Comprehensive community behavioral health providers must meet all training requirements set forth in any contracts between them and OCFMH to provide outpatient competency restoration services and must ensure all personnel providing restoration services attend any additional trainings as required by OCFMH, via contract, and the BHA.

C. Standards for conducting services 1. Comprehensive community behavioral health providers must provide competency restoration services in an outpatient setting to adult and juvenile individuals that are involved with the criminal justice system and deemed by the court to be incompetent to proceed.

2. An agency must provide care coordination and collaborate with community and state partners when referrals are needed to assist in removing barriers to successful restoration to competency.

3. An agency must provide written notice within a minimum of thirty (30) calendar days in advance to individuals, OCFMH, and the BHA of intention to no longer provide outpatient competency restoration services. Responsibility for continuity of care must remain with the agency currently serving the individual until the transfer is complete.

4. If an agency provider is removed from the approved provider list held by the outpatient competency restoration services program within OCFMH, the BHA may take action to suspend and/or revoke the safety net approval pursuant to part 12.7 of this Chapter. 12.6 Procedures for Approval and BHA Oversight 12.6.1 Initial Approval A. Applicants seeking approval as a behavioral health safety net provider will be approved in accordance with the requirements set forth in this section.

B. The applicant shall initially notify the BHA of their intent to seek approval by submitting a letter of intent. The letter of intent must indicate the provider’s intent to seek approval as an essential behavioral health safety net provider and/or comprehensive community behavioral health provider as well as the services the provider intends to provide.

C. The applicant shall provide the BHA with a complete application including all information and attachments specified in the application form available to access on the BHA’s website and any additional information requested by the BHA.

1. An a pplication may be considered abandoned if the applicant fails to complete the application within twelve (12) months and fails to respond to the BHA. The BHA may administratively close the application process.

2. After an administrative closure, the applicant may file a new application.

D. With the submission of an application for approval as a behavioral health safety net provider, or within ten (10) days after a change in ownership or management of a behavioral health safety net provider, each owner and manager shall submit a complete set of the owner's and manager's fingerprints to the Colorado Bureau of Investigation (CBI) for the purpose of conducting a fingerprint-based criminal history record check. The CBI shall forward the fingerprints to the Federal Bureau of Investigation (FBI) for the purpose of conducting fingerprint-based criminal

history record checks. Each owner and each manager shall pay the CBI the costs associated with the fingerprint-based criminal history record check. Upon completion of the criminal history record check, the CBI shall forward the results to the BHA. The BHA may acquire a name-based criminal

history record check for an applicant who has twice submitted to a fingerprint-based criminal

history record check and whose fingerprints are unclassifiable.

1. An e ntity that holds a current license to operate from the BHA or CDPHE, and/or is currently recognized as a federally qualified health center are exempt from this E. The applicant shall provide the following information:

1. Evidence of current licensure in good standing by the Department of Public Health and Environment, Department of Regulatory Agencies, Department of Human Services, or other state agency where applicable, unless otherwise exempt from licensing per applicable state or federal rule or statute.

a. For applicants, including but not limited to federally qualified health centers, that are exempt from licensure but require federal recognition, the applicant shall provide documentation to demonstrate current recognition.

b. Applicants with an existing license from the BHA shall indicate their licensure status within the application. Evidence of licensure by the BHA does not need to be provided by the applicant for approval.

2. The legal name of the applicant and all other names used by it to provide services. The applicant has a continuing duty to submit notification to the BHA for all name changes at least thirty (30) calendar days prior to the effective date of the change.

3. Contact information for the applicant must include a mailing address, telephone number, and e-mail address. If applicable, the applicant’s website and facsimile number are to be 4. The identity, address, and telephone number of all persons and business entities with a controlling interest in the applicant, including but not limited to:

a. A non-profit corporation shall list the governing body and officers.

b. A for-profit corporation shall list the names of the officers and stockholders who directly or indirectly own or control five (5) percent or more of the shares of the corporation.

c. A s ole proprietor shall include proof of lawful presence in the United States.

d. A partnership shall list the names of all partners.

e. The chief executive officer of the facility or agency.

f. If the addresses and telephone numbers provided above are the same as the contact information for the applicant itself, the applicant shall also provide an alternate address and telephone number for at least one individual for use in the event of an emergency or closure.

5. Proof of professional liability insurance. Behavioral health safety net providers must maintain such coverage for the duration of the approval term and must notify the BHA of any change in the amount, type, or provider of professional liability insurance coverage during the license term.

6. Articles of incorporation, Articles of organization, partnership agreement, or other organizing documents required by the secretary of state to conduct business in Colorado; and by-laws or equivalent documents that govern the rights, duties, and capital contributions of the business entity.

7. The address(es) of the physical location where services are delivered, as well as, if different, where records are stored for BHA review.

8. A copy of any management agreement pertaining to operation of the entity that sets forth the financial and administrative responsibilities of each party.

9. If an applicant leases one (1) or more building(s) to operate under the approval, a copy of the lease or leases must be filed with the license application and show clearly in its context which party to the agreement is to be held responsible for the physical condition of the property.

10. A statement, on the applicant’s letterhead, if available, signed and dated, submitted with the application stating whether any of the actions listed in this part 12.6.1.E.10 of these rules have occurred, regardless of whether the action has been stayed in a judicial appeal or otherwise settled between the parties. The actions are to be reported if they occurred within ten (10) years preceding the date of the application for initial approval.

The BHA may, based upon information received in the statement, request additional information from the applicant beyond the ten-year (10) time frame.

a. For initial approval as a behavioral health safety net provider, whether one (1) or more individuals or entities identified in the response to part 12.6.1.E.4 has a controlling or ownership interest in the business entity and has been the subject or party to any of the following:

(1) A civil judgment or criminal conviction resulting from conduct or an offense in the operation, management, or ownership of an agency or other entity related to substandard care or health care fraud. A guilty verdict, a plea of guilty, or a plea of nolo contendere (no contest) accepted by the court is considered a conviction.

(2) A d isciplinary action imposed by a governmental entity in another state that registers or licenses agencies including but not limited to: a sanction, probation, civil penalty, or a denial, suspension, revocation, or modification of a license or registration.

(3) Limitation, denial, revocation, or suspension by any federal, state, or local authorities of any health care related license.

(4) The refusal to grant or renew a license for operation of an agency, or contract for participation or certification for Medicaid, Medicare, or other public health or social services payment program.

b. For a change of ownership of an agency, whether any of the new owners have been the subject of, or a party to, one (1) of more of the following events:

(1) A civil judgment or a criminal conviction in a case brought by the federal, state, or local authorities that resulted from the operation, management, or ownership of an agency or other entity related to substandard care or health care fraud.

(2) Limitation, denial, revocation, or suspension of a state license or federal certification by another jurisdiction.

11. Any statement regarding the information requested in part 12.6.1.E.10 of this Chapter must include the following, as applicable:

a. If the event is an action by a governmental agency, as described in part 12.6.1.E.10.b: the name of the agency, its jurisdiction, the case name, and the docket proceeding or case number by which the event is designated, and a copy of the consent decree, order, or decision.

b. If the event is a felony conviction or misdemeanor involving moral turpitude: the court, its jurisdiction, the case name, the case number, a description of the matter or a copy of the indictment or charges, and any plea or verdict entered by the court. For the purposes of this rule, “ crimes of moral turpitude” include the following felony, misdemeanor, or municipal offenses or equivalent out-of-state or federal offenses:

(1) Any of the offenses against the person set forth in Article 3 of Title 18 of are not limited to, any assault, menacing, or unlawful sexual behavior;

(2) Any of the offenses against property set forth in Article 4 of Title 18 of the not limited to, any arson, theft, trespass, or criminal mischief;

(3) Any of the offenses involving fraud set forth in Article 5 of Title 18 of the Colorado Revised Statutes;

(4) Computer crime as set forth in Article 5.5 of Title 18 of the Colorado Revised Statutes;

(5) Any of the offenses involving the family relations set forth in Article 6,

Part 4 (wrongs to children), when committed intentionally and knowingly or recklessly; Part 6 (harboring a minor); or Part 8 (domestic violence) of Title 18 of the Colorado Revised Statutes;

(6) An y of the offenses constituting wrongs to at-risk adults set forth in,

Article 6.5 of Title 18 of the Colorado Revised Statutes;

(7) Any of the offenses relating to morals set forth in Article 7 of Title 18 of are not limited to, prostitution, indecent exposure, and criminal invasion of privacy;

(8) Any other offense in any jurisdiction whatsoever that is committed intentionally, knowingly, or recklessly, and involves violence, coercion, threats, cruelty, fraud, deception, or deprivation of legally recognized rights; and, (9) Any conspiracy, solicitation, or criminal attempt to commit any of the above offenses, or participation as an accessory to any of the above offenses.

c. If the event is a civil action or arbitration proceeding: the court or arbiter, the jurisdiction, the case name, the case number, a description of the matter or a copy of the complaint, and a copy of the verdict of the court or arbitration decision.

F. Each application must be signed under penalty of perjury by an authorized corporate officer, general partner, or sole proprietor of the agency as appropriate.

G. BHA shall conduct a preliminary assessment of the application and notify the applicant of any application defects.

1. The applicant shall respond within fourteen (14) calendar days to written notice of any H. BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a I. BHA will act on an application within ninety (90) calendar days of receipt of the completed J. The duration of the initial approval will be two (2) years from the date of issuance.

1. BHA may conduct annual inspections during the two (2) year approval duration, in addition to any other inspections indicated in Section 12.6.6.G. 12.6.2 Provisional Approval A. Where an applicant for an initial approval fails to fully conform to the applicable statutes and regulations but the BHA determines the applicant is in substantial compliance with these rules and regulations and is temporarily unable to conform to all the minimum standards, a provisional approval may be granted. No provisional approval may be issued to an applicant if the operations may adversely affect individual health, safety, or welfare.

1. A provisional approval will be valid for ninety (90) days.

2. A second provisional approval, for another ninety (90) days, may be issued if the BHA determines that it is likely that compliance can be achieved by the date of expiration of the second provisional approval.

3. The second provisional approval may be issued for the same duration as the first. The BHA may not issue a third or subsequent provisional approval to the entity.

4. During the term of the provisional approval, the BHA shall conduct any review it deems necessary to determine if the agency meets the requirements for a regular approval.

5. If the BHA determines, prior to expiration of the provisional approval, that the agency is in compliance with all applicable rules, it may issue a regular approval. The regular approval will be valid for one (1) year from the date of issuance of the regular approval, unless otherwise acted upon pursuant to part 12.7 of this Chapter. 12.6.3 Renewal of Approval A. An agency seeking renewal must provide the BHA with a renewal application, signed under penalty of perjury by an authorized corporate officer, general partner, or sole proprietor of the agency as appropriate at least sixty (60) calendar days prior to the expiration of the existing approval. Renewal applications shall contain the information required in part 12.6.1.E of this

Chapter unless the information has been previously submitted and no changes have been made to the information currently held by the BHA.

B. Failure of the agency to accurately answer or report any of the information requested by the BHA will be considered good cause to deny the renewal application.

C. The BHA shall conduct a preliminary assessment of the renewal application and notify the agency of any application defects.

1. The agency shall respond within fourteen (14) calendar days to written notice of any D. The duration of the renewal approval will be two (2) years from the date of issuance.

1. The BHA may conduct annual inspections during the two (2) year approval duration, in addition to any other inspections indicated in section 12.6.6.G. 12.6.4 Change of Ownership/Management A. If an agency undergoes a change in ownership without following the procedures outlined in this

part 12.6.4, their existing approval will be terminated. Termination of the approval may not occur until after a hearing and in compliance with the provisions and procedures specified in Section 24-4-101 through - 109, C.R.S.

B. When an agency initiates a change of ownership, the agency must submit notification to inform the BHA of the change.

C. Each agency undergoing a change of ownership shall submit an application, as prescribed in part 12.6.1 of this Chapter at least thirty (30) calendar days before a change of ownership.

1. The application must include supporting documentation for change of ownership.

D. The BHA will consider the following criteria in determining whether there is a change of ownership of an agency that requires a new approval. The transfer of fifty percent (50%) of the ownership interest referred to in this part 12.6.4.D may occur during the course of one (1) transaction or during a series of transactions occurring over a five (5) year period.

1. So le proprietors:

a. The transfer of at least fifty percent (50%) of the ownership interest in an agency from a sole proprietor to another individual, whether or not the transaction affects the Title to real property, shall be considered a change of ownership.

b. Change of ownership does not include forming a corporation from the sole proprietorship with the proprietor as the sole shareholder or forming a limited liability company from sole proprietorship.

2. Partnerships:

a. Dissolution of the partnership and conversion into any other legal structure shall be considered a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the ownership to one (1) or more new owners.

b. Change of ownership does not include dissolution of the partnership to form a corporation with the same persons retaining ownership in the new corporation.

3. Corporations:

a. Merger of two (2) or more corporations resulting in the creation of a new corporate entity will be considered a change of ownership if the consolidation includes a transfer of at least fifty percent (50%) of the ownership to one or more new owners.

b. Formation of a corporation from a partnership, a sole proprietorship, or a limited liability company will be considered a change of ownership if the change includes a transfer of at least fifty percent (50%) of the ownership to one (1) or more new c. The transfer, purchase, or sale of shares in the corporation such that at least fifty percent (50%) of the ownership of the corporation is shifted to one (1) or more new owners will be considered a change of ownership.

4. Limited liability companies:

a. The transfer of at least fifty percent (50%) of the ownership interest in the company will be considered a change of ownership.

b. The termination or dissolution of the company and the conversion thereof into any other entity will be considered a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the ownership to one (1) or more new owners.

c. Change of ownership does not include transfers of ownership interest between existing members if the transaction does not involve the acquisition of ownership interest by a new member. For the purposes of this part.

5. Non-profits:

a. T he transfer of at least fifty percent (50%) of the controlling interest in the nonprofit is considered a change of ownership.

6. Management contracts, leases, or other operational arrangements:

a. If the agency enters into a lease arrangement or management agreement whereby the owner retains no authority or responsibility for the operation and management of the agency, the action will be considered a change of ownership that requires a new approval.

7. Legal structures:

a. The conversion of an agency’s legal structure, or the legal structure of a business entity that has an ownership interest in the agency is a change of ownership if the conversion also includes a transfer of at least fifty percent (50%) of the agency’s ownership interest to one (1) or more new owners.

E. The existing agency is responsible for correcting all rule violations and deficiencies in any current plan of action before the change of ownership becomes effective. In the event that such corrective actions cannot be accomplished in the time frame specified, the prospective agency shall be responsible for all uncorrected rule violations and deficiencies including any current plan of action submitted by the previous agency unless the prospective agency submits a revised plan of action, approved by the BHA, before the change of ownership becomes effective.

F. Wh en the BHA issues an approval to the new owner, the previous owner must return its approval to the BHA within five (5) calendar days of the new owner’s receipt of its approval. 12.6.5 Rule Waivers A. Any agency or applicant that has applied for or been approved as a behavioral health safety net provider has the right to apply for a waiver of any rule or standard set forth in these rules which, in their opinion, poses an undue hardship on the applicant, agency, or community.

B. Nothing contained in these provisions abrogates the agency’s obligation to meet minimum requirements under local safety, fire, electrical, building, zoning, and similar codes.

C. Nothing herein authorizes a waiver of any statutory requirement under state or federal law, except D. Upon application to the BHA, a waiver may be granted in accordance with this part 12.6.5. Absent the existence of a current waiver issued pursuant to this part, behavioral health safety net providers are expected to comply at all times with all applicable regulations except in instances where they are granted a provisional approval in accordance with part 12.6.2 of this Chapter.

E. Waiver applications must be submitted to the BHA in writing.

1. The BHA will only consider one (1) regulation per waiver application.

2. The waiver application must provide the BHA information related to:

a. T he regulation the agency or applicant is requesting to waive;

b. The reason why the waiver is being requested;

c. A proposed alternate compliance plan;

d. Any other information relevant to the waiver request that would inform the BHA’s 3. The waiver application must be signed by an authorized representative of the agency or applicant, who is the primary contact person and the person responsible for ensuring that accurate and complete information is provided to the BHA.

F. In making its determination, the BHA may consider any information it deems relevant, including 1. Critical incident and complaint investigation reports, licensure or certification survey reports, anticipated impact of the waiver on individual safety and quality of care if any, and findings of these reports related to the agency and/or the operator or owner thereof.

2. When determining whether a waiver should be granted, the BHA shall prioritize the impact of the waiver on the health, safety, and welfare of individuals over any alleged undue hardship.

G. The BHA shall act on a waiver application within ninety (90) calendar days of receipt of the completed application. An application will not be deemed complete until the applicant has provided all information and documentation requested by the BHA.

H. T he BHA may specify terms and conditions under which any waiver is granted, including which terms and conditions must be met in order for the waiver to remain effective. The term for which each waiver granted will remain effective must be specified at the time of issuance but may not exceed the term of the current approval.

1. At any time, upon reasonable cause, the BHA may inspect an agency with an active waiver to ensure that the terms and conditions of the waiver are being observed, and/or that the continued existence of the waiver is otherwise appropriate.

2. Within thirty (30) calendar days of the termination, expiration, or revocation of a waiver, the agency shall submit to the BHA an attestation of compliance with the regulation to which the waiver pertained.

I. The BHA will institute termination of a waiver upon a change of ownership of the agency, as defined in part 12.7.4. However, to prevent such termination, the prospective new owner may submit a waiver application to the BHA prior to the effective date of the change of ownership.

Provided the BHA receives the new application by prior to the effective date of the change of ownership, the waiver will be deemed to remain effective until such time as the BHA acts on the application. Termination of the waiver may not occur until after a hearing and in compliance with the provisions and procedures specified in Section 24-4-101 through -109, C.R.S.

1. Except as otherwise provided in this part 12.6.5, a waiver may not be granted for a term that exceeds the current approval term.

2. If an agency wishes to maintain a waiver beyond the stated term, it must submit a new waiver application to the BHA not less than ninety (90) calendar days prior to the expiration of the current term of the waiver or with an approval renewal.

J. Notwithstanding anything in this part 12.6.5 to the contrary, the BHA may revoke a waiver if it determines that:

1. The waiver's continuation jeopardizes the health, safety, or welfare of individuals served by the agency;

2. The waiver application contained false or misleading information;

3. The terms and conditions of the waiver have not been complied with;

4. The conditions under which a waiver was granted no longer exist or have changed 5. A change in a federal or state statute or regulation prohibits, or is inconsistent with, the K. Notice of the revocation of a waiver must be provided to the agency in accordance with the Colorado Administrative Procedures Act and will not be effective until after a hearing in compliance with the provisions and procedures specified in Section 24-4-101 through -109, 12.6.6 Continuing Obligations and BHA Oversight A. Ea ch agency must have and maintain electronic business communication tools, including but not limited to, internet access and a valid e-mail address. The agency must use these tools to receive B. The approval is only valid while in the possession of the agency to whom it is issued and may not be subject to sale, assignment, or other transfer, voluntary or involuntary.

C. The agency must provide accurate and truthful information to the BHA during inspections, investigations, applications, and oversight activities.

D. When an agency is subject to inspection, certification, or review by other agencies, accrediting organizations, or inspecting companies, the agency shall provide and/or release to the BHA, upon request, any correspondence, reports, or recommendations concerning the agency that were E. Each agency must submit notification to the BHA regarding any change in the information required by part 12.6.1.E of this Chapter from what was contained in the last submitted approval 1. Changes to the operation of the agency may not be implemented without prior approval from the BHA. An agency shall, at least thirty (30) calendar days in advance, submit notification to the BHA regarding any of the following proposed changes.

a. Change in license category or classification.

b. Change in the scope of services, including the addition or removal of an endorsement, a service, or a physical location.

c. Change in legal name of the agency and all other names used by it to provide F. The BHA and any duly authorized representatives thereof have the right to enter upon and into the premises of any approved agency or applicant for an agency approval in order to determine the state of compliance with the statutes and regulations and must initially identify themselves to the person in charge of the agency at the time.

G. T he BHA may use the following measures to ensure an agency’s full compliance with the applicable statutory and regulatory criteria.

1. The BHA may conduct an unscheduled or unannounced review of a current agency based upon, but not limited to, the following criteria:

a. Routine compliance inspection, b. Reason exists to question the agency’s continued fitness to conduct or maintain operations in accordance with the approval requirements, c. A complaint alleging non-compliance with approval requirements, d. Discovery of previously undisclosed information regarding an agency or any of its owners, officers, managers, or other employees if such information affects or has the potential to affect the agency’s provision of services, or e. The omission of relevant information from documents requested by the BHA or indication of false information submitted to the BHA.

2. Plan of action a. If after review or pursuant to a complaint, it is determined that an agency is not in compliance with these rules, the agency shall be notified in writing, within thirty (30) business days of the specific deficiency/deficiencies.

b. After any review, the BHA may request a plan of action from an agency or require an agency’s compliance with a BHA directed plan of action.

c. If the agency does not agree with any or all of the findings regarding noncompliance, the agency has ten (10) business days from the receipt of noncompliance notice to dispute the findings by submitting evidence to the BHA.

d. The agency shall receive a written response within thirty (30) business days of the review of submitted evidence.

e. If the submitted information is sufficient, the agency shall be determined in f. If the agency continues to be found out of compliance with these rules, the agency shall have thirty (30) business days from the date of receipt of the review findings to submit a plan of action.

g. The plan of action must be in the format prescribed by the BHA and included, but not be limited to, the following:

(1) A description of how the agency will correct each identified deficiency.

(a) If deficient practice was cited for specific personnel, the not reoccur for the affected individuals and/or other individuals (2) A d escription of how the agency will monitor the corrective action to ensure each deficiency is remedied and will not reoccur, and (3) A completion date that is no later than ninety (90) calendar days from the the BHA. The completion date is the date that the entity deems it can h. A completed plan of action must be:

(1) Signed by the agency’s director, administrator, or manager, and (2) Submitted to the BHA within thirty (30) calendar days after the date of the BHA’s written notice of deficiencies.

(a) If an extension of time is needed to complete the plan of action, the agency shall request an extension in writing from the BHA prior to the plan of action due date. The BHA may grant an extension of time.

i. The BHA has discretion to approve, impose, modify, or reject a plan of action.

(1) If the plan of action is accepted, the BHA shall notify the agency by issuing a written notice of acceptance, served either in-person or by firstclass mail.

(2) If the plan of action is unacceptable, the BHA shall notify the agency in writing, and the agency shall re-submit the changes within the time frame prescribed by the BHA in the notice.

(3) If the agency fails to comply with the requirements or deadlines for submission of a plan or fails to submit requested changes to the plan, the set forth in part 12.7 of this Chapter.

(4) If the agency fails to implement the actions agreed to by the action date in the approved plan of action, the BHA may impose enforcement sanctions as set forth below in part 12.7.

H. The agency must provide, upon request, access to or copies of the following to the BHA for the 1. Individual records.

2. Reports and information including but not limited to, staffing reports, census data, statistical information, and other records, as determined by the BHA.

I. Oversight and enforcement activities may include review of endorsements and/or separate physical locations as necessary for the BHA to ensure the health, safety, and welfare of 12.7 Enforcement and Adverse Actions 12.7.1 Denial A. The BHA may deny an agency’s approval as a behavioral health safety net provider for reasons including but not limited to, the following:

1. T he agency has not fully complied with all local, state, and federal laws and regulations applicable to the approval;

2. The application or its accompanying documents contain a false statement of material fact;

3. The agency fails to respond to BHA requests for additional information in the time frame indicated in the request;

4. The agency refuses any part of an inspection;

5. The agency fails to comply with federal financial participation requirements;

6. The agency fails to comply with state and federal data and financial reporting requirements;

7. The agency has failed to cooperate with the investigation of any local, state, or federal regulatory body or law enforcement agency; or 8. The agency is not in compliance with regulatory requirements or has a documented pattern of non-compliance that has harmed or has the potential to harm the health or safety of the individual(s) served.

B. If the BHA denies an application for approval, it shall provide the agency with a written notice, served either in-person or by first-class mail, explaining the basis for the denial and affording the agency the opportunity to respond and request a hearing.

C. Appeals of denials must be conducted in accordance with the State Administrative Procedure Act,

Section 24-4-101 through -109, C.R.S. 12.7.2 Revocation of Approval A. The BHA may revoke an existing approval if an agency fails or refuses to comply with the statutory and/or regulatory requirements applicable to its approval. Failures to comply include:

1. Making a false statement of material fact about individuals served by the agency, its personnel, capacity, or other operational components verbally or in any public document, or in a matter under investigation by the BHA or another governmental entity, 2. Preventing, interfering with, or attempting to impede in any way the work of a representative or agent of the BHA in investigating or enforcing the applicable statutes or regulations, 3. Falsely advertising or in any way misrepresenting the agency’s ability to provide services for the individuals served based on its license type or status, 4. Failing to provide reports and documents required by regulation or statute in a timely and complete fashion, 5. Failing to comply with or complete a plan of action in the time or manner specified, 6. Falsifying records or documents, 7. K nowingly using or disseminating misleading, deceptive, or false information, 8. Accepting commissions, rebates, or other forms of remuneration for referrals or other treatment decisions, or 9. Exercising undue influence or coercion over an individual to obtain certain decisions or actions or for financial or personal gain. A relationship other than a professional relationship, including but not limited to a relationship of a sexual nature, between an owner, director, manager, administrator, or other personnel and an individual.

B. Revocation must not occur until after a hearing and in compliance with the provisions and procedures specified in Article 4 of Title 24 and in Section 27-50-505, C.R.S. 12.7.3 Intermediate Restrictions A. The BHA may impose the following intermediate restrictions or conditions on an agency that has sought enhanced service payments in accordance with Section 27-50-505(3), C.R.S.:

1. Retaining a consultant to address corrective measures including deficient practice resulting from systemic failure;

2. Monitoring by the BHA for a specific period;

3. Providing additional training to personnel, owners, or operators of the agency;

4. Complying with a directed written plan to correct the violation; or 5. Paying a civil fine not to exceed two thousand dollars ($2,000) in a calendar year.

B. The agency may appeal any intermediate restriction or condition to the BHA in accordance with the Colorado Administrative Procedures Act Section 24-4-101, et seq., C.R.S. 12.7.4 Right to Appeal A. Any agency adversely affected or aggrieved by these rules or by the BHA’s decisions in regard to implementation of these rules, has the right to appeal to the Colorado Department of Personnel and Administration, Office of Administrative Courts, and may subsequently seek judicial review of the BHA’s action in accordance with Section 24-4-101 through -109, C.R.S.

B. The following actions may be submitted to an administrative law judge for an evidentiary hearing: denial or revocation of an approval.

C. After written notification from the BHA of intended action, the agency has twenty-one (21) calendar days to submit a written appeal. The appeal must be received by the BHA within twentyone (21) days from the date the written notification of action letter was sent by the BHA.

D. In all cases except waiver denials, the BHA will file a notice of charges with the Office of Administrative Courts to begin the administrative process. In waiver denials, if the applicant for the waiver requests an appeal, the request for appeal must be forwarded to the Office of Administrative Courts. Once the appellant’s request is forwarded to the office of administrative courts, the BHA may file a notice of charges.

E. S ubsequent to an evidentiary hearing at the Office of the Administrative Courts and the issuance of a final agency decision, a party may seek to appeal the final agency decision through judicial The following sections 21.000 through 21.290.58 and sections 21.400 through 21.400.6 of these rules are applicable to agencies approved or designated by the BHA prior to January 1, 2024, pursuant to Section 27-81-106, C.R.S.; Sections 27-50-101 through 27-50-903; Sections 27-65-101 through 27-65-131; or Sections 27-66-101 through 27-66-110, C.R.S. until such time that such agencies’ approval or designation expires and/or is up for renewal. Upon renewal, Chapters 1 - 11 above shall apply.

Chapter 13: Controlled Substance Services 13.1 Definitions “Administer” means the direct application of a controlled substance, whether by injection, inhalation, ingestion, or any other means to the body of an individual.

“Approved Private Treatment Facility” means a private agency meeting the definition set forth in Section 27-81-102(2), C.R.S., and standards prescribed and approved under Section 27-81-106, C.R.S., and shall be referred to as “approved treatment facility”.

“Approved Public Treatment Facility” means an agency operating under the direction and control of or approved by BHA and meeting the definition set forth in Section 27-81-102(3), C.R.S., and standards prescribed and approved under Section 27-81-106, C.R.S., and shall be referred to as “approved treatment facility.”

“Compound” means to produce or create by combining two or more substances.

“Controlled Substance” means a drug whose general availability is restricted or any substance that is strictly regulated or outlawed because of its potential for abuse or dependence. Controlled substances include narcotics, stimulants, depressants, hallucinogens, and cannabis.

“Corrective Action” means a time limited remedial measure applied to agencies that are out of compliance during a one (1) year licensing period.

“Diversion” means the transfer of any controlled substance from a licit to an illicit channel of distribution or “Maintenance Treatment” means the dispensing of a controlled substance, such as methadone or buprenorphine, at stable dosage levels for a period in excess of twenty-one (21) days in the supervised treatment of an individual for opioid use disorder.

“Medically Supervised Withdrawal” means the process through which an individual who is physically dependent on alcohol, illicit drugs, prescription medications, or a combination of these substances is over a period of time withdrawn from the substances of dependence and the process may include the use of controlled substances to manage the symptoms of withdrawal under the supervision of a qualified “Office-based opioid treatment” or “OBOT” means the prescribing of medications for the treatment of opioid use disorders by a federally authorized primary care or general health care provider outside of programs required to be licensed pursuant to Section 27-80-201 et seq., C.R.S.

“Physical dependence” means a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

“Practitioner” means:

A. A physician or other person licensed, registered or otherwise permitted to distribute, dispense, or to administer a controlled substance in the course of professional practice.

B. A pharmacy, hospital or other institution licensed, registered, or otherwise permitted to distribute, dispense, or to administer a controlled substance in the course of its professional practice in this state. 13.2 Authority and Applicability A. These rules are established to create standards for agencies seeking a controlled substance B. All agencies providing controlled substance licensed services as defined within 13.3 shall meet the standards in this Chapter 13. Controlled substance licensed agencies shall require a BHE license, and the agency shall comply with Chapter 2 and corresponding Chapters of these rules applicable to levels of care provided. 13.3 Controlled Substance License Requirements A. Agencies shall apply for and obtain a controlled substance license if they dispense, compound, or administer (pursuant to Section 27-80-204, C.R.S.) a controlled substance in order to treat a substance use disorder or to manage the withdrawal symptoms of a substance use disorder, from stock medication. All applicants for a controlled substance license must demonstrate compliance with these rules and all applicable state and federal statutes and regulations, including but not limited to the 72-hour emergency rule and others pertaining to controlled substances. The 72hour emergency rule means the regulation issued by the Drug Enforcement Administration (DEA) found at 21 C.F.R. § 1306.07 (Apr. 2024), which is hereby incorporated by reference, no later editions or amendments are incorporated. This regulation is available at no cost from the DEA at 8701 Morrissette Drive, Springfield, VA 22152 or at https://www.ecfr.gov/current/title-21. This

regulation is also available for public inspection at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash st, Suite C140, Denver, CO 80246, during regular B. An office-based opioid treatment (OBOT) provider that does not dispense, compound, or administer a controlled substance from stock medication on-site is not required to obtain a controlled substance license pursuant to this part 13.3.

C. In accordance with 21 C.F.R. § 1306.07(c), as incorporated by reference in Section 13.3.a. administering or dispensing of narcotic drugs: BHA CSL rules are not intended to impose limitations on a physician or authorized hospital staff to administer or dispense narcotic drugs in a hospital to maintain or detoxify a person as an incidental adjunct to medical or surgical treatment of conditions other than addiction, or to administer or dispense narcotic drugs to persons with intractable pain in which no relief or cure is possible or none has been found after reasonable efforts. 13.3.1 Licensing Procedures A. Treatment facilities meeting all the requirements of Colorado Revised Statutes Part 1 of Article 280 of Title 12; Part 3 of Article 18 of Title 18; Section 27-81-106, C.R.S.; the requirements of the controlled substance license rules; and all applicable state and federal regulations including those that apply to controlled substances shall be issued a controlled substance license.

B. A controlled substance license issued by BHA shall be obtained annually for each approved treatment facility that dispenses, compounds, or administers a controlled substance to treat substance use disorders or the withdrawal symptoms of a substance use disorder.

C. A separate controlled substance license is required for each approved treatment facility site where controlled substances are dispensed, compounded, or administered, in order to treat substance use disorders or the withdrawal symptoms of a substance use disorder.

D. Any approved treatment facility that receives a controlled substance license may dispense, compound, or administer controlled substances only to the extent authorized by their license and in conformity with Colorado Revised Statutes Part 1 of Article 280 of Title 12, and Article 18 of Title 18.

E. Routine Monitoring: Controlled substance licensing visits shall be scheduled and conducted by BHA during the approved agencies' normal business hours to the extent possible.

F. BHA shall conduct unscheduled site visits for specific monitoring purposes and investigation of complaints or critical incidents involving approved agencies that have a controlled substance license. These unscheduled visits shall be in accordance with the:

1. Controlled Substance License Rules;

2. BHA policies and procedures;

3. Department substance use disorder BHA Rules; and 4. Any statutes and regulations that protect the confidentiality of individual identifying information.

G. BHA shall have access to all individual, agency, and personnel records and any other relevant documentation required to determine compliance with these rules and to coordinate individual placement and care.

H. A controlled substance license shall not be granted to an agency unless there is documentation that the medical director or qualified practitioner dispensing, compounding or administering controlled substances has not been convicted within the last two (2) years of a willful violation of

Part 1 of Article 180 of Title 12 of the Colorado Revised Statutes or any other state or federal law regulating controlled substances 13.3.2 Initial License A. Applicants for an initial controlled substance license to dispense, compound, or administer controlled substances to treat a substance use disorder or to manage the withdrawal symptoms of a substance use disorder shall submit a controlled substance license application that has been affirmed and signed by a qualified practitioner, a copy of current policies and procedures addressing the use of controlled substances to treat substance use disorders or withdrawal symptoms of a substance use disorder, and the application fee of five hundred dollars ($500).

B. No approved treatment facility that is required to be licensed shall engage in any activity for which a controlled substance license is required until the facility's application is granted, and a license is issued to the facility by BHA.

C. Initial controlled substance license applications received by BHA that are not completed according to instructions, do not include the application fee, or do not include the required policies and procedures shall be returned to the applicant by certified mail with the submitted application fee and a written explanation as to why their application is being returned.

D. BHA shall review complete initial applications that have the required fee and appropriate policies and procedures and BHA shall conduct an on-site inspection to determine that the applicant is in compliance with these controlled substance license rules, treatment rules, and all state and federal statutes and regulations. If the Governor or local government declares an emergency or disaster BHA has discretion to modify the requirement for on-site inspections. If BHA modifies the requirement for on-site inspections, the requirement shall only be modified as necessary because of circumstances related to the disaster or emergency.

E. Initial applicants that have submitted satisfactory policies and procedures and other required documentation shall be granted a one hundred and eighty (180) day provisional license.

F. BHA may conduct a site visit to determine that the provisionally licensed agency is in compliance with these controlled substance license rules, treatment rules, and all state and federal statutes and regulations. If, after the first provisional license, an agency has not demonstrated full compliance, a second one hundred and eighty (180) day provisional license may be granted if substantial progress continues to be made, and it is likely compliance can be achieved by the date of expiration of the second provisional license. If, at the end of the first provisional license, an agency demonstrates compliance, a full controlled substance license shall be issued. BHA will not issue a third or subsequent provisional license to the applicant.

G. BHA shall conduct a site visit to determine compliance with all applicable state and federal laws and regulations at the end of the second provisional license period. If at the end of the second provisional license an agency demonstrates compliance, a full controlled substance license shall be issued.

H. An applicant for licensure pursuant to these rules and regulations shall also be considered an applicant for registration pursuant to Section 18-18-302, C.R.S.

I. Initial applicants that are found not to be in full compliance shall have their license applications returned by certified mail with a written explanation as to why their application is being returned and notification that their controlled substance license application has been denied as of ten (10) days from the date the denial letter was mailed. Application fees shall not be refunded. If an applicant disagrees with the decision, they may appeal (Part 2.24.5 of these Rules); or upon remedying the noted deficiencies, may re-apply for an initial license in accordance with Chapter 13 of these rules. 13.3.3 License Renewal A. A controlled substance license shall expire one (1) year from the date the license is granted. A term shorter than one (1) year may be issued if agreed upon between the agency and BHA.

1. If a term shorter than one (1) year is issued, fees may be prorated to reflect the time period of the license term.

B. Agencies wishing to continue their controlled substance license shall submit a license renewal application to BHA thirty (30) days prior to the expiration date of their current controlled substance license along with the required fee of five hundred dollars ($500). A copy of the agency’s DEA narcotic treatment program registration and SAMHSA accreditation or certification as applicable shall also be submitted with each annual renewal application for this program type.

C. Any treatment facility that currently has a controlled substance license issued by BHA may not apply for renewal more than sixty (60) days before the expiration date of the current controlled substance license.

D. A controlled substance license renewal application that is received by BHA fewer than thirty (30) calendar days prior to the expiration of their existing license may fail to receive their new license prior to the expiration of their existing license. An agency that submits its renewal application fewer than thirty (30) days prior to the expiration of the current license and does not receive a new license prior to the current license expiration may reapply for an initial license in accordance with Chapter 13 of these rules.

E. A controlled substance license renewal application that is received by BHA after the current license expiration date shall be returned by certified mail with written notification that the license is no longer in effect. Applicants may reapply for an initial license in accordance with Chapter 13 F. If the governor or local government declares an emergency or disaster BHA has discretion to modify the requirement for on-site inspections. If BHA modifies the requirement for on-site inspections, the requirement shall only be modified as necessary because of circumstances related to the disaster or emergency.

G. An agency that is in full compliance shall be granted renewal of their annual controlled substance license that shall be effective for one (1) year from the prior license’s expiration date. 13.3.4 Probationary License A. At BHA’s discretion, a probationary license may be issued to an agency out of compliance with applicable BHA, state, or federal regulations prior to issuance of a renewal license or during a current license term. The agency will be notified in writing of non-compliance areas and the need for a plan of action (see Part 2.24.3 of these rules).

B. A probationary license will replace the current license for a period not to exceed ninety (90) calendar days.

C. Administrative and treatment activities may be limited by a probationary license while the agency addresses corrective actions.

D. A second probationary license may be issued for a period not to exceed ninety (90) calendar days if substantial progress continues to be made and it is likely that compliance can be achieved by the date of expiration of the second probationary license.

E. If the agency fails to comply with or complete a plan of action in the time or manner specified, or is unwilling to consent to the probationary license, BHA shall revoke the license and the agency shall be notified by certified mail that the agency's license is revoked as of ten (10) days from the date the letter was mailed. If an agency disagrees with the decision, the agency may appeal (see

Part 2.24.5 of these rules).

F. Upon remedying the noted deficiencies, an agency may re-apply for an initial license in accordance with Part 13.5 of these rules. 13.3.5 License Denial, Revocation, Or Suspension A. A controlled substance license may be denied, suspended, or revoked in accordance with Part 2.24 of these rules and upon finding that the agency:

1. Is not in compliance with the controlled substance license rules;

2. Has violated any provision of Part 1 of Article 280 of Title 12, And Article 18 of Title 18 of the Colorado Revised Statutes;

3. Has failed to implement BHA imposed corrective actions;

4. Has been negligent resulting in risk to individual and/or personnel health or safety;

5. Has failed to provide for adequate supervision of treatment personnel as outlined in Part 2.5.1 of these rules and defined by the supervisor's professional practice board;

6. Has furnished false or fraudulent information in an application;

7. Has, as a practitioner, been convicted of, or has had accepted by a court a plea of guilty or nolo contendere to a felony under any state or federal law relating to a controlled substance; or 8. Has had their federal registration to manufacture, conduct research on, distribute, or dispense a controlled substance suspended or revoked.

B. BHA may limit revocation or suspension of a controlled substance license to the particular controlled substance, which was the basis for revocation or suspension.

C. If BHA denies, suspends, or revokes a controlled substance license, all controlled substances owned or possessed by the agency at the time of the denial or suspension or on the effective date of the revocation order must be placed under seal. No disposition may be made of substances under seal until the time for making an appeal has elapsed or until all appeals have concluded, unless a court orders otherwise or orders the sale of any perishable controlled substances and the deposit of the proceeds with the court, or if BHA orders otherwise. Upon a revocation order becoming final, all controlled substances may be forfeited to the state.

D. BHA shall promptly notify the Drug Enforcement Administration and the appropriate professional licensing agencies, if any, of all charges and the final disposition thereof and of all forfeitures of a controlled substance. 13.4 Treatment Provisions Under A Controlled Substance License 13.4.1 Agency Policies And Procedures A. Agencies shall develop and implement policies and procedures, as defined in this Part 13.4.1, that address the use of controlled substances in the treatment of substance use disorders or the withdrawal symptoms of a substance use disorder. These policies shall include, but are not limited to, how individuals are assessed to be appropriate to receive a controlled substance to treat their substance use disorder or the withdrawal symptoms of a substance use disorder.

These policies shall meet the requirements of all federal, state, and local laws pertaining to controlled substances.

B. Medication assisted treatment using a controlled substance shall be provided to individuals with a substance use disorder who are seeking treatment to manage symptoms of physical and psychological withdrawal and cravings, and to reduce risk associated with drug use, including overdose, death, and the spread of infectious diseases.

C. Approved agencies must only dispense, compound, or administer, controlled substances by or on the order of a qualified practitioner who currently possesses and maintains a license to practice medicine in the State of Colorado as provided by Article 240, of Title 12, C.R.S. The qualified practitioner’s medical order must be documented in the individual’s treatment record.

D. Approved agencies that dispense, compound, or administer controlled substances must also have a current registration from the Drug Enforcement Administration for the state in which they are licensed.

E. All controlled substances must be dispensed, compounded, or administered according to applicable state and federal statutes, regulations and rules, controlled substance license rules, and BHA rules.

F. Controlled substances must be dispensed, compounded, or administered in accordance with the manufacturer’s specifications found on product labels and/or in printed instructions accompanying the product.

G. Agencies shall maintain an individual dispensing record on each individual that receives controlled substances at their facility. The dispensing record shall include:

1. Complete name of individual receiving the controlled substance;

2. Name of the controlled substance, strength, and dosage form;

3. Amount consumed;

4. Amount dispensed;

5. Date dispensed;

6. Amount and dosage form taken home by individual (if applicable); and 7. First initial and last name and the credentials of the individual who dispensed the controlled substance medication.

H. Agencies shall ensure that all personnel are working within their scope of practice and shall only allow licensed medical personnel to dispense, compound, or administer controlled substances.

I. Each approved treatment facility shall provide formal training and testing on an annual basis to all personnel for the following:

1. State and federal requirements regarding controlled substances and confidentiality, including BHA rules; and 2. Pharmacology of controlled substances dispensed, including but not limited to loss of tolerance, dangerous drug or alcohol interactions, signs and symptoms of overdose,

purpose of its use. 13.4.2 Critical Incident Reporting A. In addition to the provisions of Part 2.16 of these rules, theft, loss, misuse, diversion, or illicit distribution of agency-dispensed or prescribed controlled substance medication shall also be considered a critical incident and BHA critical incident reporting policy shall be followed. Critical incidents must be reported to BHA within one (1) business day of when the agency determines that a reportable incident has occurred or upon BHA request. 13.4.3 Medical Evaluations A. Individuals who wish to receive medication assisted treatment shall have medical evaluations conducted by a qualified practitioner to determine physical dependence and to determine that such individuals are appropriate for treatment with a controlled substance. Evaluations shall 1. A medical history that includes a detailed and comprehensive account of substance use

history, which includes all substances of misuse;

2. Evidence of current physical dependence (for OTPS, see Part 13.8.1.C.2); and 3. A pregnancy screen for females and pregnancy-capable individuals of childbearing age. 13.4.4 Informed Consent to Receive a Controlled Substance A. All individuals receiving medication assisted treatment shall sign informed consent indicating they are voluntarily agreeing to treatment with a controlled substance. The individual shall be informed of what controlled substance they are receiving and the expected benefits and risks of medication assisted treatment. All individuals receiving controlled substances must also be informed of the risks of using other substances in combination with a controlled substance. Should an individual change controlled substance medications over the course of treatment, the individual must sign a new informed consent specific to each controlled substance they are receiving under the care of the controlled substance license. 13.4.5 Security Controls and Operating Procedures A. All agencies must follow the standards of physical security controls and operating procedures required by the Federal Drug Enforcement Administration necessary to prevent diversion as outlined in Title 21, Food and Drugs, Chapter II, Code of Federal Regulations, Sections 1301.71 through 1301.77 (September 2022), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control, 2401 Jefferson Davis Highway, Alexandria, VA 22301; or, the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St. Suite C140, Denver, CO 80246; or at any state publications depository library, during regular business hours. 13.4.6 Record Keeping A. Agencies must follow the record keeping requirements of the Federal Drug Enforcement Administration, Code of Federal Regulations (Title 21, Food and Drugs, Part 1304) to ensure compliance with the requirements in Part 1 of Article 280 of Title 12, C.R.S. (September 2021), which are hereby incorporated by reference. No later editions or amendments are incorporated.

These regulations are available at no cost from the U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control, 2401 Jefferson Davis Highway, Alexandria, VA 22301; or the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St. Suite C140, Denver, CO 80246; or at any state publications depository library, during regular business hours.

B. Agencies must also keep inventories, records, and reports that are required by any other state or federal law or standard regulating controlled substances. 13.4.7 Handling and Storage A. All agencies shall have adequate and proper facilities for the handling and storage of controlled substances. All agencies must maintain proper control over such controlled substances to ensure against their being illegally dispensed or distributed. Access to the storage area shall be restricted to personnel specifically authorized to handle controlled substances. This includes restricting the number and accessibility of keys or passwords.

B. Agencies shall also develop and implement policies on how controlled substances will be obtained, stored, and accounted for. These policies shall include, but are not limited to:

1. What controlled substance the agency will be using for the substance use disorder they are treating and how these controlled substances will be dispensed, compounded, or administered, as well as who will be responsible for ordering the controlled substances;

2. Where the controlled substances will be stored;

3. How the controlled substances will be accounted for; and 4. Who will have access to the controlled substances. 13.4.8 Toxicology Screening Requirements A. Agencies shall develop and implement toxicology screen policies and procedures that specify a random sample collection protocol and these policies must include, but are not limited to:

1. How appropriate and approved samples for drug testing shall be collected and analyzed in accordance with applicable state and federal statutes and regulations;

2. How toxicology screens shall be used to detect the presence of the approved controlled substance, that is being dispensed, and its metabolite, for which laboratory analyses are available;

3. How all individuals entering medication assisted treatment shall provide a toxicology screen at time of admission and then as clinically indicated throughout the treatment episode;

4. How an agency shall address an individual having illicit substances in a toxicology screen, including unauthorized prescription medication; and 5. How the agency incorporates harm reduction, trauma-informed practices, and respect for the gender identity of the individuals being screened. 13.5 Opioid Treatment Programs (OTP)

A. These parts 13.5 through 13.8 are applicable to agencies licensed as an Opioid Treatment Program (OTP).

B. Agencies shall follow all federal requirements in accordance with 42 C.F.R. Part 8 (2024), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Health & Human Services, Substance Abuse & Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD 20857, or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St. Suite C140, Denver, CO 80246, during regular 13.5.1 Definitions “21 C.F.R. Part 1300, 1301, and 1304” means the federal regulations issued by the Drug Enforcement Administration of the U.S. Department of Justice found at 21 C.F.R. Part 1301, 1302, and 1304 (Oct. 2021), which are hereby incorporated by reference. No later editions or amendments are incorporated.

These regulations are available at no cost from the U.S. Department of Justice, Drug Enforcement Administration, Liaison and Policy Section, 8701 Morrissette Drive, Springfield, VA 22152 or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St. Suite C140, “42 C.F.R. PART 8” means the federal regulations issued by the United States Secretary of Health and Human Services found at 42 C.F.R. Part 8 (Apr. 2024), as incorporated by reference in Section 13.5.B.

“Administrative Discharge” means a process whereby an OTP has determined immediate treatment discharge is the most appropriate pathway for an individual for causes such as safety concerns for the individual or others, incarceration or other confinement which does not permit the individual’s treatment continuation, or for non-payment of fees. The timeframe for this typically involves a treatment transfer and/or taper at a rate set forth by the program.

“Administrative Transfer” means a process whereby an OTP has determined treatment continuation for an individual is unsafe for the individual receiving treatment or others and a program decides to transfer care to another clinic of the individual’s choice. To avoid unnecessary medication taper, this individual is to be transferred at a time frame that is determined by agreement with the receiving OTP.

“Comprehensive Metabolic Panel” means a blood test that measures proteins, enzymes, electrolytes, minerals and other substances in the body. A qualified practitioner can use the results to diagnose, screen for or monitor health conditions or side effects of medications, and make appropriate medical referrals.

“Dilute urinalysis” for the purposes of these rules means a creatinine level less than twenty (20) milligrams.

“Diversion Control Plan” or “DCP” means a written document that contains specific measures to reduce theft, loss, misuse, or illicit distribution of agency-dispensed or prescribed controlled substance “Guest Dosing” means a process where an individual in an OTP may be able to dose at another clinic, either in the state or out of state, to maintain the continuity of care for their OTP.

“History Of Present Illness” means a chronological description of the development of the individual’s present illness from the first sign and/or symptom or from the previous encounter to the present. It shall include the following elements: location, quality, severity, duration, timing, context, modifying factors, and associated signs and symptoms as applicable.

“Lock In” means a process where a program, along with the State authority, determines that an individual is best served clinically at one (1) program. This determines where the individual is to go for their OTP.

“Lock Out” means a process where a program, along with the State authority, determines that it is in an individual's best interest to be locked out of a program due to concerns of this individual not being safe to themselves or others in a program and/or could be a threat to that program due to diversion or other items.

“Medical Director” means a physician licensed to practice medicine in the jurisdiction in which the OTP is located and shall assume responsibility for all medical and behavioral health services performed by the OTP, including their administration in accordance with 42 C.F.R. § 8.2., as incorporated by reference in

Section 13.5.

“Medication Unit” means an entity that is established as part of, but geographically separate from, an OTP from which qualified practitioners, contractors working on behalf of the OTP, or community pharmacists may dispense or administer medications for opioid use disorder (MOUD), collect samples for drug testing or analysis, or provide other OTP services. Medication units can provide the same services as an OTP, as used in 42 C.F.R. Part 8, as incorporated by reference in Section 13.5.

“Mobile Opioid Treatment Unit” for the purpose of this Chapter 13 has the same meaning as “Mobile Narcotic Treatment Program” as used in 21 C.F.R. Part 1300.01, as incorporated by reference in this

Section 13.5.1. An OTP operating from a motor vehicle that serves as a mobile component (conveyance) and is operating under the registration of the OTP and engages in maintenance and/or detoxification treatment with narcotic drugs in schedules II-V, at a location or locations remote from, but within the same state as, its registered location. Operating a mobile OTP is a coincident activity of an existing OTP, as listed in § 1301.13(E).

“Motor Vehicle” means a vehicle propelled under its own motive power and lawfully used on public streets, roads, or highways with more than three (3) wheels in contact with the ground. This term does not include a trailer, as used in 21 C.F.R. Part 1300.01.

“OTP” means opioid treatment program.

“Review Of Systems” means an inventory of body systems obtained through a series of questions to identify signs and/or symptoms the individual may be experiencing or has experienced.

“Special Exception Requests” are requests for take-home doses beyond what is allowed for an individual who is prescribed a controlled substance at the time of the request. Requests must be sent to the state

authority for final approval.

“Split Dosing” means, in accordance with SAMHSA, the dispensing of a single dose of MOUD as separate portions to be taken within a twenty-four (24) hour period. Split dosing is indicated among, but not limited to, those individuals who: possess a genetic variant which increases methadone metabolism; concurrently take other medications or drink alcohol that also induce hepatic enzymes leading to more rapid metabolism of methadone; who are pregnant; or for whom methadone or buprenorphine are being used to treat a concurrent pain indication in addition to the diagnosis of Opioid Use Disorder (OUD). This leads to more stable, steady-state medication levels.

“Take-Home Dose” is a prescription of individually labeled bottles or containers of methadone and other controlled substances, dose and quantity determined by prescribing qualified practitioner, and dispensed to the individual. Each bottle or container is labeled with proper required DEA information.

“Take-Home Dose Callback” means a measure of dispensed controlled substance diversion control wherein the OTP contacts and requests the individual to report back to the OTP within a reasonable period (e.g., 24 to 36 hours) with all take-home doses dispensed by the OTP. This practice may be a result of randomized individual selection or for-cause (when concerns of diversion are present) in nature.

The number of take-home doses remaining must correspond to the number expected based on prescribed ingestion.

“Taper” refers to when an individual is being reduced on their dose for any reason, either of their own accord or due to concerns that the medical director raises. Tapers are started with a medical order and monitored by the medical personnel.

“Torsades de Pointes” or simply Torsades, is a French term that literally means “twisting of the spikes.” It refers to a specific, rare variety of ventricular tachycardia that exhibits distinct characteristics on the electrocardiogram (ECG).

“Transfer” is when an individual transfers from one program to another without a break in treatment. 13.6 Opioid Treatment Program General Provisions A. Opioid Treatment Programs (OTP) must provide treatment to individuals meeting criteria for opioid use disorder according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) (2022)

B. Agencies applying to be licensed as an OTP must have the following:

1. Controlled substance license;

2. Drug Enforcement Administration (DEA) registration;

3. Substance Use and Mental Health Services Administration (SAMHSA) certification; and 4. Federal accreditation, when applicable.

C. In addition to OTP provisions beginning with 13.6., OTPs shall adhere to requirements listed within 13.1 through 13.8.5. 13.6.1 Services for Pregnant and Postpartum Individuals A. When prospective or currently enrolled individuals are pregnant or postpartum, the following considerations shall be cared for through policies, procedures, and clinical documentation:

1. Agencies must provide admission to pregnant individuals within forty-eight (48) hours of request for services or provide interim services until an admit date is available;

2. Confirmation of pregnancy for pregnancy-capable individuals upon OTP enrollment;

3. Agencies must not medically withdraw pregnant individuals receiving methadone or other approved controlled substances without the approval of the Behavioral Health Administration;

4. Prenatal care and other sex-specific services, including reproductive health services, for pregnant and postpartum individuals shall be provided and documented either by the OTP or by referral to appropriate healthcare practitioners; and 5. Evidence-based treatment protocols for the pregnant individual, such as split dosing regimens, may be instituted after assessment by a qualified practitioner operating within the OTP. 13.6.2 Admission Criteria A. Agencies must follow all federal requirements in accordance with 42 C.F.R. Part 8 (2024), as incorporated by reference in Section 13.5.B.

B. OTPS offering short-term or long-term detoxification treatment shall follow all applicable state and federal laws, rules, and regulations regarding admission criteria.

C. At time of admission, individuals shall be oriented to OTP policies and procedures, including, but 1. Benefits and risks of medication for Opioid Use Disorder;

2. Fee structure and payment options. This policy must include written acknowledgement of understanding from the individual. The individual will be provided with a copy of this document and a copy will be placed in the clinical record;

3. Conditions for dosing, counseling and toxicology sample collection. The policy must include provisions for holding doses, evaluation of the “impaired” individual, treatment stipulations and agreements, “refusal” or “inability” to provide specimens for toxicology testing and unacceptable/unsafe behavior that limits the individual's ability to participate in OTP;

4. Take-home treatment structure established by the OTP;

5. Special exception requests;

6. Consequences for violating policies; and 7. Written procedures and signed acknowledgements around the following shall include, but not be limited to:

a. Behavioral agreements;

b. Office treatment lock-in;

c. Office treatment lock-out;

d. Reduction in take-home doses;

e. Administrative discharges;

f. Administrative transfers;

g. Guest dosing;

h. OTP transfer policy;

i. Taper protocol for any and all circumstances, including inability to pay;

j. Hospitalization while in OTP instructions, including clinic after-hours information;

k. Emergency procedures in case of a natural disaster, human-induced disaster, or emergent closing of the clinic;

l. Use of prescription drug monitoring program in treatment;

m. Use of other prescription medications in treatment; and n. Provisions around conditions for dosing.

D. OTPs shall provide alternatives to admission denial due to lack of government-issued photo identification. This is including, but not limited to, accepting various forms of suitable identification, coordinating with BHA to establish a unique treatment identifier within the central registry system, and direct referral to alternative MOUD (medications for opioid use disorder) treatment options.

E. Individuals re-admitted to treatment following treatment absences of six (6) months or more must undergo medical evaluations, physical examinations, and/or laboratory tests as deemed appropriate by an OTP medical director or qualified practitioner. 13.6.3 Prescribing, Dispensing, And Administering Approved Controlled Substances A. An OTP medical director or a qualified practitioner shall order approved controlled substances and document orders in individual records.

B. Exceptions to dosing regimens outlined in federal regulations shall require approval by BHA prior to dosing.

C. Approved controlled substances must be administered by OTPs according to manufacturer's specifications found on product labels and/or in printed instructions accompanying the product.

D. In circumstances where individuals must be administratively discharged from the agency OTP or MOUD services, OTPs shall make a good faith documented effort to obtain appropriate consents and coordinate transition of care to nearby MOUD treatment and other applicable services to reduce the risk of opioid withdrawal and harm. When transfer effort is unsuccessful, OTPs shall notify and coordinate with BHA before providing a safe medical taper due to inability or unwillingness to pay. Pregnant individuals shall have the option to defer payment for treatment and continue to receive MOUD.

E. OTP medical directors and leadership shall develop a medication induction protocol which considers, on an individualized basis and among other factors, rate of dose adjustment and when initiation of take-home dose protocol would be safe for the individual and community.

F. In an effort to prevent medication disruption, OTPs shall make a good faith effort to provide or coordinate services for treatment-enrolled individuals in treatment settings outside of the agency, including carceral settings. 13.6.4 Take-Home Dose Guidance A. In accordance with 42 C.F.R. § 8.12(i)(2)(i-vi), as incorporated by reference in Section 13.5.B of these rules, OTP decisions on dispensing MOUD to individuals for unsupervised use shall be determined by an appropriately licensed OTP medical practitioner or the medical director. In determining which individuals may receive unsupervised medication doses, the medical director or program medical practitioner shall consider, among other pertinent factors that indicate that the therapeutic benefits of unsupervised doses outweigh the risks, the following criteria:

1. Absence of active substance use disorders, other physical or behavioral health conditions that increase the risk of individual harm as it relates to the potential for overdose, or the ability to function safely;

2. Regularity of attendance for supervised medication administration;

3. Absence of serious behavioral problems that endanger the individual, the public, or others;

4. Absence of known recent diversion activities;

5. Whether take-home medication can be safely transported and stored; and 6. Any other criteria that the medical director or medical practitioner considers relevant to the individual's safety and the public's health.

B. Buprenorphine products that are dispensed, compounded, and administered by an OTP do not require time in treatment requirements as listed in this Part 13.6.4. However, an OTP is still responsible for including all controlled substances dispensed, compounded, and administered in their division control plan, including OTP directed buprenorphine take-home doses.

C. In accordance with 42 C.F.R. § 8.12(I)(3)(I-III), as incorporated by reference in Section 13.5.B, such determinations and the basis for such determinations consistent with the criteria outlined in 13.6.4 of this section shall be documented in the individual's medical record. If it is determined that an individual is safely able to manage unsupervised doses of MOUD, the dispensing restrictions set forth in D.1 through D.3 of this section apply. The dispensing restrictions set forth in paragraphs D.1 through D.3 of this section do not apply to buprenorphine and buprenorphine products.

1. During the first fourteen (14) calendar days of treatment, take-home doses are limited to a seven (7) day supply. It remains within the discretion of the qualified practitioner operating within the OTP to determine the number of take-home doses up to seven (7) days, but decisions must be based on the criteria listed in A.1-6. The rationale underlying the decision to provide unsupervised doses of methadone must be documented in the 2. From fifteen (15) calendar days of treatment, take-home doses are limited to a fourteen (14) day supply. It remains within the discretion of the qualified practitioner operating within the OTP to determine the number of take-home doses up to fourteen (14) calendar days, but decisions must be based on the criteria listed in a.1-6. The rationale underlying the decision to provide unsupervised doses of methadone must be documented in the 3. From thirty-one (31) calendar days of treatment, take-home doses provided to an individual are not to exceed a twenty-eight (28) day supply. It remains within the discretion of the qualified practitioner operating within the OTP to determine the number of take-home doses up to twenty-eight (28) days, but decisions must be based on the criteria listed in A.1-6. The rationale underlying the decision to provide unsupervised doses of methadone must be documented in the individual's clinical record.

D. In determining a safe amount of take-home doses for individuals transferring from one Colorado OTP to another Colorado OTP, the receiving OTP shall determine and document the amount of take-home doses provided by the previous OTP.

E. Individuals transferring from out of state must meet the Colorado state requirements for the takehome doses they are requesting.

F. OTPs shall seek BHA and SAMHSA approval prior to providing take-home doses beyond limits defined by 13.6.4 of this ruleset and 42 C.F.R. § 8.12(I)(3)(I-III) as incorporated by reference in

Section 13.5.

G. Take-home doses may be approved by OTPs for days clinics are closed, including Sundays and state and federal holidays.

H. Take-home doses shall not be approved for individuals undergoing short-term supervised withdrawal.

I. Written agreements shall be developed and implemented for individuals approved for take-home doses. Agreements must be part of the service plan and shall explain the rationale for approving take-home medication, stipulate dose amounts, and set consequences for violating agreement conditions.

J. Take-home doses shall be dispensed in medication containers that conform to state and federal poison prevention packaging requirements, including childproof lids.

K. Labels must be affixed to containers with the following information:

1. OTP names, addresses, and telephone numbers;

2. Individual names;

3. Drug types;

4. Dose amounts, if not OTP medical director-authorized blind doses; and 5. Directions for use.

L. Take-home doses numbering six (6) or less shall be transported in a discrete and secure manner agreed upon by OTPs and individuals.

M. Take-home doses numbering seven (7) or more shall be transported in locked, well-constructed containers that resist tampering.

N. Take-home doses shall be securely and discretely stored in a manner that reduces the risk for access by children and unauthorized persons.

O. OTPs must submit and obtain BHA approval for the following:

1. Take-home doses for individual supervised withdrawal lasting less than thirty (30) consecutive calendar days 2. Take-home doses that do not conform to take-home dose requirements; and 3. Take-home doses for OTP individuals admitted to extended health care agencies, licensed residential substance use disorder agencies, or carceral settings.

P. OTPs shall have policies and procedures for transporting methadone or other approved controlled substances to individuals in residential treatment, carceral settings, or recovery agencies, that include chain-of-custody documentation retained by the OTP and a secure plan for storage from the facility.

Q. In the event of take-home medication theft, loss, or diversion, take-home dose replacement shall not be provided until documented review and approval is given by a qualified practitioner within the OTP. In-person dosing shall be continued in the event of take-home medication theft, loss, misuse, or diversion.

R. OTPs shall offer either directly or through prescription, opioid antagonists for all individuals receiving MOUD take-home doses. 13.6.5 Prescription Drug Monitoring Program (PDMP)

A. Medical directors and other qualified health care professionals within the OTP shall utilize the information obtained from the Colorado State Board of Pharmacy's Electronic Prescription Drug Monitoring program (PDMP), developed pursuant to Section 12-280-403, C.R.S. The PDMP shall be utilized at key decision-making points, including at intake and take-home dose consideration.

Documentation should include relevant recent prescription history and/or copy of results uploaded to the clinical chart. 13.6.6 Diversion Control and Central Registry A. OTPs shall maintain a current diversion control plan, which assigns responsibility to OTP medical and administrative leadership and personnel for developing, performing, and monitoring measures and functions described in OTP’s diversion control plan.

B. The diversion control plan shall include, at minimum, the following categories:

1. Program environment;

2. Dosing;

3. Take-home doses;

4. Take-home dose callbacks;

5. Prevention of multiple program enrollment; and 6. Misuse of prescription medication as outlined in SAMHSA federal OTP guidelines;

C. As a core function of diversion control, the following must occur:

1. Randomized take-home dose callbacks shall be performed and documented at a minimum of two (2) per year for individuals whose take-home doses equal seven (7) or greater and may coincide with random toxicology screens.

2. For-cause take-home dose callbacks shall be performed whenever take-home dose diversion or misuse is suspected and OTPs shall develop written protocol to determine consistently under which circumstances and how those take-home callbacks will be conducted and documented.

D. OTPs shall prevent simultaneous enrollment of individuals in more than one (1) clinic by fully participating in the behavioral health administration central registry, developed pursuant to

Section 27-80-215, C.R.S.

1. Prior to admitting applicants to treatment, OTPs shall initiate a clearance inquiry to BHA’s central registry of OTP-enrolled individuals by submitting applicant information in BHAprescribed formats.

2. Applicant information must include:

a. Name:

b. Date of birth;

c. Proposed date of admission; and d. Other information required by the individual clearance procedure.

3. Applicants shall not be admitted to treatment when BHA’s central registry shows them as currently enrolled in another OTP.

4. In the event that the central registry is inaccessible, not functioning, or BHA is closed, an OTP shall contact another OTP within their geographic area to verify an individual’s enrollment status.

5. OTPs must report clinic discharges to BHA’s central registry within three (3) business days or immediately upon transfer.

E. By definition, mobile opioid treatment units and medication units operate under the license of an OTP and therefore do not require a central registry account separate from the home OTP.

Individuals receiving services at either mobile or med units must be enrolled in the primary OTP’s central registry. It is the OTP’s responsibility to prevent medication error and diversion across that spectrum of service delivery. 13.6.7 Mobile Opioid Treatment Units and Medication Units A. OTPs utilizing mobile opioid treatment units or medication units shall follow all applicable state and federal regulations, including these BHA OTP rules as incorporated by reference in Part 13.5.1 of these rules.

B. OTPs are not required to obtain a separate behavioral health entity license or controlled substance license for medication units or mobile opioid treatment units.

C. OTPs shall develop the following plans for mobile opioid treatment units or medication units:

1. Staffing plan;

2. Security plan;

3. Adequate handling and storage plan of controlled substances;

4. Contingency plans for mobile opioid treatment unit closure, including but not limited to, adverse weather events, human-induced disasters, and unit breakdown for mobile medication units only; and 5. Vehicle maintenance plan for mobile medication units only.

D. Mobile opioid treatment units and medication units shall comply with reporting requirements determined by BHA pursuant to Part 2.16 of these rules.

E. OTPs shall submit current schedule of planned dosing stops for mobile medication units to BHA prior to initiating care at those stops. 13.7 Personnel 13.7.1 OTP Medical Directors A. An OTP must have a designated medical director who shall authorize and oversee other qualified practitioners, other appropriately licensed and/or certified medical personnel and all medical services provided.

B. The medical director must be available to the OTP for service provision or consultation.

C. The medical director, qualified practitioners, and all other medical healthcare providers shall currently possess and maintain licenses to practice medicine/nursing in compliance with the credentialing requirements of their own profession in Colorado as provided by Article 240, Title 12, C.R.S. OTP medical directors shall assure appropriate credentials and training for other OTP physicians and other qualified health care providers to dispense, compound or administer a controlled substance in an OTP.

D. The medical director must complete an annual review of federal and state guidelines and rules to ensure that the OTP agency is in compliance with all state and federal rules and regulations regarding medical treatment for opioid use disorder.

E. The medical director shall sign an acknowledgment of review of all BHA-issued BHE and controlled substance licensing violations and recommendations connected to the OTP.

F. OTPs utilizing a qualified practitioner shall have a plan that at minimum:

1. Identifies all qualified practitioners with prescriptive authority;

2. Identifies the number of hours practitioners with prescriptive authority are onsite weekly;

3. Establishes qualified practitioner supervision requirements, including review and documentation of all medication orders for approved controlled substances and other medications, which also includes subsequent dose adjustments and changes to takehome doses; and 4. Addresses consultation requirements for when medical directors are not onsite.

G. OTP medical directors and qualified practitioners must ensure the following:

1. Medical evaluations are completed, including evidence of current physical dependence and/or history of opioid use or exceptions to admission criteria that are documented prior to initial dosing;

2. These medical evaluations are done at admission prior to initial dose;

3. The physical examinations and all appropriate laboratory tests are performed and reviewed within fourteen (14) calendar days following treatment admission;

4. All medical professionals must educate individuals regarding risks and benefits of OTP and document that individuals are entering voluntarily;

5. Other medical concerns shall be addressed by OTPs or referred to other medical agencies when appropriate, as determined by an OTP medical director or a qualified practitioner; and 6. All medical orders are properly signed or countersigned, including initial orders for approved controlled substances and other medications, subsequent dose increases or decreases, changes in take-home doses, emergency situations, and other special circumstances by a qualified practitioner in an OTP, operating within scope of their H. Medical directors shall ensure that OTPs make documented efforts to outreach individuals actively enrolled at the OTP who have missed three (3) or more consecutive doses. 13.7.2 OTP Sponsors A. OTP sponsors are responsible for the following:

1. Overall operation of the program, including, but not limited to:

a. Compliance with all applicable state and federal laws, rules, and regulations;

b. Medical and counseling personnel are qualified to provide opioid replacement c. Ensures an active medical director is assigned to the OTP and available for supervision;

d. Individuals are enrolled on their own volition;

e. Full disclosure is made to individuals about opioids and their use in treatment f. Written, informed consents for opioid replacement treatment are signed by individuals eighteen (18) years of age and older;

g. Written, informed consents for all aspects of opioid replacement treatment are signed by parents, legal guardians or other responsible adults designated by appropriate state authorities for individuals under age eighteen (18) years old;

h. Written (OTP) policies and procedures are developed, implemented, and maintained that are based on and in compliance with BHA rules;

i. All reasonable and clinically indicated efforts are made to coordinate treatment with other healthcare and behavioral health providers. Documentation includes obtaining individuals' consent to release information to communicate with those practitioners;

j. Methadone and other controlled substances are disposed of in accordance with the federal regulations; and k. Printed acknowledgements are signed by individuals and kept in individual records stating that they have been informed of the United States Department of Transportation regulation against the use of OTP prescribed methadone by commercial drivers and the possible loss of commercial driver's license if taking methadone for an opioid use disorder is discovered. 13.7.3 Personnel Training A. Training for new OTP personnel is documented in personnel records, including, but not limited to, provisions of part 2.5.I of these rules and the following:

1. Federal OTP laws and regulations;

2. State OTP laws and regulations;

3. Agency OTP policies and procedures;

4. Clinical practices including, but not limited to:

a. Protocols around special exception requests;

b. Take-home dose adjustment requests; and c. Any take-home protocol such as holiday dosing, weekend dosing, hold doses, hospitalization of individuals, incarceration, nursing home stays, and guest dosing.

5. Pharmacology of methadone and other controlled substances, including, but not limited to, loss of tolerance to opioids, dangerous drug or alcohol interactions, signs and symptoms of overdose, and purpose of its use.

B. Annual training for OTP personnel, including, but not limited to:

1. Most current pharmacology of medications used, and clinical practices applicable to OTP, including problems with interactions of medications ;

2. Review of federal and state regulations and rules;

3. Review of current agency OTP policies and procedures; and 4. Infectious disease risks and screening. 13.8 Service Delivery 13.8.1 Medical Evaluations A. Individuals admitted to OTPs shall have medical evaluations conducted by a medical director or qualified practitioner prior to the first dose.

B. In accordance with 42 C.F.R. § 8.12(F)(2)(B)(II), as incorporated by reference in Section 13.5, if the practitioner is not a qualified practitioner operating within the OTP, the medical evaluation must be completed no more than seven (7) days prior to OTP admission. Where the evaluation is performed outside of the OTP, the written results and narrative of the examination, as well as available lab testing results, must be transmitted, consistent with applicable privacy laws, to the OTP, and verified by a qualified practitioner operating within the OTP.

C. Medical evaluations must include, at minimum, the following:

1. Past medical history, past substance use history, including required chronologies of opioid use and dependence, choice of opioid, and route of administration;

2. Confirmation of evidence of current physical dependence, or diagnostic criteria for active moderate to severe opioid use disorder (OUD), or OUD remission, or are at high risk for disease recurrence or overdose;

3. Cardiovascular assessment for the risk of torsades de pointes; and 4. Other co-occurring conditions. 13.8.2 Physical Examinations A. Physical examinations, informed by the results of history of present illness and comprehensive review of systems, shall be conducted, evaluated, and documented in individual records by medical directors or authorized OTP practitioners practicing within their scope, within fourteen (14) consecutive calendar days following treatment admission and annually from date of admission.

B. In accordance with 42 C.F.R. § 8.12(F)(2)(B)(III), as incorporated by reference in part 13.5 of these rules. The full exam can be completed by a qualified practitioner operating outside of the OTP, if the exam is verified by a qualified practitioner operating within the OTP as being true and accurate and transmitted in accordance with applicable privacy laws.

C. At a minimum, physical examinations shall consist of:

1. History of present illness;

2. Comprehensive review of systems; and 3. Vital signs (temperature, pulse, blood pressure, and respiratory).

D. When exam results indicate further testing or medical follow-up, the OTP shall make documented efforts to educate the individual and make referrals to appropriate medical care. 13.8.3 Laboratory Tests A. Admission laboratory tests shall be conducted either on-site or through referral, and results shall be evaluated and documented in individual records within fourteen (14) consecutive calendar days following treatment admission. When utilizing laboratory tests performed outside of the OTP to comply with rule, the OTP must ensure tests are drawn not more than thirty (30) days prior to admission to the OTP.

B. Screening for the following shall be documented and the following laboratory tests shall be completed when clinically indicated:

1. Urine toxicology or other tests to determine current substance use;

2. Viral hepatitis, syphilis, tuberculosis, HIV/AIDS, sexually transmitted infections, and other infectious diseases;

3. Complete blood count and differential;

4. Routine and microscopic urinalysis; and 5. Comprehensive metabolic panel (CMP).

C. The following laboratory tests shall be conducted with consent, every two (2) consecutive years from date of admission when clinically indicated:

1. Viral hepatitis, syphilis, tuberculosis, HIV/AIDS, sexually transmitted infections, and other infectious diseases; and 2. Complete blood count and differential;

3. Comprehensive metabolic panel (CMP).

D. When laboratory test results indicate further testing or medical follow-up, the OTP shall make documented efforts to educate the individual and make referrals to appropriate medical care.

E. In accordance with 42 C.F.R. § 8.12 (f)(2)(b)(iii), as incorporated by reference in part 13.5 of these rules, an individual’s refusal to undergo lab testing for co-occurring physical health conditions should not preclude them from access to treatment, provided such refusal does not have potential to negatively impact treatment with medications. 13.8.4 Toxicology Screens/Urine Drug Screens A. OTPs shall develop and implement policies and procedures that ensure a random sample collection protocol that minimizes falsification and respectfully limits refusal to provide specimens for testing, including offering alternative methods for testing.

1. Individuals shall have no notification prior to the day they are required to give a sample.

2. Individuals shall not be allowed to give a sample on days they normally attend the clinic unless those days are coincidentally randomly assigned sample days.

B. OTPs shall develop and implement policies and procedures that establish treatment responses to 1. Evidence of unauthorized drugs in toxicology screens, including prescription medications;

2. Lack of all OTP-administered controlled substances in toxicology screens;

3. Dilute urine analysis;

4. Use of the prescription drug monitoring program; and 5. How the agency incorporates harm reduction and trauma-informed practices, and respect for the gender identity of the individuals being screened.

C. Toxicology screens shall occur with the following frequencies:

1. One (1) toxicology screen at admission;

2. Eight (8) annual random toxicology screens;

3. An initial toxicology screen for individuals undergoing short-term supervised withdrawal;

4. An initial toxicology screen and at least one (1) random toxicology screen per month for individuals undergoing long-term supervised withdrawal;

5. At least one (1) random toxicology screen during thirty (30) day reduction in take-home doses due to diversion or other factors as indicated in 13.6.4 of this Chapter; and 6. If toxicology screening frequency is above standards listed in 13.8.4.C 1-5, the OTP shall document medical or clinical necessity.

D. Refusal to provide samples for toxicology screens shall be considered to be positive toxicology screens.

E. Dilute urinalysis will be reviewed and assessed.

F. The state authority will monitor drug trends and may require testing for additional substances that pose a risk to health and safety of individuals receiving OTP services.

G. Results of OTP drug screening shall be utilized as a clinical tool for monitoring an individual’s substance use patterns before and during treatment. The agency’s medical director shall ensure that drug screen results are not to be utilized as the sole factor in the administrative discharge of an individual from treatment in cases that do not involve negative drug screens for methadone metabolite. 13.8.5 Counseling Services A. In accordance with 42 C.F.R. § 8.12(F)(5)(I)(II) & (III), as incorporated by reference in Part 13.5.1 of these rules, OTPs operating in Colorado shall follow the following standards of counseling care:

1. OTPs must provide adequate substance use disorder counseling and psychoeducation to each individual as clinically necessary and mutually agreed-upon, including harm reduction education and recovery-oriented counseling. This counseling shall be provided by a program counselor, qualified by education, training, or experience, to assess the psychological and sociological background of individuals, and engage with individuals, to contribute to the appropriate care plan for the individual and to monitor and update individual progress;

2. OTPs must provide counseling on preventing exposure to, and the transmission of, human immunodeficiency virus (HIV), viral hepatitis, and sexually transmitted infections (STIs) and either directly provide services and treatments or actively link to treatment each individual admitted or readmitted to treatment who has received positive test results for these conditions from initial and/or periodic medical examinations;

3. OTPs must provide directly, or through referral to adequate and reasonably accessible community resources, vocational training, education, and employment services for individuals who request such services or for whom these needs have been identified and mutually agreed-upon as beneficial by the individual and program staff;

4. Individual refusal of counseling shall not preclude them from receiving MOUD. OTPs shall perform re-assessment of individual’s interest in counseling services at least every one hundred and eighty (180) days and document as necessary in the individual's service plan; and 5. As part of quality improvement planning, OTPs shall track, in addition to requirements outlined in Chapter 2.17, OTP discharges, reasons for discharge, and progress to retention improvement efforts.

Chapter 14: Recovery Support Services Organizations 14.1 Authority and Applicability A. House Bill 21-1021 provides that it is in the best interest of the state to support the peer support professional workforce through the creation of peer-run recovery support services organizations.

B. The general assembly authorized the Colorado Department of Human Services, in collaboration with the Department of Health Care Policy and Financing, to promulgate rules establishing minimum standards that recovery support services organizations must meet. § 27-60-108(3)(A), (C) C.R.S. 14.2 Definitions “Licensed Mental Health Provider” means:

A. A mental health professional licensed or certified pursuant to Section 12-245-203(2), C.R.S., except for unlicensed psychotherapists pursuant to Section 12-245, C.R.S.

B. Advanced practice registered nurse registered pursuant to Section 12-255-111, C.R.S. with training in substance use disorders or mental health.

C. Physician assistant licensed pursuant to Section 12-240-113, C.R.S. with specific training in substance use disorders or mental health.

D. Psychiatric technician licensed pursuant to Section 12-295-103(4), C.R.S.

E. Medical doctor or doctor of osteopathy licensed pursuant to Section 12-240-107, C.R.S. 14.3 License Requirement A. Organizations shall apply for and obtain a recovery support services organization license if:

1. They are a peer-run organization providing peer support to individuals with behavioral health disorder; and 2. The organization is seeking reimbursement through Medicaid.

B. All applicants for a recovery support services organization license shall demonstrate compliance with these rules and all applicable state and federal regulations and statutes. 14.4 Annual License A. Each approved recovery support services organization that provides peer support and seeks reimbursement through Medicaid shall obtain a BHA-issued recovery support services organization license annually.

B. Peer-run service providers are not required to seek RSSO licensure to provide services unless they seek Medicaid reimbursement for peer support services rendered under a peer-run service provider. 14.5 General Provisions 14.5.1 Service Provisions A. Recovery support services organizations may provide a variety of nonclinical, recovery-focused services and supports. These services shall include engaging individuals in peer-to-peer relationships that support healing, personal growth, life skills development, self-care, and crisisstrategy development to help achieve recovery, wellness, and life goals. These services may 1. Peer-run drop in centers;

2. Recovery and wellness centers;

3. Employment services;

4. Prevention and early intervention activities;

5. Peer mentoring for children and adolescents;

6. Warm lines; or 7. Advocacy services.

B. A peer support professional may provide services on behalf of a recovery support services organization in a variety of clinical and nonclinical settings that may include, but are not limited to:

1. Justice-involved settings;

2. Physical health settings, such as pediatrician or obstetric and gynecological health care offices;

3. Emergency departments;

4. Services delivered via telehealth;

5. Agencies serving homeless communities;

6. Peer respite homes;

7. School-based health centers; or 8. Home and community-based settings.

C. Recovery support services organizations must have an established process by which the organization coordinates its services with those rendered by other agencies, including treatment agencies, to ensure an uninterrupted continuum of care to persons with behavioral health 14.5.2 Staff Requirements and Training A. Recovery support services organizations must employ or contract with a licensed mental health provider pursuant to Section 12-245-203(2), C.R.S. to administer on-going supervision of peer support professionals employed or contracted by recovery support services organizations. The licensed mental health provider must be in good standing with their credentialing body and must demonstrate in a manner determined by the behavioral health commissioner having received formal training specific to:

1. Provision of peer support services;

2. Supervision of peer support professionals; and 3. Role of peer support professionals.

B. For peer support professionals with less than twelve (12) months experience, individual supervision by the licensed mental health provider of sufficient length to address needs for a minimum of thirty (30) minutes, two (2) times per month is required. For peer support professionals with more than twelve (12) months experience, individual supervision by the licensed mental health provider of sufficient length to address needs for a minimum of thirty (30) minutes, once per month is required. Supervisors shall maintain documentation of all supervisory sessions.

C. Recovery support services organizations must employ or contract with peer support professionals who have successfully completed formal training covering all content areas outlined in “core competencies for peer workers in behavioral health services – 2018” established by United States Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) and does not include any later amendments or editions. These regulations are available at no cost at https://www.samhsa.gov/ and are also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St, Suite C410, Denver, CO 80246 during regular business hours.

D. Peer support professionals must obtain a certification as a peer support professional and be in good standing with their certifying body.

E. All staff employed or contracted by a recovery support services organization must comply with background checks and employment verification processes outlined in 2 CCR 502-1 Part 2.5 and be verified at least annually. 14.5.3 Documentation Requirements A. Recovery support services organizations shall comply with release of information requirements pursuant to 2 CCR 502-1 Part 2.7.13.

B. Recovery support services organizations shall comply with consent requirements pursuant to 2 CCR 502-1 Part 2.7.a.7.

C. Recovery support services organizations shall maintain records of the services provided to individuals by the RSSOs. The record shall be shared with BHA pursuant to a procedure determined by the behavioral health commissioner. For each encounter in which services are provided, the record shall contain:

1. Date of service;

2. Total contact time with person;

3. Session setting/place of service;

4. Reason for the encounter and description of services provided; and 5. Provider’s dated signature and relevant qualifying credential.

D. Recovery support services organizations shall have policies and procedures that address at a minimum:

1. Experience and hiring requirements for peer support professionals and licensed mental health providers;

2. The program's standards of practice and code of ethics;

3. Training for peer support professionals related to providing support services;

4. Training for licensed mental health providers related to the supervision of peers;

5. A description of each aspect of the program, including staff roles and responsibilities and how the organization meets the description of “peer run”;

6. The program’s care coordination policy, including referral procedures;

7. The handling of grievances and complaints by individuals receiving services;

8. Reporting and reviewing critical incidents in accordance with 2 CCR 502-1 Part 2.16;

9. Compliance with confidentiality, HIPAA, and 42 C.F.R. Part 2; and 10. Methods for recording information required by 2 CCR 502-1 Part 14.5.3. 14.5.4 Site Visits A. Routine monitoring: recovery support services organization licensing visits shall be scheduled and conducted by BHA during the RSSO’s normal business hours to the extent possible.

B. BHA shall conduct unscheduled site visits for specific monitoring purposes and investigation of complaints or critical incidents involving approved organizations that have a recovery support services organization license. These unscheduled visits shall be in accordance with the:

1. Recovery support services organization license rules;

2. BHA policies and procedures; and 3. Any statutes and regulations that protect the confidentiality of individual identifying information, including HIPAA and 42 C.F.R. Part 2 as incorporated by reference in Part 1.2 of these rules.

C. BHA shall have access to all individual, organization, and staff records and any other relevant documentation required to determine compliance with these rules and to coordinate individual D. Site inspection may be required at the sole discretion of BHA. 14.6 Ethical Standard A. Recovery support services organizations shall ensure that peer support professionals adhere to ethical standards. Violations of ethical standards include:

1. Performing duties outside of the scope of practice of a peer support professional;

2. Any breach of professional boundaries between a peer support professional and an individual receiving services, including relationships of a sexual or romantic nature between the peer support professional and individual receiving services;

3. Fraudulent activity, including but not limited to misrepresenting credentials and falsifying records;

4. Failure to meet generally accepted standards of peer support professional practice; or 5. Any conduct described in 2 CCR 502-1 Part 2.24. 14.7 Critical Incident Reporting A. Critical incident reporting shall occur in accordance with 2 CCR 502-1 Part 2.16. 14.8 Licensing Procedures 14.8.1 Initial Licenses A. Applications for initial licenses for RSSOs shall be submitted and processed according to procedures outlined in 2 CCR 502-1 Part 2.18.

B. The application fee for an RSSO license shall be two hundred dollars ($200).

C. No initial license shall issue prior to BHA inspection per 2 CCR Part 2.18. 14.8.2 Provisional Licenses A. Provisional licenses may be granted under the circumstances and through the processes described in 2 CCR Part 2.19. 14.8.3 License Renewal A. License renewal shall be conducted according to processes outlined in 2 CCR 502-1 Part 2.20. 14.8.4 Conditional License A. Conditional licenses may be granted under the circumstances and through the processes described in 2 CCR 502-1 Part 2.24.3. 14.8.5 License Revocation, Denial, Suspension, Limitation, or Modification A. A license may be revoked, denied, suspended, limited, or modified according to 2 CCR Part 2.24.2.

B. A license may be revoked, denied, suspended, limited, or modified if an individual providing services under the organization’s auspices violates ethical standards outlined in 2 CCR 502-1

Part 2.24.2.a.

C. A recovery support services organization that has a limited, suspended, or modified license will maintain that licensure status even if the recovery support services organization changes its name but retains the same supervising licensed mental health provider. 14.8.6 Inactivation or Surrender of a License A. No recovery support services organization license shall be inactivated except with BHA’s approval. A recovery support services organization may request inactivation at any time. Approval to inactivate a license will not be unreasonably denied. Inactivation or surrender of a license will not avoid discipline if otherwise justified. 14.9 Appeal A. Any recovery support services organization adversely affected or aggrieved by these rules or by BHA's decisions in regard to implementation of these rules has the right to appeal a BHA action in accordance with 2 CCR 502-1 Part 2.24.5.

CHAPTER 15: DESIGNATION OF FACILITIES PROVIDING EATING DISORDER TREATMENT AND

RECOVERY SERVICES 15.1 Authority A. Chapter 15 establishes the conditions that a provider must meet in order to be designated to provide services for eating disorder treatment and recovery (EDTR). The statutory authority for the promulgation of these regulations is set forth in Section 27-65-128, C.R.S., Section 27-65.5- 101, C.R.S., Section 26-1-107(5)(b), C.R.S., and Section 26-1-107(6)(g), C.R.S.

B. As of January 1, 2026, the Behavioral Health Administration (BHA) shall require all eating disorder treatment and recovery facilities to hold an appropriate designation based on the level of care the facility provides, including facilities that offer intensive outpatient treatment, partial hospitalization, residential programs, and inpatient programs. Licensed clinicians who are not facility-based and offer behavioral health therapy to individuals with an eating disorder on an outpatient basis are not required to hold a designation.

C. Any facility providing involuntary eating disorder treatment and recovery services must also obtain a 27-65 facility designation from BHA pursuant to Sections 27-65-101 through 27-65-132, C.R.S.

1. If there is any conflict between the Rules of this Chapter 15 and the requirements of

Article 65 of Title 27, C.R.S. and/or Chapter 11, the requirements of Chapter 11 and/or the 27-65 designation shall supersede these Chapter 15 rules. 15.2 Definitions “Administration” for the purpose of this Chapter 15 means assisting a person in the ingestion, application, inhalation, or, using universal precautions, rectal or vaginal insertion of medication, including prescription drugs, according to the legibly written or printed directions of the attending physician or other authorized practitioner or as written on the prescription label and making a written record thereof with regard to each medication administered, including the time and the amount taken, but “administration” does not include judgment, evaluation, or assessments or the injections of medication, the monitoring of medication, or the self-administration of medication, including prescription drugs and including the self-injection of medication by the resident. “Administration” also means ingestion through placement and use of gastrostomy tubes or naso-gastric tubes, if administered by a person authorized pursuant to Sections 25.5-10-204 (2)(j) and 27-10.5-103 (2)(i), C.R.S., as part of inpatient, residential or day programming services provided through designated facilities and supervised by a licensed physician or nurse.

“Affiliate of an Entity,” for the purposes of this Chapter 15, means:

A. A person or entity that owns more than five percent of the ownership interest in the business operated by the designee or the applicant for a license;

B. An executive, office member of the governing board, or employee of an entity; or C. A relative of an entity who is otherwise involved in the management or operations of the facility or “Eating Disorder(s)” means a range of irregular eating patterns characterized by disturbance of eating or eating-related behaviors that results in altered consumption or absorption of food as defined and updated by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), as incorporated by reference in Part 1.2 of these Rules; or, significantly impairs physical health, mental health and/or psychosocial functioning. This does not include food restriction related to lack of food availability, religious and/or spiritual practices, except as it impacts the health or safety of the individual, or developmentally normal behaviors.

“Eating Disorder Treatment” means treatment to address the physical, mental, and behavioral aspects of an individual’s struggles with an eating disorder. Eating disorder treatment may include, but is not limited to, psychotherapy, psychiatric care and monitoring, medical care and weight monitoring, nutritional support, medications, or any combination of these approaches.

“Eating Disorder Treatment Facility” means a facility that offers, but is not limited to, one or more of the following levels of care for individuals with eating disorders: inpatient, residential services, partial hospitalization, and/or intensive outpatient programs as these levels of care are described in Chapters 1 through 10 of these Rules.

“Facility” for the purposes of this Chapter 15, means an agency, general hospital, psychiatric hospital, behavioral health entity, residential child care facility (RCCF), or similar, designated by BHA for the purposes of providing eating disorder treatment and recovery services.

“Informed Consent” means an informed assent that is freely given. It is always preceded by the following:

A. An explanation of the nature and purpose of the recommended treatment or procedure in layman's terms and in a form of communication understood by the individual or the individual’s designated representative;

B. An explanation of the risks and benefits of a treatment or procedure, the probability of success, mortality risks, and serious side effects;

C. An explanation of the alternatives with the risks and benefits of these alternatives;

D. An explanation of the risks and benefits if no treatment is pursued;

E. An explanation of the recuperative period, which includes a discussion of anticipated problems;

F. An explanation that the individual, or the individual’s designated representative, is free to withdraw consent and to discontinue participation in the treatment regimen at any time with the exception of an involuntary feeding tube pursuant to Part 15.16.4 of this Chapter 15.

“Medical emergency” for eating disorder treatment means an acute injury or illness that poses an immediate risk to a person's life or long-term health.

“Medical necessity” means treatment that is recommended or ordered by a licensed Colorado health-care provider. The following factors, at a minimum, must be considered when determining medical necessity or the appropriate level of care for an individual diagnosed with an eating disorder:

A. The individual’s eating or compensatory behaviors;

B. The individual’s need for supervised meals and support interventions;

C. Physical exam data and laboratory results, including but not limited to, the individual’s heart rate, renal or cardiovascular activity, blood pressure, and degree of malnutrition;

D. The recovery environment; and E. Co-occurring disorders the individual may have.

"Minor," for purposes relating to consent for mental health services and for this Chapter 15, means a person under eighteen (18) years of age; except that the term does not include a person who is fifteen (15) years of age or older who is living separately and apart from the person’s parent or legal guardian and is managing the person’s own financial affairs, regardless of the person’s source of income, or who is married and living separately and apart from the person’s parent or legal guardian.

"Patient Representative" means a person designated by a mental health facility to process patient complaints or grievances or to represent patients who are minors pursuant to Section 27-65-104(4), “Physical Activity,” for the purposes of this Chapter 15, means the free movement and motion of an individual’s body.

“Physical Exercises” for the purposes of this Chapter 15, means the individual’s movement or manipulation of their body in a specific manner or process to be carried out for a specific purpose in response to a request, order, or direction.

“Transitional Measures” means physical guidance, prompting techniques of short duration, or an initial temporary approved physical positioning of an individual at the onset or in response to a re-escalation during a physical management, for the purpose of quickly and effectively gaining physical control of that individual in order to prevent harm to self or others. 15.3 Designation Requirements A. Facilities designated to provide eating disorder treatment and recovery shall be in compliance with the requirements listed in this Chapter 15 and, if providing involuntary services Chapter 11 of these Rules.

B. All providers providing eating disorder treatment and recovery services pursuant to Article 65.5 of Title 27, C.R.S., shall meet the applicable standards in this Chapter 15. If the facility requires any other license, designation, and/or endorsement type, the facility shall also comply with those applicable standards. 15.4 Eating Disorder Designation Procedures 15.4.1 Application Process A. Entities applying for eating disorder designation shall submit an application to BHA on a stateapproved form, available on BHA’s website.

B. Applicants providing eating disorder treatment and recovery pursuant to Section 65.5 of Title 27, C.R.S., must apply for a separate eating disorder designation based on the unique physical address of each site. If two or more buildings or units share a physical address, each building or unit must be designated separately for eating disorder services.

C. BHA will provide written notice to the applicant within thirty (30) calendar days of receipt of a D. BHA will act on an application within ninety (90) calendar days of receipt of the completed application. The applicant may be approved for eating disorder designation, granted provisional approval, or the application may be denied.

E. An applicant approved as a facility designated to provide eating disorder treatment and recovery services, shall receive a designation, effective for up to a one (1) year period.

F. BHA may deny an application for an eating disorder treatment and recovery designation if the applicant has been an affiliate of an entity, an affiliate of an agency, or an affiliate of a facility which is the subject of a previous negative licensing action or is the subject of a pending investigation by any Department that may result in a negative licensing action.

G. If the application for eating disorder designation is denied, the reason(s) for denial shall be provided in a certified letter to the address of the applicant as shown on the application or to the address subsequently furnished in writing by the applicant. If an applicant disagrees with the decision, the applicant, if within sixty (60) days of receiving notice of the decision, may request a hearing to review the denial pursuant to Sections 24-4-105 and 24-4-106, C.R.S.; or upon remedying the noted deficiencies, may re-apply for an eating disorder designation in accordance with this Part 15.4. 15.4.2 Provisional Designation A. Provisional designation approval may be granted for a period not to exceed ninety (90) calendar days if, after initial inspection and review of an application:

1. The applicant is in substantial compliance with these Rules and is temporarily unable to conform to all the minimum standards required under these Rules. No provisional eating disorder designation shall be issued to an applicant if the operation of the facility may adversely affect individual health, safety, or welfare of individuals in care;

2. Compliance will be achieved within the ninety (90) day duration of the provisional designation; and 3. The applicant has a reasonable plan or schedule in writing for achieving compliance and provides a written copy of the plan to BHA.

B. The applicant shall provide proof that attempts are being made to conform and comply with C. A second provisional designation approval for a period not to exceed ninety (90) calendar days may be granted under the same criteria if necessary to achieve compliance.

D. If the applicant is not able to come into compliance within one hundred and eighty (180) calendar days from the date of initial provisional designation being granted, the application may be denied with a right to request a hearing as described in Part 15.4.1.G of this Chapter 15. 15.4.3 Conditional Designation A. A conditional eating disorder designation may be granted to a facility found to be out of compliance with applicable BHA or state and federal regulations prior to issuance of a renewal designation or during a current designation period. The facility will be notified in writing of noncompliance areas and the need for a plan of action as described in Part 15.8 of this Chapter 15.

B. A conditional eating disorder designation will replace the current eating disorder designation for a period not to exceed ninety (90) calendar days.

C. Administrative and treatment activities may be limited by a conditional designation as set forth in the conditional designation while the facility addresses corrective actions.

D. A conditional designation may be re-issued for an additional period not to exceed ninety (90) calendar days if substantial progress continues to be made and it is likely that compliance can be achieved by the date of expiration of the second conditional designation.

E. If the facility fails to comply with or complete a plan of action in the time or manner specified, or is unwilling to consent to the conditional designation, the modification to a conditional designation shall be treated as a revocation of the designation. The facility shall be notified by certified mail of the deficiencies and the reason for action. BHA may then institute revocation proceedings pursuant to Part 15.6.2 of this Chapter 15. 15.4.4 Change in Designation A. If a facility makes a change in its designation status or decides to drop its designation, it shall notify BHA in writing no later than thirty (30) calendar days prior to the desired effective date. The facility shall submit a written plan for the transfer of care for the persons with eating disorders if the facility will no longer treat those individuals. This plan shall be submitted no later than ten (10) business days prior to the effective date. 15.4.5 Designation Renewal A. A facility seeking eating disorder designation renewal shall provide BHA with a completed eating disorder designation application at least sixty (60) calendar days prior to the expiration of the existing eating disorder designation.

B. Eating disorder designation renewal applications received by BHA after the current designation expiration date has passed shall be returned to the facility by certified first-class mail and/or through electronic means with written notification that the eating disorder designation is no longer in effect. Applicants may reapply for an initial eating disorder designation in accordance with Part 15.4.1 of this Chapter 15.

C. Eating disorder designation renewal applications that are received by BHA fewer than sixty (60) calendar days prior to the expiration of their existing eating disorder designation is a basis from which BHA may deny the renewal application.

1. If BHA denies the renewal application for being untimely, BHA will provide the facility with notice of the decision by certified first-class mail. If the facility disagrees with the decision, it may request a hearing as described in Part 15.4.1.G of this Chapter 15.

2. Any facility that submits its renewal application fewer than sixty (60) calendar days prior to the expiration of the current eating disorder designation and does not receive a new eating disorder designation prior to that date and/or notice that BHA decided to deny the renewal application may reapply for an initial eating disorder designation in accordance with Part 15.4.1 of this Chapter 15.

D. Failure of a facility seeking renewal of a designation to accurately answer or report any information requested by BHA shall be considered good cause to deny the eating disorder designation renewal application.

E. Facilities designated to provide care and treatment to persons with eating disorders pursuant to

Section 27-65.5-101, C.R.S. shall receive an annual review by BHA for compliance.

F. Facilities shall be notified in writing of non-compliance areas and the need for a plan of action as outlined in Part 15.8 of this Chapter 15. A conditional eating disorder designation may be granted.

G. A facility in compliance with applicable Rules of this Chapter 15 and state and federal regulations may be granted an eating disorder designation effective through the expiration date, for a period not to exceed one (1) year. 15.5 Change of Ownership/Management A. If a designated eating disorder facility undergoes a change in ownership without following the procedures outlined in this Part 15.5, its existing designation may be terminated. Termination of the designation for this basis may not occur until after a hearing and in compliance with the provisions and procedures specified in Sections 24-4-101 through -109, C.R.S.

B. When a designated eating disorder facility initiates a change of ownership, the facility must submit notification to BHA within the specified time frame, and the prospective new facility shall submit an application and supporting documentation for change of ownership within the same time frame. The time frame for submission of the notification and the application, and supporting documentation shall be at least thirty (30) calendar days before a change of ownership involving any designation facility.

C. Each designated eating disorder facility undergoing a change of ownership shall submit an application as prescribed in Part 15.4.1 of this Chapter 15.

D. The existing designated eating disorder facility is responsible for correcting all rule violations and deficiencies in any current plan of action before the change of ownership becomes effective. In the event that such corrective actions cannot be accomplished in the time frame specified, the prospective facility shall be responsible for all uncorrected rule violations and deficiencies including any current plan of action submitted by the previous facility unless the prospective facility submits a revised plan of action, approved by BHA, before the change of ownership becomes effective.

E. When BHA issues a designation to the new owner, the previous owner must return its designation to BHA within five (5) calendar days of the new owner’s receipt of its designation. 15.6 Enforcement and Adverse Actions 15.6.1 Designation Denial A. BHA may deny an application for an initial or renewal designation for reasons including but not limited to the following:

1. The application or accompanying documents contain a false or misleading statement of a material fact;

2. The facility/applicant fails to respond to BHA requests for additional information in the time frame indicated in the request;

3. The facility/applicant refuses any part of an inspection;

4. The facility/applicant fails to comply with or successfully complete an acceptable plan of action;

5. The facility/applicant has failed to cooperate with the investigation of any local, state, or federal regulatory body or law enforcement agency;

6. The facility/applicant is not in compliance with regulatory requirements or has a documented pattern of non-compliance that has harmed or has the potential to harm the health or safety of the individual(s) served;

7. The facility/applicant was or is affiliated with a person or entity that is the subject of a previous negative licensing action; or 8. The facility/applicant is the subject of a pending investigation by BHA that may result in negative enforcement action.

B. If BHA denies an application for an initial or renewal designation, it shall provide the facility with a written notice by certified mail to the applicant or designee at the address shown on the application. The notice must explain the basis for the denial and afford the facility the opportunity to respond.

C. Appeals of designation denials must be conducted in accordance with the State Administrative Procedure Act, Sections 24-4-101 through -109, C.R.S., and Section 26-1-106, C.R.S. 15.6.2 Revocation or Suspension of Designation A. BHA may limit, revoke, or suspend an existing designation if a facility fails or refuses to comply with the statutory and/or regulatory requirements applicable to its designation or to other licenses, endorsements, approvals, or designations the facility may have from BHA. BHA may limit the overall designation, physical locations, or both, for failure or refusal to comply. Failures to comply 1. Making a false or misleading statement of material fact about individuals served by the facility, its personnel, capacity, or other operational components verbally or in any public document or in a matter under investigation by BHA or another governmental entity;

2. Preventing, interfering with, or attempting to impede in any way the work of a representative or agent of BHA in investigating or enforcing the applicable statutes or regulations;

3. Falsely advertising or in any way misrepresenting the facility’s ability to provide services for the individuals served based on its designation type and/or status;

4. Failing to provide reports and documents required by regulation or statute in a timely and complete fashion;

5. Failing to comply with or complete a plan of action in the time or manner specified;

6. Falsifying records or documents;

7. Knowingly using or disseminating misleading, deceptive, or false information;

8. Accepting commissions, rebates, or other forms of remuneration for referrals or other treatment decisions;

9. Exercising undue influence or coercion over an individual to obtain certain decisions or actions or for financial or personal gain. a relationship other than a professional relationship, including but not limited to a relationship of a sexual nature, between an owner, director, manager, administrator, or other personnel and an individual; or 10. Non-compliance with the requirements of Section 27-65.5-101, C.R.S., and any applicable regulations promulgated pursuant to those statutes.

B. Except in the case of a summary suspension in accordance with Section 24-4-104(4)(a), C.R.S., suspension or revocation must not occur until after a hearing and in compliance with the provisions and procedures specified in Section 24-4-101 through Section -109, C.R.S. 15.6.3 Right to Appeal A. Any facility adversely affected or aggrieved by BHA’s decisions in regard to implementation of these Rules has the right to appeal to the Colorado Department of Personnel and Administration, Office of Administrative Courts, and may subsequently seek judicial review of BHA’s action in accordance with Sections 24-4-101 through -109, C.R.S.

B. The following actions may be submitted to an Administrative Law Judge for an evidentiary hearing: denial of a designation; denial of a designation renewal; provisional designation; conditional designation; revocation; denial of a waiver; limitation of a designation; denial of a modification; and imposition of an intermediate restriction or condition.

C. After written notification from BHA of intended action, the facility has twenty-one (21) calendar days to submit a written appeal. The appeal must be received by BHA within twenty-one (21) calendar days from the date the written notification of action letter was sent by BHA.

D. In all cases except waiver denials, BHA will file a Notice of Charges with the Office of Administrative Courts to begin the administrative process. In waiver denials, if the applicant for the waiver requests an appeal, the request for appeal must be forwarded to the Office of Administrative Courts. Once the appellant’s request is forwarded to the Office of Administrative Courts, BHA may file a Notice of Charges.

E. Subsequent to an evidentiary hearing at the Office of Administrative Courts and the issuance of a final agency decision, a party may seek to appeal the final agency decision through judicial 15.6.4 Closure of a Facility A. Each eating disorder treatment and recovery designation issued by BHA will become invalid if the facility fails to timely renew the designation, ceases operation, or there is a final BHA action suspending or revoking the designation. The designation certificate must be returned to BHA within ten (10) calendar days of the event that invalidated it.

B. Emergency Closures 1. In the event of an emergency affecting the physical space of the facility that necessitates the removal of individuals and personnel from the facility, the facility shall provide BHA with verbal notice of the event at the time of removal and a written report within fourteen (14) calendar days after the removal explaining the emergent situation and the actions taken by the facility to provide services that meet the health and safety needs of the individuals. Based on the extenuating circumstances, BHA may approve the continuation of the designation during the time period that it takes to make the physical space appropriate for individuals and personnel to return.

C. Permanent Closures 1. Each facility that surrenders its designation shall accomplish the following with regard to any individual records that the entity is legally obligated to maintain:

a. Within ten (10) calendar days prior to closure, inform BHA in writing of the specific plan for storage and retrieval of individual records;

b. Unless noted otherwise within an endorsement chapter, within ten (10) calendar days of closure, inform all individuals or designated representatives thereof, in writing, how and where to obtain their individual records; and c. Provide secure storage for any remaining individual records.

2. In the event of a facility closure, the facility shall be responsible for appropriate continuity of care for each individual served by the facility. 15.7 Rule Waivers A. This Part establishes procedures with respect to the waiver of regulations relating to facility B. Any facility or applicant that has applied for or been issued a designation to operate an eating disorder and treatment recovery facility has the right to apply for a waiver of any rule or standard set forth in these Rules which, in their opinion, poses an undue hardship on the applicant, facility, or community.

C. Nothing contained in these provisions negates the obligation of the facility/applicant to meet minimum requirements under local safety, fire, electrical, building, zoning, and similar codes.

D. Nothing herein authorizes a waiver of any statutory requirement under state or federal law, except E. Upon application to BHA, a waiver may be granted in accordance with this Part 15.7. Absent the existence of a current waiver issued pursuant to this part, designated facilities are expected to comply at all times with all applicable regulations except in instances where they are granted a provisional designation in accordance with Part 15.4 of this Chapter 15. Designated facilities must comply with all applicable regulations unless and until a waiver is granted.

F. Waiver applications must be submitted to BHA in writing.

1. BHA will only consider one regulation per waiver.

2. The waiver application must provide BHA information related to:

a. The regulation the facility or applicant is requesting to waive;

b. The reason why the waiver is being requested;

c. A proposed alternate compliance plan; and d. Any other information relevant to the waiver request that would inform BHA’s 3. The waiver application must be submitted by an authorized representative of the facility or applicant, who is the primary contact person and the person responsible for ensuring that accurate and complete information is provided to BHA.

G. In making its determination, BHA may consider any information it deems relevant, including but 1. Critical incident and complaint investigation reports, licensure or certification survey reports, anticipated impact of the waiver on individual safety and quality of care if any, and findings of these reports related to the facility and/or the operator or owner thereof.

2. When determining whether a waiver should be granted, BHA shall prioritize consideration of the impact of the waiver on the health, safety, and welfare of individuals over any alleged undue hardship.

H. BHA shall act on a waiver application within ninety (90) calendar days of receipt of the completed application. An application will not be deemed complete until the facility or applicant has provided all information and documentation requested by BHA.

I. BHA may specify terms and conditions under which any waiver is granted, including which terms and conditions must be met in order for the waiver to remain effective. The term for which each waiver granted will remain effective must be specified at the time of issuance, but may not exceed the term of the current designation.

1. At any time, upon reasonable cause, BHA may inspect a facility with an active waiver to ensure that the terms and conditions of the waiver are being observed, and/or that the continued existence of the waiver is otherwise appropriate.

2. Within thirty (30) calendar days of the termination, expiration, or revocation of a waiver, the facility shall submit to BHA an attestation of compliance with the regulation to which the waiver pertained.

J. A waiver will automatically terminate upon a change of ownership of the facility, as outlined in

Part 15.5 of this Chapter 15. However, to prevent such automatic termination, the prospective new owner may submit a waiver application to BHA prior to the effective date of the change of ownership. Provided BHA receives the new application by this date, the waiver will be deemed to remain effective until such time as BHA acts on the application.

1. Except as otherwise provided in this Part 15.7, a waiver may not be granted for a term that exceeds the current designation term.

2. If a facility wishes to maintain a waiver beyond the stated term, it must submit a new waiver application to BHA not less than ninety (90) calendar days prior to the expiration of the current term of the waiver or with a designation renewal.

K. BHA may revoke a waiver if it determines that:

1. The waiver's continuation jeopardizes the health, safety, or welfare of individuals served by the facility;

2. The waiver application contained false or misleading information;

3. The terms and conditions of the waiver have not been complied with;

4. The conditions under which a waiver was granted no longer exist or have changed 5. A change in a federal or state statute or regulation prohibits, or is inconsistent with, the L. Notice of the revocation of a waiver must be provided to the facility in accordance with the Colorado Administrative Procedures Act, Sections 24-4-101 through -109, C.R.S.

M. A facility may appeal the decision of BHA regarding a waiver application or revocation, as provided in the Colorado Administrative Procedure Act, Sections 24-4-101 through -109, C.R.S. 15.8 Continuing Obligations and BHA Oversight A. Each facility must have and maintain electronic business communication tools, including but not limited to internet access and a valid e-mail address. The facility must use these tools to receive B. The designation is only valid while in the possession of the facility to whom it is issued and may not be subject to sale, assignment, or other transfer, voluntary or involuntary, nor is a designation valid for any premises other than those for which it was originally issued.

C. The facility must provide accurate and truthful information to BHA during inspections, investigations, and licensing activities.

D. When a facility is subject to inspection, certification, or review by other agencies, accrediting organizations, or inspecting companies, the facility shall provide and/or release to BHA, upon request, any correspondence, reports, or recommendations concerning the facility that were E. Each facility must submit notification to BHA of any change in the information required by Part 15.4 of this Chapter 15 from what was contained in the last submitted designation application.

1. Changes to the operation of the facility may not be implemented without prior approval from BHA. A facility shall, at least thirty (30) calendar days in advance, submit notification to BHA regarding any of the following proposed changes.

a. Change in designation or license category.

b. Change in the scope of services, including the addition or removal of a service or a physical location.

c. Change in legal name of the facility and all other names used by it to provide F. BHA and any duly authorized representatives thereof have the right to enter upon and into the premises of any facility or applicant for an eating disorder treatment and recovery designation in order to determine the state of compliance with the statutes and regulations, and must initially identify themselves to the person in charge of the facility at the time.

G. BHA may use the following measures to ensure a facility’s full compliance with the applicable statutory and regulatory criteria.

1. BHA may conduct an unscheduled or unannounced review of a current facility based upon, but not limited to, the following criteria:

a. Routine compliance inspection;

b. Reason exists to question the facility’s continued fitness to conduct or maintain designated operations;

c. A complaint alleging non-compliance with designation requirements;

d. Discovery of previously undisclosed information regarding a facility or any of its owners, officers, managers, or other personnel if such information affects or has the potential to affect the facility’s provision of services; or e. The omission of relevant information from documents requested by BHA or indication of false information submitted to BHA.

2. Plan of action a. If after review or pursuant to a complaint, it is determined that a facility is not in compliance with these Rules, the facility shall be notified in writing, within thirty (30) calendar days of the specific deficiency/deficiencies.

b. After any review, BHA may request a plan of action from a facility or require a facility’s compliance with a BHA-directed plan of action.

c. If the facility does not agree with any or all of the findings regarding noncompliance, the facility has fourteen (14) calendar days from the receipt of the non-compliance notice to dispute the findings by submitting evidence to BHA.

d. The facility shall receive a written response within thirty (30) calendar days of the review of submitted evidence.

e. If the submitted information is sufficient, the facility shall be determined in compliance with these Rules.

f. If the facility continues to be found out of compliance with these Rules, the facility shall have thirty (30) calendar days from the date of receipt of the review findings to submit a plan of action.

g. The plan of action must be in the format prescribed by BHA and include, but not be limited to, the following:

(1) A description of how the facility will correct each identified deficiency.

(a) If deficient practice was cited for specific personnel, the not reoccur for the affected individual (s) and/or other individuals (2) A description of how the facility will monitor the corrective action to ensure each deficiency is remedied and will not reoccur, and (3) A completion date that is no later than ninety (90) calendar days from the BHA. The completion date is the date that the entity deems it can h. A completed plan of action must be:

(1) Signed by the facility’s director, administrator, or manager, and (2) Submitted to BHA within thirty (30) calendar days after the date of BHA’s written notice of deficiencies.

(a) If an extension of time is needed to complete the plan of action, the facility shall request an extension in writing from BHA prior to the plan of action due date. BHA may grant an extension of time.

i. BHA has discretion to approve, impose, modify, or reject a plan of action.

(1) If the plan of action is accepted, BHA shall notify the facility by issuing a written notice of acceptance.

(2) If the plan of action is unacceptable, BHA shall notify the facility in writing, and the facility shall resubmit the changes within the time frame prescribed by BHA.

(3) If the facility fails to comply with the requirements or deadlines for submission of a plan or fails to submit requested changes to the plan, set forth in Part 15.6 of this Chapter 15.

(4) If the facility fails to implement the actions agreed to by the action date in the approved plan of action, BHA may impose enforcement sanctions as set forth below.

H. The facility must provide, upon request, access to or copies of the following to BHA for the 1. Individual records.

2. Reports and information, including but not limited to staffing reports, census data, statistical information, and other records, as determined by BHA.

I. Oversight and enforcement activities may include review of separate physical locations as necessary for BHA to ensure the health, safety, and welfare of individuals. 15.9 General Eating Disorder Designation Provisions 15.9.1 Eating Disorder Designation General Standards A. The facility shall only provide services for which it holds/has a designation, approval, and/or another BHA license.

B. Facility designation applies only to the physical location(s) listed on the eating disorder designation certificate from BHA and not to any other non-designated physical locations operated by the facility.

C. The eating disorder facility shall ensure all operations, locations, and services, including contracted services or personnel, comply with laws, regulations, and standards as required for any additional BHA-issued licenses, designations, or approvals the facility may hold. 15.9.2 Critical Incident Reporting A. A critical incident includes but is not limited to the following:

1. Breach of confidentiality: any unauthorized disclosure of protected health information as described in HIPAA, 42 C.F.R. Part 2, as incorporated by reference in Part 1.2 of these Rules, and/or Sections 27-65-101 through -131, C.R.S.

2. Death: including the death of an individual inside of or outside of the facility’s physical location while an individual is receiving services or where an individual has attempted to receive services from the facility within the past thirty (30) calendar days.

3. Elopement: absconding from a mental health hold, certification, emergency/involuntary commitment, or a secure facility where an individual is being held as a result of a court order. This includes any unauthorized absence of a child, when a child cannot be accounted for or when there is reasonable suspicion to believe the child has absconded.

4. Any instance when an individual cannot be located following a search of the facility, the facility grounds, and the area surrounding the facility, and:

a. There are circumstances that place the individual’s health, safety, or welfare at risk; or b. The individual has been missing for eight (8) hours.

5. Medication diversion: any medication diversion as defined in Part 1.2 of these Rules shall also include theft, loss, misuse, or illicit distribution of any prescription medication.

6. Medication error: a medication error that resulted or could have resulted in harm to the 7. Medical emergency: any suicide attempt/self-injury, other form of serious injury, health emergency, overdose, or serious illness that occurred on facility premises or in the presence of facility personnel.

a. This does not include the individual’s need for medical stabilization while receiving eating disorder treatment and recovery services, such as electrolyte imbalance, glucose level, or other medical conditions as a result of the eating (1) When an individual leaves the program to receive medical services and returns after stabilization, a critical incident report to BHA is not required.

(2) When an individual leaves the program to receive medical services and does not return, a critical incident report is required to be submitted to BHA in accordance with Part 15.9.2 of this Chapter 15.

8. Any instance involving physical, sexual, or verbal abuse of an individual, as described in Sections 18-3-202, 18-3-203, 18-3-204, 18-3-206, 18-3-402, 18-3-404, 18-3-405, 18-3- 405.3, 18-3-405.5, and 18-9-111 (exempting however, the phrase “intended to harass”), C.R.S. by another individual, personnel, or a visitor to the facility.

9. Any instance that results in any of the following serious injuries to an individual:

a. Brain or spinal cord injuries;

b. Life-threatening complications of anesthesia or life-threatening transfusion errors c. Second- or third-degree burns involving twenty percent (20%) or more of the body surface area of an adult or more than fifteen percent (15%) of the body surface area of a child.

10. Any instance involving caretaker neglect of an individual, as defined in Section 26-3.1- 101(2.3), C.R.S., or child abuse or neglect as defined in Section 19-1-103(1), C.R.S.

11. Any instance involving misappropriation of an individual’s property, meaning patterns of loss or single incidences of deliberately misplacing, exploiting, or wrongfully using, either temporarily or permanently, an individual’s belongings or money without the individual’s 12. Any occurrence involving the malfunction or intentional or accidental misuse of care equipment that occurs during treatment or diagnosis of an individual and that significantly or adversely affects or, if not averted, would have significantly adversely affected an B. Critical incidents must be reported to BHA within one (1) business day after the incident. Critical incidents must also be reported to BHA within one (1) business day of when the facility determines that a reportable incident has occurred and BHA requests such reporting.

C. BHA may conduct scheduled or unscheduled site reviews for specific monitoring purposes and investigation of critical incident reports in accordance with:

1. BHA policies and procedures, 2. Regulations that protect the confidentiality and individual rights in accordance with Sections 27-65-101 through -131, C.R.S.; HIPAA; and 42 C.F.R. Part 2, as incorporated by reference in Part 1.2 of these Rules.

D. BHA shall have access to the relevant documentation required to determine compliance with these Rules.

1. Refusal to provide relevant information, documentation, or access to any part of the facility may result in adverse licensing action.

E. The facility must:

1. Establish written policies and procedures for reporting and reviewing all critical incidents 2. Submit critical incident reports to BHA using state-prescribed forms that can be obtained from BHA’s website at: https://bha.colorado.gov/for-providers. This is not in lieu of other reporting mandated by state statute or federal guidelines;

3. Make available a report with the investigation findings for review by BHA, upon request;

4. Maintain critical incident reports for a minimum of three (3) years following the incident F. Nothing in this Part shall be construed to limit or modify any statutory or common law right, 15.9.3 Policies and Procedures A. Any facility designated for eating disorder treatment and recovery must develop, implement, and every three (3) years review the following policies and procedures listed below:

1. The governing body shall have policies and procedures regarding administrative and/or clinical oversight of the designated services and requirements.

2. Personnel needed for services and staffing ratios for direct care;

a. Required education and training; and b. Background checks as listed in 15.10.2.

3. Training schedules and demonstration of training for personnel;

4. Emergency and crisis protocol(s);

5. Record protection, sharing, and retention protocol;

6. Disclosure of intervention, treatment, and/or medication;

7. Policies and procedures regarding the use or non-use of restraint, seclusion, and/or physical management pursuant to Part 15.15 of this Chapter 15;

8. Continuity and transfer of care upon admittance and discharge from the facility;

9. Communication of rights of individuals;

10. Facility rules and how they are communicated to individuals receiving services, including visitation and dress code expectations;

11. Weight monitoring procedures, including the prohibition of using body mass index (BMI) as the only measure of medical necessity;

12. Critical incident reporting;

13. Treatment and care for transgender and gender non-conforming individuals, including use of restroom facilities, preferred pronouns, and assessment of the individual’s related gender identity needs;

14. Use of restroom facilities, bathing, supervision, and documentation of restroom activities, including policies that prohibit requiring individuals to share a stall of a restroom or a single-occupancy bathroom while in the act of using the restroom:

a. With another individual in care at any time; and b. With personnel, unless medically indicated;

(1) Documentation showing the individual’s need for assistance in the restroom shall be maintained as part of the clinical record as described in

Part 15.11 of this Chapter 15. The need for assistance shall be reviewed at least every seven (7) calendar days and updated in the clinical record.

c. Policies and procedures must be in line with the Patient Bill of Rights as described in Part 15.14 of this Chapter 15; and 15. Respect and accommodation of a patient’s sexual orientation, gender identity, religion, and unless clinically contraindicated, personal dietary ethics;

16. Meal times, dietary practices, and meal planning/preparation.

B. Any policies and procedures in subparts of this Chapter 15 must be followed in addition to those listed in this part.

C. Weight monitoring policies and procedures shall reflect, at a minimum, the following 1. How individuals shall be weighed without other individuals present in the same room, when requested.

2. Individuals shall be allowed to wear their own clothing during a weigh-in or the facility shall provide clothing that provides privacy and covers the individual's body.

a. If the facility provides the individual with alternative clothing, the clothing shall not be transparent; and b. Individuals shall not be required to remove their undergarments.

3. The facility shall not require physical exercises during a weigh-in.

a. If the treatment provider has sufficient cause to believe that the individual would be at risk of harm without requiring a physical exercise, at which point the treatment provider shall document the concern and need for further investigation in the individual's clinical record.

(1) Utilizing physical exercise during a weigh-in may only be used to obtain accurate weight information, as described in the facility’s policies and b. If the individual is asked to perform any physical exercises, they must be provided a space with sufficient privacy that preserves the individual's dignity to the greatest extent possible.

4. Only personnel with appropriate training or credentials, as described in the facility’s policies, shall be allowed to monitor individual weigh-ins.

D. All policies and procedures listed in this Chapter 15 must be created and implemented within the facility’s trauma-informed and trauma-aware framework as described in Part 15.9.4 of this 15.9.4 Trauma-Informed Care and Treatment A. Any facility providing eating disorder treatment and care must implement a trauma-informed treatment network and must create policies and procedures that support the implementation of a trauma-informed treatment framework. The trauma-informed framework, utilizing an evidencebased model, must include at a minimum:

1. Safety: Ensuring physical, social, emotional, and psychological safety of all individuals receiving care;

2. Trustworthiness and Transparency: Prioritizing the therapeutic relationship between personnel and individuals receiving services when personnel perform multiple functions within the facility;

3. Collaboration and Mutuality: Empowering individuals and their identified supportive others to have their voice heard and their choice(s) considered in the decision-making process;

4. Cultural, Historical, and Gender issues: How the facility will promote access, cultural affirmation, and anti-discrimination practice; and 5. Support and Self-help: Ways to build healthy relationships and interactions.

B. Facilities designated for eating disorder treatment and recovery must review the trauma-informed framework and corresponding policies and procedures every three (3) years. Revisions to framework and policies must reflect current best practices and be data-informed. Data used in the revision process must include, but is not limited to:

1. The facility’s performance improvement plan;

2. The facility’s use of seclusion and/or restraint;

3. The facility’s internal critical incidents tracking; and 4. Satisfaction surveys from individuals and/or family members.

C. All personnel shall be trained in evidenced-informed, trauma-informed practices and the facility’s trauma-informed framework as part of the initial orientation training in addition to the requirements of Part 15.10.2 of this Chapter 15.

1. All personnel shall receive annual training on trauma-informed practices, the facility’s framework, and applications of trauma-informed care for eating disorder treatment and recovery.

D. Behavior Management 1. Each facility shall have written documentation of policies and procedures that describe the trauma-informed model upon which the behavior management system is based and who shall be responsible for any disciplinary measures.

2. The behavior management system shall be explained to the individual, the individual’s legal guardian or legal custodian upon admission. The behavioral management system must be explained in a manner that takes into account the individual’s developmental and cognitive level.

3. The behavior management system shall include, at a minimum:

a. Positive and constructive components, such as talking with the individual about the situation, positive reinforcement, skill training, and skill development;

b. Clear rules and expectations with predictable, consistent consequences or interventions that will be used by the facility’s personnels to reinforce positive behaviors and to address unsafe behaviors;

c. A continuum of de-escalation and redirection techniques;

d. A review process for addressing chronic or acute behavioral concerns when the individual is not responding to the behavior management plan;

e. Individuals shall not be disciplined by other individuals in care; and f. Therapeutic services or clinically appropriate coping tools shall not be withheld as part of the behavior management system.

4. The program will have a monitoring process of the behavior management system to assure both consistency in implementation and for continuous quality improvement as needed to address changing client needs and behaviors.

5. All interventions utilized as part of the behavior management system shall be documented in the individual’s clinical record. 15.9.5 Quality Improvement Plan A. The facility must develop and implement a quality improvement (QI) plan that is designed to monitor and improve safety, quality of care, trauma-informed practices, and treatment outcomes and meets the following criteria:

1. Utilizes a data-driven approach to identify patterns and trends in the data;

2. Analyzes the data to determine what improvements and changes must be implemented;

3. Is reviewed and/or modified no less than quarterly based on outcomes data.

B. The QI plan must be submitted to the Division of Quality and Standards, Licensing and Designation of BHA, annually as part of the facility’s re-designation application. 15.10 Personnel And Safety Requirements For Eating Disorder Designated Facilities 15.10.1 General Building Safety A. Each facility shall be in compliance with all applicable local zoning, housing, fire, and sanitary codes and ordinances of the city, city and county, or county where it is situated.

B. The facility shall provide an interior environment that is clean and sanitary, maintained and in good repair, free of hazards to health and safety.

1. Facilities shall have policies and procedures to ensure the facility is kept in good repair, maintenance is conducted as needed or on a routine basis, and hazards are identified and removed within a specified timeframe.

2. Items that could pose a threat to the health, safety, and welfare of an individual shall be kept in a manner that is inaccessible to individuals in care.

C. The facility shall ensure the prominent posting of evacuation routes and exits in each physical D. The facility shall prominently post the hours of operation at the entrance of each physical location and on the facility’s website.

E. There shall be separate identified room(s) to allow for private conversations and counseling sessions.

F. Restroom stalls and bathroom facilities shall comply with the following standards:

1. Facilities shall provide gender non-conforming and transgender individuals with the same policies provided for cisgender individuals.

2. Individuals shall not be required by a facility to share a stall of a restroom or a singleoccupancy bathroom while in the act of using the restroom:

a. With another individual in care at any time; and b. With personnel, unless medically indicated.

(1) Should an individual in care need assistance utilizing restroom facilities from personnel, such as through the use of a gait belt for physical stability, the facility shall document within the individual’s record the need for medical assistance. 15.10.2 Personnel A. Any personnel who are physically or mentally unable to adequately and safely perform duties that are essential functions may not be assigned duties as direct care personnel or volunteer at an eating disorder treatment and recovery facility. Facilities shall outline criteria in their policies and procedures for determining whether a person is able to safely perform duties in its policies and B. The facility shall not employ or allow any personnel who are under the influence of a controlled substance, as defined in Sections 18-18-203 through -207, C.R.S., or who are under the influence of alcohol in the workplace. This does not apply to personnel using controlled substances under the direction of a physician and in accordance with their health care provider’s instructions, as long as it does not pose a safety risk to the person, other personnel, or C. The facility shall employ sufficient personnel to ensure that the provision of services meets the needs of individuals. The facility shall:

1. Ensure each physical location must have at least one person trained in cardio-pulmonary resuscitation (CPR) and first aid on-site and on-duty at all times when individuals are present.

a. Telehealth-only service providers are exempt from this requirement.

D. If the facility administers medications to individuals while in care, the facility shall ensure that, at minimum, one of the following qualified personnel is available to administer medications at all times:

1. Licensed practical nurse, registered nurse, advanced practice registered nurse, physician, physician’s assistant, pharmacist, or qualified medication administration E. All personnel assigned to direct individual care must be qualified through either professional credentials, education, training, and/or experience in the principles, policies, procedures, and appropriate techniques for providing individual services.

1. Personnel providing individual services must be legally authorized to provide the service in accordance with applicable federal, state, and local laws.

2. Licensed, certified, and/or registered personnel must have an active license, certification, or registration in the State of Colorado and may only provide services within their scope of practice.

3. The facility shall verify the license, certification, or registration, and check for any disciplinary action against personnel providing individual services, through the Colorado Department of Regulatory Agencies or other state or federal agency no more than thirty (30) days before official hire date prior to hire.

4. The facility shall create policies and procedures regarding supervision of all personnel pursuant to Parts 15.10.2 and 15.10.3 of this Chapter 15.

F. The facility shall obtain, prior to hire or contract of new personnel or acceptance of persons for volunteer service, if that volunteer service involves unsupervised direct contact with individuals receiving services, a name-based criminal history record check for each prospective personnel or volunteer.

1. If the prospective personnel has lived in Colorado for more than three (3) years at the time of application, the facility shall obtain a name-based criminal history report conducted by the Colorado Bureau of Investigation (CBI).

a. Designated facilities providing services to individuals under the age of 18 years must also, prior to hiring or accepting new personnel, submit to the Federal Bureau of Investigation (FBI) a complete set of fingerprints taken by a qualified law enforcement agency to obtain any criminal record held by the FBI, for each prospective personnel. Payment of the fee for the criminal record check is the responsibility of the facility. No direct contact with children may take place until the background check is cleared by the FBI.

2. If the prospective personnel has lived in Colorado for three (3) years or less at the time of application, the facility shall obtain a name-based criminal history report for each state in which the prospective personnel has lived during the past three (3) years, conducted by the respective states’ bureaus of investigation or equivalent state-level law enforcement agency, or a national criminal history report conducted by the federal bureau of investigation.

3. The facility must conduct sex offender searches in the Colorado Bureau of Investigation (CBI) sex offender registry and the national sex offender public website operated by the United States Department of Justice for each operator, applicant for employment, current employee, or any individual who has direct contact with children/youth or is associated with the designation prior to the first day of employment or service at the facility.

a. Records of the checks must be maintained in the employee file and include the following criteria at minimum:

(1) Known current names and prior names, or known aliases, of each 4. The facility shall bear the cost of obtaining such information.

5. If a facility contracts with a staffing agency for the provision of services, it shall require that the staffing agency meet the requirements of Part 15.10.2 of this Chapter 15.

6. When determining whether a prospective personnel is eligible for hire or contract, if the criminal history record check reveals the person has a conviction or plea of guilty, active deferred judgment, or nolo contendere, the facility shall follow its policy developed in accordance with Part 15.10.2 of this Chapter 15.

7. All background check results shall be maintained as part of the personnel record and in accordance with applicable state and federal laws.

G. The facility shall have written personnel policies developed in accordance with Part 15.10.2 of this

Chapter 15, including, but not limited to:

1. Line of authority/management hierarchy of personnel.

2. Job descriptions/responsibilities.

3. Written criteria and procedures for evaluating which convictions or complaints make prospective personnel unacceptable for hire, or for existing personnel unacceptable for retention, including:

a. Factors to be considered when determining whether prospective personnel are eligible for hire when their criminal history record check reveals a conviction or plea of guilty, active deferred judgment, or nolo contendere, including, but not (1) The nature and seriousness of the offense;

(2) The nature of the position and how the offense relates to or may impact the duties of the position. Experience in the criminal justice system is not necessarily a disqualifier and, in certain circumstances, a facility may determine that some lived experiences would benefit a particular position;

(3) The length of time since the conviction or plea;

(4) Whether such conviction is isolated or part of a pattern; and (5) Whether there are mitigating or aggravating circumstances involved.

4. Conditions of employment, including but not limited to:

a. That personnel refrain from sexual or romantic relationships between supervisors and supervisees and sexual or romantic relationships with individuals served.

5. Position qualifications and required credentials.

6. Orientation, training, and continuing education requirements for the populations served and services provided.

a. Policies and procedures for professional development and ongoing training shall be based on trauma-informed care and the facility’s policies around implementation of their trauma-informed model.

7. Routine monitoring of personnel credentials and disciplinary actions.

8. Requirements for self-reporting of new or current investigations, criminal charges, indictments, or convictions that may affect the personnel’s ability to carry out their duties or functions of the job.

9. Policies requiring all personnel to be free of communicable diseases that can be readily transmitted in the facility.

a. All personnel who have direct contact with individuals must be required to have a tuberculin skin test prior to direct contact with individuals. In the event of a positive reaction to the skin test, evidence of a chest x-ray and other appropriate follow-up may be required in accordance with community standards of practice.

b. Designated facilities providing telehealth services only are exempt from this H. The facility shall ensure that all personnel have access to and know about the facility’s policies, procedures, and state and federal laws and regulations relevant to their respective duties.

I. All designated facilities shall ensure there is at least one patient representative and/or advocate available during the hours of operations.

1. The patient representative is responsible for the following:

a. Primary contact for grievances received from individuals receiving care, or their family members;

b. Address individual inquiries, concerns, or complaints;

c. Acting as a member of the multidisciplinary team; and d. Ensuring the individual has the necessary support and information to make informed decisions about their care.

J. The facility must maintain records on all personnel, including, but not limited to:

1. Date of hire;

2. Job description;

3. Results of criminal history record checks;

4. Documentation of professional credentials, education, and training;

5. Documentation of any disciplinary action taken against the person by a credentialing body;

6. Documentation of orientation and training;

7. Evidence of review of the facility’s policies, procedures, and state and federal laws and regulations relevant to their respective duties; and 8. Documentation of tuberculosis testing and results, or vaccination documentation, for personnel who have direct contact with individuals.

K. Treatment personnel, for the purpose of eating disorder treatment and recovery services, unless otherwise noted, means the following behavioral health professionals trained in mental health and/or substance use disorder identification and treatment and acting within their scope of practice:

1. Authorized practitioners;

2. Licensees;

3. Candidates;

4. A registered nurse, licensed pursuant to Part 255 of Title 12, C.R.S.;

5. Counselors-in-training, students, and/or interns.

a. If utilizing counselors-in-training, students, and/or interns, the facility shall have the following policies and procedures:

(1) Supervision of counselors-in-training, students, and/or interns;

(a) Total number of students and/or interns the facility can accept;

(b) How often supervision and consultation will be provided; and (c) What services are appropriate for students and/or interns to provide.

(2) Ensuring that all clinical documentation is reviewed and co-signed by a clinical supervisor able to supervise pursuant to their scope of practice;

b. The use of counselors-in-training, students, and/or interns shall not be a substitute for services provided by licensees or authorized practitioners. 15.10.3 Leadership Personnel Requirements and Responsibilities A. Facility director 1. The facility director is responsible for the following:

a. Overall direction and responsibility for the individuals, program, facility, and fiscal management;

b. Overall direction and responsibility for supervision of personnel;

c. The selection and training of a capable personnel member who can assume responsibility for management of the facility in the director’s absence; and d. The establishment of relationships and maintaining contact with allied facilities, services, and mental health resources within the community.

2. Qualifications of a facility director:

a. The facility director shall have at minimum, received a bachelor’s degree from an accredited college or university and have three (3) years of verified experience in position; or, b. The facility director shall have at minimum, received a master’s degree from an accredited college or university and have two (2) years of verified experience in position.

3. Assistant or acting facility director:

a. In each facility, there shall be a specifically designated personnel member capable of acting as a substitute for the facility director during their absence. The duties and responsibilities of the acting facility director shall be clearly defined within the facility’s policies and procedures in order to avoid confusion and conflict among other personnel and individuals.

b. If the facility director is regularly absent from the facility for more than fifty percent (50%) of their working hours, an assistant or acting director shall be appointed who meets the qualifications outlined in this Part 15.10.3.

B. Clinical director 1. The clinical director is responsible for the following:

a. Assuring that there is adequate training and supervision for personnel;

b. Multidisciplinary personnel members are practicing within their scope;

c. Ethical standards are upheld;

d. Ensure services are provided in an appropriate, trauma-informed manner and as indicated by screenings and assessments; and e. Ensure clinical oversight of the facility’s personnel in accordance with Parts 15.10.2 and 15.10.3 of this Chapter 15.

2. Qualifications of a clinical director:

a. The clinical director shall possess a master’s degree or doctoral degree in a mental health-related field or a bachelor’s degree in a mental health-related field plus five (5) years of related work experience.

b. The clinical director shall possess a valid clinical license to practice medicine and/or behavioral health services in the State of Colorado. 15.10.4 Personnel Training Requirements For Eating Disorder Designated Facilities A. In addition to training identified in Part 15.10.2 of this Chapter 15, facilities designated for services under these Rules shall develop policies and procedures for personnel training curriculum and schedules in order to meet the following requirements. Training shall be conducted in a traumainformed, culturally competent, and linguistically competent manner.

B. All supervisory and direct care personnel shall receive training or facility certification of competency in the recognition and response to common side effects of psychiatric medications.

These personnel shall be trained to respond to emergency drug reactions in accordance with the facility's policies.

C. All personnel who administer restraint, and/or physical management techniques shall receive training and/or certification prior to direct care with individuals.

1. On an annual basis, the facility shall provide training and/or certification to refresh restraint skills, prevention strategies, and de-escalation in accordance with the facility's restraint model.

2. Facilities providing treatment and care to individuals under eighteen (18) years of age shall complete refresher training and/or certifications on a semi-annual basis.

D. All program administrators and program supervisory personnel shall receive annual training or annual facility certification of competency on alternative or representative medical decision making, including, but not limited to, advance directives, medical durable powers of attorney, E. The facility must ensure that all personnel complete an initial orientation on basic infection prevention and control, safety, and emergency preparedness procedures.

F. The facility must ensure that all personnel receive the following training prior to working independently with individuals, and on a periodic basis consistent with policies developed in accordance with the following:

1. Training specific to the particular needs of the populations served, including the provision of person-centered, trauma-informed, harm reduction-focused, physically and programmatically accessible, and culturally and linguistically responsive services;

a. Weight stigma;

b. Gender responsive care for individuals with disordered eating;

c. Developmentally (age and cognitive functioning) responsive care;

d. Neurodivergence; and e. Inclusivity (racism).

2. Infection control;

3. Emergency preparedness, including de-escalation of potentially dangerous situations, including but not limited to threats of violence, acts of violence, and abuse/mistreatment of an individual;

4. Critical incident reporting;

5. Suicide prevention;

6. Individual rights of the population served;

7. Confidentiality, including individual privacy and records privacy, and security;

8. Facility policies and procedures;

9. Mandatory reporting requirements for suspected abuse or neglect in accordance with

Section 19-3-304, C.R.S.; and 10. Understanding basic pharmacology and medications that are relevant to the treatment type and population served by the facility.

G. Personnel providing residential/overnight services shall also be trained in the following:

1. The recognition and response to common side effects of medications used for behavioral 2. Behavior management and de-escalation techniques, including incidents involving harm 3. Behavioral health and medical emergency response training, consistent with emergency services policies required in Part 15.9.2.E.1 of this Chapter 15.

4. Personnel preparing or serving food shall complete food safety training.

a. At a minimum, this must include that personnel overseeing dietary services shall have knowledge of foodborne disease prevention, including, but not limited to, hygienic practices and food safety techniques pertaining to preparation, food storage, and dishwashing. 15.11 Individual Records 15.11.1 General Procedures for Individual Records A. Records shall be kept in conformity with Part 15.11 of this Chapter 15, applicable federal and state laws, and shall contain, at a minimum, the following:

1. Demographic and medical information;

a. Individual’s full name, including any known aliases, if applicable;

b. Individual’s date of birth, sex/gender identity, marital status, and social security number, where needed for Medicaid or employment purposes;

c. Individual’s current address of residence;

d. Date of admission;

e. Name, address, and telephone number of relatives or parent, legal custodian, legal guardian or legal representative(s), or other person(s) to be notified in an f. Name, address, and telephone number of the individual’s primary physician, and case manager if applicable, for use in emergency;

g. Religious preference, if any;

h. Individual’s diagnoses, at the time of admission;

i. Current record of the individual’s allergies;

j. Screenings, assessments, reassessments, service plans, documentation of informed consent, releases of information, documentation of services, treatment progress notes, admission summary, and discharge summary;

(1) Treatment progress notes shall include the following:

(a) Documentation of all treatment procedures, including, but not limited to: physical restraint, seclusion, mechanical restraint, medications voluntary and involuntary, and other therapies or interventions.

(b) Information regarding any serious injury of or by the individual and the circumstances and outcome.

(c) Documentation of all transfers, whether permanent or temporary, and reasons for transfer.

(d) Consultations and/or case reviews.

(e) Pertinent information from outside facilities or persons or from 2. Medication administration record, if applicable;

3. Personal belongings inventory, including any prescribed medications, if applicable;

4. Records of required communications with outside sources; and 5. Physician’s orders.

B. Individual records must be available to an individual or their designated representative through the facility or their designated representative at reasonable times and upon reasonable notice in accordance with all applicable state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and 42 C.F.R. Part 2, as incorporated by reference in Part 1.2 of these Rules.

1. If the service provider is deceased or unavailable, the current custodian of the record shall designate a substitute service provider for purposes of compliance with these C. A statement of the eating disorder facility’s procedures for obtaining records, and the right to appeal grievances regarding access to records to BHA, must be posted in conspicuous public places on the premises and made available to each individual upon admission and discharge to the facility.

D. An individual, whether currently receiving services or discharged from a facility, may inspect or obtain a copy of their own record. The facility must act on the request to review the individual’s record within a reasonable time, which must not exceed thirty (30) calendar days, except when an extension is allowable in accordance with HIPAA, which is incorporated by reference in Part 1.2 of these Rules.

E. Facilities must not charge the individual or designated representative for inspection of the individual's record.

F. Records must be kept in accordance with all applicable state and federal laws and regulations.

G. Access to medical records contained within the individual’s records must be accessed in a manner that is consistent with all applicable state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which is incorporated by reference in Part 1.2 of these Rules.

H. If there are changes/corrections, deletions, or other modifications to any portion of an individual record, the person who is making the changes must note in the record the date, time, nature, reason, correction, deletion, or other modification, and their name, to the change, correction, deletion, or other modification.

I. The confidentiality of the individual record, including all medical, behavioral health, psychological, and demographic information, must be protected in accordance with all applicable federal and state laws and regulations, including during record use, storage, transportation, transmission, and disposal.

J. When an eating disorder facility closes a physical location, it must maintain records of individuals served in accordance with the requirements of this Part 15.11. 15.11.2 Admissions Requirements and Disclosures A. The facility shall develop written admission criteria based on the facility’s ability to meet the individual’s needs. Admission criteria shall be based upon:

1. A comprehensive assessment of the individual’s mental health;

2. A comprehensive assessment of the individual’s physical health;

3. The individual’s substance use; and 4. The individual’s capacity for self-care.

5. The assessment shall determine the level of intervention and supervision required, including medication management, behavioral health services, and stabilization prior to discharge.

B. An individual may only be admitted into a locked setting if there is no less restrictive appropriate alternative setting.

1. Any eating disorder and recovery facility utilizing a locked setting shall also be a 27-65 designated facility.

C. A facility shall not admit or keep any individual who meets the following exclusion criteria:

1. Is consistently incontinent unless the individual or personnel is capable of preventing such incontinence from becoming a health hazard.

2. Has a communicable disease or infection that is:

a. Reportable under the Colorado Department of Public Health and Environment's regulations 6 CCR 1009-1 and 6 CCR 1009-2, which are incorporated by reference in Part 11.16.8.D.4.a of these Rules.

b. Potentially transmittable in a facility unless the individual is receiving medical or 3. Has acute withdrawal symptoms, is at risk of withdrawal symptoms, or is incapacitated due to a substance use disorder, and the facility does not have appropriate capacity/endorsements to address issues of withdrawal.

4. The facility shall create policies for any other exclusionary criteria and procedures for care coordination when appropriate.

D. There shall be written evidence of consent to treat, and the following upon admission to the individual or the individual’s parent, legal custodian, legal guardian, or legal representative, as appropriate. Acknowledgements shall specify the understanding between the parties regarding, at a minimum:

1. Charges and fees;

2. Services included in the rates and charges;

3. Types of services provided by the facility, those services which are not provided, and 4. Transportation services;

5. Therapeutic diets;

6. A physically safe and sanitary environment;

7. Personal services;

8. Protective oversight;

9. Presence and purpose of any video monitoring;

10. Social and recreational activities;

11. A provision that the facility must give individuals thirty (30) calendar days’ notice of closure;

12. Management of personal funds and property;

13. Facility rules, established pursuant to Part 15.12.1.C of this Chapter 15;

14. Staffing levels based on individual needs; and 15. Types of daily activities, including examples of activities that will be provided. 15.11.3 Request for Release of Information Procedures A. The eating disorder and recovery facility must comply with all applicable state and federal laws and regulations for release of information, including, but not limited to, Section 27-65-123, C.R.S., 42 C.F.R. Part 2, and HIPAA, which are incorporated by reference in Part 1.2 of these Rules.

B. When obtaining a consent or an authorization for the release of information, the signed release must state, at a minimum:

1. Person(s) or facility who may receive the information in the records;

2. The purpose of obtaining this information;

3. The information to be released;

4. That the release may be revoked by the individual, parent, legal custodian, or legal guardian at any time; and 5. That the release of information is only valid for a time period specified, but such time cannot exceed two (2) years from the date of signature.

C. Except as provided in this Part 15.11.3 C, all information obtained and records prepared in the course of providing any services to any individual are confidential and privileged matter. The information and records may be disclosed only:

1. In communications between qualified personnel in the provision of services or appropriate referrals;

2. When the individual designates other persons to whom information or records may be released, but, a. If an individual is a ward or conservatee and the ward’s or conservatee’s guardian or conservator designates, in writing, persons to whom records or information may be disclosed, the designation is valid in lieu of the designation by the recipient;

b. Except that nothing in this section compels a physician, psychologist, social worker, nurse, attorney, or other personnel to reveal information that has been given to the individual in confidence by members of an individual’s family or other informants;

3. To the extent necessary to make claims on behalf of a recipient of aid, insurance, or medical assistance to which the recipient may be entitled;

4. If BHA has promulgated rules for the conduct of research, such rules must include, but are not limited to:

a. The requirement that all researchers must sign an oath of confidentiality;

b. All identifying information concerning individuals, including names, addresses, telephone numbers, and social security numbers, must not be disclosed for research purposes;

5. To family members upon admission of an individual with a mental health disorder for inpatient or residential care and treatment.

a. The only information that may be released pursuant to this Part 15.11.3 C 7 is the location and fact of admission of the person with a mental health disorder who is receiving care and treatment. The disclosure of location is governed by HIPAA and 42 C.F.R. Part 2, which are incorporated by reference in Part 1.2 of these Rules, and/or, 6. To family members actively participating in the care and treatment of a person with a mental health disorder, regardless of the length of the participation. This disclosure is governed by HIPAA and 42 C.F.R. Part 2, which are incorporated by reference in Part 1.2 of these Rules. The information released pursuant to this subpart is limited to one (1) or more of the following:

a. The diagnosis;

b. The prognosis;

c. The need for hospitalization and anticipated length of stay;

d. The discharge plan;

e. The medication administered and side effects of the medication; and f. The short-term and long-term treatment goals. 15.11.4 Screening and Assessment A. Screening tools/approaches must be culturally and linguistically appropriate. Tools shall be trauma-informed and should accommodate an individual's disability/disabilities (hearing disability, cognitive limitations, visual impairment, etc.) as required.

B. The screening shall be completed no later than the time of admission and shall contain the 1. Identifying information;

2. Primary complaint/reason for seeking services;

3. Current behavioral health symptoms, including severity, duration, mental status, and 4. Medical concerns/chronic health issues, including pregnancy and postpartum status; and 5. Evaluation of imminent risk, including:

a. Suicide risk;

b. Danger to self or others;

c. Urgent or critical medical conditions, including withdrawal or overdose risk; or d. Other immediate risks, including threats from another person.

6. Substance use in the past 24 hours:

a. Substance name;

b. Amount used; and c. Route of administration.

7. Current medications; and 8. Advance directives, psychiatric and/or medical assessment documentation.

C. Screenings that identify an imminent risk must be reviewed by a licensee, an authorized practitioner, or a licensure candidate, performing within the scope of their practice.

D. Screenings should be conducted in-person unless contraindicated. If contraindicated, screenings may be conducted via audio-visual or audio-only telehealth. Clinical rationale must be documented in the case of a telehealth screening.

E. Comprehensive assessment 1. The facility must complete a comprehensive best practices assessment that focuses on person-centered care, which is signed and/or approved by a licensee, a licensure candidate, or authorized practitioner performing within the scope of their practice.

2. Comprehensive assessments must be completed within the following timeframes:

a. Inpatient/residential: within 72 hours of admission b. Partial Hospitalization Program (PHP) or Intensive Outpatient Program (IOP): no later than fourteen (14) days from the date of admission c. Outpatient: no later than 60 calendar days from the date of admission.

3. Information gathered as part of screening may be incorporated into the comprehensive assessment.

4. The facility must conduct assessments throughout the course of treatment, review previous assessments, and update those assessments whenever there is a change in the person's level of care or functioning. The assessments must occur, at minimum, every six (6) months, unless otherwise indicated.

5. All methods and procedures used to assess and evaluate an individual must be developmentally and age-appropriate, culturally and linguistically appropriate, and trauma-informed. All methods and procedures used to assess and evaluate an individual must be able to be provided in the preferred language and/or communication method of frequently encountered limited English proficiency (LEP) groups of the facility.

6. The comprehensive assessment must be documented in the individual’s record and, at minimum, include the following information, if available and applicable:

a. Identification and demographic data;

b. Primary complaint/reason for seeking services, including onset of symptoms and severity of symptoms;

c. A diagnosis with sufficient supporting criteria, as well as any subsequent changes in diagnosis;

d. Mental health history, including but not limited to:

(1) Suicidal risk and ideation, and (2) Homicidal ideation.

e. Substance use and substance use withdrawal history;

f. Physical and dental health status, including but not limited to human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), hepatitis A, B, or C, and other infectious diseases status and risk evaluation;

(1) Assessments must apprise the individual, as applicable, of risk factors associated with acquiring and transmitting HIV/AIDS, tuberculosis (TB), hepatitis A, B, or C, and other infectious diseases. appropriate testing and pre and post-test counseling must be offered on-site or through referral.

(2) Current healthcare providers (3) Screening the individual for current pregnancy status, where and when applicable. Any contraindications shall be documented in the clinical (a) Individuals must be asked if they want access to contraceptive/family planning care, and the individual must be appropriately referred when requested by the individual.

(4) A list of current prescriptions and prescribing physicians, over-thecounter medications, and any other substances the individual may be taking, including doses and frequency; and (5) Assessment of need for medical care (with referral and follow-up as required).

g. History of involuntary treatment;

h. Determination regarding whether or not the individual has advance directives, including medical and psychiatric;

i. Capacity for self-sufficiency and daily functioning;

j. Cultural factors that may impact treatment, including age, ethnicity, linguistic/communication needs, gender, gender identity, sexual orientation, relational roles, spiritual beliefs, socio-economic status, personal values, level of acculturation and/or assimilation, and coping skills;

k. Education, vocational training, and military service;

l. Family and/or social relationships;

m. Trauma and trauma history;

n. Physical and/or sexual abuse or perpetration and current risk;

o. Legal issues that may impact behavioral health outcomes;

p. Issues specific to older adults, such as hearing loss, vision loss, strength, mobility, and other aging issues;

q. Issues specific to children, such as growth and development, daily activities, legal guardians, and the need for family involvement and engagement in the child's treatment;

r. Strengths, abilities, skills, and interests; and s. Barriers to treatment. 15.11.5 Service Plans A. The facility shall ensure the development and review of a written service plan for each individual as follows:

1. The service plan must be completed within the following timeframes:

a. Inpatient/Residential: Within 72 hours of admission b. PHP/IOP: 14 days from completion of the comprehensive assessment c. Outpatient: 30 days from completion of the comprehensive assessment 2. The service plan must be reviewed and revised in writing when there is a change in the individual’s level of functioning or service needs. Revisions must include documentation of progress made in relation to planned treatment outcomes, changes in treatment focus, and length of stay adjustments, as applicable.

3. The service plan must:

a. Meet the developmental and cultural needs of the individual in a traumaresponsive manner.

b. Specify goals based on the initial and/or comprehensive assessment in a manner understandable to the individual.

c. Identify the type, frequency, and duration of services.

d. Be individually directed, including the individual’s strengths and identities.

e. Include involvement of other identified family or supportive individuals, when f. Specific criteria required for discharge from treatment or to progress to less restrictive treatment alternatives.

4. The service plan must be signed by all parties involved in the development of the plan, including the individual, and/or the individual’s parent or legal guardian in cases where the individual is a minor, or the individual has a court-appointed legal guardian and has not consented to services without the involvement of the legal guardian. Signatures must include at least one of the following: a licensee, an authorized practitioner, or a licensure candidate performing within the scope of their practice.

a. A copy of the service plan must be offered to the individual, or to the individual’s parent or legal guardian, as appropriate.

b. The facility must include documentation in the individual record in cases where the plan is not signed by the individual or the individual's parent or legal guardian if involved in the development of the plan, and in cases where offering the service plan to a parent or legal guardian is contraindicated.

5. A physician or other legal prescriber shall be responsible for the component of the plan requiring medication management services. 15.11.6 Discharge Planning A. Discharge instructions and care coordination instructions must contain the following in both the individual’s clinical record and available as instructions for the individual:

1. Documentation that the notice of discharge was provided to the individual, the individual’s parent, legal custodian, legal guardian or the individual’s legal representatives as follows:

a. At least twenty-four (24) hours in advance of discharge or transfer.

b. In cases of a medical or psychiatric emergency, the emergency contact shall be notified as soon as possible.

2. Documentation of discharge coordination with the individual, and, with permission, the individual’s family member(s), legal custodian, legal representative, or appropriate facility.

3. For transfers between eating disorder designated facilities, documentation of appropriate clinical information and coordination of services between the two facilities, including mode of transportation.

4. Information if the discharge is being made against the advice of the treating authorized B. The facility shall document in the individual's record whether the individual accepted the discharge instructions.

C. The facility shall provide the discharge instructions to the individual's parent or legal guardian if the individual is under eighteen (18) years of age, and to the individual's lay person, when possible and if consistent with state and federal law.

D. Requirements for a discharge summary to facilitate continuity of individual care, including, but not 1. The timeframe for discharge summary completion, which may not be more than fifteen (15) calendar days after discharge.

2. Information to be included in the discharge summary to inform future providers of treatment history, including, but not limited to:

a. Demographic information, including, but not limited to, name, date of birth, gender identity, emergency contact information, insurance information, preferred language, and any cultural factors to consider in treatment;

b. A brief summary of the episode of care, including, but not limited to, the presenting issue, services received, diagnosis assigned or modified, and any outstanding needs identified;

c. Information on the individual’s status within the judicial system, including any type of behavioral health certification or hold;

d. A summary of medications prescribed during treatment, including the individual's responses to medications;

e. Medications recommended and prescribed at discharge; and f. Documentation of referrals and recommendations for follow-up care.

3. This discharge information may be in narrative or abbreviated format and must be written in a manner that can be readily understood by a receiving provider to allow for prompt resumption of services.

4. Information and documentation to be provided to the individual upon discharge, unless clinically contraindicated, including, but not limited to:

a. Medication information, including medication name, dosage, instructions for follow-up, and whether the individual was provided with medication upon discharge.

(1) The facility may provide the individual with unused, prescribed medications as part of the discharge process, unless it has been determined that doing so would pose a risk to the health and safety of b. Detailed information on transitioning care to other providers, including referral information, when providing referrals.

c. Documentation that the discharge is being made against the advice of the provider, as applicable.

d. Written notification of discharge with reason for discharge.

e. Written notification of facility and BHA dispute resolution and grievance 15.11.7 Treatment Progress Documentation Requirements A. The individual record must include progress notes, documenting a chronological record of treatment, date and type of service, session activity, and progress toward individual-specific B. The minimum frequency of progress note completion shall be completed at the following intervals:

1. Inpatient/residential: one (1) service note per service, minimum daily or more often when there is a change in the individual’s functioning.

2. Outpatient: a minimum of one (1) service note per service.

C. Progress notes must include any noted change in physical, behavioral, cognitive, and functional condition and action taken by personnel to address the individual’s changing needs.

D. Progress notes must be signed and dated or electronically approved by personnel, practicing within the scope of their practice, at the time they are written, with at least the first initial, last name, and degree and/or professional credentials.

E. Treatment progress notes shall include the following:

1. Documentation of all treatment procedures, including, but not limited to: brief physical restraint, seclusion, medications, and other therapies or interventions.

2. Information regarding any critical incident involving the individual, the circumstances, and the outcome.

3. Documentation of all transfers, whether permanent or temporary, and reasons for transfer.

4. Consultations and/or case reviews.

5. Pertinent information from outside facilities or persons or from the individual.

6. Correspondence to and from relevant facilities and persons.

7. Consent forms as appropriate for alternative treatments or voluntary treatment.

8. Use or non-use of psychiatric and medical advance directives. 15.12 Inpatient and Residential Care Requirements for Eating Disorder Treatment and Recovery A. A facility designated for eating disorder treatment and recovery providing residential, overnight, or inpatient levels of care shall meet the requirements of this Part 15.12 in addition to the provisions of Chapter 15. Requirements listed in 15.13 for outpatient levels of care are not applicable to residential, overnight, or inpatient services and levels of care.

B. Facilities providing inpatient or residential care for eating disorder treatment and recovery shall have detailed policies and procedures specific to the therapeutic programming provided to the individual while in the facility’s care.

1. Programming shall be trauma-informed, person-centered, and appropriate for the individual’s diagnosis and needs.

2. Services provided shall be documented in the individual’s clinical record.

3. Programming shall be facilitated by appropriately trained or credentialed personnel for the type of service(s) provided. 15.12.1 Service Delivery Requirements A. The facility shall have policies and procedures specific to the residential/overnight services or physical location, as applicable, including, but not limited to:

1. Policies and procedures to be followed in the event of serious illness, injury, or death of an individual during their stay, including, but not limited to:

a. Criteria for when an individual's injury or illness warrants medical treatment or an in-person medical evaluation.

b. Requirements for notifying the individual’s emergency contact, including immediate notification in the case of an emergency room visit or unscheduled c. Reporting procedures within the facility.

2. Bed-based or room-based care is allowed only as a last resort and must be documented in the individual’s clinical record as the reason for such restrictive measures. All lowerlevel interventions must be documented as part of the multidisciplinary team decision making process and reflect meaningful engagement with individuals.

a. This does not apply to eating disorder treatment and recovery designated services offered within a general hospital setting.

3. Eating disorder facilities that provide overnight/residential services shall maintain enough food and water on hand to provide all individuals in care with three (3) nutritionally balanced meals for four (4) days.

4. Procedures for the management of the individual’s personal funds and property, a. An inventory of all the individual’s personal belongings must be conducted upon admission, and documented by at least two (2) individuals, one of whom must be the individual when the individual is capable and willing to document the inventory. Such inventory must be maintained in the individual record.

b. All inventoried property must be returned to the individual upon discharge, and such return must be documented by at least two (2) individuals, one of whom must be the individual when the individual is capable and willing to document the inventory. Such documentation must be included in the individual record.

5. Infection control procedures to address risks associated with housekeeping, dietary services, and linen and laundry services.

a. Policies for linen and laundry services must include:

(1) Procedures for preventing contamination between soiled linen and clean linen through either the use of gloves or hand washing.

(2) Procedures for soiled linen to be stored separately from clean linen, in separate enclosed areas.

(3) Individuals in care must have access to laundry services for personal clothing, which may be provided through the use of personal laundry facilities, a centralized laundry service, or may be contracted for with an outside provider.

(4) A requirement to maintain a sufficient supply of clean linen, including sheets and towels.

b. Dietary services must be provided using methods that conform to state or local food safety standards, including, at a minimum:

(1) Food must be prepared, handled, and stored in a sanitary manner, so that it is free from spoilage and/or contamination, and must be safe for human consumption.

(2) Reusable equipment, dishes, cutlery, and other wares used for the preparation, serving, or storage of food must be washed in a safe and sanitary manner, and, in the case of dishwashing machines, in accordance with the manufacturer’s instructions.

(3) Provide at least three meals daily, at regular times comparable to normal mealtimes in the community, or in accordance with individual needs, preferences, and plans of care.

(a) Nourishing meal substitutes and between-meal snacks must be provided, in accordance with plans of care, to the individual who want to eat at non-traditional times or outside of scheduled meal service times.

(b) Meals must include a variety of foods, be nutritionally balanced, and sufficient in amount to satisfy the appetites of the individual.

(c) Appealing substitutes of similar nutritive value must be available for the individual who chooses not to eat food that is initially served or who requests an alternative meal.

(d) Respect and accommodate an individual’s religious or dietary ethics, unless clinically contraindicated.

(e) Any deviation, and reason for the deviation, from the offered menu must be documented in the individual’s clinical record.

(4) Offer drinks, including water and other liquids, to individuals in care with every meal and between meals as determined by the individual’s nutrition plan.

6. Procedures for required safety checks of all individuals in care should be conducted at least every thirty (30) minutes and at every shift change to identify and remedy hazards.

a. The facility shall maintain these records for a minimum of two years unless otherwise required by law.

b. The facility shall have policies and procedures for how and when an individual’s needs are more restrictive than this requirement occurs, but at a minimum, must include:

(1) When there is a change in the individual’s functioning or an increase in danger to self or others, and (2) When the safety of the individual(s) in care requires a more restrictive staffing ratio as described in 15.12.3 B.

7. The type of first aid equipment maintained by the facility, including a requirement that such equipment be maintained in a readily accessible location, at each physical location providing residential and/or overnight services. First aid equipment must include, but not be limited to, an automated external defibrillator (AED).

a. First aid supplies and equipment must be kept unexpired and in a reliable condition.

8. Smoking policies applicable to individuals in care, including, but not limited to any prohibitions on smoking, designated areas for smoking, and methods/substances allowed under any smoking policy, such as tobacco, electronic cigarettes, vaporizers, etc.

9. The facility shall ensure that individuals in care have access to basic hygiene supplies in a manner consistent with their needs.

10. Emergency policies and procedures shall address:

a. When to evacuate the premises, when to shelter in place, and the procedures for doing so;

b. A predetermined means of communicating with individuals in care, families, personnel and other providers;

c. A plan that ensures the availability of, or access to, emergency power for essential functions and all individual required medical devices or auxiliary aids or services;

d. Storage and preservation of medications; and e. In the event relocation of individuals in care becomes necessary, written agreements with other health facilities and/or community agencies.

11. The facility shall have readily available a roster of current individuals, their room assignments, and emergency contact information, along with a facility diagram showing room locations.

12. A facility serving both adults and children must ensure that management of the living space assignments includes physical barriers and personnel oversight of activities to ensure safety. This management must include, but is not limited to:

a. Physical barriers, such as doors or walls;

b. Personnel stations that separate living space assignments;

c. Other practical arrangements that support the safe management of the individual B. Each facility shall maintain reasonable security capabilities to guard against the risk of unauthorized departures. The least restrictive method to prevent an unauthorized departure shall C. Facility rules 1. The facility shall establish written policies, which shall list all possible actions that may be taken by the facility if any policy is knowingly violated by an individual. Facility policies may not violate or contravene any rule herein, or in any way discourage or hinder an individual’s rights.

2. The facility shall prominently post its policies in writing, which shall be available at all times to individuals in care. Such policies shall address at least the following:

a. Smoking;

b. Cooking;

c. Visitors;

d. Telephone usage, including frequency and duration of calls;

e. Use of common areas, including the use of television, radio, or other electronic media;

f. Consumption of alcohol and/or illicit drugs;

g. Dress code; and h. Pets, which shall not be allowed in the facility; however, in no event shall such rules prohibit service or guide animals.

D. Physical health assessment by a qualified licensed practitioner:

1. Within twenty-four (24) hours of admission and shall include at a minimum:

a. Baseline vital signs including temperature, resting heart rate, blood pressure, body mass index (BMI), and physical appearance;

b. Individual’s height and weight;

c. A review of the individual’s overall bodily functioning (i.e., gastrointestinal, nervous system, cardiovascular, etc.);

d. Complete blood count and metabolic panel, if clinically indicated; and e. Electrocardiogram, if clinically indicated.

2. Additional physical health assessments are required when:

a. There is a significant change in the individual’s condition;

b. Evidence of possible infection (open sores, etc.);

c. Injury or accident sustained by the individual that might cause a change in the individual’s condition;

d. Known exposure of the individual to a communicable disease; or e. Development of any condition that would have initially precluded admission to the facility.

E. Emergency Medical and Dental Care 1. The facility shall ensure the availability of emergency medical and dental care to meet the needs of each individual. The obligation to ensure the availability of emergency medical services shall not be construed as the obligation to pay for such services; however, the facility shall secure these services regardless of the source of payment. The facility shall have and adhere to a written plan for providing emergency medical and dental care to include at least:

a. The availability of a qualified licensed independent practitioner or emergency medical facility on a twenty-four (24) hour, seven (7) days a week basis.

b. Emergency medical or dental treatment, when indicated, shall be accessed immediately upon determination that an emergency exists.

c. Whenever indicated, an individual shall be referred to an appropriate specialist for either further assessment or treatment. The facility shall be responsible for securing an appropriate assessment to determine the need for further specialty consultation. This information shall be contained in the clinical record.

2. If an individual requires inpatient medical care at a hospital, the facility shall be responsible for coordinating transportation from the facility to the inpatient medical provider, communicating any psychiatric needs of the individual, and coordinating care with the medical provider until the individual no longer requires inpatient medical care.

F. Individuals in care may administer oxygen if the individual is able to manage the administration themselves, and personnel shall assist with the administration as needed for safety, when prescribed by a physician, and if the facility follows appropriate safety requirements regarding oxygen herein.

1. Oxygen tanks shall be secured upright at all times to prevent falling over and secured in a manner to prevent tanks from being dropped or from striking violently against each other.

2. Tank valves shall be closed except when in use.

3. Transferring oxygen from one container to another shall be conducted in a well-ventilated room with the door shut. Transfer shall be conducted by trained personnel or by the individual for whom the oxygen is being transferred, if the individual is capable of performing this task safely. When the transfer is being conducted, no person, except for a person conducting such transfer, shall be present in the room.

4. Tanks and other oxygen containers shall not be exposed to electrical sparks, cigarettes, or open flames.

5. Tanks shall not be placed against electrical panels or live electrical cords where the cylinder can become part of an electric circuit.

6. Tanks shall not be rolled on their side or dragged.

7. Smoking shall be prohibited in rooms where oxygen is used or stored. Rooms in which oxygen is used shall be posted with a conspicuous “no smoking” sign.

8. Tanks shall not be stored near radiators or other heat sources. If stored outdoors, tanks shall be protected from weather extremes and damp ground to prevent corrosion.

G. Whenever transportation of an individual is required, the treating personnel of the facility shall assess the individual for danger to self and/or others. Whenever clinically and safely appropriate, the individual may be transported by other means such as an ambulance, a care van, or a private vehicle. 15.12.2 Building Safety A. The facility shall ensure the following standards are met regarding the physical operation of the residential, overnight, or inpatient designated location:

1. The facility shall have common areas adequate to accommodate all individuals in care, including a designated dining area capable of seating all individuals, and meeting the following accessibility requirements:

a. All common areas and dining areas must be accessible to individuals in care using an auxiliary aid without requiring transfer from a wheelchair to a walker or from a wheelchair to a regular chair.

b. Doors to individual accessible rooms shall be at least thirty-two (32) inches wide.

2. A minimum of two entryways shall be provided for ingress and egress from the building by any individual using a wheelchair.

B. A facility shall only place an individual in a bedroom with video monitoring due to good cause or safety/security reasons, which must be noted in the individual’s clinical record. The individual shall be notified in writing when placed in bedrooms with video monitoring capabilities.

C. Designated facilities shall have policies for assessing when video monitoring in bedrooms is required, which personnel are allowed access to the video recordings, and under what circumstances video recordings are maintained longer than thirty (30) days. The policy shall contain, at a minimum, the following:

1. Video monitoring is prohibited in bathroom facilities.

2. Facilities shall maintain a signed acknowledgement in the individual’s clinical record when an individual is placed into a room with video monitoring, or when video monitoring is clinically indicated. The acknowledgement shall be signed by the individual, the individual’s parent, legal custodian, legal guardian or a legal representative, and personnel of the facility.

3. Video monitoring shall not be used as a substitute for direct supervision.

4. The use of video monitoring shall ensure individual privacy to the extent allowed by clinical assessment.

D. The following requirements must be met for bedrooms:

1. No individual may be assigned to any room other than a regularly designated bedroom.

Temporary occupancy of a room not designated as a bedroom is permissible on a limited

basis when the use of the assigned bedroom is contraindicated due to circumstances related to individual safety or emergent issues. Justification for such placement and the length of placement shall be documented in the individual record.

2. No more than two (2) individuals in care shall reside in a bedroom.

3. Each bedroom for individuals in care must have at least 100 square feet for a single individual, or 120 square feet for two residents. Bathroom areas and closets shall not be included in the determination of square footage.

4. Each individual shall have separate storage facilities adequate for personal articles, such as a closet or locker, available inside their bedroom. Shelves may be provided for folded garments in lieu of hanging garments.

5. Each bedroom must include a comfortable, standard-sized bed with a clean mattress, mattress protector, and pillow. Rollaway-type beds, cots, folding beds, or bunk beds are not permitted.

6. The bedroom shall have a safe and sanitary method to store the individual’s towel, such as a breakaway towel rack.

7. Extension cords and multiple-use electrical sockets shall be prohibited in individual bedrooms.

8. The bedroom shall include a chair unless contraindicated, in which case, alternate seating shall be provided in close proximity to the bedroom.

E. The following standards must be met for bathrooms:

1. Each floor with bedrooms must have at least one bathroom that can be accessed without entering a bedroom.

2. The physical location of the facility’s operations must have at least one full bathroom accessible to any individual using an auxiliary aid, including properly installed grab bars at each tub and/or shower, and adjacent to each toilet.

3. Bathtubs and shower floors must have non-skid surfaces.

4. Toilet seats shall be constructed of non-absorbent materials and free of cracks.

5. Individuals in care must have individualized personal care articles and supplies, such as soap and towels, shall not be shared.

6. Toilet paper must be available at all times in each bathroom.

7. Liquid soap and paper towels must be available at all times in the common bathrooms.

Bathrooms must be equipped with soap dispensers, or the facility shall have a procedure in place that prevents individuals in care from sharing soap.

8. The facility must ensure there is a minimum of one (1) full bathroom for every six (6) individuals in care, including a toilet, sink, toilet paper dispenser, mirror, tub and/or shower, and towel rack. 15.12.3 Inpatient, Residential, or Overnight Personnel A. Residential, overnight, or inpatient designated providers must meet the requirements listed in Part 15.10 of this Chapter 15 in addition to the requirements listed in this Part 15.12.3.

B. The facility shall employ sufficient personnel to ensure that the provision of services meets the needs of individuals in care. The facility shall:

1. Ensure that each shift has a minimum of two (2) personnel whenever one (1) or more individuals in care are present in the milieu;

2. Inpatient: Maintain individual-to-personnel ratios not exceeding a one to six (1:6) direct care personnel to individual ratio at all times;

a. Direct care staff includes, but is not limited to, behavioral health technicians, nursing staff, or other identified milieu staff as per the facility’s policies and b. If the facility is licensed as a hospital with the Colorado Department of Public Health and Environment (CDPHE), the facility must comply with staffing requirements pursuant to Section 25-3-128, C.R.S. in lieu of compliance with

Part 15.12 of this Chapter 15.

3. Residential: Maintain individual-to-personnel ratios not exceeding a one to ten (1:10) direct care personnel to individual ratio at all times;

a. Direct care staff includes, but is not limited to, behavioral health technicians, nursing staff, or other identified milieu staff as per the facility’s policies and b. Designated facilities shall define staffing patterns and substitute direct care coverage through the facility's policies and procedures.

4. Each physical location must have appropriate oversight personnel, such as an administrator and/or clinical director, or personnel delegated those same responsibilities, available twenty-four (24) hours per day, seven (7) days per week. Appropriate oversight personnel for all other levels of care must be available during hours of operation.

a. Oversight personnel when the administrator and/or clinical director are not physically on-site must be in accordance with policies as required at Part 15.10 of this Chapter 15.

C. The facility shall ensure that, at minimum, one of the following qualified personnel is available to administer medications at all times:

1. Licensed practical nurse, registered nurse, advanced practice registered nurse, physician, physician’s assistant, pharmacist, or qualified medication administration D. In addition to the training requirements listed in 15.10, personnel providing residential, overnight, or inpatient services shall also be trained in the following:

1. The recognition and response to common side effects of medications used for behavioral 2. Behavior management and de-escalation techniques, including incidents involving harm 3. Behavioral health and medical emergency response training, consistent with emergency services policies .

4. Personnel preparing or serving food shall complete food safety training.

a. At a minimum, this must include that personnel overseeing dietary services shall have knowledge of foodborne disease prevention, including, but not limited to, hygienic practices and food safety techniques pertaining to preparation, food storage, and dishwashing. 15.13 Outpatient Care Standards for Eating Disorder Treatment and Recovery 15.13.1 General Outpatient Standards A. A facility designated for eating disorder treatment and recovery providing any outpatient services shall meet the standards in this Part 15.13, in addition to the service standards of this Chapter 15.

Designated facilities providing outpatient services only are exempt from the provisions of Part 15.12 of this Chapter 15.

B. Outpatient services are generally intended for individuals who are assessed as not appropriate for more intensive levels of care. Outpatient services may also be a step-down from a higher level of care or offered when an individual is in early stages of change and declines voluntary participation in the higher level of care indicated by the assessment.

C. All services provided must be adapted to the individual’s developmental stage, physical, cultural, 1. Service frequency and intensity must be modified to meet assessment and service plan objectives. Services may include medical services, individual therapy, group therapy, medication management, educational/occupational groups, peer professional services, recreational therapy, and other therapies as deemed appropriate by assessment of the individual receiving services. 15.13.2 Service Delivery and Setting A. Outpatient services may be delivered via in-person, audio-visual telehealth, or audio-only telehealth format in accordance with the following guidelines:

1. If the designated provider uses telehealth methods, it must develop and implement policies and procedures regarding telehealth services, including:

a. Collection of required signatures;

b. Training for personnel specific to the modality or manner for determining competence with the modality;

c. Procedure for personnel response if an individual experiences an emergency while receiving services via telehealth, including collection of information about the individual’s remote location for each session;

d. Confidentiality protocols designed to protect the individual’s privacy in accordance with state and federal law; and e. Specification as to whether policies apply to the facility as a whole, or a physical location, as appropriate.

2. Services provided via telehealth methods must be documented in the individual’s record, consistent with documentation requirements for in-person services.

3. Services may be provided through synchronous audio-visual methods, but must not include text-only methods such as text message or email. Some services may be provided through audio-only methods according to state and federal regulations. If audioonly methods are used, the following must be noted in the individual record:

a. The reason that audio-visual methods were not utilized.

b. The clinical determination and rationale of appropriateness for service delivery methods.

B. Outpatient treatment services must be provided in accordance with the individual’s service plan and facilitated by providers acting within their scope of practice.

C. Treatment groups must not exceed fifteen (15) enrolled individuals receiving services.

1. Family members or supportive individuals participating in groups with the enrolled individual shall not be counted in the total group size.

2. The facility shall create and maintain policies and procedures for ensuring adequate personnel for supervising larger treatment groups of both enrolled individuals in care and family members or supportive individuals.

D. For the purposes of this Chapter 15, eating disorder treatment and recovery designated facilities providing day treatment services shall meet the requirements of partial hospitalization programming in Part 15.13.3. 15.13.3 Partial Hospitalization Programming A. These Rules are established to create standards for facilities providing partial hospitalization program (PHP) eating disorder treatment and recovery services.

B. PHP services are generally intended for individuals who require daily monitoring or management to treat mental health, eating disorders, and co-occurring disorders, in accordance with the DSM- 5- TR, as incorporated by reference in Part 1.2 of these Rules. These services can be provided in a structured outpatient setting and include direct access to medical, psychiatric, nutritional counseling and management, and laboratory services.

1. PHPs require a minimum of 20 hours of treatment contact per week, including a minimum of three (3) hours per day and a minimum of four (4) calendar days per week.

C. PHP agencies must meet the facility requirements set forth in Part 15.10.1 of this Chapter 15 or requirements in accordance with facility mandates under other regulatory state and federal entities for licensure in cases such as a medical facility, school, or other.

D. PHP support systems 1. Facilities providing PHP services must inform individuals receiving treatment how to access emergency services by telephone twenty-four (24) hours per day, seven (7) days per week when the program is not in session. At minimum, agencies must provide emergency services information that includes contact information for services provided by the behavioral health crisis response system created pursuant to Section 27-60-103, 2. Agencies providing PHP services must have direct affiliation or close coordination through referral to more and less intensive levels of care. Agencies providing PHP services must also have a documented consultation and/or referral process through internal staff or other affiliations for medical, psychiatric, and medication-assisted treatment needs.

a. Referral(s) will be provided in collaboration with the individual and their choice(s) 15.13.4 Intensive Outpatient Service (IOP) Delivery and Setting A. IOP services are intended for individuals who require a higher level of intervention than can be provided in standard outpatient services.

B. All services must be adapted to the individual’s developmental stage and physical and C. IOP support systems 1. Agencies providing IOP services must have direct affiliation or close coordination through referral to more and less intensive levels of care. Agencies must also have a documented consultation and/or referral process through internal staff or other affiliations in place for medical, psychiatric, and other clinically identified treatment needs.

a. Referral(s) will be provided in collaboration with the individual and their choice(s)

D. Services must be conducted in regularly scheduled sessions that follow a planned format of treatment services of nine (9) to nineteen (19) contact hours per week for adults and six (6) to nineteen (19) contact hours per week for children under the age of eighteen (18). 15.13.5 Outpatient Personnel A. Outpatient services may include recovery support services rendered by peer support professionals in accordance with Chapter 3 of these Rules.

B. Agencies providing PHP, IOP, or outpatient services must ensure treatment personnel have supervisor consultation available within twenty-four (24) hours via in-person or by telehealth to discuss, when warranted, psychiatric or medical concerns of individuals receiving services.

1. Personnel must have supervisor consultation available within one (1) hour via in-person or telehealth to discuss, when warranted, crisis and/or emergency situations during program hours.

C. Agencies providing PHP, IOP, or outpatient services must provide training appropriate to the treatment-type focus and best practice standards.

1. Training must include that treatment personnel understand the signs and symptoms of mental health, substance use, eating disorders, and co-occurring disorders, and the basics of psychopharmacology. 15.14 Rights of Individuals Receiving Services within an Eating Disorder Facility 15.14.1 Individual Rights A. The facility shall develop, implement, uphold, and enforce policies and procedures regarding individual rights in accordance with Part 2.7 of these Rules.

B. All individuals in care within an eating disorder treatment and recovery facility shall be provided a copy of their “Bill of Rights” in written, electronic, and verbal form. Facilities shall uphold and enforce these rights.

C. All patient rights must be posted (in the predominant languages of the community in which it operates and explained in a language or modality accessible to the individual) in prominent places frequented by individuals in care and their family member(s) receiving services, and the facility shall assist the individual in exercising and upholding the following rights:

1. To request, and have access to, any medical examination, including weigh-ins, without other patients in the room;

2. To remain clothed during weight checks.

a. If clothing is to be removed, individuals in care have the right to be provided with alternative clothing. The alternative clothing must cover the individual’s body and provide sufficient privacy.

3. To not be required to perform physical exercises during weight checks, unless;

a. If the professional providing care has sufficient cause to believe that the individual would be at risk of harm without requiring a physical exercise, the professional shall document the concern and need for further investigation in the b. If the individual is asked to perform any physical exercises, they shall be provided a space with sufficient privacy that preserves the individual's dignity to the greatest extent possible.

4. To be provided personal privacy to the greatest extent possible during the course of treatment. Individuals in care shall not be required to share a stall of a restroom or a single-occupancy bathroom while in the act of using the restroom:

a. With another individual in care at any time; and b. With personnel unless medically evaluated and determined to be required.

5. Facilities shall provide gender non-conforming and transgender individuals in care with the same restroom policies as provided to cisgender individuals in care;

6. Receive care and treatment, in compliance with state statute, that is free from discrimination on the basis of physical or mental disability, race, ethnicity, socio-economic status, religion, gender expression, gender identity, sex, sexuality, culture, and/or languages spoken; and that recognizes an individual's dignity, cultural values and religious beliefs; as well as provides for personal privacy to the extent possible during the course of treatment.

7. The facility shall accommodate the individual’s personal dietary ethics to the greatest extent possible;

a. Any deviation from the individual’s preferred dietary ethics shall be documented in the clinical record and shall only be denied based on clinical need as determined by the interdisciplinary team of the individual;

8. Receive care in a safe setting, provided by a skilled professional, and be treated humanely. Individuals in care shall have their treatment tailored to their unique needs and implemented in a trauma-informed and trauma-aware manner. Individuals in care have the right to be treated fairly, with respect and recognition of their dignity and individuality by all employees of the facility with whom they come into contact;

a. Only staff qualified by education, experience, training, and/or facility policy and procedure may be present or facilitate weigh-ins, bathroom time, vital sign checks, individual therapy, and group therapy.

b. If a staff member performs multiple functions at the facility, the facility must ensure they preserve and prioritize the therapeutic relationship between the staff member and the individual in care.

9. To continue to practice their religious or spiritual practices, unless a specific practice would impact the health or safety of the individual or others in care.

10. To have a minimum amount of physical activity per day, as clinically appropriate.

Individuals in care shall not have their bodily movement restricted as a form of punishment.

D. Within one (1) business day of making a request, individuals in care have the right to see and receive the services of a patient representative. The patient representative shall not have direct clinical or administrative responsibility for care provided. Individuals in care have the right to have assistance filing a complaint or grievance.

E. If at any time during the course of evaluation, treatment and care, the individual believes their rights have violated, individuals in care may file a grievance with BHA, the Colorado Department of Public Health and Environment (CDPHE), or the Office of the Ombudsman for Behavioral Health Access to Care established pursuant to Section 27-80-303, C.R.S. 15.14.2 Dispute and Grievance Resolution A. Each facility shall post a clear and unambiguous notice of dispute and grievance procedures for a violation of an individual’s rights in each physical location and in an area that is open to the public and on the facility’s website. This posted notice must also be provided in writing and electronically upon admission to services, and include information regarding the submission of grievances to BHA as required in Part 15.14.2.B of this Chapter 15.

1. The facility shall establish a uniform procedure for prompt management of disputes brought by individuals accessing, receiving, or being evaluated for services and their family members. The facility shall develop policies and procedures for handling disputes.

2. The facility shall provide a fair dispute resolution process that allows options for submitting both verbal and written disputes. The process must provide the individual with a response no later than thirty (30) calendar days from submission of the dispute. If the dispute is received verbally, the representative shall create a written documentation of the dispute.

B. As part of the facility’s resolution process, the facility must inform persons who have submitted a dispute verbally or in writing that they may also submit a grievance to BHA. The facility must provide information about how to submit a grievance to BHA.

1. The facility shall designate a representative who must be available to assist individuals in care in resolving disputes.

2. The facility shall educate individuals in care and their representatives about the mechanisms in place for filing disputes. This education must include an explanation of the individual's rights; the dispute process and procedures; and the name, contact information, and responsibilities of the designated representative within the facility.

Appropriate contacts for external appeal must also be provided, which may include, but are not limited to, the following:

a. Colorado Department of Regulatory Agencies;

b. Colorado Department of Public Health and Environment;

c. Colorado Department of Health Care Policy and Financing; or d. The governor’s designated protection and advocacy system for individuals with mental illness.

e. Documentation in the records must include the dated signature of the individual receiving the information.

3. The facility must post a notice of rights, dispute procedure, and the designated representative’s name, office location, responsibilities, and telephone number in prominent locations where persons access, receive or are evaluated for services. The notice shall be translated into languages commonly used by the populations in the service area.

4. The facility must maintain a record of submitted disputes, separate from the individual records that include the date, the type of dispute, and the outcome of the investigation. These dispute records must be provided annually to BHA, upon request.

5. Upon request, the facility must provide an individual and any interested person with contact information for registering complaints with any other state departments. 15.15 Seclusion, Restraint, and Physical Management 15.15.1 General Provisions A. The following rules covering seclusion, restraint, and physical management apply to all facilities that use seclusion, restraint, and/or physical management. If a facility has decided to use seclusion, restraint, and/or physical management, the facility shall use seclusion, restraint, and/or physical management only in accordance with the rules in this Part 15.15.

B. These Rules do not supersede any requirements under Sections 26-20-101 through-110, C.R.S.

C. If any provision of this Part 15.15 conflicts with any provision concerning the use of seclusion, restraint, and/or physical management on an individual with an intellectual or developmental disability as stated in Article 10.5 of Title 27, C.R.S., Article 10 of Title 25.5, C.R.S. or any rule adopted pursuant to those articles, the provisions of those articles or rules prevail.

D. A facility may only use seclusion, restraint, and/or physical management:

1. In cases of emergency, as defined at Section 26-20-102(3), C.R.S., to be a serious, probable, imminent threat of bodily harm to self or others where there is the present ability to affect such bodily harm; and, 2. After less restrictive lower-level alternatives have been exhausted, including but not limited to after all attempts to verbally direct or de-escalate the individual have failed; or 3. After a determination that such alternatives would be inappropriate or ineffective under E. A facility that uses seclusion, restraint, and/or physical management pursuant to the provisions of this Part 15.15 may only use such seclusion, restraint, and/or physical management:

1. For the purpose of preventing the continuation or renewal of an emergency;

2. For the period of time necessary to accomplish its purpose; and 3. In the case of physical restraint, with no more force than is necessary to limit the individual's freedom of movement.

F. Seclusion, restraint, and/or physical management must never be used:

1. As a punishment or disciplinary sanction;

2. As a means of coercion;

3. As part of an involuntary service plan or behavior modification plan;

4. For convenience;

5. For the purpose of retaliation; or 6. For the purpose of protection, unless:

a. The restraint or seclusion is ordered by a court; or b. In an emergency, as provided for in this Part above.

G. Physical management for individuals in care under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to Part 15.15.7 of this 15.15.2 Policies And Procedures Regarding Seclusion, Restraint, And Physical Management A. Facilities shall have and shall implement written policies and procedures that describe the situations in which the use of seclusion, restraint, and/or physical management are considered appropriate in the facilities and personnel who can order their use. The policies and procedures must include the requirements in this Part 15.15.2 and Sections 26-20-101 through -110, C.R.S. these policies and procedures must also include at a minimum:

1. For a facility that does not authorize the use of seclusion, restraint, and/or physical management of any type, a policy statement noting the prohibition against the use of seclusion, restraint, and/or physical management and the procedures that personnel will a. When a facility does not utilize physical management, seclusion, and/or restraint interventions, the policy shall include facility processes and procedures should personnel use these prohibited interventions.

2. For a facility that utilizes seclusion, restraint, and/or physical management, a policy statement regarding the review process for the use of seclusion, restraint, and/or physical management. The review process must include a provision for terminating the seclusion, restraint, and/or physical management episode when the reviewer does not concur with a. If the reviewer is not an authorized practitioner, then the order must be 3. Personnel shall ensure that no individual endures harm or harassment when secluded 4. A policy statement that a facility shall ensure that the care and treatment are skillfully and humanely administered with full respect for the individual’s dignity 5. Protocols for when the use of restraint, seclusion, and/or physical management is appropriate, and the restrictions on the use of these techniques, the facility may impose more, but not fewer, restrictions on the use of these techniques than is required by this 6. Details on the type of physical management, restraint, and seclusion interventions or models that the personnel are approved to use.

7. Details on how seclusion, restraint, and/or physical management will be altered to include any necessary accommodations the individual may need, including but not limited to, changing emergency interventions to not restrain hands and the ability to communicate for those individuals in care who speak sign language. 15.15.3 Personnel Training A. The facility shall ensure that all personnel involved in utilizing seclusion, restraint, and/or physical management are trained in the use of seclusion, restraint, and/or physical management as described in this Part 15.15.3 in accordance with the training model being utilized by the facility.

B. The facility shall ensure that personnel are trained to explain, where possible, the use of seclusion, restraint, and/or physical management to the individual who may be secluded, restrained, or physically managed and to the individual’s designated representative, if appropriate, upon admission.

C. Training programs must be standardized and evaluated by facility leadership every three (3) years to ensure incorporation of evidence-based best practices for seclusion, restraint, and/or D. Training must be provided to personnel within the first month of their orientation period and E. Personnel shall obtain certification in cardiopulmonary resuscitation (CPR), including periodic F. Training must include at a minimum, but is not limited to:

1. The safe use of seclusion, restraint, and/or physical management including content related to the risks of positional asphyxia, aspiration, traumatization, and recognize and respond to signs of physical distress of an individual who is secluded, restrained, and/or 2. Address concepts related to prevention and non-physical interventions, including, but not limited to, de-escalation and mediation;

3. Educate personnel of how their culture, language, biases, values, and perceptions influence their response and escalation of the individual involved; and 4. Understanding and recognizing underlying behavioral health and physical health conditions, medications, and their potential effects as well as how age, developmental level, cultural background, language, history of physical or sexual abuse, and prior experience with seclusion, restraint, and/or physical management will influence an G. Personnel must demonstrate knowledge and application of seclusion, restraint, and physical management training on an annual basis when working with persons eighteen (18) years of age and older, and on a semi-annual basis when working with youth seventeen (17) years old and younger. 15.15.4 Standards of Care Upon Admission A. At admission, the facility shall inform both the individual and the individual’s parent, legal custodian, legal guardian or legal representative, as applicable, of the facility’s policy regarding the use, or prohibition, of seclusion, restraint, and physical management during an emergency behavioral health episode for individuals in care. This must, as is reasonable under the circumstances, be communicated, if feasible, in a language and modality accessible to the 1. If communication barriers exist, they shall be documented in the individual’s clinical 2. The facility shall document all future attempts to communicate the potential for this intervention while the individual is in the care of the facility.

B. Upon an individual’s admission, personnel shall collaborate with the individual and the individual’s parent, legal custodian, legal guardian or legal representative, when applicable, to formulate strategies that may minimize the potential for a behavioral health emergency event that requires interventions of seclusion, restraint, and/or physical management.

C. A facility electing to utilize seclusion, restraint, and/or physical management shall assess each 1. Assault and trauma history;

2. Seclusion, restraint, and/or physical management history;

3. Individual’s risk factors for a behavioral emergency, and individually identified strategies 4. The facility shall ascertain any applicable behavioral health advance directives.

D. Assessment of an individual's behavioral health emergency history and prevention plan shall be maintained in the individual’s clinical record and in a location easily accessible to any personnel providing direct care to the individual. 15.15.5 Use of Physical Management A. Physical management for individuals in care under the age of eighteen (18) must always be considered as restraint and follow the restraint order rules pursuant to Parts 15.15.6, 15.15.7, and 15.15.14 of this Chapter 15.

B. Physical management shall only be used on an emergency basis for a maximum of one (1) minute.

1. If physical management is used for longer than one (1) minute, the intervention is restraint, pursuant to Section 26-20-102(6), C.R.S., and personnel must follow the restraint rules pursuant to Part 15.15.7 of this Chapter 15.

C. To ensure the safety of each individual and personnel, each facility shall designate emergency D. The term “physical management” does not include briefly holding an individual in order to comfort E. The physical management continuum may include:

1. Utilizing transitional measures;

2. Placing one’s hands on an individual to physically guide and/or physically control the 3. Use of an approved restraint method specified in the facility’s policies and procedures to maintain the safety of the individual;

4. Placing an individual into an approved prolonged restraint method specified in the facility’s policies and procedures; or 5. Physical management may be used to move or escort an individual into seclusion.

a. Seclusion, in itself, is not a form of physical management.

F. Physical management must be documented in the clinical record to include the following:

1. Documentation of the behavioral necessity for physical management and any de- 2. Documentation of the approved physical management method utilized. 15.15.6 Orders For Seclusion/Restraint A. If an order for seclusion/restraint is verbal, the verbal order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency 1. The registered nurse or other trained licensed professional receiving a verbal order for the seclusion/restraint must document the verbal order in the clinical record.

2. The physician or other authorized practitioner permitted to order seclusion/restraint must verify the verbal order in a signed written form in the individual’s record. Signatures must 3. The physician or other authorized practitioner to order seclusion/restraint must be available to personnel for consultation, at least by telephone, throughout the period of the B. Within one (1) hour of the initiation of the original order of seclusion/restraint an authorized practitioner or a registered nurse, trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the individual, shall conduct an in-person assessment of the physical and psychological well-being of the individual C. When the emergency intervention continues up to one (1) hour, personnel must conduct an inperson assessment. The assessment may be conducted by a registered nurse or an authorized practitioner. The assessment shall include the following components at a minimum;

1. The individual’s physical and psychological status;

2. The individual’s behavior and determination if the behaviors require continued 3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

D. Results of the one (1) hour assessment, as described in Part 15.15.6.C, must determine if continued emergency interventions need to be re-ordered by the authorized practitioner.

1. The new order/extension must not exceed an additional three (3) hours.

2. Assessment results and continuation order, if applicable, must be contained in the clinical E. Any behavioral health emergency situation that requires intervention past four (4) hours shall include an in-person assessment and new emergency intervention orders every four (4) hours as described in Part 15.15.6.C. 15.15.7 Use of Restraint A. The decision to restrain must be based on a current clinical assessment and behavioral presentation.

B. Restraint includes chemical restraint, mechanical restraint, and physical restraint.

C. Restraint must not be used solely to prevent unauthorized departure, unless the individual is being held under the provisions of an emergency mental health hold.

D. Restraint of an individual by a chemical spray is not permissible.

E. The type of restraint must be appropriate to the type of behavior to be controlled, the physical condition of the individual, the age of the individual, and the type of effect restraint may have upon the individual.

F. Lower-level and alternative interventions shall be attempted prior to initiation of restraint unless the alternative interventions would be ineffective or unsafe to the individual’s self or others G. The term “restraint” as used in this section, does not include restraints used while the facility is engaged in transporting an individual from one facility location to another facility location when it is within the scope of that facility’s powers and authority to conduct such transportation pursuant to Sections 26-20-101 through -110, C.R.S.

H. No restraint of an individual may place excess pressure on the chest or back of that individual, cover the individual’s face, or inhibit or impede the individual’s ability to breathe. 15.15.8 Chemical Restraint A. An order for a chemical restraint, along with the reasons for its issuance, must be recorded in writing at the time of its issuance.

B. An order for a chemical restraint must be signed at the time of its issuance by such authorized practitioner, who is present at the time of the emergency.

C. An order for a chemical restraint, if authorized by telephone, must be transcribed and signed at the time of its issuance by personnel with the authority to accept telephone medication orders who are present at the time of the emergency.

D. Personnel trained in the administration of medication shall make notations in the record of the individual as to the effect of the chemical restraint and the individual’s response to the chemical 15.15.9 Use of Seclusion A. Seclusion occurs any time an individual is placed alone in a room and not allowed to leave.

B. The decision to seclude must be based on a current clinical assessment and behavioral presentation. Seclusion must be used only when other less restrictive methods have failed.

1. Documentation of less restrictive methods and the outcome must be contained in the C. Seclusion must not be used for punishment, for the convenience of personnel, or as a substitute D. Seclusion rooms must be lighted, clean, safe, and have a window for personnel to observe.

E. Seclusion rooms must be a minimum of 100 square feet, unless the facility is licensed as a hospital and the seclusion room size is in compliance with applicable CDPHE regulations.

F. Relief periods from seclusion must be offered for reasonable access to toilet facilities. 15.15.10 Explanation to Individual in Seclusion/Restraint A. In any situation in which seclusion/restraint is utilized, information must be given to the secluded/restrained individual, and the individual’s parent, legal custodian, legal guardian or legal representative when applicable, as soon as possible after they have been secluded or restrained.

The individual must be given a clear explanation of:

1. The reasons for the use of such intervention;

2. The observation procedure, the desired effect, and 3. The circumstances under which the procedure will be terminated.

B. That the explanation has been given to the individual and the individual’s parent, legal custodian, legal guardian or legal representative, when applicable, must be documented in the clinical C. As soon as possible, upon termination of seclusion and/or restraint, personnel shall debrief with the individual and assess for any traumatic stress that may have been triggered as a result of 15.15.11 Observation and Care of Individuals in Seclusion and/or Restraint A. An individual who is in seclusion/restraint must be observed in person by trained facility personnel. Observation for an individual in restraint must not be more than ten (10) feet physical distance from the individual. Any individual placed in seclusion must be observed through direct observation and not solely through the use of video surveillance.

1. Such observation, along with the behavior of the individual, must be documented every B. Unless contraindicated by the individual's condition, such observation must include consistent 1. All contraindications shall be documented in the clinical record.

C. Ongoing provisions must be made for nursing care, hygiene, diet, and motion of any restrained D. Facility personnel must maintain a continuous line-of-sight throughout the episode with the E. For individuals in care held in mechanical restraints, facility personnel must observe the individual at least every fifteen (15) minutes to ensure that:

1. The individual is properly positioned;

2. The individual’s blood circulation is not restricted;

3. The individual’s airway is not obstructed; and 4. The individual’s other physical needs are met, pursuant to this Part 15.15.11 C.

F. For individuals in care held in mechanical restraints, the facility shall offer relief periods of at least ten (10) minutes as often as every two (2) hours, so long as relief from the mechanical restraint is determined by personnel to be safe pursuant to this Part 15.15.11.

G. Personnel must document relief periods both offered and granted.

H. The individual must have access to food at least every four (4) hours.

I. The individual must have access to fluids and toileting upon request or during offered relief periods, but must at minimum be offered every two (2) hours.

1. During such relief periods, personnel shall ensure proper positioning of the individual and J. Personnel must provide assistance for the use of necessary toileting methods.

1. Appropriate toileting does not include the use of adult diapers, bedpans, or other mobile toileting equipment if not typically used by the individual when not restrained or secluded.

2. If the individual typically uses adult diapers, they are to be changed immediately if soiled.

K. Personnel shall maintain the individual’s dignity and safety during relief periods.

L. Cameras and other electronic monitoring devices must not replace face-to-face observations.

M. To the extent that the duties specified in Sections 26-20-101 through -110, C.R.S. are more protective of individual rights or are in conflict with the provisions in this Part 15.15, the provisions of Sections 26-20-101 through -110, C.R.S. shall apply. 15.15.12 Continued Use of Seclusion and/or Restraint A. Personnel must document efforts to assure that the use of seclusion/restraint are as brief as B. Seclusion and/or any type of restraint must not be ordered on an “as needed” basis.

C. Continued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative 1. The administrative reviewer shall be a different authorized practitioner with the authority and knowledge necessary to review clinical information and reach a determination that the extension of a seclusion and/or restraint episode beyond twenty-four (24) hours is 2. If the administrative reviewer does not concur with the order for continuation of seclusion/restraint, the order must be discontinued, and the authorized practitioner in D. An administrative review must be initiated at the conclusion of each twenty-four (24) hour period 15.15.13 Documentation Requirements A. Each facility must ensure that an appropriate notation of the use of seclusion, restraint and/or physical management is documented in the record of the individual who was secluded, restrained, and/or physically managed and must be completed before the end of the shift of the personnel involved in the seclusion, restraint and/or physical management episode(s). Each facility shall document the following in the individual’s record:

1. Specifics of the episode including identified triggers, precipitating events, the individual's specific behavior(s), and the nature of the danger;

2. Lower-level interventions utilized, or reasoning why lower-level interventions would have been ineffective or inappropriate;

a. A description of specific non-physical and least restrictive interventions that were attempted prior to the intervention and the individual’s response;

3. Type of restraint, if utilized;

4. Specific date and times of initiation and discontinuation of seclusion, restraint, and/or physical management and total length of time individual is secluded, restrained, and/or 5. Identification of personnel involved in the initiation and application of the seclusion, restraint, and/or physical management;

6. Notification to an authorized practitioner within one (1) hour of the seclusion/restraint 7. Care provided while the individual was secluded, restrained, and/or physically managed, a. Observations conducted;

b. Assessments of position, respiration, circulation, and range of motion;

c. Documentation of ongoing 15-minute observation and care checks, as subject to applicable rules, along with relief periods both offered and granted for food, fluid, d. Interventions provided to promote comfort and safety as well as expedite release;

e. The individual’s response to these interventions; and f. The effect of the restraint or seclusion on the individual;

8. Documentation that the individual, and the individual’s parent, legal custodian, legal guardian or legal representative if applicable, was given a clear explanation of the reasons for use of such intervention, the observation procedure, the desired effect, and the circumstances under which the intervention will be terminated including criteria for release and individual understanding of that criteria; and, 9. Documentation that personnel debriefed the incident with the individual and assessed for B. Any administrative reviewer shall document the clinical justification for the continued use of seclusion/restraint in the individual's clinical record. The justification must include:

1. Documentation that the authorized practitioner ordering the continuous use of seclusion/restraint in excess of four (4) hours has conducted a face-to-face evaluation of 2. Documentation of the ongoing behaviors or findings that warrant the continued use of 3. Documentation of a plan for ongoing efforts to actively address the behaviors that 4. A determination of the clinical appropriateness of the continuation of seclusion/restraint;

5. A summary of the information considered by the reviewer and the result of the administrative review, with the date, time and signature of the person completing the C. Information regarding the use of seclusion/restraint must be readily accessible to authorized persons for review. The facility shall have the ability to gather data as follows:

1. Each seclusion/restraint episode, including date and time the episode started and ended, specific to each individual over the period of one complete calendar year from January 1 15.15.14 Additional Procedures and Requirements for Seclusion/Restraint of a Youth A. Procedures for youth must include the following in addition to the requirements found in this Part 15.15, unless otherwise required in this Part 15.15.14.

B. This Part 15.15.14 does not apply to adult individuals in care, ages 18 (eighteen) and older, receiving services in an adult facility.

C. An emergency safety intervention must be performed in a manner that is safe, proportionate, and appropriate to the severity of the behavior, and the youth’s chronological and developmental age; size; gender; physical, medical, and psychiatric condition; and personal history (including any D. Orders for seclusion/restraint must be made by an authorized practitioner in the facility within the scope of practice to order seclusion/restraint, trained in the use of emergency safety interventions, and in accordance with 42 C.F.R. Part 441, which is incorporated by reference in

Part 1.2 of these Rules.

1. This requires that inpatient psychiatric services for individuals in care under age twentyone (21) be provided under the direction of a physician.

E. If the individual’s treatment team assigned physician or authorized practitioner is available, only they can order seclusion/restraint. If they are not available, then another authorized practitioner on the treatment team may make the order.

F. A physician or other authorized practitioner must order the least restrictive emergency safety intervention that is most likely to be effective in resolving the emergency safety situation based on G. If the order for seclusion/restraint is verbal, the order must be received by a registered nurse or other trained licensed personnel, such as a licensed practical nurse, while the emergency safety intervention is being initiated by personnel or immediately after the emergency safety situation 1. The registered nurse or other trained licensed professional receiving a verbal order for the emergency intervention must document the verbal order in the clinical record.

2. The physician or other authorized practitioner permitted to order restraint or seclusion must verify the verbal order in a signed written form in the youth’s record. Signatures must be entered into the record no more than twenty-four (24) hours after the event.

3. The physician or other authorized practitioner to order restraint or seclusion must be available to personnel for consultation, at least by telephone, throughout the period of the H. Each order for seclusion/restraint must be limited to no longer than the duration of the emergency I. If the total order time exceeds the following durations, the facility must evaluate the individual to determine whether they should be moved to a higher level of care, unless the facility is a hospital:

1. Four (4) hours for persons ages eighteen (18) to twenty-one (21);

2. Two (2) hours for persons ages nine (9) to seventeen (17); or 3. One (1) hour for persons under the age of nine (9).

J. Within one (1) hour of the initiation of the order of the emergency safety intervention a registered nurse or authorized practitioner trained in the use of emergency safety interventions and permitted to assess the physical and psychological well-being of the youth, must conduct an inperson assessment of the physical and psychological well-being of the individual including but not 1. The youth’s physical and psychological status;

2. The youth’s behavior;

3. The appropriateness of the intervention measures; and 4. Any complications resulting from the intervention.

K. Results of the one (1) hour assessment must be documented in the individual’s record.

L. Notification of parent(s) and/or legal guardian(s), when applicable:

1. The facility must notify the parent(s) and/or legal guardian(s) of the individual who has been in seclusion or restraint as soon as possible after the initiation of each emergency 2. The facility shall document in the individual’s record that the parent(s) or legal guardian(s) have been notified of the emergency safety intervention, including date and time of the 3. If notification to the parent, legal guardian, or legal custodian is contraindicated, this shall be documented in the youth’s clinical record. 15.16 Use of Feeding Tubes for Eating Disorder Treatment and Recovery 15.16.1 Informed Consent for Feeding Tubes A. Use of a feeding tube for purposes of eating disorder treatment requires obtaining signed written informed consent prior to initiation of such procedure unless the facility is initiating involuntary placement of the feeding tube. If the facility is involuntarily placing a feeding tube, the facility must provide the individual with the written advisement of Rule 15.16.1 C of this Chapter 15 to allow the individual an opportunity to give informed consent. Informed consent is required when:

1. A feeding tube is initially placed;

2. When a facility wants to utilize and use an existing tube that was not placed by the facility; or 3. When a facility initiates an emergency feeding tube in alignment with Part 15.16.3 of this B. For voluntary placement of a feeding tube, written informed consent shall be obtained and documented in the individual’s clinical record, reflecting the agreement by both the individual and the treatment provider or facility.

1. When the individual receiving the feeding tube ages fourteen (14) and younger, the parent/guardian must provide written informed consent for the feeding tube. The individual must be provided with the information and opportunity to ask questions regarding the process.

2. When the individual receiving the feeding tube, age fifteen (15) years and older, both the individual and the parent or legal guardian, as applicable, must provide written informed consent for the use of the feeding tube. If the individual does not consent, the facility must follow the procedures outlined in Sections 27-65-104(6) and 27-65-113, C.R.S.

a. A facility may not involuntarily place or utilize a feeding tube unless designated under Section 65 Title 27, C.R.S. and Chapter 11 of these Rules. A facility involuntarily placing or continuing the use of a feeding tube must follow all requirements listed in Chapter 11 of these Rules.

C. Informed consent for a feeding tube procedure shall contain and document the following:

1. The reason for such treatment;

2. The nature of the procedures to be used in such treatment, including their probable frequency and duration;

3. The probable degree and duration of improvement or remission of symptoms expected with or without such treatment;

4. The nature, degree, duration, and probability of the side effects and significant risks of such treatment commonly known by the medical profession;

5. The reasonable alternative treatments, if any, and why the authorized practitioner is recommending the specific treatment;

6. That the individual has the right to refuse or accept the proposed treatment and has the right to revoke their consent for any reason at any time, either orally or in writing; and 7. An offer to answer any inquiries concerning the recommended feeding tube placement.

D. For voluntary feeding tubes, if written informed consent is not obtained, then the individual's consent for the procedure is revoked. 15.16.2 Personnel Training Requirements A. Feeding tubes shall only be placed by personnel of the facility who possess the knowledge and skill of placement through training and/or education. Personnel shall only place feeding tubes when their scope of practice allows.

B. In addition to the training requirements in Part 15.10 of this Chapter 15, personnel placing or utilizing feeding tubes must have annual competency training.

C. The facility shall maintain policies and procedures regarding which personnel can place or utilize the feeding tube procedures, processes, and training based on their education and credentials. 15.16.3 Emergency Feeding Tube Requirements A. Emergency feeding tubes may be administered in an emergency situation as determined by the facility’s policies and procedures. Policies shall include, at a minimum, the following:

1. Consultation by two licensed physicians, with expertise in treating eating disorders, prior to placement and use of the emergency feeding tube;

2. Medical condition(s) that would constitute the need for emergency feeding;

3. Evaluation of an individual’s decision to refuse nutrition; and 4. Documentation of insufficient time to obtain a court order for an involuntary feeding tube.

B. Emergency feeding tubes shall only be utilized by designated facilities that also hold a valid 27-65 Designation from BHA.

C. Emergency feeding tubes shall only be utilized by an eating disorder treatment and recovery facility within a general hospital setting, where emergency medical services are available onsite.

D. Reasonable attempts to obtain voluntary acceptance of a feeding tube shall be made prior to the placement or use of an emergency feeding tube. All attempts shall be documented in the E. Continuation of an emergency:

1. If the emergency has abated because of the use of the feeding tube and the physicians are of the opinion that the feeding tube is necessary to keep the emergency in abeyance beyond seventy-two (72) hours, then within that seventy-two (72) hours, the following steps shall be taken:

a. The facility shall send a written request for a court hearing for an order to administer the feeding tube involuntarily; and b. An examination of the individual, a review of the clinical record, including an assessment as to whether the emergency condition continues to exist, and whether or not the individual can voluntarily receive nutrition.

2. In no case shall an individual receive an emergency feeding tube involuntarily for a period exceeding ten (10) business days without an order from a court of competent jurisdiction, including continuation orders from the court.

3. The individual shall be notified of the right to contact their attorney and/or the court of competent jurisdiction at the time the written request for court-ordered feeding tube is made. This notification shall be documented in the clinical record. If an individual chooses to exercise this right, the eating disorder treatment and recovery facility shall aid the individual, if necessary, in accomplishing the foregoing.

F. The specific facts outlining conditions supporting the finding of the emergency condition shall be detailed in the clinical record. Every twenty-four (24) hours thereafter until such time a final court order is issued, the emergency is resolved, or the individual accepts a feeding tube or other appropriate nutrition voluntarily, the facility shall document the behaviors that substantiated the need to continue the emergency feeding tube, and the physician shall continue the order.

G. During the course of the emergency feeding tube, the individual shall be offered the nutrition on a voluntary basis each time the nutrition is given. If the individual voluntarily consents to take the nutrition, and the attending physician determines that the individual will likely continue to accept the nutrition on a voluntary basis and no longer requires an involuntary feeding tube, this shall be documented in the record and the involuntary procedures shall be terminated.

H. If the individual again refuses to voluntarily accept nutrition and their clinical condition returns to an emergency situation, pursuant to Part 15.16.3 of this Chapter 15, the emergency feeding tube procedures may be re-instituted. 15.16.4 Involuntary Feeding Tube Requirements A. Any eating disorder treatment and recovery facility utilizing involuntary feeding tubes and/or restraint for feeding tubes shall be a 27-65 designated facility and meet the requirements of the designation as described in Chapter 11.

B. In non-emergency situations in which an individual is detained pursuant to Sections 27-65-106, - 108.5, -109, -110, or –111, C.R.S. would benefit from the placement and utilization of a feeding tube, but the individual does not consent, the facility shall petition the court to obtain permission to administer such procedure. The following conditions must be documented in the petition:

1. The individual is unable to effectively participate in the treatment decision;

a. The individual is unable to effectively participate in treatment decision making or unable to consent due to their mental illness, as determined by an evaluation of capacity. This evaluation shall be documented in the clinical record.

2. Treatment by an involuntary feeding tube is necessary to prevent significant and likely long-term deterioration in the individual’s mental and physical condition;

3. A less intrusive and appropriate treatment alternative is not available or inappropriate;

4. The individual’s need for treatment by an involuntary feeding tube is sufficiently compelling to override any bona fide and legitimate interest of the individual refusing C. The petition shall specify the type of feeding tube is being recommended as potentially beneficial to the individual.

D. Feeding tubes shall not be placed and/or utilized without the individual’s consent or the consent of the individual’s parent/legal guardian, except under emergency conditions under Part 15.16.3 of this Chapter 15 or pursuant to an order from a court of jurisdiction.

1. Individuals subject to involuntary feeding tubes shall be provided the same information as described Part 15.16.1, ability to ask questions, and receive answers. 15.16.5 Use of Restraint During Feeding Tube Placement and Utilization A. Use of restraint for feeding tube intervention shall be used as a last resort, when all lower-level interventions have been exhausted, and shall not be used as a punitive or coercive response to 1. Multidisciplinary team decision-making to utilize physical or mechanical restraints for feeding tube placement shall be made on an individual basis. Decision-making shall be documented within the individual’s clinical record.

B. Eating disorder treatment and recovery designated facilities utilizing restraint for the placement and intervention of a feeding tube shall develop and implement policies and procedures in accordance with Parts 15.15 and 15.16 and the following minimum requirements:

1. Details on the type of physical management, restraint, and/or model the personnel are approved to use.

2. The multidisciplinary team shall document the decision-making process, including a comprehensive physical and mental health risk assessment prior to implementation of restraint;

3. Restraint may only be utilized to ensure the physical safety of the individual and/or personnel; and 4. How the restraint will be removed and in what timeframe. 15.16.6 Documentation Requirements A. Any physical management, physical restraint, and/or mechanical restraint required for feeding tube placement or use must be documented as described in Part 15.15.13 of this Chapter 15.

B. Any facility utilizing physical management, physical restraint, and/or mechanical restraint for feeding tube placement or use shall have policies and procedures that comply with the requirements of Part 15.15 of this Chapter 15. 15.17 Psychiatric Medications 15.17.1 Informed Consent A. In all instances where prescription medications are to be ordered as a part of a treatment program, the following information in these Parts 15.17 shall be provided, consistent with federal and state law, to the individual and legal guardian(s), if applicable, and communicated in both written and verbal formats.

1. For individuals in care, ages fifteen (15) up to age eighteen (18), the information outlined in 15.17.1 C of this Chapter 15 shall also be provided to the individual’s parent(s) or legal guardian(s).

2. When an individual has designated another to act concerning medication issues, pursuant to a medical durable power of attorney, advanced directive, or proxy, the information shall be provided to that person also.

B. The facility shall have policies and procedures for documenting in the clinical record that the required information was given to the individual, parent, or guardian and consent obtained before prescribing and the initial administration of medication(s).

C. The information required as part of the informed consent shall include, at a minimum, the 1. The name(s) of the medication being prescribed;

2. The typical uses of the medication(s) to be prescribed;

3. The reasons for ordering the medication(s) for this individual;

4. A description of the benefits expected;

5. The common side effects and common discomforts, if any;

6. The major risks, if any;

7. The probable consequences of not taking the medication(s);

8. Any significant harmful drug or alcohol interactions, or food interactions;

9. Appropriate treatment alternatives, if any;

10. That the individual may withdraw agreement to take the medication at any time; and 11. Ensure that medication will not interfere or negatively interact with any of the individual’s other prescribed medication(s).

D. The provider with prescriptive authority or their designee shall offer to answer inquiries regarding the medication(s) upon prescribing or any other time upon request.

E. No individual shall be threatened with or subjected to adverse consequences by facility personnel solely because of a refusal to accept psychiatric medication voluntarily. 15.17.2 Prescribing, Handling, and Administration of Psychiatric Medication(s)

A. All psychiatric medication(s) may only be administered on the written order of a professional authorized by statute to order such medications. Verbal medication orders may be given according to facility policies.

B. The facility shall have written policies and procedures regarding Part 15.17 of this Chapter 15 for informed consent, and the following:

1. Documentation of the administration of medication, medication variances/errors, and adverse medication reactions related to medication administration;

2. Notification to professional staff authorized by statute to order such medications in case of medication errors and/or medication reactions/events;

3. Discontinuance of medication;

4. Disposal of medications;

5. Acceptance of verbal, fax, or electronically transmitted medication orders; and 6. Medication shortages and substitutions.

C. Facilities shall ensure all clinical staff are aware of and have access to the medication formulary, when applicable and appropriate.

D. Facilities shall ensure their providers have access to the medications on the medication formulary when prescribing medications to treat behavioral health disorders.

E. Facilities shall document in the individual’s clinical and/or medication administration record all prescription medications administered to the individual by the facility, including:

1. The name and dosage of medication;

2. The reason for ordering the medication;

3. The time, date and dosage when medication(s) is administered;

4. The name and credentials of the person who administered the medication; and 5. The name of the prescribing physician or advanced practice registered nurse to order such medication.

F. Medication Administration 1. The facility must ensure that medications are administered only by licensed or certified personnel allowed to administer medications under their own scopes of practice, or unlicensed personnel who are qualified medication administration persons (QMAPs) acting within their own scope of practice.

2. When using QMAPs to administer medication, the facility shall ensure compliance with 6 CCR 1011-1 Chapter 24, as incorporated by reference in Part 2.15.B of these Rules.

3. Facilities shall follow psychiatric medication standards as outlined in Part 15.17 of this

Chapter 15 and the following:

a. Only a licensed registered nurse may accept telephone or verbal orders for medication from a physician or other authorized practitioner. All telephone orders shall be evidenced by a written and signed order and documented in the individual’s record and the facility’s medication administration record.

b. The facility shall be responsible for complying with the prescriber’s or advanced practice registered nurse's orders associated with the administration of medication or treatment. The facility shall implement a system that obtains clarification from the physician, as necessary, and documents that the physician:

(1) Has been asked whether refusal of the medication or treatment should result in physician notification.

(2) Has been notified, where such notification is appropriate.

(3) Has provided documentation that such notification shall be made in the individual’s clinical record.

(4) Coordinates with external providers or accepts responsibility to perform the care using facility personnel.

(5) Trains personnel regarding the parameters of the ordered care as (6) Documents the delivery of the care, including refusal by the individual, of the medication or treatment. 15.17.3 Medication Storage, Disposition, and Disposal A. All personal medication must be surrendered to the facility to be logged in and stored by the facility. Individuals in care shall not be allowed to self-administer medication in the facility, when the facility is providing residential or inpatient level(s) of care.

B. Personal medication shall be returned to the individual or individual’s parent, legal custodian, legal guardian or legal representative, upon discharge or death.

1. The return of medication to the individual may be withheld when a physician or other authorized medical practitioner has determined that the individual lacks the decisional capacity to possess or administer such medication safely.

2. If the medication is withheld, the decision to withhold the medication shall be documented in the individual’s clinical record.

C. Medications shall be labeled with the individual’s full name, pursuant to Article 280 of Title 12, D. Any medication container that has a detached, excessively soiled, or damaged label shall be returned to the issuing pharmacy for re-labeling or disposed of appropriately.

E. All medication shall be stored in a manner that ensures the safety of all individuals in care.

F. Medication shall be stored in a central location, including refrigerators, and shall be kept under lock and shall be stored in separate or compartmentalized packages, containers, or shelves for each individual in order to prevent intermingling of medication.

G. Individuals in care shall not have access to medication that is kept in a secure and central H. Medications that require refrigeration shall be stored separately in locked containers in the refrigerator. If medication is stored in a refrigerator dedicated to that purpose, and the refrigerator is in a locked room, then the medications do not need to be stored in locked containers.

I. Prescription and over the counter medication shall not be kept in stock or bulk quantities unless such medication is administered by a licensed medical practitioner.

J. Medication disposal procedures include:

1. The return of medication shall be documented by the facility.

2. Medication that has a specific expiration date shall not be administered after that date 15.18 Continuity of Care and Transfer of Care 15.18.1 Continuity of Care A. Each facility shall adopt and implement a written policy for continuity of care. The policy shall include at a minimum the following:

1. Access to all necessary care and services within the facility, and coordination with any other current health care providers or other systems of care or support as appropriate;

2. Coordination of care with the individual's previous mental health care providers or medical providers as appropriate, including retrieval of psychiatric and medical records;

3. Coordination of the individual's care with family members, guardians, and other interested parties as appropriate and in a manner that reflects the individual's culture; and/or 4. The facility shall facilitate access to proper medical care and shall be responsible for coordinating mental health treatment with medical treatment provided to the individual. 15.18.2 Transfer of Care: Non-Emergent A. The individual shall only be transferred to another eating disorder treatment and recovery facility when adequate arrangements for care by the receiving facility have been made and documented in the clinical record. Transfer coordination shall include at least one discharge planning conference, face-to-face or by telephone, with participants from both facilities and the individual and their guardian, whenever possible.

B. At least twenty-four (24) hours advance notice of transfer shall be given to the individual, unless knowingly waived in writing by the individual and guardian, if applicable and as appropriate, except in cases of a medical emergency.

C. The transferring facility shall ask the individual to indicate two (2) persons to whom notification of transfer should be given and shall notify such persons within twenty-four (24) hours of notification to the individual. Such notification shall be made by the transferring facility with the appropriate written authorization. Actions taken under Part 15.18 of this Chapter 15, shall be documented in 15.18.3 Care Coordination A. Eating disorder treatment and recovery designated facilities shall work with the individual to identify the individual’s service and support needs and preferences and shall carry out care coordination as defined in Part 1.1 of these Rules to facilitate access to those services and supports.

B. Care coordination must, to the extent possible, be carried out in accordance with the individual's expressed preferences and with involvement of the individual's family member(s), parent, legal custodian, legal representative, advocate, caregiver, and other supports identified by the C. Care coordination activities may include, as appropriate for the needs and preferences of the 1. Development of person and family-centered service plans that:

a. Promote integrated whole person care across the spectrum of health services.

b. Address each individual’s priorities, goals, and the barriers they face.

c. Address access to acute and chronic physical and behavioral health care, peer support networks, social services including income supports, health insurance, housing, educational systems, and employment opportunities as necessary to facilitate wellness and recovery of the whole person in alignment with an individual’s assessed needs and expressed goals.

2. Facilitating access to needed resources and services to carry out the service plan. This may include, but is not limited to:

a. Conducting application assistance, referrals, and warm hand-offs to access resources and care;

b. Providing accessible, culturally and linguistically appropriate resources and information, including access to resource directories such as OWNPATH;

c. Coordinating with partners to provide specialized services, risk stratification, discharge planning, transition planning, prior authorization, insurance appeal, and medication reconciliation;

d. Identifying the information, social service, and health care systems that an individual will need to access in order to navigate systems, manage their care, and achieve whole person health;

e. Equipping the individual with information through means that are accessible and appropriate for the individual based on their needs and preferences and as required by federal and state statute;

f. Collaborating with other systems and entities providing care coordination services to the individual;

(1) If care coordination activities necessary to meet the individual’s needs and fulfill the service plan are being carried out by an alternate entity, the behavioral health safety net provider shall document the responsibilities of each entity within the record and update the record in response to changes in the individual's needs and/or preferences, and the alternate entity’s involvement.

g. Providing outreach, planning, problem-solving, advocacy, education, and selfmanagement support;

3. Deliberate and coordinated planning to prevent disengagement from services, identifying and mitigating risks for individuals in care, including identifying and implementing prevention strategies to proactively mitigate risk, and connecting the individual to supports to promote ongoing maintenance and prevention.

a. Risks may include, but are not limited to, risk of grave disability, risk of danger to self or others, risk of institutionalization, risk of incarceration, risk of overdose, risk of housing and income instability including loss of benefits, and risk for out of home placement for a youth.

b. Risk assessment must involve the individual and their service providers, be done on an ongoing basis, and be addressed within the service plan.

c. When a risk for disengagement is identified, the service plan must address prevention of and response to an individual disengaging from services including missing appointments.

4. Monitoring an individual’s progress, engagement, and satisfaction with treatment and recovery in alignment with outcomes identified by the individual.

5. If the facility does not provide a treatment approach or support service necessary to meet the individual’s treatment needs, the facility must ensure that care coordination occurs.

6. All care coordination efforts and implementation must be documented in the individual’s 15.19 Data Reporting for Eating Disorder Treatment and Recovery Services A. Each facility designated for eating disorder treatment and recovery services shall file an annual report with BHA. This report shall be submitted in the format and timeframe specified by BHA.

B. For each facility, the annual report shall include:

1. Facility name;

2. County, and address of the facility; and 3. A list of any other licenses approved by BHA and held by the facility.

C. The facility shall maintain confidentiality over the data sets. The reports generated from these data sets are also confidential. BHA may release aggregated information contained in the reports so long as the total number of individuals in care in any aggregate group is greater than thirty (30). If the total number of such a data group is less than or equal to thirty (30), BHA may release this information by redacting such a number.

D. Facilities must submit their annual data report to BHA by July 1 of each year for the most recent, complete calendar year covering January 1 through December 31. The report must meet the requirements of this Part 15.19 of this Chapter 15 and on the BHA-created form available on the BHA website. All submitted data shall include non-identifying information and whole numbers.

1. Demographic summary of individuals served:

a. Age;

b. Sex;

c. Gender identity; and d. Race and ethnicity.

2. Total number of individuals served, at each level of care, as applicable:

a. Inpatient;

b. Residential;

c. Partial hospitalization;

(1) Virtual;

(2) In-person; or (3) Hybrid.

d. Intensive outpatient; and (1) Virtual;

(2) In-person; or (3) Hybrid.

e. Outpatient.

(1) Virtual;

(2) In-person; or (3) Hybrid.

3. Total number of outcomes per level of care:

a. Programming completed successfully;

b. Individual discharged against medical or clinical advice; and/or c. Individual was administratively discharged prior to program completion. Reason for individual’s administrative discharge:

(1) Individual eloped from facility;

(2) Individual was transferred to higher level of care or more appropriate treatment setting (i.e. substance use services, detox, involuntary mental health care, etc.);

(3) Individual was non-compliant with treatment or services;

(4) Individual no longer had funding;

(5) Medical emergency;

(6) Death of the individual;

(7) A legal guardian or legal custodian removed the individual from 21.000 BEHAVIORAL HEALTH 21.100 DEFINITIONS “42 C.F.R. Part 2” means the federal regulations issued by the Substance Abuse & Mental Health Services Administration of the U.S. Department of Health & Human Services found at 42 C.F.R. Part 2 (Feb. 2018), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Health & Human Services, Substance Abuse & Mental Health Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD 20857 or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours.

“Acute Treatment Unit” (ATU) means a designated facility or a distinct part of a facility for short-term psychiatric care, which may include substance use disorder treatment. An ATU provides a twenty-four (24) hour, therapeutically planned and professionally staffed environment for individuals who do not require inpatient hospitalization but need more intense and individualized services, such as crisis management and stabilization services, than are available on an outpatient basis, as defined in 27-65- 102(1), C.R.S.

“A ggrieved” means having suffered actual loss or injury or being exposed to potential loss or injury to legitimate interests as defined in 24-4-102 (3.5), C.R.S.

“Behavioral Health” for the purposes of these rules, behavioral health includes substance use and mental health. “ Department” is the Colorado Department of Human Services.

“Community Mental Health Clinic” means a health institution planned, organized, operated, and maintained to provide basic community services for the prevention, diagnosis, and treatment of emotional or mental disorders, such services being rendered primarily on an outpatient and consultative basis.

"Counselor-in-training" means an individual currently in the process of obtaining a professional credential pursuant to Part 8 of Article 245 of Title 12, C.R.S. "Counselor-in-training" does not include a psychologist candidate; a clinical social worker candidate; a marriage and family therapist candidate; a licensed professional counselor candidate; or an addiction counselor candidate.

“Designated Facility” means an agency has applied for and been approved by the department under these rules to provide mental health services.

“Designated Managed Service Organization” means an organization approved and authorized by the Department to manage oversight, quality assurance, and contract compliance of substance use disorder treatment providers within one or more of the seven established geographic sub-state planning areas. isaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life or property resulting from any natural cause or cause of human origin, including but not limited to fire, flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in the state as defined in Section 24-33.5-703(3), C.R.S..

“Emergency” means an unexpected event that places life or property in danger and requires an immediate response through the use of state and community resources and procedures Section 24-33.5- 703(3.5), C.R.S.

“HIPAA” means the Health Insurance Portability and Accountability Act of 1996, pub. l. no. 104-191, 110 stat. 1936 (1996), codified at 42 U.S.C. § 300GG (2012) and 29 U.S.C. § 1181 et seq. (2012) and 42 U.S.C. § 1320D et seq. (2012) and the federal regulations issued by the U.S. Department of Health & Human Services found at 45 C.F.R. Part 160 (2017); 45 C.F.R. Part 162 (2017); and, 45 C.F.R. Part 164 (2017), which are hereby incorporated by reference. No later editions or amendments are incorporated.

These statutes are available for public inspection and copying from the Tenth Circuit Court of Appeals Library, Room 430 Byron Rogers Courthouse, 1929 Stout Street, Denver, Colorado 80294, from the hours of 8 A.M. TO 4:30 P.M. or at http://uscode.house.gov/. These statutes are also available for public inspection and copying at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours. These regulations are available at no cost from the U.S. Department of Health & Human Services, Office of Civil Rights, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201 or at https://www.ecfr.gov/. These regulations are also available for p ublic inspection and copying at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236 during regular business hours. ndividual” means a person seeking or receiving services.

“Inpatient” refers to inpatient hospitalization as well as twenty-four (24) hour residential levels of care.

“Inspection” means a process of review to ensure licensed or designated entities are operating in substantial conformity with applicable licensing and/or designation rules. Inspections may be conducted remotely for licensure or designation renewals if the entity has received an on-site visit within three (3) years or for entities providing telehealth-only services.

“Legal Guardian” is an individual appointed by the court, or by will, to make decisions concerning an incapacitated individual's or minor's care, health, and welfare.

“Legal Representative” means one of the following:

A. The legal guardian of the individual, where proof is offered that such guardian has been duly appointed by a court of law, acting within the scope of such guardianship;

B. An individual named as the agent in a Power of Attorney (POA) that authorizes the individual to act on the individual's behalf, as enumerated in the POA;

C. An individual selected as a proxy decision-maker pursuant to Section 15-18.5-101, et seq., C.R.S., to make medical treatment decisions. For the purposes of these rules, the proxy decisionmaker serves as the individual's legal representative for the purposes of medical treatment decisions only; or, D. A c onservator, where proof is offered that such conservator has been duly appointed by a court of law, acting with the scope of such conservatorship.

“Licensed Agency” means an agency approved and licensed under these rules by the Department to provide substance use disorder treatment.

“Medication formulary” means the Required Formulary Psychotropic Medications: 2018, which is hereby incorporated by reference. No later editions or amendments are incorporated. The medication formulary is available at no cost from the Colorado Department of Human Services at https://www.colorado.gov/pacific/cdhs/behavioral-health-laws-rules. The medication formulary is also available for public inspection and copying at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, CO 80236, during regular business hours.

The medication formulary is a list of minimum medications, established pursuant to 27-70-103, C.R.S., that may be used by service providers to increase the likelihood that a broad spectrum of effective medications are available to individuals to treat behavioral health disorders, regardless of the setting or service provider. The medication formulary may not contain a complete list of medications, and providers may prescribe and/or carry any additional medications they deem necessary.

“Office” is the Office of Behavioral Health within the Colorado Department of Human Services.

“Plan of Action” is a description of how an agency plans to bring into compliance any standards identified as out of compliance within a specified time period.

“Placement facility” means a public or private facility that has a written agreement with a designated facility to provide care and treatment to any individual undergoing mental health evaluation or treatment by the designated facility. A placement facility may be a general hospital, nursing care facility, or licensed residential child care facility.

“RCCF” means a residential child care facility licensed pursuant to 12 CCR 2509-8, Section 7.705, et seq., by the Colorado Department of Human Services, Division of Child Welfare. hort-Term” psychiatric care means the average lengths of services are from three (3) to seven (7) days.

“The ASAM Criteria” means the publication from the American Society of Addiction Medicine, Mee-Lee, D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., EDS. The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, 3rd ed. Carson City, NV: The Change Companies®; 2013, which is hereby incorporated by reference. No later editions or amendments are incorporated. Mee-Lee, D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., EDS. The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, 3rd ed. Carson City, NV: The Change Companies®; 2013, is available for a reasonable charge at http://www.asam.org/resources/the-asam-criteria. Mee-Lee, D., Shulman, G.D., Fishman, M.J., Gastfriend, D.R., Miller, M.M., EDS. The ASAM Criteria: Treatment Criteria for Addictive, Substance Related, and Co-Occurring Conditions, 3rd ed. Carson City, NV: The Change Companies®; 2013, is also available for public inspection at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours. 21.105 RIGHT TO APPEAL [Eff. 5/1/16]

Any licensee or designee adversely affected or aggrieved by these rules or by the Department’s decisions in regard to implementation of these rules, has the right to appeal to the Colorado Department of Personnel and Administration, Office of Administrative Courts, and may subsequently seek judicial review of the Department’s action in accordance with Section 24-4-101, et seq., C.R.S.

A. T he following actions may be submitted to an Administrative Law Judge for an evidentiary hearing: denial of a license or designation, provisional license, probationary license, revocation, denial of a waiver, limitation of a license, denial of a modification.

B. After written notification from the Department of intended action, the licensee or designee has twenty one (21) calendar days to submit a written appeal. The appeal must be received by the Division of Behavioral Health within twenty one (21) days from the date the written notification of action letter was sent by the Department.

C. In all cases except waiver denials, the Department will file a notice of charges with the Office of Administrative Courts to begin the administrative process. In waiver denials, the Appellant’s request for appeal shall be forwarded to the Office of Administrative Courts. Once the appellant’s request is forwarded to the Office of Administrative Courts, the Department may file a notice of charges.

D. An answer to the notice of charges shall be due twenty one (21) calendar days after the date of mailing of the notice of charges.

E. The Office of Administrative Courts shall send out a procedural order directing the course of the proceedings and setting the matter for hearing.

F. Subsequent to an evidentiary hearing at the Office of the Administrative Courts and the issuance of a final agency decision, a party may seek to appeal the final agency decision through judicial 21.110 GOVERNANCE [Eff. 11/1/13]

A. Licensed and or designated entities by the Department shall be recognized by and allowed to do business in Colorado.

B. Governance shall provide for and maintain at minimum:

1. Compliance with these rules and applicable federal and state regulations;

2. Agency operating policies and procedures based on these rules, Department policies and procedures, and applicable state and federal regulations;

3. Organizational structures that clearly delineate staff positions, and lines of authority, and supervision;

4. Adequate financial resources to maintain agency personnel, physical facilities, and operations;

5. Physical facilities that meet all current and applicable local and state health, safety, building, plumbing and fire codes and zoning ordinances;

6. P roperty liability insurance;

7. Professional liability (malpractice) insurance;

8. Accurate, up-to-date individual attendance and payment records; and, 9. A written emergency plan and procedures that address provisions for dealing with medical or natural emergencies. Maps of emergency exits shall be conspicuously posted in each site.

21.120 BEHAVIORAL HEALTH LICENSURE AND DESIGNATION 21.120.1 General Provisions A. Any agency licensed and/or designated by the Department shall comply with Sections 21.100 through 21.190 and all rules applicable to the specific behavioral health services for which it is licensed or designated.

B. The Department will review compliance, at a minimum:

1. Licensed agencies once every two (2) years;

2. Facilities designated to provide mental health services per Title 27, Article 65, C.R.S., annually and all other designated agencies at least once every two (2) years; and, 3. When there is reasonable cause to question the agency’s fitness to conduct or maintain a license or designation.

C. Compliance review of sub-contractors and affiliate agencies shall be at the discretion of the Department. Review will be limited to those services that are provided pursuant to contract or affiliation agreement with the licensed or designated agency.

D. Based on compliance issues identified through application review and inspection, the agency may be issued a provisional or probationary license or designation.

E. Applicants that are in full compliance shall be granted a Department license to provide substance use disorder services and/or designated to provide mental health services for up to two (2) consecutive years from the date granted.

F. Licenses and designations shall be displayed in a prominent, publicly accessible place within each agency and or site.

G. Current licenses and designations shall remain in effect during the approval process when completed license and designation applications are received by the Department sixty (60) calendar days prior to the existing license or designation expiration date.

H. An agency whose license or designation is not current shall not indicate in any form or manner that it is licensed or designated and shall not provide behavioral health services requiring a license or designation.

I. An y agency site that has not provided behavioral health services specific to its license or designation status for two (2) years shall be reviewed for termination of licensure or designation.

J. Applicants may appeal licensing decisions in accordance with the state Administrative Procedure Act, as found in Section 24-4-101, et seq., C.R.S.

21.120.2 LICENSING PROCEDURES FOR AGENCIES PROVIDING SUBSTANCE USE

DISORDER SERVICES 21.120.21 Criteria [Eff. 11/1/13]

A. Providers shall obtain a license if:

1. Required by statute to be licensed by the Department;

2. They receive public funds to provide substance use disorder treatment or substance use disorder education;

3. They provide such treatment to individual populations whose referral sources require them to be treated in agencies licensed by the Department; or, 4. They are acquiring existing agencies or sites licensed by the Department.

B. Licenses for treatment and education services and levels of care are required for each physical site.

C. A license is not transferable from one licensed agency to another, from one treatment site to another, or from a licensed agency to an unlicensed organization or individual.

D. Hours of education and treatment provided by agencies whose license is not currently in effect may not count toward fulfilling individual obligations to courts; probation; parole; Colorado Department of Revenue, Motor Vehicle Division; and, other referral sources.

E. Agencies funded by the Department or a by a designated Managed Service Organization shall be licensed to treat individuals involuntarily committed to treatment in accordance with Section 21.270. 21.120.22 Initial Licenses A. Applicants for an initial license to provide substance use disorder services shall submit a completed application with required documentation and fees.

B. An agency may be approved for licensure, granted provisional approval, or have its application denied. The applicant shall be advised of the decision in writing within sixty (60) business days of the initial inspection.

C. An applicant not in compliance may have its license application returned by certified mail with written summaries of deficiencies and notification that the license application is denied. If an applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon remedying the noted deficiencies, may re-apply for an initial license in accordance with Section 21.120.2 of these rules. Application fees may not be refunded.

21.120.23 P rovisional Licenses A. A provisional license may be granted for a period not to exceed ninety (90) calendar days if after initial inspection and review:

1. The provider is in substantial compliance with these rules and regulations and is temporarily unable to conform to all the minimum standards required under these rules.

No provisional license shall be issued to a provider if the operations may adversely affect individual health, safety, or welfare;

2. Compliance will be achieved within a reasonable period of time;

3. The provider has a reasonable written plan or schedule for achieving compliance; and, 4. The provider shall provide proof that attempts are being made to conform and comply with applicable rules.

B. A second provisional license for a period not to exceed ninety (90) calendar days may be granted if substantial progress continues to be made, and it is likely compliance can be achieved by the date of expiration of the second provisional license.

C. During the term of the provisional license, reviews and inspections may be conducted to determine if the applicant is in compliance and meets the requirements for a license.

D. Initial applicants who have completed all provisions and are found to be in compliance prior to the expiration of the provisional license shall be granted a license for up to two (2) consecutive years from the date the original provisional license was issued.

E. If the applicant does not come into compliance during the provisional licensing period, the application for a two (2) year license shall be denied. A denied application shall be returned by certified mail with written summaries of deficiencies and notification that the provisional license is no longer in effect as of ten (10) days from the date the letter was mailed. Original application fees shall not be refunded. If an applicant disagrees with the decision, s/he may appeal (see

Section 21.105); or upon remedying the noted deficiencies, may re-apply for an initial license in accordance with Section 21.120.2 of these rules. 21.120.24 License Renewal A. An agency seeking renewal shall provide the Department with a completed license application and the applicable fee at least sixty (60) calendar days prior to the expiration of the existing B. License renewal applications received by the Department after the current license expiration date shall be returned by certified mail with written notification that the license is no longer in effect.

Applicants may reapply for an initial license in accordance with Section 21.120.2 of these rules.

C. License renewal applications that are received by the Department fewer than sixty (60) calendar days prior to the expiration of their existing license may fail to receive their new license prior to the expiration of their old license. An agency that submits its renewal application fewer than sixty (60) days prior to the expiration of the current license and does not receive a new license prior to that date may reapply for an initial license in accordance with Section 21.120.2 of these rules.

D. F ailure of a licensee to accurately answer or report any of the information requested by the Department shall be considered good cause to deny the license renewal application.

E. The agency licensee shall be notified in writing of non-compliance areas and the need for a plan of action as outlined in Section 21.120.6. A probationary license may be granted.

F. An agency in compliance with the applicable Department rules and state and federal regulations shall be granted a license renewal effective as of the expiration dates of the current license. 21.120.25 Probationary License [Eff. 11/1/13]

A. At the Department’s discretion, a probationary license may be granted to an agency out of compliance with applicable Department, state or federal regulations prior to issuance of a renewal license or during a current license term. The agency will be notified in writing of non-compliance areas and the need for a plan of action (see Section 21.120.6).

B. A probationary license will replace the current license for a period not to exceed ninety (90) calendar days.

C. Administrative and treatment activities may be limited by a probationary license while the agency addresses corrective actions.

D. A pr obationary license may be re-issued for a period not to exceed ninety (90) calendar days if substantial progress continues to be made and it is likely that compliance can be achieved by the date of expiration of the second probationary license.

E. If the licensee fails to comply with or complete a plan of action in the time or manner specified, or is unwilling to consent to the probationary license, the modification to a probationary license shall be treated as a revocation of the licensee and s/he shall be notified by certified mail that the probationary license is no longer in effect as of ten (10) days from the date the letter was mailed.

If an applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon remedying the noted deficiencies, may re-apply for an initial license in accordance with Section 21.120.2 of these rules. 21.120.26 License Modifications A. An agency shall submit a license modification application and written documentation demonstrating compliance with all applicable Department rules, policies and procedures, a minimum of thirty (30) calendar days prior, in the following circumstances:

1. Adding, selling, moving or closing agencies, sites, services, or levels of care;

2. Changing the agency name;

3. Changing agency governance.

B. Failure to submit license modification applications and required documentation within thirty (30) calendar days may result in the agency, specific sites, and or levels of care not being licensed.

C. A pplication fees for a license modification are not required.

D. Emergency license modification request 1. An agency may submit a request to the department for an emergency or disaster modification to their license during the timeframe services are disrupted due to a statewide emergency or disaster.

2. An agency shall provide the department information including but not limited to:

a. An explanation for the need for an emergency or disaster license modification;

b. An explanation or demonstration of compliance with all applicable department rules, policies and procedures.

3. At the department’s discretion, an emergency or disaster license modification may be granted to an agency without an on-site inspection by the department.

4. Upon receiving confirmation of an emergency or disaster license modification, an agency may provide services immediately and continue to operate under the modified license for up to sixty (60) days after the disaster or emergency has ceased.

5. To continue to operate beyond sixty (60) days after the emergency or disaster has ceased, an agency shall submit a permanent license modification pursuant to 21.120.26.a. 21.120.27 Limited License [Eff. 11/1/13]

A. At the Department’s discretion, a limited license may be issued to an agency to prevent or address a perceived conflict of interest and/or a dual relationship within the agency that may negatively impact persons receiving services.

The following include, but are not limited to, circumstances where there may be a perceived conflict of interest and/or a dual relationship exists within an agency:

1. The sharing of information across systems that could negatively impact the individual; or, 2. A financial interest of the agency that may have negative treatment and/or referral implications pertaining to the individual; or, 3. The combining of professional roles within the agency that is incompatible to the best interests of the individual(s) receiving treatment.

B. Limitation of the license may include, but is not limited to:

1. Limiting the specific clientele an agency may serve;

2. Limiting the specific location(s) where an agency may or may not offer services; or, 3. Limiting the specific level of care that may be provided pursuant to the license.

C. If an applicant is unwilling to consent to the limitation on the license, the limitation shall be treated as a denial and s/he may appeal (see Section 21.105); or upon remedying the noted perceived conflict of interest and/or a dual relationship, may re-apply for an initial license in accordance with

Section 21.120.2 of these rules. 21.120.3 FACILITIES DESIGNATED TO PROVIDE MENTAL HEALTH SERVICES [Eff. 11/1/16]

Facilities des ignated to provide mental health services may be:

A. A general or psychiatric hospital licensed or certified by the Colorado Department of Public Health and Environment;

B. A community mental health center Licensed by the Colorado Department of Public Health and Environment or a community mental health clinic;

C. An acute treatment unit licensed by the Colorado Department of Public Health and Environment;

D. A crisis stabilization unit, licensed as an acute treatment unit or as a community clinic by the Colorado Department of Public Health and Environment; or, E. A residential child care facility licensed by the Colorado Department of Human Services, Division of Child Welfare.

Applicant facilities shall identify any parent organization ultimately responsible for their operation. 21.120.31 Application of Rules [Eff. 11/1/16]

A. Designated facilities that are hospitals, acute treatment units, or crisis stabilization units shall comply with all applicable rules including provisions contained in Section 21.280.

B. Designated facilities that are community mental health centers pursuant to Section 27-66-101, C.R.S., shall comply with Sections 21.130 through 21.200.15, where applicable, and Section 21.280. Treatment provisions, as contained in Sections 21.280.3 through 21. 280.9 shall apply to only those individual being treated involuntarily pursuant to Title 27, Article 65, C.R.S.

C. Designated facilities that are community mental health clinics shall comply with Sections 21.130 through 21.200.15 and Sections 21.280.21 through 21.280.22.

D. Designated facilities that are residential child care facilities (RCCF) shall follow Section 21.120.3 through 21.120.44 and 21.200 through 21.200.15, where applicable. RCCFs designated to provide mental health services pursuant to Title 27, Article 65, C.R.S. shall follow Sections 21.200, where applicable, and Section 21.280.

E. Designated managed service organizations (DMSO) shall only comply with 21.120.5 and 21.120.8. 21.120.32 Mental Health Services Pursuant to Title 27, Article 65, C.R.S., Care and Treatment of Persons with Mental Illness Designations [Eff. 5/1/16]

A. A facility meeting the criteria in Section 21.120.3, excluding community mental health clinics, may apply to the Department to become designated to provide any or all of the following services:

1. Seventy-two (72) hour treatment and evaluation;

2. Short-term treatment; or, 3. Long-term treatment.

B. Facilities designated for seventy-two (72) hour treatment and evaluation, short-term, or long-term treatment shall have a person who is licensed in Colorado to practice medicine or a certified Colorado psychologist, either employed or under contract, who is responsible for the evaluation and treatment of each individual. Hospital staff privileges shall be an acceptable form of contractual arrangement. The professional person licensed in Colorado to practice medicine or a certified Colorado psychologist may delegate part of his/her duties, except as limited by licensing statutes or these rules, but s/he shall remain responsible at all times for the mental health treatment administered.

21.120.33 S eventy-Two (72) Hour Treatment and Evaluation Facilities [Eff. 5/1/16]

A. Facilities that are designated as seventy-two (72) hour treatment and evaluation facilities may detain on an involuntary basis persons placed on a seventy-two (72) hour hold for the purpose of evaluation and treatment.

B. ExcIusion of Saturdays, Sundays, and Holidays Evaluation shall be completed as soon as possible after admission. The designated treatment and evaluation facility may detain a person for seventy-two (72) hour evaluation and treatment for a period not to exceed seventy-two (72) hours, excluding Saturdays, Sundays and holidays if evaluation and treatment services are not available on those days. For the purposes of these rules, evaluation and treatment services are not deemed to be available merely because a professional person licensed in Colorado to practice medicine or a certified Colorado psychologist is on call during weekends and holidays. 21.120.34 Short-Term and Long-Term Treatment Facilities [Eff. 5/1/16]

A. Facilities that are designated as short-term treatment facilities may involuntarily detain individuals for short-term (a period of not more than three months) or extended short-term care and treatment (a period of not more than an additional three months).

B. Facilities that are designated as long-term treatment facilities may involuntarily detain individual for long-term care and treatment (a period not to exceed six months) or extended long-term treatment (a period of not more than additional six months).

C. Every person receiving treatment for a mental health disorder by a designated short-term or longterm facility shall upon admission be placed under the care of a person who is licensed in Colorado to practice medicine or a certified Colorado psychologist and employed by or under contract with the designated facility. 21.120.35 Mental Health Centers and Community Mental Health Clinics [Eff. 5/1/16]

A. Mental health centers and community mental health clinics shall use membership on the governing board or equivalent for soliciting input regarding issues which impact persons receiving care. Input shall be solicited from adults, children and adolescents receiving services, and their parents or guardians. The input shall be taken into consideration by management or the governing board during decision-making processes.

B. Emergency/crisis services and evaluation under Sections 27-65-105 and 106, C.R.S., shall be provided twenty-four (24) hours per day including Saturdays, Sundays and holidays. Initial responses to emergencies shall occur either by telephone within fifteen (15) minutes of the call, within one (1) hour of contact in urban and suburban areas, or within two (2) hours of contact in rural and frontier areas. 21.120.36 Med ication Consistency in Designated Facilities A. Designated facilities shall ensure all clinical staff are aware of and have access to the medication formulary.

B. Designated facilities shall ensure their providers have access to the medications on the medication formulary when prescribing medications to treat behavioral health disorders.

21.120.4 DESIGNATION PROCEDURE

A. Facilities applying for designation shall submit an application to the Department on a state approved form.

B. Facilities providing twenty-four (24) hour inpatient or acute crisis care, must apply for a separate designation based on the unique physical address of each site.

C. Except in emergency circumstances affecting the facility's ability to provide evaluation and treatment services, a facility seeking to exclude Saturdays, Sundays and holidays from the seventy-two (72) hour limitation on detaining persons for evaluation and treatment must supply in its application for designation or re-designation documentation to establish that it does not have evaluation services available on these days due to the limited availability of a professional person licensed in Colorado to practice medicine or a certified Colorado psychologist.

D. Receipt of the application shall be acknowledged in writing and state what additional information or documents, if any, are required for review prior to an inspection.

E. F or initial designation applications, the applicant shall be advised in writing within sixty (60) calendar days of initial inspection of the decision of the Department. The facility may be approved for designation, granted provisional approval, or the application may be denied.

F. A facility that is found to be in compliance with these rules shall be approved as a facility designated to provide mental health services effective for up to a two (2) year period.

G. Designations shall be automatically revoked or deemed lapsed for any facility whose license to operate as a health care or residential child care facility has been withdrawn, revoked or allowed to lapse.

H. If the application for designation is denied, the reason(s) for denial shall be provided in a certified letter. If an applicant disagrees with the decision, s/he may appeal (see Section 21.105); or upon remedying the noted deficiencies, may re-apply for designation in accordance with Sections 21.120.3 and 21.120.4 of these rules. 21.120.41 Provisional Designation [Eff. 11/1/13]

A. Provisional approval may be granted for a period not to exceed ninety (90) calendar days if, after initial inspection and review of a facility:

1. The facility is in substantial compliance with these rules, and is temporarily unable to conform to all the minimum standards required under these rules. No provisional designation shall be issued to a facility if the operation of the facility may adversely affect individual health, safety, or welfare;

2. Compliance will be achieved within a reasonable period of time; and, 3. The facility has a reasonable plan or schedule in writing for achieving compliance.

B. The facility shall provide proof that attempts are being made to conform and comply with C. A s econd provisional approval for a period not to exceed ninety (90) calendar days may be granted under the same criteria if necessary to achieve compliance.

D. If the facility is not able to come into compliance within one hundred and eighty (180) calendar days from date initial provisional license granted, the application may be denied. 21.120.42 Re-Designation A. A facility seeking designation renewal shall provide the department with a completed designation application at least sixty (60) calendar days prior to the expiration of the existing designation.

B. Designation renewal applications received by the Department after the current designation expiration date shall be returned by certified mail with written notification that the designation is no longer in effect. Applicants may reapply for an initial designation in accordance with Section 21.120.4 of these rules.

C. Designation renewal applications that are received by the Department fewer than sixty (60) calendar days prior to the expiration of their existing designation may fail to receive their new designation prior to the expiration of their old designation. An agency that submits its renewal application fewer than sixty (60) days prior to the expiration of the current designation and does not receive a new designation prior to that date may reapply for an initial designation in accordance with section 21.120.2 of these rules.

D. F ailure of a designee to accurately answer or report any of the information requested by the Department shall be considered good cause to deny the designation renewal application.

E. Facilities designated to provide care and treatment to persons with mental health disorders pursuant to Section 27-65-101, et seq., C.R.S., shall receive an annual review for compliance. All other designated facilities shall be reviewed on-site at least every two (2) years.

F. Facilities shall be notified in writing of non-compliance areas and the need for a plan of action as outlined in Section 21.120.6. A probationary designation may be granted.

G. A facility in compliance with applicable Department rules and state and federal regulations shall be granted designation effective as of the expiration date for a period not to exceed two (2) years. 21.120.43 Probationary Designation [Eff. 11/1/13]

A. A probationary designation may be granted to a licensee out of compliance with applicable Department or state and federal regulations prior to issuance of a renewal designation or during a current designation period. The facility will be notified in writing of non-compliance areas and the need for a plan of action (see Section 21.120.6).

B. A probationary designation will replace the current designation for a period not to exceed ninety (90) calendar days.

C. Administrative and treatment activities may be limited by a probationary designation while the facility addresses corrective actions.

D. A probationary designation may be re-issued for a period not to exceed ninety (90) calendar days if substantial progress continues to be made and it is likely that compliance can be achieved by the date of expiration of the second probationary license.

E. If the facility fails to comply with or complete a plan of action in the time or manner specified, or is unwilling to consent to the probationary designation, the modification to a probationary designation shall be treated as a revocation of the designation and the facility shall be notified by certified mail of the deficiencies, reason for action, and that the probationary designation is no longer in effect as of ten (10) days from the date the letter was mailed. If the facility disagrees with the decision, it may appeal (see Section 21.105); or upon remedying the noted deficiencies, may re-apply for a designation in accordance with Sections 21.120.3 and 21.120.4 of these rules. 21.120.44 Change in Designation [Eff. 11/1/13]

If a facility makes a change in its designation status or decides to drop its designation, it shall notify the Department in writing not later than thirty (30) calendar days prior to the desired effective date. The facility shall submit a written plan for the transfer of care for the individuals with mental health disorders if the facility will no longer treat those individuals. This plan shall be submitted no later than ten (10) business days prior to the effective date.

21.120.5 DE

SIGNATED MANAGED SERVICE ORGANIZATION (DMSO) [Eff. 11/1/13]

A. The Office of Behavioral Health, within the Department, has the authority pursuant to Section 27- 80-107, C.R.S., to designate a Managed Service Organization (MSO) responsible for service delivery to eligible persons, as described in the annual federal Substance Abuse Prevention and Treatment Block Grant application, residing in each of the seven (7) defined geographic regions.

B. Once designated, each managed service organization shall be reviewed annually for compliance pursuant to Section 27-80-107, C.R.S., and Department rules and contract.

C. MSO’s shall follow all applicable Department rules. 21.120.51 Role of Designated Managed Service Organizations (DMSO) [Eff. 11/1/13]

A. Each DMSO will oversee the expenditure of Department funds in providing effective populationspecific substance use disorder treatment and related services to the priority populations identified in each applicable contract.

B. Each DMSO will develop and monitor a network of licensed providers of substance use disorder services to deliver a full continuum of care as defined in the Department contract within the designated geographic regions of the state.

C. Each DMSO will ensure the delivery of population-specific services to priority populations as defined in the Department contract, to include individuals and families in need of substance use disorder treatment and related services. 21.120.52 Reporting Requirements [Eff. 11/1/13]

A. Each DMSO must maintain a fiscal reporting system that complies with state and federal B. Each DMSO must maintain an individual-services reporting system that complies with state and federal requirements. 21.120.53 Service Provision [Eff. 11/1/13]

When a DMSO provides substance use disorder treatment or a related service to any individual, it must be licensed by the Department and demonstrate compliance with all applicable rules. 21.120.54 Monitoring and Quality Improvement [Eff. 11/1/13]

A. Ea ch DMSO must demonstrate ethical, legal, and solvent fiscal practices, and must maintain a system for periodic review of its contracts, billing and coding procedures, billing records, contractual requirements, and legal requirements.

B. Each DMSO must maintain a system for periodic review of its contractors to identify any intentional or unintentional wrongdoing and to ensure that they are exercising ethical, legal, and solvent fiscal practices. 21.120.55 Revocation [Eff. 11/1/13]

A. Designation shall be revoked for reasons including but not limited to those in Section 21.120.8.

B. Prior to starting a revocation process, the DMSO shall be notified of the facts or conduct that may warrant such action. A plan of action may be required (see Section 21.120.6).

C. Where there are grounds to find that the DMSO has engaged in deliberate and willful violation or that the public health, safety, or welfare requires emergency action, the Department may summarily suspend the designation pending proceedings for suspension or revocation.

D. Written notification of action to revoke a designation shall be sent to the DMSO. Except in cases of deliberate and willful violation or of substantial danger to the public health and safety, such notice shall be sent at least ten (10) working days before the date such action goes into effect, and shall include reasons for the action and rights to the appeal process specified in the State Administrative Procedure Act, pursuant to Sections 24-4-105 through 107, C.R.S. 21.120.6 LICENSE AND DESIGNATION REVIEW PROCESS AND PLANS OF ACTION [Eff. 11/1/13]

A. If after review or pursuant to a complaint, that a licensed or designated agency, contractor, or affiliate is not in compliance with these rules, the organization shall be notified in writing, within thirty (30) business days, of the specific items found to have been out of compliance.

B. If the agency does not agree with any or all of the findings regarding non-compliance, the agency has ten (10) business days from the receipt of non-compliance notice to dispute the findings by submitting evidence to the Department.

The agency shall receive a written response within thirty (30) business days of the review of submitted evidence.

If the submitted information is sufficient, the agency shall be determined in compliance with these If the agency continues to be found out of compliance with these rules, the agency shall have thirty (30) business days from the date of receipt of the review findings to submit a plan of action.

The plan shall include anticipated dates for achieving full compliance.

C. If the agency does not dispute the findings, it shall have thirty (30) business days from the receipt of the notice of non-compliance to submit a written plan of action addressing the compliance issues. The plan shall include anticipated dates for achieving full compliance within ninety (90) business days of the submitted plan.

D. A fter reviewing the agency’s plan of action, the Department may take action as follows:

1. Approve the proposed plan and schedule for achieving full compliance; or, 2. Approve a modified plan and schedule for achieving full compliance; or, 3. Initiate action to revoke, suspend, make probationary, limit, or modify the license or designation of the agency as provided in Section 24-4-104, C.R.S.; and, 4. In cases where a plan of action has been approved, the agency shall remain licensed or designated subject to the achievement of the plan of action. 21.120.7 WAIVERS [Eff. 11/1/13]

Every licensed and designated agency shall comply in all respects with applicable rules. Upon application to the Department, a waiver of the specific requirements of these rules may be granted in accordance with this section, unless the requirements are otherwise required by state or federal law, and individual rights shall not be waived.

A. Time Period A waiver of a specific rule may be granted to a licensed or designated agency, or an agency seeking initial application, for a period not to exceed the two year licensing or designation period.

The waiver may be renewed at the time of re-licensing or designation.

B. Compliance with all Other Regulations Agencies applying for or granted a waiver shall be in compliance with local, state and federal regulations, shall not have outstanding findings with regulatory authorities, and be in good standing with meeting any and all contractual requirements related to providing behavioral health C. Grounds for a Waiver A waiver may be granted upon a finding that:

1. The waiver would not adversely affect the health, safety and welfare of the individuals; and/or, 2. Either it would improve care or application of the particular rule would create a demonstrated financial hardship on the organization seeking the waiver.

D. Burden of Proof The agency seeking the waiver has the burden of proof. Consideration shall be given as to whether the intent of the specific rule has been met.

E. Placement Facilities When a designated agency provides mental health services through a placement facility and a waiver is sought for such services, the designated agency and not the placement facility shall request the waiver.

F. Requests for Waivers Requests for waivers shall be submitted to the Department on the state prescribed form. The request shall include:

1. A de tailed description of the behavioral health services provided by the agency;

2. The rule section proposed to be waived and the waiver’s effect on the health, safety and welfare of the individuals served;

3. The expected improvement in the care of individuals;

4. If there would be undue financial hardship on the agency, and to what degree; and, 5. Signature of the Board President, Director of the agency, or designee.

G. Decision Process Unless additional time is required to make inspections or obtain additional information from the agency, the agency shall be notified in writing of the decision within thirty (30) calendar days following the date of receipt of the completed waiver application.

H. Appeal Rights An agency may appeal the decision of the Department regarding a waiver application as provided by the Colorado Administrative Procedure Act, Sections 24-4-104 and 24-4-105, C.R.S.

21.120.8 LICENSE AND DESIGNATION REVOCATION, DENIAL, SUSPENSION, LIMITATION

OR MODIFICATION [Eff. 11/1/13]

A. At the Department’s discretion, a license or designation may be revoked, denied, suspended, modified or have limited licenses or designation. Written notification of the basis for action shall be sent by certified mail to the last known address of the agency, and is effective ten (10) days from the date the letter was mailed. If the affected agency disagrees with the decision, it may appeal per Section 21.105.

B. A license or designation may be summarily suspended pending proceedings for suspension or revocation in cases of deliberate or willful violation of applicable statutes and regulations or where the public health, safety, or welfare requires emergency action.

C. A license or designation may be revoked, denied, suspended, modified, or limited for reasons including, but not limited to, the following:

1. Non-compliance with these rules, applicable federal and state laws and regulations, or contracting requirements.

2. Negligence resulting in risk to individuals, staff, public health or safety;

3. Knowingly using or disseminating misleading, deceptive, or false information about other agencies including, but not limited to, advertising;

4. Exercising undue influence on or otherwise exploiting individuals to obtain or sell services, goods, property, or drugs for financial or personal gain;

5. A ccepting commissions, rebates, or other forms of remuneration for referring persons to or by the licensed or designated agency;

6. Evidence of agency fraud or misrepresentation;

7. Failure to provide persons with information required by these rules and applicable state and federal statutes, rules, and regulations;

8. Failure to submit required data in an accurate and timely manner to the Department or its authorized representatives;

9. Withholding access to clinical, staff, or fiscal records, or administrative information when requested by the Department;

10. Sale, use or distribution of alcohol or illicit drugs, or unauthorized sale or distribution of prescription or over-the-counter drugs on treatment premises or during treatment activities off premises;

11. Knowingly using, and/or disseminating false information about these rules, Department rules and state or federal regulations, or other information essential to interpreting or managing an individual’s status, case management or interagency coordination.

12. Commits a fraudulent insurance act as defined in Section 10-1-128, C.R.S.

13. Failure to comply with a written plan of action. 21.130 DATA REQUIREMENTS [Eff. 11/1/13]

Licensed and designated organizations shall provide accurate and timely submission of required data to the Department identified data collection systems or its authorized representatives and retain a copy in treatment record.

21.140 CRITICAL INCIDENT REPORTING

A critical incident is any significant event or condition that must be reported within twenty-four (24) hours to the Department that is of public concern and/or has jeopardized the health, safety and/or welfare of individuals or staff.

A. The Department may conduct scheduled or unscheduled site reviews for specific monitoring purposes and investigation of critical incidents reports in accordance with:

1. CDHS policies and procedures;

2. Regulations that protect the confidentiality and individual rights in accordance with Sections 27-65-101, et seq., C.R.S.; HIPAA; AND, 42 C.F.R. Part 2.

3. Controlled substance licensing, Title 27, Article 82, C.R.S.; Section 27-80-212, C.R.S., B. The Department shall have access to relevant documentation required to determine compliance with these rules.

C. The agency shall:

1. Establish written policies and procedures for reporting and reviewing all critical incidents 2. Submit Critical Incidents reports to the Department according to state prescribed forms.

This is not in lieu of other reporting mandated by state statute or federal guidelines;

3. Mak e available a report with the investigation findings for review by the Department, upon 4. Maintain critical incidents reports for a minimum of three years following the incident.

D. Nothing in this section shall be construed to limit or modify any statutory or common law right, privilege, confidentiality or immunity. 21.150 QUALITY IMPROVEMENT [Eff. 11/1/13]

A. The agencies and programs that the Department contracts with, licenses, or designates, shall have a quality improvement program designed to monitor, evaluate, and initiate activities to improve the quality and effectiveness of administrative and behavioral health services.

B. The agency shall adopt and implement a written quality improvement plan that includes, at a minimum the following processes:

1. Clinical quality measurement of performance.

2. Determine the appropriateness and effectiveness of treatment through a clinical review of a representative sample of open and closed records at a minimum of every six (6) months.

3. Identify and respond to trends concerning significant events, risks, emergency procedures, critical incidents as defined in Section 21.140, and grievances as defined in

Section 21.180.

4. Incorporate documented quality improvement findings into clinical and organizational planning, decision making, and to develop staff and individual educational programs.

5. Evaluate annually and update the quality improvement plan as necessary. A copy of the annual findings and report shall be available for review.

21.160 PERSONNEL

21.160.1 GENERAL PROVISIONS

A. The organization shall have written personnel policies and procedures that include:

1. Personnel (including contracted staff, interns, and volunteers) shall have access to and be knowledgeable about the organization’s policies, procedures, and state and federal laws and regulations relevant to their respective duties.

2. Personnel are assigned duties that are commensurate with documented education, training, work experience, and professional licenses and certifications. Licensed or certified staff shall perform duties in accordance with applicable statutes, rules and 3. Training a. The organization shall document the evaluation of applicable previous related experience for volunteers and for staff, and ensure that these personnel have all of the training, including on-the-job training, required in this section.

b. Al l staff shall be given on-the-job training or have related experience in the job assigned to them. They shall be supervised until they have completed on-the-job training appropriate to their duties and responsibilities, or have had previous related experience evaluated.

c. The organization shall maintain records documenting completion of all required training, or review of evaluation of previous related experience.

d. Volunteers having direct individual contact shall receive training appropriate to their duties and responsibilities.

e. Personnel shall receive the following training when first hired and on a periodic

basis:

1) Training specific to the particular needs of the populations served;

2) Orientation of the physical plant;

3) Emergency preparedness;

4) Individual rights of the population served;

5) Confidentiality (individual privacy and records privacy and security); and, 6) Training on needs identified through the quality improvement program.

4. Personnel (including contracted staff, interns, and volunteers) shall not engage in prohibited activities outlined in Section 12-245-224, C.R.S.

B. Documentation of training, including topics and attendance, shall be maintained in personnel files or organization training log.

C. Personnel files for each staff shall be maintained by the organization.

1. Files of current staff shall be available onsite for review by the Department.

2. Files shall include documentation of:

a. Job description that shall detail minimum qualifications, core competencies, duties, and supervisory structure;

b. Education and work experience; and c. Background investigations as described in Section 21.160.2.

21.160.2 BACKGROUND CHECKS AND EMPLOYEE VERIFICATION

A. Pre-employment background investigations:

1. Shall be required for all staff, interns and volunteers who have direct contact with individuals receiving services.

2. Take place at submission of an initial Office of Behavioral Health license or designation application or take place at pre-employment.

3. Consist of at least a criminal background check performed by the Colorado Bureau of Investigation.

B. Pr e-employment inquiries:

1. The agency shall verify license, certification, and a check of disciplinary action through the Colorado Department of Regulatory Agencies; and, 2. Complete a reference check.

C. Organizations shall maintain evidence of background investigations and employee verification in personnel files.

D. The organization shall have written criteria for evaluating which convictions or complaints make an applicant unacceptable for hire or a staff unacceptable for retention.

E. The organization shall incur the costs of obtaining a criminal history and background check of potential employees.

F. The organization shall develop and implement written criteria for:

1. Routine monitoring of employee credentials and disciplinary actions; and, 2. Reporting requirements of investigations, indictments, or convictions that may affect employee’s ability to carry out his/her duties or functions of job.

21.170 RECORDS CARE AND RETENTION

21.170.1 GENERAL PROVISIONS

A. Agencies shall assure that all paper and electronic records are maintained to prevent unauthorized access in accordance with 42 C.F.R. Part 2 and HIPAA.

B. For outpatient agencies:

1. Individual records for adults shall be retained for seven (7) years from date of discharge from agency.

2. For individuals who are under eighteen (18) years of age when admitted to the agency, records shall be retained until the individual is twenty five (25) years of age.

C. For inpatient agencies:

1. Individual records for adults shall be retained for ten (10) years from date of discharge from agency.

2. For individuals who are under eighteen (18) years of age when admitted to the agency, records shall be retained until the individual is twenty eighty (28) years of age.

D. All records are to be disposed in accordance with State and Federal confidentiality statutes and E. Disposal services commissioned by an agency to dispose of individual records shall sign Qualified Service Organization Agreements or Business Associate Agreements.

F. S taff having access to individual records shall be knowledgeable of state and federal statutes, policies, and procedures which protect individual identity and service information from unauthorized access and disclosure.

G. Agencies shall develop policies and procedures that protect individual identity and treatment information when transporting electronic and written records.

H. Agencies shall establish guidelines for reporting breach or potential loss of individual identity and service information in accordance with state and federal confidentiality statutes and regulations.

I. Records shall be accessible to agency staff and the Department.

J. Agencies that are closing or acquired by another agency shall protect individual identity per state and federal regulations. 21.170.2 CONFIDENTIALITY [Eff. 11/1/13]

A. The confidentiality of the individual record, including all medical, mental health, substance use, psychological and demographic information shall be protected at all times, in accordance with all applicable state and federal laws and regulations.

B. The information in this section shall not be construed to limit the access of duly authorized representatives of the Department to confidential material for purposes of assuring compliance with these rules. Such duly authorized representatives of the Department are obligated to protect the confidentiality of any individual information reviewed.

21.170.3 RELEASE OF INFORMATION

A. An agency that is licensed or designated by the Department must comply with release of information regulations Pursuant to 42 C.F.R. Part 2 and HIPAA.

B. The signed release of information shall state, at a minimum:

1. Persons who shall receive the information;

2. For what purpose;

3. The information to be released;

4. That it may be revoked by the individual, parent, or legal guardian at any time;

5. That the release of information shall be time limited up to two (2) years.

C. Records shall be released to the staff of the governor’s designated Protection and Advocacy System for Individuals with Mental Illness, per Section 27-65-121(1)(i), C.R.S., under the following guidelines for all records of:

1. Any individual who is an individual of the system or the legal guardian, conservator, or other legal representative of such individual has authorized the system to have access;

2. An y individual with a mental health disorder, who has a legal guardian, conservator, or other legal representative, with respect to whom a complaint has been received by the system or with respect to whom there is probable cause to believe the health or safety of the individual is in serious and immediate jeopardy, whenever:

a. Such representative has been contacted by such system upon receipt of the name and address of such representative;

b. Such system has offered assistance to such representative to resolve the situation;

c. Such representative has failed or refused to act on behalf of the individual.

D. Whenever a family member or other party requesting information, not including the agency, requests that information revealed to treating personnel remain confidential, such information shall not be released unless otherwise provided by law or court order.

1. Whenever confidential information provided by a family member or other party providing information is ordered released, attempts shall be made to notify the family member or informant of the release of information by the individual who has obtained the court order.

2. The fact that confidential information is being withheld may be disclosed to individuals requesting the information, but if the individual's attorney has requested the information, the fact that confidential information is being withheld shall be disclosed.

21.170.4 CONSENTS

A. A written agreement shall be executed between the agency and the individual or the individual’s legal representative at the time of admission. The parties may amend the agreement provided such amendment is evidenced by the written consent of both parties. No agreement shall be construed to relieve the organization of any requirement or obligation imposed by law or

regulation.

B. Individual consents shall include consent to treatment.

C. Services shall involve families and significant others with written individual consent, unless clinically contraindicated.

D. For minor's consent, please review Care of Children, Youth, and Families in Section 21.200.13.

E. For opioid medication assisted treatment consent, see Section 21.320.

F. If the Governor or local government declares an emergency or disaster an agency may obtain documented oral agreements or consents in place of written agreements or consents.

Documented oral agreements and consents shall only be used as necessary because of circumstances related to the emergency or disaster. Agencies shall send a hard copy or electronic copy of the documented agreement or consent to the individual within two (2) business days of the oral agreement or consent. 21.180 GRIEVANCE [Eff. 11/1/13]

A. The agency shall establish a uniform procedure for prompt management of grievances brought by individuals accessing, receiving or being evaluated for services and their family members. The organization shall develop policies and procedures for handling grievances. A grievance shall mean any expression of dissatisfaction about any matter related to provided services, and shall be accepted verbally or in writing.

B. T he agency shall provide a fair and accessible grievance resolution process, which shall provide the individual with a resolution no later than fifteen (15) business days from submission of the grievance. If the grievance is received verbally the representative shall create a written documentation of the grievance.

C. The agency shall designate a representative, who shall be available to assist individuals in resolving grievances, and who shall have no involvement in the clinical or regular care of the D. The agency shall educate service recipients and their representatives about the mechanisms in place for filing grievances. This education shall include rights, and internal grievance process and procedures, and the name, contact information, and responsibilities of the designated representative within the agency. Appropriate contacts for external appeal shall also be provided, which may include, but are not limited to, the following: the Colorado Department of Regulatory Agencies, the Colorado Department of Public Health and Environment, the Colorado Department of Health Care Policy and Financing, or the governor’s designated Protection and Advocacy System for Individuals with Mental Illness. Documentation in the records shall include dated signature of the individual receiving the information.

E. A notice of rights, grievance procedure, the representative’s name, office location, responsibilities, and telephone number shall be posted within the agency in prominent locations where persons access, receive or are evaluated for services.

F. The agency shall maintain a record of submitted grievances, separate from the individual records that include the date, the type of grievance, and the outcome of investigation. Data shall be reported annually to the Department.

21.190 DOCUMENTATION IN INDIVIDUAL RECORDS 21.190.1 DEFINITIONS [Eff. 5/1/16]

“Admission Summary” is a brief review of assessments and other relevant intake data, including screenings, which summarizes the current status and provides a basis for individualized service planning.

“Assessment” is a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment and referral. This information establishes justification for “Best Practices” are interventions, techniques, and treatment approaches that have some quantitative data showing positive treatment outcomes over a period of time, but may not have enough research or replication to be considered an evidence-based approach.

“Case Management” means activities that are intended to help individuals gain access to behavioral health and supportive services (including social, educational, and medical) that are coordinated and appropriate to the changing needs and stated desires of the individual over time. Activities include, but are not limited to: service planning, referral, monitoring, follow-up, advocacy, and crisis management. hief Complaint/Presenting Problem” means the reason/concern/motivation that prompts the client to seek services or that their referral source identifies as the issue, which requires intervention, usually in the person’s own words. It also includes onset, duration, other symptoms noted, progression of the problem, solutions attempted at alleviating the problem, how the person’s life has been impacted, and how the person views responsibility for the problem. It can be information from a referral, family or other professional.

“Culture” means the shared patterns of behaviors and interactions, cognitive constructs, and affective understanding learned through a process of socialization. These shared patterns identify the members of a culture group while also distinguishing those of another group. People within a culture usually interpret the meaning of symbols, artifacts, and behaviors in the same or similar ways. Culture includes, but is not limited to: race, ethnicity, religion, spirituality, gender, sexual orientation, language and disabilities.

“Cultural Assessment” means identifying and understanding aspects of an individual's culture and linguistic needs in order to incorporate the information into service planning and service delivery. It is necessary to incorporate cultural considerations into service delivery in order to best understand and address ways in which culture influences an individual's behavioral health issues. ischarge” means the termination of treatment obligations and service between the individual and the “Evidence-Based” practices, principles, and programming are interventions, techniques, and treatment methods that have been tested using scientific methodology and proven to be effective in improving outcomes for a specific population.

“Screening” is a brief process used to determine the identification of current behavioral health or health needs and is typically documented through the use of a standardized instrument. Screening is used to determine the need for further assessment, referral, or immediate intervention services. 21.190.2 CONTENT OF RECORDS [Eff. 5/1/16]

A. A confidential record shall be maintained for each individual. Records shall be dated and legibly recorded in ink or in electronic format.

B. Documents shall include, where applicable:

1. Consent to treatment;

2. Consent to release confidential information;

3. Assessments and screenings;

4. Admission summary;

5. Service plan;

6. Re-assessment(s);

7. Progress notes;

8. Medication administration or monitoring record;

9. Physician's orders;

10. Documentation of on-going services provided by external services providers;

11. Advance directives;

12. Acknowledgements and disclosures;

13. Legal and court paperwork; and, 14. Discharge summaries.

C. See specific program areas for additional content of record requirements. 21.190.3 ASSESSMENT [Eff. 5/1/16]

A. A comprehensive best practices assessment shall be completed as soon as is reasonable upon admission and no later than seven (7) business days of admission into services with the noted exceptions:

1. Acute Treatment Unit: within twenty-four (24) hours of admission.

2. Withdrawal Management units, inpatient hospitalization: within seventy-two (72) hours of admission.

B. Assessment shall continue throughout the course of treatment and shall be reviewed and updated when there is a change in the person's level of care or functioning, or, must occur at minimum, every six months.

C. Al l methods and procedures used to assess and evaluate an individual shall be developmentally and age appropriate, culturally responsive, and conducted in the individual's preferred language and/or mode of communication.

D. The assessment shall be documented in the individual record and, at minimum, include the following where information is available and applicable:

1. Identification and demographic data;

2. Chief complaint/presenting problem;

3. Mental health history;

4. Substance use;

5. Physical and dental health status;

6. A diagnosis with sufficient supporting criteria and any subsequent changes in diagnosis;

7. A mental status examination for each individual who is given a diagnosis;

8. History of involuntary treatment;

9. Advance directives.

10. Capacity for self-sufficiency and daily functioning;

11. Cultural factors that may impact treatment, including age, ethnicity, linguistic/communication needs, gender, sexual orientation, relational roles, spiritual beliefs, socio-economic status, personal values, level of acculturation and/or assimilation, and coping skills;

12. Education, vocational training, and military service;

13. Family and social relationships;

14. Trauma;

15. Physical/sexual abuse or perpetration and current risk;

16. Legal issues;

17. Issues specific to older adults such as hearing loss, vision loss, strength; mobility and other aging issues;

18. Issues specific to children/adolescents such as growth and development, daily activities, legal guardians and need for family involvement and engagement in the child's treatment;

19. S trengths, abilities, skills, and interests; and, 20. Barriers to treatment.

E. See specific program areas for additional assessment requirements.

21.190.4 SERVICE PLANNING AND REVIEWS 21.190.41 Service Planning Requirements [Eff. 5/1/16]

A. An individualized, integrated, comprehensive, written service plan will be:

1. Collaboratively developed between the individual and service provider or treatment team;

2. Goal focused;

3. Written in a manner that fosters an individual's highest possible level of independent functioning; and, 4. Ongoing throughout treatment.

B. Service planning shall be developed with the individual following an identified assessment(s) and shall apply intervention, treatment, recovery oriented services and continuing care strategies to the degree indicated by the findings of the assessment(s).

C. An initial service plan shall be formulated to address the immediate needs of the individual within twenty-four (24) hours of assessment.

D. The service plan shall be developed, by a multidisciplinary team when applicable, as soon as is reasonable after admission and no later than:

1. Acute Treatment Units (ATU): twenty-four (24) hours of admission;

2. Withdrawal Management: seventy-two (72) hours of admission;

3. Inpatient Hospitalization: seventy-two (72) hours of admission;

4. Residential Treatment Facility: ten (10) business days after assessment;

5. Partial Hospitalization: seven (7) business days after assessment; or, 6. Outpatient: fourteen (14) business days after assessment.

E. In addition, services plans shall:

1. Specify goals based on the assessment;

2. Be s trength-based, gender appropriate, and individually directed;

3. Reflect findings of a cultural assessment, to include, but not limited to: gender, sexual orientation, socio-economic status, ethnicity, personal values, level of acculturation and/or assimilation, spirituality, linguistics, age, family systems, interpretation of trauma and coping skills;

4. Contain specific, measurable, attainable objectives that relate to the goals and have realistic expected date(s) of achievement;

5. Goals and objectives written in a manner understandable to the individual;

6. Identify the type, frequency and duration of services;

7. Be developmentally and/or age appropriate; and, 8. Include involvement of other identified family and supportive individuals, when F. All parties (the individual, legal guardian, multidisciplinary team members) who participate in the development of the plan shall sign the plan. The record shall contain documentation whenever a plan is not signed by the individual or participating parties.

G. There shall be documentation that the individual was offered a copy of the plan. 21.190.42 Service Plan Revisions and Reviews [Eff. 5/1/16]

A. Unless otherwise indicated, reviews and any service plan revisions shall be completed and documented when there is a change in the individuals' level of functioning or service needs and no later than:

1. Acute Treatment Units (ATU) and Withdrawal Management: three (3) calendar days;

2. Inpatient Hospitalization: every seven (7) calendar days for four (4) weeks; after four (4) weeks: monthly; and, after six (6) months: quarterly;

3. Residential Treatment Facility: monthly for six (6) months and quarterly after six (6) months;

4. Partial Hospitalization: every fourteen (14) calendar days;

5. Opioid Medication Assisted Treatment: every three (3) months; or, 6. Outpatient: every six (6) months, unless individuals receive medication/psychiatric services only as described in Section 21.190.7.

B. The service plan review shall include documentation of:

1. P rogress made in relation to planned treatment outcomes;

2. Any changes in the individual's treatment focus; and, 3. Adjustments to the plan concerning individual lengths of stay as indicated by on-going assessments.

C. Reviews shall be conducted collaboratively by clinician and individual.

D. The record shall contain documentation whenever the individual or participating parties do not sign a revised plan.

E. There shall be documentation that the individual was offered a copy of the plan. 21.190.5 TREATMENT PROGRESS DOCUMENTATION REQUIREMENTS [Eff. 5/1/16]

A. Progress notes are a written chronological record of an individual's progress in relation to planned outcomes of services.

B. Progress notes shall contain the following information unless otherwise noted in specific service population sections of these rules:

1. Ongoing progress including dates and types of service, adhering to program-specific frequency requirements;

2. A summary of the activity for the session and progress toward specific treatment goals to be completed with minimum frequency of:

a. One (1) note per session for outpatient and intensive outpatient, b. Daily for inpatient and intensive residential services, c. Weekly for partial hospitalization and all other levels of residential treatment;

3. The individual's response to treatment approaches and information about progress toward achieving service plan goals and objectives;

4. Changes in the service plan with reasons for such changes;

5. Information regarding support and ancillary services recommended and provided;

6. Any significant change in physical, behavioral, cognitive and functional condition and action taken by staff to address the individual's changing needs; and, 7. Case management notes reflecting the content of each contact, including ancillary and collateral contacts.

C. Treatment notes shall not include protected health information pertaining to other individuals D. Treatment entries shall be signed and dated by the author at the time they are written, with at least first initial, last name, degree and or professional credentials. Telephone orders shall be written at the time they are given and authenticated at a later time.

21.190.6 DI

SCHARGE PLANNING AND SUMMARIES 21.190.61 Discharge Planning Requirements [Eff. 5/1/16]

A. Discharge planning begins at the time of admission, is updated during the course of services, and engages the individual and support systems s/he identifies in the planning process.

B. Discharge policies and procedures shall include criteria outlining the requirements for an individual's discharge from treatment.

C. Discharge plans shall be concise, complete, and comprehensive to facilitate transition to the next level of care when applicable.

D. Persons receiving services on a voluntary basis shall be discharged from treatment immediately at their request unless emergency commitments or emergency mental health holds are in effect.

E. Documentation of discharge information provided to the individual, where applicable, shall include:

1. Medications at discharge including, dosages and instructions for follow-up;

2. Legal status and any other legal restrictions placed upon the individual;

3. Referrals with details; and, 4. Information if the discharge is being made against advice of provider. 21.190.62 Discharge Summary [Eff. 5/1/16]

Discharge summaries shall be completed as soon as possible, no later than thirty (30) calendar days after discharge. The agency's policy and procedures shall determine the minimum timeframe for completion.

Records shall contain a written discharge summary to include, but not limited to, the following information, where applicable:

A. Reason for admission;

B. Reason for discharge;

C. Primary and significant issues identified during course of services;

D. Diagnoses;

E. Summary of services, progress made, and outstanding concerns;

F. Coordination of care with other service providers;

G. Advance directives developed or initiated during course of services.

H. Summary of medications prescribed during treatment, including the individual's responses to I. Medications recommended and prescribed at discharge;

J. Summary of legal status throughout the course of services and at time of discharge;

K. Documentation of referrals and recommendations for follow up care;

L. Documentation of the individual's and/or family's response and attitude regarding discharge; and, M. Information regarding the death of the individual.

21.190.7 MEDICATION/PSYCHIATRIC SERVICES ONLY AT MENTAL HEALTH CENTERS

AND CLINICS [Eff. 11/1/13]

A. A person qualifies to be classified as receiving medication/psychiatric services only when the agency provides a maximum of three (3) services, in addition to services related to medications, within a six (6) month period of time.

B. At l east annually, a licensed behavioral health professional shall complete and document in the clinical record:

1. Clinical rationale supporting a medication/psychiatric services only status;

2. An updated assessment;

3. An updated service plan; and, 4. A Colorado Client Assessment Record (CCAR).

21.200 CARE AND TREATMENT OF CHILDREN, YOUTH AND FAMILIES

21.200.1 BEHAVIORAL HEALTH SERVICES FOR CHILDREN AND YOUTH 21.200.11 Definitions A. “Psychotherapy” or “ psychotherapy services” as defined in Section 12-245-202(14), C.R.S., means the treatment, diagnosis, testing, assessment, or counseling in a professional relationship to assist individuals or groups to alleviate behavioral and mental health disorders, understand unconscious or conscious motivation, resolve emotional, relationship, or attitudinal conflicts, or modify behaviors that interfere with effective emotional, social, or intellectual functioning.

Psychotherapy follows a planned procedure of intervention that takes place on a regular basis, over a period of time, or in the cases of testing, assessment, and brief psychotherapy, psychotherapy can be a single intervention.

B. “Youth” in this section means, under the age of twenty-one (21), unless otherwise noted. 21.200.12 General Provisions A. In addition to these rules, programs providing behavioral health services to children and adolescents must follow provisions made in Sections 21.110 through 21.190.

B. Residential child care facilities licensed by the Colorado Department of Human Services, Division of Child Welfare, shall follow Sections 21.120 and 21.200, where applicable. 21.200.13 Rights of Children and Adolescents These pr ovisions shall not apply to any youth admitted to a facility designated under Title 27, Article 65, C.R.S., Care and Treatment of Persons with Mental Illness, for behavioral health purposes pursuant to the Children’s Code, Title 19, C.R.S., when there have been judicial proceedings authorizing the placement of the youth into a facility.

A. In addition to the individual rights in Section 21.280.26 for adults, youth who are fifteen (15) years of age or older, with or without the consent of a parent or legal guardian, have the right to:

1. Consent to receive behavioral health services from an agency or a professional person;

2. Consent to voluntary hospitalization;

3. Object to hospitalization and to have that objection reviewed by the court under the provision of Section 27-65-103, C.R.S.; and 4. Consent to release of information.

B. Parents or legal guardians shall be contacted without the youth’s written or verbal consent if:

1. The individual presents as a danger to self or others; or, 2. Essential medical information is necessary for parents or legal guardians to make informed medical decisions on behalf of youth.

C. Behavioral health facilities must obtain parental or legal guardian consent for youth under fifteen (15) years of age, with the following exception:

1. Section 12-245-203.5(2), C.R.S. allows psychotherapy services, as defined in Section 12-245-202(14)(a), C.R.S., to be provided to a youth who is twelve (12) years of age or older, with or without the consent of the youth’s parent or legal guardian if the youth is knowingly and voluntarily seeking such services and the provision of psychotherapy services is clinically indicated and necessary to the youth’s well-being. The following mental health professionals are the only professionals allowed to provide outpatient psychotherapy services in an outpatient setting, to a youth who is twelve (12) years of age or older, with or without the consent of the youth’s parent or legal guardian:

a. A professional person as defined in Section 27-65-102(17), C.R.S., which means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the united states, the united states public health service, or the united states department of veterans affairs;

b. A m ental health professional licensed pursuant to Article 245, of Title 12, C.R.S., which in accordance with Section 12-245-203.5, C.R.S., includes:

1) A psychologist licensed pursuant to Part 3 of Article 245, of Title 12, C.R.S. or a psychologist candidate pursuant to Part 3 of Article 245, of Title 12,C.R.S.;

2) A social worker licensed pursuant to Part 4 of Article 245, of Title 12, C.R.S.;

3) A marriage and family therapist licensed pursuant Part 5 of Article 245, of Title 12, C.R.S.;

4) A professional counselor licensed pursuant to Part 6 of Article 245, of Title 12, C.R.S. or a licensed professional counselor candidate pursuant to Part 6 of Article 245, of Title 12, C.R.S.;

5) An addiction counselor licensed pursuant to Part 8 of Article 245, of Title 12, C.R.S.; or c. A school social worker licensed by the Department of Education.

D. Youth who are under the age of fifteen (15) have the right to object to hospitalization and to have a guardian ad litem appointed pursuant to Section 27-65-103, C.R.S.

E. Appropriate educational programs shall be available for all school age youth who are residents of the designated facility in excess of fourteen (14) calendar days. These educational programs may be provided by either the local school district or by the designated facility. If provided by the designated facility, the educational program shall be approved by the Colorado Department of Education.

21.200.14 A ssessment of Children and Adolescents [Eff. 5/1/16]

Agencies shall follow Section 21.190.3 and the following:

A. Assessments must include an evaluation of the family's, or other supportive adult's, social and environmental challenges and strengths that may pertain to the youth's treatment. If family or other supportive adults support needs are identified, this shall be addressed in the service plan.

B. The assessment must explore how the identified family members, supportive individuals or significant others will be involved in behavioral health services. In the event that any individual's involvement is contraindicated, the clinical rationale must be documented.

C. An assessment shall address any needs of a youth at least seventeen (17) years of age who is expected to require behavioral health services and supports beyond the age of eighteen (18). 21.200.15 Service Planning for Children and Adolescents [Eff. 5/1/16]

Agencies shall follow Section 21.190.4, service planning and reviews, and the following:

A. The service plan shall be developed in collaboration with the youth's parent or legal guardian and be signed by both. In the event that involvement of the parent or legal guardian is contraindicated, the rationale shall be documented.

B. A copy of the service plan shall be provided to the individual and parent or legal guardian, unless contraindicated.

C. T he service plan shall include goals and objectives that address family support needs as identified in the assessment. 21.200.2 LICENSED SUBSTANCE USE DISORDER AGENCIES TREATING YOUTH [Eff. 5/1/16]

A. Agencies providing substance use disorder treatment services to youth shall be licensed by the Department to treat youth and comply with Section 21.210.

B. Agencies shall implement evidence-based screening, assessment instruments, and curricula, designed and developed for youth.

C. Agencies shall provide recovery-oriented services appropriate for youth, when indicated.

D. Youth shall be informed that non-compliance with treatment programs to which they are sentenced shall be reported by the agency to referring courts and/or their agents. 21.200.3 Minor in Possession: Education and Treatment [Eff. 5/1/16]

For the purposes of this section “ Minor in Possession” (MIP) is the legal terminology used for an offense that is issued to individuals age twenty (20) and younger for underage drinking or possession. MIP may result in a revocation of a driver's license, a substance use disorder assessment, and/or alcohol education and treatment classes per Section 18-13-122, C.R.S. 21.200.31 General Provisions [Eff. 5/1/16]

A. Agencies providing MIP services shall comply with Section 21.200.2.

B. A gencies shall not place a youth with a MIP citation in DUI/DWAI education or therapy groups unless the youth also has a DUI/DWAI offense.

C. All agency education and treatment staff shall have documented training, supervision and experience in adolescent development and prevention, intervention and treatment approaches.

D. When possible, minors sixteen (16) years of age and under should be treated in separate groups than those that are provided to individuals seventeen (17) to twenty (20) years old.

E. Agencies shall conduct ongoing assessment of progress in education and/or treatment level of care to determine if youth are in the appropriate service level. 21.200.32 Minor in Possession: First Offense Education and Intervention [Eff. 5/1/16]

A. MIP education is for youth who have received their first MIP citation and shall be conducted in an outpatient setting.

B. MIP education shall be at least eight (8) hours, completed over no less than a two (2) day period with no more than four (4) hours of education per day.

C. Education topics shall include:

1. Current legal consequences for additional MIP citations;

2. Resources or referrals for treatment level services, when indicated;

3. Developmental impact of early onset substance use and subsequent impact on developing brain;

4. Physiological effect of alcohol and other drug use;

5. Refusal skills; and, 6. Avoidance of high risk situations.

D. For youth seventeen (17) years old and younger, agencies shall include and document a minimum of two (2) hours of parental involvement, unless contraindicated.

21.200.33 M inor in Possession: Second and Subsequent Offense Treatment [Eff. 5/1/16]

A. Second Minor in Possession Offense 1. Second offense MIP therapy shall be conducted in an outpatient setting, shall be a minimum of twelve (12) hours in duration over eight (8) weeks, and shall not exceed ninety (90) minute sessions, excluding breaks and administrative procedures.

2. Agencies shall complete an individualized service plan, with each youth in accordance with Sections 21.190.4 and 21.200.15 of these rules.

3. For youth seventeen (17) years old and younger, agencies shall include and document a minimum of four (4) hours of parental involvement, unless contraindicated.

B. Third and Subsequent Minor in Possession Offenses 1. A third MIP results in a Class 2 misdemeanor. Youth shall complete a minimum of twenty (20) hours of substance use disorder treatment over a minimum thirteen (13) week period, as determined by the assessment. Groups shall not exceed ninety (90) minutes in duration.

2. Multiple levels of care shall be offered to meet the needs of the individual and family members, when appropriate.

3. Agencies shall include and document parental involvement, unless contraindicated, throughout the length of treatment. 21.200.4 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Chapter 4> 21.200.41 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.1> 21.200.42 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.2> 21.200.43 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.3> 21.200.44 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.4> 21.200.45 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.5> 21.200.47 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.7> 21.200.48 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.8> 21.200.481 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.8.1> 21.200.482 [THIS SECTION HAS BEEN MOVED TO 2 CCR 502-6] <Part 4.8.2> 21.200.5 FAMILY ADVOCACY MENTAL HEALTH JUVENILE JUSTICE PROGRAMS [Eff. 5/1/16]

These rules and standards implement the Integrated System of Care Family Advocacy Programs for Mental Health Juvenile Justice Populations defined in Section 27-69-101, et seq., C.R.S. The rules and standards do not apply to other forms of family advocacy provided by persons or organizations, nor do they place any requirements or assume authority over such persons or organizations. Families of youth with mental health and co-occurring disorders who are in, or at-risk of becoming involved with, the juvenile justice system, may choose any form of advocacy and support that best meets their needs and are not limited to utilizing entities approved under these rules and standards.

In order to be eligible for state funding for a family advocacy program as described in Section 27-69-101, et seq., C.R.S., and these rules, an entity must be approved by the Department according to the rules described herein. Such funding is contingent on available appropriations.

21.200.51 D efinitions [Eff. 5/1/16]

“At-risk of involvement with the juvenile justice system” means a youth who has come into contact with law enforcement due to a suspected offense or otherwise exhibits behaviors that will likely result in juvenile justice involvement.

“Family advocacy organization” means an entity governed by individuals who have parented, are parenting, or have legal responsibility for a child or youth with a mental health or co-occurring disorder.

“Family member” means individual who has parented, is parenting, or has legal responsibility for a youth with a mental health or co-occurring disorder.

“Involved in the juvenile justice system” means a youth who has committed a delinquent act as defined at

Section 19-1-103(36), C.R.S.

“Partnership” means a relationship between a family advocacy organization and another entity whereby the family advocacy organization works directly with another entity for oversight and management of the family advocate or family systems navigator and family advocacy demonstration program, and the family advocacy organization employs, supervises, mentors, and provides training to the family advocate or family systems navigator.

“System of care” means a spectrum of effective, community-based services and supports for children and youth with or at risk for mental health or other challenges and their families, that is organized into a coordinated network, builds meaningful partnerships with families and youth, and addresses their cultural and linguistic needs, in order to help them to function better at home, in school, in the community, and throughout life.

“Technical assistance and coordination” means linking with resources for the purpose of developing or strengthening a family advocacy program.

“Transition services” include, but are not limited to, assisting a youth and family in accessing services and supports necessary for the youth to become a successful adult; developing life skills necessary to function in the community; returning to home, community, or school from an out-of-home placement.

“Y outh” for the purposes of this section means an individual whose age falls within the jurisdiction of the juvenile justice system and is older than ten (10) years of age and under eighteen (18) years of age (see

Section 19-1-103 (18) for definition of “ child”). A young person receiving family advocacy services may continue to do so up to twenty one (21) years of age if enrolled in the program between the ages of ten (10) and eighteen (18). 21.200.52 Intent to Become a Family Advocacy Program [Eff. 5/1/16]

A. A partnership will indicate its intent to become a family advocacy program by completing the family advocacy program application and submitting it to the Department.

B. The partnership will follow all requirements of Section 27-69-101 through 27-69-105, C.R.S. and these corresponding rules.

C. The Department will acknowledge in writing receipt of the letter of application and state which documents, if any, are required to be forwarded to the Department for review.

D. A partnership may request the Department to facilitate technical assistance and coordination, as described in Section 21.200.53, needed to complete its application. 21.200.53 Program Standards A. F amily advocacy programs will consist of a partnership between a family advocacy organization providing family advocacy and the system of care, whereby the family advocacy organization works with other entities to enable youth and families to access necessary services and supports.

The family advocacy organization employs or otherwise utilizes, supervises, mentors, and provides training to the family advocate or family systems navigator. A community agency may employ or otherwise utilize, supervise, mentor, and provide training to the family advocate or family systems navigator if there is a written agreement with a family advocacy organization describing how this will occur.

B. The purpose of a family advocacy program is to provide support to families of youth with mental health and co-occurring disorders who are in, or at-risk of becoming involved with, the juvenile justice system.

C. The support provided to families and youth will include early intervention, navigation, crisis response, integrated planning, transition services, and diversion. These supports will be provided in collaboration with community agencies with specific expertise in the area.

D. Family support will be provided by a family advocate or a family systems navigator as outlined in

Section 27-69-102(5) and (5.5), C.R.S. The requirements for these roles are as follows:

1. Family advocate:

a. Training in assisting families in accessing and receiving services and supports, and the system of care philosophy;

b. Experience as a family member of a child or adolescent with a mental health or co-occurring disorder; and, c. Experience in working with multiple youth-serving agencies and providers.

2. Family systems navigator:

a. Training in assisting families in accessing and receiving services and supports, and the system of care philosophy;

b. Skills, experience, and knowledge to work with children and youth with mental health or co-occurring disorders; and, c. Worked with multiple youth-serving agencies and providers.

E. A family advocacy program will coordinate its efforts with key service providers to ensure that support provided by family advocates and family systems navigators is integrated with services provided by community agencies. Where applicable, this coordination will include the local Interagency Oversight Group of the Collaborative Management Program, described in Section 24-1.9-102, C.R.S. and local juvenile services planning committee described in Section 19-2-211, F. A f amily advocate or family systems navigator will receive training commensurate with their duties and responsibilities. The training will include content on behavioral and co-occurring conditions, working with youth-serving systems, ethics, confidentiality and HIPAA, system of care, working with families, meeting facilitation, prevention and intervention, and documentation and service planning.

G. A family advocacy program will provide education to the relevant agencies in the system of care, describing the roles and responsibilities of family advocates and family systems navigators, and the ways in which these positions can benefit youth, families, and agency staff members.

H. A family advocacy program will ensure that adequate resources are available for program operations and evaluation as described in Section 21.200.54.

I. Family advocates or family systems navigators will receive supervision commensurate with the needs of the youth and families. Family advocates or family systems navigators working in community agencies will receive supervision consistent with the policies and procedures of the host agency.

J. Any person providing supervision to a family advocate or family systems navigator will have demonstrable knowledge about Section 27-69-101, et seq., C.R.S., these rules, and the role and function of a family advocacy program.

K. Family advocacy programs will have policies and procedures concerning the work of family advocates and family systems navigators that address:

1. Experience and hiring requirements, including a name search through the Colorado Bureau of Investigation;

2. The program's standards of practice and code of ethics;

3. Training related to providing support to families of youth with a mental health or cooccurring condition;

4. A description of each aspect of the program, including related staff roles and responsibilities;

5. The handling of grievances and complaints;

6. Confidentiality, HIPAA, and 42 C.F.R. Part 2; and, 7. Methods for recording information concerning each family receiving support including demographics, assessment results, needs and strengths, goals and objectives, support provided, and other information as needed.

L. The services and supports provided by a family advocacy program will include, but not be limited to, those outlined in Section 27-69-104(3), C.R.S., and the following:

1. An assessment of the needs and strengths of the youth and family;

2. Assisting families with significant transitions in the youth's life;

3. Coordination with the local community mental health center and other behavioral health service, and;

4. C ulturally and linguistically appropriate and responsive services including bilingual family advocates and/or family systems navigators, and/or access to translation services for families when necessary. 21.200.54 Data Reporting [Eff. 5/1/16]

A. Family advocacy programs will collect and report data to the Department. This is necessary for the program and the Department to determine its effectiveness and what, if any, changes are necessary to improve outcomes for youth and families. The results of a ny data analysis conducted by the Department will be shared with the respective family advocacy program.

B. The data collected and reported to the Department shall include the following:

1. Types of services and support the youth and families received prior to and during involvement in the family advocacy program;

2. Outcomes of services and supports provided during the youth and family's involvement in the family advocacy program;

3. Indicators of the youth and family's satisfaction with support provided by the family advocate or family systems navigator;

4. Indicators of the effectiveness of the family advocate or family systems navigator;

5. Indicators of change in the system of care, e.g., interagency agreements, service access and utilization, leadership development among youth and families; and shared resources;

6. Costs of services provided; and, 7. Types of transition services provided.

C. Data will be submitted to the Department in an established and standardized format. 21.200.55 Technical Assistance and Coordination [Eff. 5/1/16]

A. The Department will facilitate the provision of technical assistance and coordination for the

purpose of developing or strengthening a family advocacy program.

B. Technical assistance may include linking with written materials, family organizations, and phone consultation.

C. Technical assistance provided by organizations other than the Department may require a fee paid to that organization.

D. Interested entities will request technical assistance by contacting the Department verbally or in writing.

21.210 AGENCIES LICENSED TO PROVIDE SUBSTANCE USE DISORDER SERVICES

In addition to the rules provided in Sections 21.000 through 21.190, all agencies licensed to provide substance use disorder services shall comply with the following rule Sections 21.210.1 through 21.210.924. 21.210.1 Agency Staff Qualification and Training A. Agencies shall ensure treatment staff are appropriately trained and properly credentialed to provide substance use disorder services in Colorado and are in good standing with their credentialing body.

B. A gencies shall ensure treatment staff providing independent treatment services in substance use disorder programs within each licensed site are credentialed in accordance with applicable state laws and regulations and are providing treatment services allowed within their scope of practice.

Treatment staff is defined in 21.210.1.E. For clinically managed residential withdrawal management staffing requirements, see 21.210.914.

C. Counselor-in-training staff or certified addiction technician shall not independently counsel, sign clinical documentation or carry out other duties relegated solely to the treatment staff identified in 21.210.1.E. Counselor-in-training staff and certified addiction technicians shall not comprise more than twenty-five percent (25%) of total staff.

1. Counselor-in-training staff must have all clinical documentation reviewed and co-signed by their agency clinical supervisor able to supervise pursuant to their scope of practice.

2. Certified addiction technicians may independently provide services within the statutorily defined scope of practice pursuant to Section 12-245-805(3)(a), C.R.S.

D. Unless otherwise noted, all agencies shall have a designated clinical administrator who shall authorize and oversee the clinical practice and supervise the treatment staff defined in 21.210.1.E. The clinical administrator shall be in good standing with his or her credentialing body and properly licensed as a physician or as one of the following mental health professionals:

1. Licensed psychologist;

2. Licensed clinical social worker;

3. Licensed marriage and family therapist;

4. Licensed professional counselor; or 5. Licensed addiction counselor.

E. Treatment staff, for the purpose of this Section 21.210, unless otherwise noted, means the following behavioral health professionals trained in substance use disorder identification and treatment and acting within his or her scope of practice:

1. Licensed physician;

2. Licensed advanced practice nurse included in the advanced practice registry with a population focus in mental health, behavioral health or psychiatry;

3. Licensed psychologist;

4. Licensed clinical social worker;

5. Licensed marriage and family therapist;

6. Licensed professional counselor;

7. Licensed addiction counselor;

8. Certified addiction specialist; or 9. Candidate status staff receiving supervision to become a licensed or certified mental health professional pursuant to Article 245 of Title 12, C.R.S. Candidate level staff shall not make up more than fifty percent (50%) of an agency’s treatment staff.

F. Al l agencies shall provide and document initial training in methods of preventing and controlling infectious diseases and in universal precautions providing protection from possible infection when handling blood and other body fluids. Annual refresher training, including updates, shall be provided and documented.

G. Staff collecting samples for drug or alcohol testing shall be knowledgeable of collection, handling, recording and storing procedures assuring sample viability for evidentiary and therapeutic purposes.

H. Agencies administering and/or monitoring individual medications shall maintain at least one staff person per shift who is currently qualified by certification and/or training to perform those functions in accordance with applicable Department rules and state and federal regulations.

I. Agencies shall document that at least one residential treatment staff person per shift is currently certified in cardiopulmonary resuscitation and basic First Aid.

21.210.2 CONTENT OF RECORDS

In addition to 21.190.2, agencies licensed to provide substance use disorder services shall maintain individual records to include:

A. Individual acknowledgments of:

1. 42 C.F.R. PART 2;

2. HIPAA;

3. Individual rights;

4. Mandatory disclosure statement;

5. Chargeable fees and collection procedures; and, 6. Awareness of agency emergency procedures.

B. The out-of state offender questionnaire shall be completed and in all clinical records.

C. Personal belongings inventories, when applicable.

D. Court documents, when applicable.

E. Records of required communication with referral sources such as court, probation, child welfare, and parole, when applicable.

F. Drug and alcohol testing and monitoring results, when applicable. 21.210.3 COUNSELOR AND INDIVIDUALS RECEIVING SERVICES’ SIGNATURES [Eff. 11/1/13]

A. Counselor signatures shall be required on the following treatment documents:

1. Screenings;

2. Assessments;

3. Admission summaries;

4. Service plans;

5. Service plan reviews;

6. Treatment notes;

7. Discharge summaries.

B. Credentialed counselors who counsel independently shall sign treatment documents with at least first initial, last name, and Colorado addiction counselor credential, other professional credential, or academic degree.

C. C ounselors not credentialed may sign treatment documents if countersigned by supervising credentialed counselors.

D. Signature stamps shall be permissible in lieu of written signatures if initialed by the counselors whose signatures they represent. Electronic signatures shall be permissible for computerized individual records.

E. Agencies shall require persons receiving services, or guardians, to sign service plans, service plan reviews, and revisions, consents, acknowledgments, and other documents needing individual authorization.

21.210.4 PROVISION OF SERVICES 21.210.41 Admission Criteria [Eff. 11/1/13]

A. The following shall not be the sole reason for treatment ineligibility:

1. Relapse;

2. Leaving previous treatment against advice;

3. Pregnancy;

4. Intravenous drug use; or, 5. Involuntary commitment.

B. Restrictions, priorities, or special admission criteria shall be applied equally to all prospective persons seeking services. 21.210.42 Screening [Eff. 5/1/16]

A. Agencies shall screen all female individuals of child bearing age seeking or being referred to substance use disorder treatment for pregnancy.

B. At admission individuals shall be screened for past and present risk factors associated with substance use disorders that are associated with:

1. Pregnancy complications, including risks to the health of the pregnant woman and fetus;

2. Acquiring and transmitting Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), Tuberculosis (TB), Hepatitis A, B, or C, and other infectious diseases; and, 3. If clinically indicated by the presence of continuing risk factors, screening shall be conducted at a minimum on a quarterly basis.

C. Individuals shall be apprised of risk factors associated with acquiring and transmitting HIV/AIDS, TB, Hepatitis A, B, C, and other infectious diseases. Appropriate testing and pre and post-test counseling shall be offered on-site or through referral.

D. Criminal justice system referrals for substance use related offenses, such as DUI/DWAI, BUI, FUI, and/or controlled substance violations, may be exempt from further substance use disorder screening if previously assessed, or evaluated. Supporting documentation from the referring agency shall be present in the individual record.

E. Adults shall be screened for past and present criminal charges in any state. Persons with out-ofstate charges must be registered by the licensed agency with the interstate compact office in accordance with Title 17, Article 27.1, Section 101, et seq., C.R.S.

21.210.43 LEVEL OF CARE GENERAL PROVISIONS

A. In addition to meeting the requirements established in 21.190, Agencies shall:

1. Use the ASAM Criteria as a guide for assessing and placing individuals in the appropriate level of care;

2. Include information gathered on all six (6) dimensions outlined in The ASAM Criteria in assessments; and 3. Utilize the decisional flow process as outlined in The ASAM Criteria to determine level of care.

B. Agencies shall specify the specific level(s) of care services the agency plans to provide, including the population(s) the agency plans to serve.

C. Each level of care shall offer a range of treatment approaches and support services based on the assessment of the individual’s treatment needs. Treatment services may include, but are not 1. Assessment;

2. Group and individual counseling;

3. Motivational enhancement;

4. Family therapy;

5. Educational groups;

6. O ccupational and recreational therapy;

7. Addiction pharmacology;

8. Medication management;

9. Peer, social and recovery support;

10. Case management or service coordination; and 11. Support for development of life skills.

D. In addition to meeting the staff qualification and training requirements established in 21.210, agencies shall document that staff are appropriately credentialed and qualified to provide treatment services in the levels of care described in this section and to the individual populations they serve.

E. Agencies shall apply sliding fee scales equally to all prospective persons seeking services.

F. Agencies shall be responsible for monitoring and routinely reporting to referring courts and the criminal justice system the individual’s progress within treatment, including any ancillary services.

G. In addition to meeting the requirements established in 21.200, agencies shall ensure all staff working with youth under the age of twenty-one (21) at each level of care are trained and knowledgeable of youth development and engaging youth in care.

H. agencies shall obtain a Controlled Substance License from the Office of Behavioral Health if the program plans to dispense, compound, or administer a controlled substance in order to treat a substance use disorder or to treat the withdrawal symptoms of a substance use disorder.

I. Agencies shall continue individuals on their medication-assisted treatment regimen and will only detox individuals from medications treating opioid use disorders at the individual’s request or if it is deemed medically necessary.

J. Agencies shall inform individuals receiving services about access to medication-assisted treatment. Upon the individual’s consent, agencies shall provide medication-assisted treatment directly, if the agency or provider is appropriately licensed to do so. If an agency or provider is not licensed to provide medication-assisted treatment and an individual receiving services requests medication-assisted treatment, an agency shall refer the individual to an agency that provides medication-assisted treatment. 21.210.5 LEVELS OF CARE Specific Requirements Each le vel of care is based on a specific level of care outlined in The ASAM Criteria. 21.210.6 OUTPATIENT SUBSTANCE USE DISORDER SERVICES (Level 1)

A. Level 1 services shall generally be intended for individuals who are assessed as not appropriate for more intensive levels of care. Level 1 may also be a step-down from a higher level of care or offered when an individual is in early stages of change and not willing to participate in the higher level of care indicated by the assessment.

B. Level 1 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the mental health disorders are of moderate severity, or are of high severity but have been stabilized. 21.210.61 Level 1 Service Provisions A. Level 1 services shall be conducted in regularly scheduled sessions of less than nine (9) treatment contact hours per week for adults, and less than six (6) treatment contact hours per week for youth under the age of eighteen (18).

B. Level 1 treatment services shall be provided by treatment staff defined in section 21.210.1.E.

C. Agencies providing Level 1 services shall inform individuals receiving services how to access emergency services by telephone twenty-four (24) hours per day, seven (7) days per week. At minimum, emergency services information shall include contact information for services provided by the Behavioral Health Crisis Response System created pursuant to § 27-60-103, C.R.S.

D. A gencies providing Level 1 services shall have direct affiliation or close coordination through referral to more intensive levels of care.

E. Agencies providing Level 1 services shall ensure treatment staff has staff-to-staff consultation available within twenty-four (24) hours by telephone to discuss when warranted, at minimum, psychiatric or medical concerns of individuals receiving services.

21.210.7 INTENSIVE OUTPATIENT/PARTIAL HOSPITALIZATION SUBSTANCE USE

DISORDER SERVICES (Level 2) 21.210.71 INTENSIVE OUTPATIENT SUBSTANCE USE DISORDER SERVICES (Level 2.1)

A. Level 2.1 services shall generally be intended for individuals who require a more structured substance use disorder outpatient treatment experience than can be received in Level 1 outpatient treatment.

B. Level 2.1 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the disorders are of moderate severity, or are of higher severity but have been stabilized. 21.210.711 Level 2.1 Service Provisions A. Level 2.1 services shall be conducted in regularly scheduled sessions that follow a planned format of treatment services of nine (9) to nineteen (19) contact hours per week for adults and six (6) to nineteen (19) contact hours per week for youth under the age of eighteen (18).

B. Level 2.1 treatment services shall be provided by treatment staff defined in section 21.210.1.E.

C. Agencies providing Level 2.1 services shall inform individuals receiving services how to access emergency services by telephone twenty-four (24) hours per day, seven (7) days per week. At minimum, emergency services information shall include contact information for services provided by the behavioral health crisis response system created pursuant to § 27-60-103, C.R.S.

D. A gencies providing Level 2.1 services shall have direct affiliation or close coordination through E. Agencies providing Level 2.1 services shall ensure treatment staff has staff-to-staff consultation available within twenty-four (24) hours by telephone and within seventy-two (72) hours in person to discuss when warranted, at minimum, psychiatric or medical concerns of individuals receiving 2.210.72 PARTIAL HOSPITALIZATION SUBSTANCE USE DISORDER SERVICES (Level 2.5)

A. Level 2.5 services shall generally be intended for individuals who require daily monitoring or management to treat substance use disorders that can be provided in a structured outpatient setting. Services include direct access to medical, psychiatric, and laboratory services. Level 2.5 service sites for school aged youth shall include access to educational services and coordination with a school system, as appropriate.

B. Level 2.5 services are appropriate for individuals with co-occurring mental health and substancerelated disorders if the disorders are of moderate severity, or are of higher severity but have been stabilized. Staff of Level 2.5 services shall understand the signs and symptoms of mental health disorders and the uses of psychotropic medications and their interactions with substance use 21.210.721 L evel 2.5 Service Provisions A. Level 2.5 services shall be conducted with a minimum frequency of twenty (20) regularly scheduled treatment contact hours per week.

B. Level 2.5 treatment services shall be provided by treatment staff defined in section 21.210.1.E.

C. Agencies providing Level 2.5 services shall inform individuals receiving services how to access emergency services by telephone twenty-four (24) hours per day, seven (7) days per week when the program is not in session. At minimum, agencies shall provide emergency services information that includes contact information for services provided by the behavioral health crisis response system created pursuant to § 27-60-103, C.R.S.

D. Agencies providing Level 2.5 services shall have direct affiliation or close coordination through E. Agencies providing Level 2.5 services shall ensure treatment staff has staff-to-staff consultation available within eight (8) hours by telephone and within forty-eight (48) hours in person to discuss when warranted, at minimum, psychiatric or medical concerns of individuals receiving services. 21.210.8 RESIDENTIAL/INPATIENT SUBSTANCE USE DISORDER SERVICES (Level 3)

Agencies providing residential/inpatient substance use disorder services (Level 3) shall construct and maintain sound and sight barriers between male and female individuals and between adult and youth under the age of eighteen (18) in bathrooms and sleeping quarters.

21.210.81 CLINICALLY MANAGED LOW-INTENSITY RESIDENTIAL SUBSTANCE USE

DISORDER SERVICES (Level 3.1)

A. Level 3.1 services shall generally be intended for whose history of chronic substance use disorders, lack of supportive living situations, unemployment, levels of social or psychological dysfunction and/or lack of housing necessitates twenty-four (24) hour structure and support. Level 3.1 services are generally provided in settings such as a halfway house, group home or other supportive living environment providing twenty-four (24) hour staff and close integration with treatment services.

B. Lev el 3.1 services shall have staff who are able to identify the signs and symptoms of acute psychiatric conditions and understand the signs and symptoms of mental health disorders, the uses of psychotropic medication and their interaction with substance use disorders.

C. Level 3.1 services shall have the capacity to arrange for psychiatric or addiction medications. 21.210.811 Level 3.1 Service Provisions and Staffing A. Level 3.1 services shall be regularly scheduled and include a minimum of five (5) hours of B. Agencies providing Level 3.1 services shall maintain individual to staff ratio not exceeding twenty to one (20:1) during nighttime hours, per agency site.

C. Agencies providing Level 3.1 services shall provide twenty-four (24) hour per day, seven (7) days per week on-site staff. Twenty-four (24) hour on-site staff shall be trained and knowledgeable of substance use disorders and the treatment of substance use disorders and in addition to treatment staff defined in 21.210.1.E may include:

1. Peer support specialists as defined in Section 21.400.1; or 2. Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff in the process of obtaining addiction counselor certification.

D. Agencies providing Level 3.1 services shall have at least one (1) treatment staff, as defined in 21.210.1.E, trained and knowledgeable of substance use disorders, the treatment of substance use disorders and able to monitor and identify psychiatric conditions available by telephone twenty-four (24) hours per day, seven (7) days per week and available to be on-site within thirty (30) minutes.

E. Agencies providing Level 3.1 services shall have direct affiliation or close coordination through F. Agencies providing Level 3.1 services shall ensure staff have telephone or in-person consultation with a physician and emergency services available twenty-four (24) hours per day, seven (7) days 21.210.82 CLINICALLY MANAGED POPULATION-SPECIFIC HIGH-INTENSITY RESIDENTIAL SUBSTANCE USE DISORDER SERVICES (Level 3.3)

A. Level 3.3 services are a structured recovery environment in combination with high-intensity clinical services to support recovery from substance-related disorders.

B. Level 3.3 is appropriate for individuals who are unable to benefit from outpatient services or services in general settings because of cognitive impairments that result in functional limitations.

Treatment is focused on preventing relapse, continued problems and/or continued use, and promoting the eventual reintegration of the individual into the community. Therapeutic rehabilitation facilities or traumatic brain injury programs are examples of this level of care.

21.210.821 L evel 3.3 Service Provisions and Staffing A. Agencies providing Level 3.3 services shall deliver treatment services in a manner that is matched to the individual’s functioning and may be provided in a deliberately repetitive fashion to address the special cognitive needs of individuals for whom this level of care is considered a medical necessity.

B. Agencies shall provide daily scheduled Level 3.3 services and include a minimum of nine (9) hours of planned treatment services per week.

C. Agencies providing Level 3.3 services shall maintain individual to staff ratios not exceeding twenty to one (20:1) during nighttime hours, per agency site. Staff shall include:

1. At least one (1) treatment staff, as defined in 21.210.1.E, trained and knowledgeable of substance use disorders, the treatment of substance use disorders and able to monitor and identify psychiatric conditions available by telephone twenty-four (24) hours per day, seven (7) days per week and available to be on-site within thirty (30) minutes;

2. Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S.;

3. A physician, physician assistant or nurse practitioner available by telephone or in-person twenty-four (24) hours per day, seven (7) days per week to provide medical evaluation and consultation; and 4. P eer support specialists as defined in Section 21.400.1.

D. Agencies providing Level 3.3 services shall have direct affiliation or close coordination through 21.210.83 CLINICALLY MANAGED HIGH-INTENSITY RESIDENTIAL SUBSTANCE USE DISORDER SERVICES (Level 3.5)

A. Level 3.5 services provide a safe and stable living environment with treatment focused on promoting skills needed to avoid relapse or continued use. Level 3.5 is appropriate for individuals with multiple limitations including criminal activity, psychological problems, and/or impaired social and/or vocational functioning.

B. Treatment is directed toward reducing relapse risk, enhancing prosocial behaviors and reintegration into the community. A variable length therapeutic community or residential treatment center are examples of this level of care. 21.210.831 Level 3.5 Service Provisions and Staffing A. Agencies shall provide daily Level 3.5 services and include a minimum of ten (10) hours of B. Agencies providing Level 3.5 services shall maintain individual to staff ratios not exceeding twenty to one (20:1) during nighttime hours, per agency site, and each shift shall have a minimum of two (2) staff members, whenever one (1) or more individuals are present. Staff shall include:

1. At least one (1) treatment staff, as defined in 21.210.1.E, trained and knowledgeable of substance use disorders, the treatment of substance use disorders and able to monitor and identify psychiatric conditions available twenty-four (24) hours per day, seven (7) days per week;

2. A ddiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff in the process of obtaining addiction counselor certification;

3. a physician, physician assistant or advanced practice nurse available to provide medical evaluation and consultation and assess and treat co-occurring biomedical disorders, as well as prescribe and monitor the administration of medications; and 4. Peer support specialists as defined in Section 21.400.1.

C. Agencies providing Level 3.5 services shall have direct affiliation or close coordination through referral to more and less intense levels of care.

21.210.84 MEDICALLY MONITORED INTENSIVE INPATIENT SUBSTANCE USE DISORDER

SERVICES (Level 3.7)

A. Level 3.7 services provide a planned and structured regimen of twenty-four (24) hour evaluation, observation, medical monitoring and addiction treatment.

B. Level 3.7 services are appropriate for individuals whose medical, emotional, behavioral or cognitive problems are so severe that they require twenty-four (24) hour medical monitoring but do not need the full resources of an acute care general hospital or medically managed inpatient treatment program (Level 4). Treatment is designed for individuals who have functional limitations in the areas of intoxication/withdrawal potential; biomedical conditions; or emotional, behavioral or cognitive conditions.

21.210.841 L evel 3.7 Service Provisions and Staffing A. Level 3.7 services shall be scheduled daily and include a minimum of twenty (20) hours of B. Agencies providing Level 3.7 services shall maintain individual to staff ratios not exceeding twenty to one (20:1) during nighttime hours per agency site, and each shift shall have a minimum of two (2) staff members, whenever one (1) or more individuals are present.

C. Level 3.7 services shall be staffed with a team that includes physicians, nurses and mental health professionals licensed or certified pursuant to Article 245 of Title 12, C.R.S. that provide twentyfour (24) hour professionally directed evaluation, care and treatment services including administration of prescribed medications, withdrawal management and integrated treatment of co-occurring medical, emotional, behavioral or cognitive conditions.

D. A licensed physician shall oversee treatment and assure quality of care in Level 3.7 services. A physician, physician assistant or nurse practitioner shall perform physical examinations for all individuals admitted. Examinations shall occur within twenty-four (24) hours of admission and thereafter as necessary.

E. A registered nurse shall conduct an alcohol or other drug-focused nursing assessment at the time of admission.

F. A licensed nurse is responsible for monitoring the individual’s progress and/or medication administration twenty-four (24) hours per day, seven (7) days per week.

G. Additional medical specialty consultation, psychological, laboratory and toxicology services are available on-site through consultation or referral. Psychiatric services are available on-site through consultation or referral within eight (8) hours by telephone or twenty-four (24) hours in 21.210.9 W ITHDRAWAL MANAGEMENT SERVICES 21.210.91 CLINICALLY MANAGED RESIDENTIAL WITHDRAWAL MANAGEMENT (LEVEL 3.2- WM)

A. Level 3.2-WM programs shall provide twenty-four (24) hour supervised withdrawal from alcohol and/or other drugs in a residential setting.

B. Level 3.2-WM programs shall provide collaboration and coordination with emergency mental health services as needed.

C. Level 3.2-WM programs shall obtain a Controlled Substance License from the Office of Behavioral Health if the program plans to dispense, compound, or administer a controlled substance in order to treat a substance use disorder or to treat the withdrawal symptoms of a substance use disorder.

D. Level 3.2-WM programs shall develop and implement policies and procedures in accordance with federal and state regulations, department rules, and in consultation with medical professionals qualified in substance use disorders. Policies and procedures must address but are not limited to:

1. Handling individuals who are assessed as being a current threat to themselves or others and shall include appropriate uses of law enforcement and monitor any use of individual restraint and/or seclusion;

2. Communication with intoxicated individuals leaving treatment against staff 3. Circumstances under which individuals shall be discharged, other than completing withdrawal management or leaving against staff recommendations. 21.210.911 Level 3.2-WM Admission and Monitoring A. Individuals admitted to level 3.2-WM services shall be intoxicated, under the influence, or in any stage of withdrawal from alcohol and/or other drugs.

B. Level 3.2-WM admission procedures shall include at a minimum:

1. Degree of alcohol and other drug intoxication as evidenced by breathalyzer, urinalysis, self-report, observation or other evidence-based or best practices;

2. Initial vital signs;

3. Need for emergency medical and/or psychiatric services;

4. Inventorying and securing personal belongings;

5. Substance use disorder history and the degree to which the use of substance affects personal and social functioning, as soon as clinically feasible following admission;

6. Pregnancy screening; and 7. Administration of a validated clinical withdrawal assessment tool.

C. Withdrawal management monitoring of individuals shall include:

1. Routine monitoring of physical and mental status including observation of individual;

2. Vital signs taken at least every two (2) hours until they remain at the person's baseline for at least four (4) hours, and then taken every eight (8) hours thereafter until discharge;

3. Documentation per shift to include all individual monitoring activities.

21.210.912 L evel 3.2-WM Service Planning A. level 3.2-WM programs shall develop and implement service plans in accordance with Section 21.190.4 and address safe withdrawal, motivational counseling, and referral for treatment.

B. Level 3.2-WM programs shall provide additional service planning for managing individuals with medical conditions, suicidal ideation, pregnancy, psychiatric conditions, and other conditions which place individuals at additional risk during withdrawal management.

C. Level 3.2-WM programs shall provide assessments of individual readiness for treatment and interventions based on the service plan and the assessments and interventions shall be 21.210.913 Level 3.2-WM Discharge A. Level 3.2-WM programs shall provide discharge information to individuals and document in the individual’s records the requirements established in Section 21.190.6, and:

1. Effects of alcohol and other drugs;

2. Risk factors associated with alcohol and other drug abuse for acquiring and transmitting HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome), Tuberculosis (TB), and other infectious diseases, and for pregnancy;

3. Availability of testing and pre/post-test counseling for HIV/AIDS, TB, Hepatitis C and other infectious diseases, and pregnancy; and 4. Availability of alcohol and other drug abuse treatment services. 21.210.914 Level 3.2-WM Staff Requirements A. At least fifty percent (50%) of withdrawal management staff including on-call staff shall consist of treatment staff as defined in 21.210.1.E, certified addiction technicians or staff in the process of obtaining addiction counselor certification. Plans for addiction counselor certification shall be available for review. Full-time staff shall obtain at least an addiction technician certification within eighteen (18) months of employment.

B. Uncertified staff or staff without a plan for addiction counselor certification shall not comprise more than fifty percent (50%) of total withdrawal management staff.

C. Level 3.2-WM programs’ individual to staff ratios shall not exceed ten to one (10:1); and 1. Procedures for responding to periods of high census and/or emergency situations shall be conspicuously posted; and 2. Each shift shall have a minimum of two (2) staff members, whenever one (1) or more individuals are present.

D. T he staff person overseeing day-to-day operations shall be:

1. Certified as an addiction specialist or licensed as an addiction counselor pursuant to Part 8 of Article 245 of Title 12, C.R.S.;

2. A physician licensed pursuant to Article 240 of Title 12, C.R.S.;

3. A psychologist licensed pursuant to Part 3 of Article 245 of Title 12, C.R.S.;

4. An advanced practice nurse licensed pursuant to Section 12-255-111, C.R.S.; or 5. A licensed clinical social worker, licensed marriage and family therapist, or licensed professional counselor licensed under Part 4, 5, or 6 of Article 245 of Title 12, C.R.S.

E. Level 3.2-WM programs shall provide twenty-four (24) hour per day, seven (7) days per week onsite staff. Twenty-four (24) hour on-site staff shall be trained and knowledgeable of substance use disorders and the treatment of substance use disorders and in addition to treatment staff as defined in 21.210.1.E, twenty-four (24) hour staff may include:

1. Peer support specialists as defined in 21.400.1; or 2. Addiction technicians certified pursuant to Part 8 of Article 245 of Title 12, C.R.S. or staff in the process of obtaining addiction counselor certification.

F. P rograms shall maintain documentation that all direct care staff have training in and evaluated knowledge of the following before providing independent services:

1. Withdrawal management;

2. Infectious diseases (AIDS/HIV, Hepatitis C, TB), including universal precautions against becoming infected;

3. Administering cardiopulmonary resuscitation (CPR) and first aid;

4. Monitoring vital signs;

5. Conducting assessment and triage, including identifying suicidal ideation;

6. Emergency procedures and their implementation;

7. Collecting urine and breath samples;

8. Cultural factors that impact withdrawal management;

9. Ethics and confidentiality;

10. Individual records systems;

11. De-escalating potentially dangerous situations; and 12. Basic counseling and motivational interviewing skills.

21.210.92 MEDICALLY MONITORED INPATIENT WITHDRAWAL MANAGEMENT (LEVEL 3.7-

WM)

Level 3.7-WM services shall be provided by licensed medical staff qualified to supervise withdrawal from alcohol and other drugs through use of medication and/or medical procedures in residential settings which possess Controlled Substances Licenses in compliance with Part 2 of Article 80 of Title 27, C.R.S. 21.210.921 Level 3.7-WM Admission and Evaluation A. Level 3.7-WM programs shall develop and implement specific admission criteria detail for which drugs, including alcohol, medical withdrawal management is provided.

B. In addition to the consent requirements established in 21.170.4, level 3.7-WM programs shall provide informed consent to medical withdrawal management that include:

1. Med ications to be used; and 2. Need to consult with primary care physicians.

C. Level 3.7-WM programs shall provide medical evaluations by physicians licensed pursuant to

Article 240 of Title 12, C.R.S. or authorized health-care professionals under the supervision of authorized physicians. The medical evaluations shall consist of, at minimum:

1. Medical histories including detailed chronologies of substance use disorders;

2. Identification of current physical addiction including drug types;

3. Physical examinations to determine appropriateness for outpatient or inpatient medical withdrawal management; and 4. Appropriate laboratory tests including pregnancy tests, and other evaluations as indicated.

D. Level 3.7-WM service protocols for usual and customary withdrawal management from each drug delineated in the admission criteria shall be developed in consultation with licensed physicians and other allied health-care professionals and shall be implemented in the form of individualized withdrawal management plans under direct supervision of program medical directors. Protocols shall include:

1. Types of intoxication;

2. Tolerance levels for the individual's drug of choice;

3. Degrees of withdrawal;

4. Possible withdrawal and/or intoxication complications;

5. Other conditions affecting medical withdrawal management procedures;

6. Types of medications used;

7. Recommended dosage levels;

8. Frequency of visits (outpatient settings);

9. Procedures to follow in the event of withdrawal management complications;

10. Daily assessments including expected improvements as well as potential problems; and 11. Expected duration of withdrawal management.

E. Medical withdrawal management programs using any controlled substances are required to have Controlled Substance Licenses issued by the Department. Buprenorphine is the only medication that can be used for opioid dependent individuals unless the medical withdrawal management program is licensed as an opioid treatment program and it has been verified through the program and coordinated with the Federal Center for Substance Abuse Treatment.

F. A uthorized physicians may prescribe buprenorphine under his/her own Drug Enforcement Administration (DEA) registration number for individuals admitted to the hospital for inpatient withdrawal management or addiction treatment.

G. Withdrawal management programs must continue patients on their medication-assisted treatment regimen when available and will only detox individuals from medications treating opioid use disorders at the patient’s request or if it is deemed medically necessary. 21.210.922 Level 3.7-WM Clinical Staff A. Level 3.7-WM programs shall provide, at minimum, the following clinical staff:

1. One medical director;

2. One registered nurse or licensed practical nurse (R.N. or L.P.N.) with at least one year of withdrawal management experience; and 3. Treatment staff as defined in 2.210.1.E, staffed at a rate that meets the needs of the individuals receiving level 3.7-WM services.

B. Level 3.7-WM program medical directors' responsibilities shall include, at minimum:

1. Quarterly reviews and revisions of drug withdrawal management categories and 2. Reviews of individual withdrawal management plans;

3. Reviews of individual prescriptions that deviate from standard withdrawal management 4. Five (5) hours of monthly supervision of and consultation with staff providing withdrawal management services;

5. Direct supervision of individual withdrawal management cases that deviate from standard protocols and/or experience complications; and 6. Develop and implement back-up systems for physician coverage when medical directors are unavailable and/or for emergencies.

C. level 3.7-WM programs shall ensure twenty-four (24) hour access to clinical staff by telephone and accommodation for unscheduled visits for crises or problem situations. 21.210.923 Level 3.7-WM Treatment Services A. Level 3.7-WM programs shall provide the following treatment services in addition to medication dosing contacts:

1. Motivational counseling and support;

2. Continuous evaluation and behavioral health intervention; and 3. Development and monitoring of a service plan per Section 21.190.4.

B. Lev el 3.7-WM programs shall ensure a minimum of one (1) daily clinical supportive services contact, which shall be documented in individual records. 21.210.924 Level 3.7-Wm Dispensing and Administration Procedures A. Level 3.7-WM programs shall develop and implement policies and procedures for dispensing medications per standard withdrawal management protocols that are in accordance with applicable state and federal statutes and for the following:

1. Individual prescriptions filled and dispensed by a registered pharmacist at a designated pharmacy location; and 2. Individual prescriptions from medical directors that are filled from stock quantities.

B. Level 3.7-WM programs shall develop and implement policies and procedures in accordance with applicable federal and state statutes for storing and accounting for all drugs including controlled substances.

21.220 GENDER-RESPONSIVE WOMEN'S TREATMENT IN SUBSTANCE USE DISORDER

PROGRAMS [Eff. 11/1/13]

In addition to Section 21.210, agencies licensed to provide Gender-Responsive Women’s Treatment shall be in compliance with Subsections 21.220.1 through 21.220.4. 21.220.1 GENERAL PROVISIONS [Eff. 11/1/13]

A. Treatment staff shall have documented training, supervision and experience in women-specific issues and services.

B. Treatment for substance use disorders shall be provided to the family as a whole, unless clinically contraindicated. Clinical contraindications to this provision must be documented in the individual C. Agencies shall offer any pregnant woman admission to treatment within forty-eight (48) hours and shall demonstrate compliance with Section 21.220.4, D, Services to Pregnant Women.

D. Agencies providing gender specific women’s treatment shall include the following components:

1. Emotional and physical safety of individuals take precedence over all other considerations in the delivery of services;

2. Services designed to increase women’s access to care, and engagement and retention of individuals (such as comprehensive case management, transportation, child care);

3. Women-only therapeutic environments;

4. Women-specific service needs and topic areas;

5. Program services shall directly address trauma issues currently manifesting in the individual’s life either through direct service provision or by referral; and, 6. M ultiple modalities that meet the specific needs of women (group and individual therapy, case management and opportunities for women to be in treatment with their children where possible).

E. Agency policy and procedures shall include the mandatory reporting of suspected child abuse, neglect and/or child safety issues, which shall include definitions of abuse and neglect under the Colorado Children’s Code (Section 19-1-103, C.R.S.), and which are consistent with the reporting of child abuse allowed under federal law.

F. Agency policy and procedures shall include the criteria for interventions offered and expected outcomes of services delivered. 21.220.2 SCREENING [Eff. 11/1/13]

In addition to the Section 21.190.3, screening shall include all of the following unless clinically contraindicated:

A. Screening and documentation of individual’s need for prenatal care (where applicable), primary medical care and family planning services;

B. Screening for child safety issues utilizing an evidence-based or best practices approved instrument. 21.220.3 TREATMENT [Eff. 11/1/13]

A. Service plans shall be established in accordance with Section 21.190.4 of these rules, and shall address each of the need areas identified in Section 21.220.3.

B. When not clinically contraindicated the following topic areas shall be addressed in treatment or by referral when applicable:

1. Reductions or elimination of substance use;

2. Individual safety issues 3. Child safety issues;

4. Trauma issues;

5. Parenting issues;

6. Ways in which substance use disorders impact and are impacted by family and relationships;

7. Medical and primary health issues;

8. Mental health issues;

9. Nutrition. 21.220.4 SERVICES TO PREGNANT WOMEN [Eff. 11/1/13]

A. Pregnant women shall be given priority admission to treatment for substance use disorders.

B. Programs shall develop policies and procedures for service delivery to pregnant women, which shall include circumstances under which pregnant women may be discharged from treatment.

1. Pregnant women may not be discharged from treatment solely for failure to maintain abstinence from substance use.

2. Every effort shall be made to retain pregnant women in treatment for the duration of their pregnancies in order to maintain an optimal period of abstinence from substance use.

C. Ev ery attempt shall be made to admit pregnant women to treatment within forty-eight (48) hours of first contact between the woman and the admitting program.

D. If a pregnant woman is not admitted to treatment within forty-eight (48) hours of first contact, the denial shall be clearly documented, the women's treatment coordinator for OBH shall be informed, and interim services shall be provided consisting of the following at minimum:

1. Referral for pre-natal care;

2. Information on the effects of alcohol and drug use on the fetus;

3. Daily phone contact with the individual; and, 4. Education regarding the transmission and prevention of communicable diseases such as HIV, hepatitis.

E. Pregnant women shall be linked to prenatal care immediately and barriers to accessing prenatal care shall be addressed, including transportation to prenatal care.

F. When a woman refuses to seek prenatal care or fails attempts to link her to care, this shall be documented in her record, and there shall be continuing efforts to link her to prenatal care until this is accomplished.

21.230 SUBSTANCE USE DISORDER EDUCATION AND TREATMENT FOR PERSONS INVOLVED

IN THE CRIMINAL JUSTICE SYSTEM

21.230.1 GENERAL PROVISIONS

A. Education, treatment, and ancillary services shall be provided to individuals convicted of misdemeanors and felonies who are assessed as needing substance use disorder treatment, as provided by Title 16, Article 11.5, Part 1, and C.R.S. and in accordance with current standardized assessment and placement protocol.

B. All agencies admitting out of state offenders must identify and notify the Interstate compact unit for Adult Offender Supervision per Section 17-27.1-101, C.R.S.

C. Services shall be based on the results of current screening and assessments.

D. Agencies shall place individuals involved in the criminal justice system according to the standardized offender assessment provided by the referring criminal justice agency.

E. Education, treatment and ancillary services as indicated by assessment and included in the service plan shall be provided for by the agency or through referrals.

F. A gencies shall have a written memorandum of understanding with ancillary providers to make available agreed upon services and require specific data and exchange of information related to the individualized services.

G. Education and treatment shall be a minimum of nine (9) months or as required by the referring criminal justice agency.

H. Frequency and intensity of education and treatment services shall be based on assessments and at minimum one two hour session per week.

I. The following content/topics shall be presented during offender treatment:

1. Physiological and psychological effects of alcohol, marijuana and/or marijuana/THC infused products, stimulants, and other drugs;

2. Signs and symptoms of substance use disorders;

3. Stress management and substance use disorders;

4. Anger management and substance use disorders;

5. Behavioral triggers leading to substance use disorders;

6. Drugs in the work place; and, 7. Legal issues and substance use disorders.

J. Agencies shall implement treatment curricula that are written in manual format and are evidencebased or best practices. All agency clinical staff working with the individuals involved in the criminal justice system population must be trained on and follow the specific curricula as written.

K. Individuals will receive a complete copy of the participant materials/workbook associated with the approved curriculum. The agency may charge for the curriculum.

L. Education and treatment sessions shall only consist of face-to-face (as defined in Section 21.240.1) contact and shall not include administrative procedures or breaks.

M. Agency staff working directly with individuals shall have documented qualifications and training in forensic populations and criminal justice systems.

N. Drug and alcohol toxicology collection must be observed by trained staff when requested by the referral source.

O. Records shall contain monthly documentation of communication with the criminal justice referral source describing progress toward specific treatment goals. Agencies shall be responsible for monitoring and reporting to referring courts or their representatives the individual's progress with ancillary services.

P. Agencies shall have written documentation in an individual's record that the individual has received services to assist in community reintegration, if applicable.

21.230.2 E

NHANCED OUTPATIENT EDUCATION AND TREATMENT SERVICES FOR

PERSONS INVOLVED IN THE CRIMINAL JUSTICE SYSTEM [Eff. 5/1/16]

A. An agency may provide enhanced outpatient services if it:

1. Is licensed by the Department for education and treatment services for individuals involved in the criminal justice system;

2. Is in compliance with Section 21.230.1; and, 3. Provides a minimum of four (4) hours over two (2) group sessions of scheduled treatment B. Frequency and intensity of treatment activities shall be based on current assessments and conducted in at least two (2) sessions per week.

C. Changes in frequency and intensity of education and treatment activities shall be assessed.

D. If, upon discharge from enhanced outpatient treatment, the minimum number of months required by the referring criminal justice agency have not been met, the agency shall transfer the individual to the appropriate level of care where remaining education and treatment requirements can be met.

21.240 DUI/DWAI, BUI, AND FUI EDUCATION AND TREATMENT

21.240.1 DEFINITIONS

“ADDS” is the Alcohol and Drug Driving Safety program, established under Section 42-4-1301.3, C.R.S.

The Judicial Department administers an Alcohol and Drug Driving Safety program in each judicial district that provides pre-sentence and post-sentence alcohol and drug evaluations on all persons convicted of Driving, Flying, and Boating Under the Influence (DUI, FUI, BUI) and Driving With Ability Impaired (DWAI).

“Alcohol and Drug Evaluation Specialists” (ADES) are persons within the criminal justice system, qualified to conduct pre- and post-sentence evaluations on, and provide supervision for, persons convicted of Driving, Flying, and Boating Under the Influence (DUI, FUI, BUI) and Driving With Ability Impaired (DWAI).

“BUI” means Boating Under the Influence.

“DUI” means Driving Under the Influence.

“DWAI” means Driving With Ability Impaired.

“Face-to-Face”, for purposes of this section 21.240, means that the individual is physically in the same room as a professional person at an office of a behavioral health licensed or approved site or video technology is being utilized.

“FUI” means Flying Under the Influence.

“Persistent Drunk Driver” defined in Section 42-1-102(68.5), C.R.S.

“Level I and Level II Education, Therapy or Treatment” means an approved alcohol and drug driving safety education or treatment program as defined in 42-4-1301.3(3)(c)(IV) C.R.S. 21.240.2 GENERAL PROVISIONS [Eff. 5/1/16]

A. Agencies providing DUI/DWAI services shall develop and implement policies, procedures, and individualized service planning demonstrating recognition of issues and treatment needs unique to this individual population.

B. A lcohol and Drug Driving Safety (ADDS) education and treatment services shall be restricted to those arrested, convicted of or receiving deferred prosecutions, sentences, or judgments for alcohol/other drug offenses related to driving (Title 42, Article 4, Part 13, C.R.S. and Title 42,

Article 2, Part 1, C.R.S.), boating (Title 33, Article 13, Part 1, C.R.S.), or flying (Title 41, Article 2,

Part 1, C.R.S.).

C. Individuals who are admitted, educated, or treated for Driving Under the Influence (DUI), Driving While Ability Impaired (DWAI), Boating Under the Influence (BUI), or Flying Under the Influence (FUI) shall be screened, referred and placed in accordance with current ADDS program screening, referral, and placement procedures.

1. If an agency does not have a copy of the ADDS referral paperwork, the agency shall conduct a screening of the individual using an evidence-based screening or promising practice process and instrument.

2. If an appropriate level of service has not been determined by the ADDS program screening, the agency shall follow guidelines established by the Colorado Department OF Human Services, Office of Behavioral Health, to determine the most appropriate level of service.

D. Agencies that do not provide services as identified through the screening or in the individual's court order shall:

1. Refer the individual back to the Alcohol and Drug Evaluation Specialist with documentation of which service(s) will not be provided on site and identified referrals and suggestions for alternative services;

2. Have a written memorandum of understanding or contract with the ancillary provider to make available agreed upon services and require specific data and exchange of information related to the individualized services; and, 3. Be responsible for monitoring and reporting to referring courts or their representatives the individual's progress with ancillary services.

E. Individuals with DUI/DWAI shall not be treated in groups with individuals with other offenses unless they need these groups as determined by the assessment and supported by the service F. Agencies providing Level I Education, Level II Therapeutic Education, and Level II Therapy shall submit information using reporting formats and data systems approved by the Department when appropriate to:

1. Sentencing courts;

2. The Department;

3. Probation departments;

4. Alcohol and Drug Evaluation Specialist;

5. Department of Revenue Hearing Section; and, 6. Motor Vehicle Division.

G. Information released shall be in accordance with federal and state confidentiality regulations and shall include:

1. Enrollment;

2. C ooperation;

3. Attendance, hours and weeks completed;

4. Treatment status and progress;

5. Education/treatment levels;

6. Fee payment;

7. Compliance with ancillary services; and, 8. Discharge status.

H. Agencies shall establish written policies and procedures to ensure that individual data is accurate and submitted within seven (7) business days of service or change in status.

I. Level I education, Level II therapeutic education, and Level II therapy shall not be combined, nor shall hours completed for one count as hours completed in another.

J. Individuals shall not be reported as finishing Level I education, Level II therapeutic education, or Level II therapy until all required content/topics have been completed over the minimum required hours and weeks.

K. Agencies shall provide proof of individual enrollment and report individual status in Level II education and therapy, including discharge, to the Colorado Department of Revenue, Division of Motor Vehicles, within seven (7) business days using Department prescribed reporting formats, in accordance with Sections 42-2-132 and 42-2-144, C.R.S.

L. Agencies shall provide accurate and timely submission of DUI/DWAI referral summaries (DRS) and other required data submitted through the Treatment Management System (TMS). Agency staff having access to the Treatment Management System shall do so in accordance with federal confidentiality laws.

M. Discharge DUI/DWAI Referral Summary Agencies shall provide a copy of the discharge DUI/DWAI referral summary, validated with an agency authorized signature, to individuals and referral sources within ten (10) business days following discharge from education and/or treatment.

1. A copy of the discharge referral summary shall be provided to individuals at no charge;

2. The discharge referral summary shall not be withheld for any reason including, but not limited to, collection of outstanding balances; and, 3. Ea ch discharge referral summary must reflect all DUI/DWAI services the individual received in a given treatment episode.

N. Ignition Interlock 1. Agencies shall screen all individuals with DUI/DWAI's for ignition interlock usage and requirements in accordance with the Department's interlock rules;

2. Agencies shall offer interlock counseling to those individuals who have installed, or plan to install, an ignition interlock device in accordance with Department rules; and, 3. Interlock counseling shall be offered on site or by referral to another Department licensed 21.240.3 PROVISION OF SERVICES A. Agencies shall use and adhere to a curriculum written in a manual form that is evidence-based or a best practice specific to DUI/DWAI, and contains content and topic areas as determined by the Department.

B. Agencies shall provide individuals with a complete copy of the participant materials and workbook associated with the approved curriculum being used. The agency may charge individuals for the curriculum materials.

C. Agencies shall assign individuals to a specific class, group or individual session throughout the treatment episode. Individuals attending DUI/DWAI education may make up sessions missed by attending other education sessions that cover the missed content. Make-up groups for DUI/DWAI therapy are not allowed.

D. S taff conducting DUI/DWAI, BUI and FUI education and therapy shall:

1. Receive training in the curriculum;

2. Meet the minimum staff qualifications per Sections 21.160 and 21.210.1, including credentialing and competency in group processes; and, 3. Possess a CAS or LAC.

E. Hours of attendance shall only be granted for face-to-face contacts and shall not include administrative procedures or breaks.

F. Drug and alcohol toxicology collection must be observed by trained staff when requested by the referral source. 21.240.4 YOUTH DUI, DWAI, BUI and FUI EDUCATION AND TREATMENT [Eff. 5/1/16]

Licensed youth DUI/DWAI agencies shall comply with Section 21.200 Behavioral Health Services for Children and Adolescents, the adult DUI, DWAI, BUI, FUI rules (21.240) as well as the following:

A. Youth under twenty-one (21) years of age that receive a DUI/DWAI are held to the same adult requirements under Alcohol and Drug Driving Safety (ADDS) education and treatment services as identified in (Title 42, Article 4, Part 13 and Title 42, Article 2, Part 1, C.R.S) boating (Title 33,

Article 13, Part 1,C.R.S.), or flying (Title 41, Article 2, Part 1, C.R.S.) and includes Section [42-4- 1301.3(3)(c)(IV)] , C.R.S.

B. Agencies licensed to provide Youth DUI, DWAI, BUI, and FUI education and treatment shall also be licensed to provide DUI/DWAI education and treatment.

C. W henever possible providers shall hold a separate group for youth.

1. Providers shall use clinical judgement when determining age appropriate placement of youth under twenty-one (21) years of age in an adult group.

2. When youth are placed in an adult group, individual sessions shall be offered to meet the developmental needs of the youth, when applicable.

D. Youth under twenty-one (21) years of age shall receive a complete copy, age appropriate materials/workbook, associated with the approved curriculum. The agency may charge for the curriculum.

E. Parents, other supportive adults, or significant others, shall participate throughout the length of treatment, unless contraindicated.

21.240.5 CONTENT OF RECORDS

Individual records shall be maintained for all levels of education and therapy and follow Section 21.170 (Records Care and Retention, General Provisions) and include:

A. Court documents regarding referral and classification and placement;

B. Attendance, individualized progress notes, and course completion data;

C. Descriptions of content and topics covered during each session;

D. Relevant reports and records of communication;

E. Copies of Discharge DUI/DWAI Referral Summary; 21.240.6 Level I EDUCATION A. Level I education shall be twelve (12) hours of face-to-face instruction; hours may include intake.

B. No more than four (4) hours shall be conducted in one (1) calendar day.

C. Level I education shall be conducted in outpatient settings. 21.240.7 Level II THERAPEUTIC EDUCATION [Eff. 5/1/16]

A. Agencies applying for approval to conduct Level II therapeutic education must also apply for approval to conduct Level II therapy and meet the requirements of both.

B. Provision of Services for Level II therapeutic education shall:

1. Be conducted in outpatient settings;

2. Consist of twelve (12) attended weeks and a total of twenty-four (24) face-to-face contact hours; and, 3. Not be conducted concurrently with Level II therapy unless clinical rationale is documented. The combined time in Level II therapeutic education and Level II therapy shall not be less than the minimum number of weeks required for Level II therapy.

C. Individuals shall not attend more than one (1) session of Level II education per week.

21.240.8 LEVEL II DUI/DWAI THERAPY 21.240.81 LEVEL II Outpatient [Eff. 5/1/16]

A. P rograms applying for approval to conduct Level II therapy must also apply for approval to conduct Level II therapeutic education and meet the requirements for both.

B. Individuals in Level II therapy shall be assigned treatment tracks in accordance with the ADDS program placement criteria or Department placement guidelines in the absence of the ADDS placement criteria. If a track has not been assigned by the ADDS program, the agency shall assign a track based on the Department's track guidelines. The Department track guidelines are as follows:

1. TRACK A. Individuals whose blood alcohol content was below the statutorily defined persistent drunk driving (PDD) level per Section 42- 1-102(68.5), C.R.S, and who have one offense for DUI/DWAI, BUI, or FUI. Track A is a minimum forty-two (42) face-to-face hours of group and/or individual Level II therapy conducted over twenty-one (21) or more 2. TRACK B. Individuals whose blood alcohol content was at or above the statutorily defined PDD level per Section 42-1-102(68.5), C.R.S., and who have one offense for DUI/DWAI, BUI, or FUI. Track B is a minimum of fifty-two (52) face-to-face hours of group and/or individual Level II therapy conducted over twenty-six (26) or more weeks.

3. TRACK C. Individuals whose blood alcohol content was below the statutorily defined PDD level per Section 42-1-102(68.5), C.R.S., and who have two or more offenses for DUI/DWAI, BUI, or FUI. Track C is a minimum of sixty-eight (68) face-to-face hours of group and/ individual Level II therapy conducted over thirty-four (34) or more weeks.

4. TRACK D. Individuals whose blood alcohol content was at or above the statutorily defined PDD level per Section 42-1- 102 (68.5), C.R.S., and who have two or more offenses for DUI/DWAI, BUI, or FUI. Track D is a minimum of eighty-six (86) face-to-face hours of group and/or individual Level II therapy conducted over forty-three (43) or more C. Level II therapy shall be conducted only after Level II therapeutic education has been completed unless there is documented assessment and clinical rationale.

D. Level II therapy group sessions (excluding enhanced or intensive outpatient) shall not be less than two (2) hours of therapeutic contact, and shall not include administrative procedures and breaks.

E. Individuals are expected to attend group one (1) time per week. Clinical rationale for any changes in frequency of group attendance (fewer or more) shall be documented, and must reflect at least one (1) session per month. Therapy hours attended shall be conducted over the minimum number of weeks associated with the therapy track assigned.

F. T he assessment shall be updated at the onset of Level II therapy.

G. Using the initial service plan as a basis, a revised service plan and subsequent reviews shall be developed for individuals in Level II therapy in accordance with Section 21.190.4. 21.240.82 DUI/DWAI Enhanced Outpatient THERAPY A. An agency licensed to provide DUI/DWAI services may qualify to provide enhanced outpatient therapy if it:

1. Is approved by the Department for Level II therapy;

2. Meets all the requirements in Sections 21.110 through 21.190, Sections 21.240.2, 21.240.3, and 21.240.5 and Section 21.240.81; and, 3. Demonstrates ability to provide eight (8) hours of scheduled treatment activities per week.

B. Level II DUI/DWAI enhanced outpatient therapy shall:

1. Be based on assessments;

2. Include a minimum of three (3) to maximum eight (8) hours of treatment activities;

3. Be conducted over a minimum of two (2) calendar days per week; and, 4. Not include Level II education.

C. DUI/DWAI enhanced outpatient services shall be in addition to any DUI/DWAI level or track D. Treatment activities shall be conducted for a minimum of ninety (90) calendar days.

E. Changes in frequency and intensity of Level II enhanced outpatient treatment shall be driven and based on treatment service plan reviews. 21.240.83 DUI/DWAI Intensive Outpatient THERAPY A. An agency licensed to provide DUI/DWAI services may qualify to provide DUI/DWAI intensive outpatient therapy if it:

1. Is approved by the Department for Level II therapy;

2. Meets all the requirements in Sections 21.110 through 21.190, Sections 21.240.2, 21.240.3, and 21.240.5, and Section 21.240.81; and, 3. Demonstrates ability to provide at least nine (9) hours of scheduled treatment activities B. DUI/DWAI intensive outpatient treatment therapy shall:

1. Be based on assessments;

2. Include a minimum of nine (9) hours of treatment activities;

3. Be conducted over a minimum of three (3) calendar days per week; and, 4. Not include Level II education.

C. DUI/DUI intensive outpatient services shall be in addition to any DUI/DWAI level or track D. The length of stay in level ii intensive outpatient shall be four (4) to six (6) weeks.

E. Any changes in frequency and intensity of Level II intensive outpatient treatment shall be based on assessments and service plan reviews. 21.240.84 Pa rtial Hospitalization, Clinically Managed Low Intensity Residential Services, Clinically Managed High Intensity Residential Services, and Medically Monitored Intensive Residential Treatment [Eff. 5/1/16]

A. Partial Hospitalization, Clinically Managed Low Intensity Residential Services, Clinically Managed High Intensity Residential Services, and Medically Monitored Intensive Residential Treatment may qualify to provide DUI/DWAI therapy if they:

1. Meet all requirements under specific level of care in Section 21.210.5;

2. Meet all requirements in Sections 21.240.2 and 21.240.3; and, 3. Are affiliated with the Department licensed outpatient DUI/DWAI programs.

B. In order for individuals to receive DUI/DWAI therapy credit for participation in Partial Hospitalization, Clinically Managed Low Intensity Residential Services, Clinically Managed High Intensity Residential Services, and Medically Monitored Intensive Residential Treatment, the assessed and identified DUI/DWAI treatment areas must be included in the individualized service 21.240.85 LEVEL II FOUR PLUS TREATMENT A. Level II Four Plus Treatment is an approved alcohol and drug driving safety education or treatment program as defined in Section 42-4-1301.3(3)(c)(IV) C.R.S. (2016), intended for someone who has four (4) or more alcohol and/or drug impaired driving offenses.

B. In order to provide Level II Four Plus Treatment an agency must be licensed to provide:

1. Level II Therapeutic Education; and, 2. Level II Therapy.

C. Level II Four Plus Treatment must consist of not less than eighteen (18) months of attendance which includes a minimum of one-hundred eighty (180) hours of treatment.

D. All Level II Four Plus Treatment shall be driven by the individual’s clinical assessment.

E. Level II Four Plus Staff Requirements 1. Staff providing Level II Four Plus Treatment must meet the requirements in Section 21.240.3(D), and:

a. CAS credentialed staff must be receiving clinical supervision or consultation by a CAS or LAC; or, b. Licensed staff must have at least one (1) year of documented addiction counseling experience.

2. Staff providing specialized treatment services must hold current and valid credentials and/or licensure in the area of service provision.

3. S taff providing assessment must hold current and valid credentials and/or licensure in the area of service provision.

F. Level II Four Plus Clinical Assessment(s)

1. A full assessment must be administered in accordance with section 21.190.3.

2. In addition to the requirements in Section 21.190.3(D), the assessment must contain information on:

a. Cognitive functioning;

b. Traumatic brain injury;

c. Adverse childhood experiences (ACES);

d. Grief and loss; and, e. Co-occurring mental health issues.

3. Agencies shall utilize an assessment tool specifically designed to address co-occurring mental health issues in the impaired driver population.

4. Agencies shall document results and coordinate further services as appropriate.

G. Level II Four Plus Service Planning and Reviews 1. Level II Four Plus service planning and reviews must be administered in accordance with

Section 21.190.4.

2. Agencies providing Level II Four Plus Treatment shall conduct service plan reviews at a minimum of every sixty (60) days in collaboration with supervising probation officers.

3. Consideration shall be given to clients’ needs for aftercare and peer recovery support H. Level II Four Plus Discharge Planning Level II Four Plus discharge planning must be administered in accordance with Section 21.190.6.

I. Provision of Level II Four Plus services shall:

1. Be determined by the results of the screenings and clinical assessment.

2. Be a combination of education and treatment strategies that include, but not limited to:

a. Individual counseling;

b. Group therapy, unless clinically contraindicated;

c. Family/other supportive adult therapy, if applicable;

d. Interlock counseling, if the individual has an ignition interlock installed;

e. DUI Level II Education or Level II Therapy, if applicable;

f. Education, if applicable;

g. Medication assisted treatment, if applicable;

h. Residential treatment, if applicable;

i. Other treatment as indicated by the initial and ongoing clinical assessment.

3. A gencies providing Level II Four Plus Treatment shall provide case management activities, where applicable, to ensure the coordination of client services and needs, and the continuity of care, with other services.

J. Testing and Monitoring 1. All clients shall be tested and/or monitored for alcohol and drug use. Testing and/or monitoring may include the following:

a. Urinalysis;

b. Breath analysis;

c. Continuous alcohol monitoring;

d. Mobile/remote breath testing;

e. Direct and indirect biomarker testing;

f. Drug and other testing as appropriate.

2. Agency drug and alcohol toxicology collection shall be observed by trained staff.

3. If testing is not done by the agency, there must be documentation of the efforts to obtain test results.

4. Testing and sharing of results shall be coordinated with probation. 21.240.9 DUI/DWAI BEHAVIORAL HEALTH SERVICES [Eff. 5/1/16]

Some behavioral health service contact hours and weeks may be included and reported as hours of Level II therapy. Credit for DUI/DWAI therapy hours may be given if the DUI/DWAI agency conducts a current comprehensive assessment and:

A. The assessment and service plan support the need for behavioral health services.

B. Supporting documentation that corresponds to requested hours and weeks of behavioral health services from the ancillary provider is requested and documented in the record.

C. A discharge DUI/DWAI referral summary is completed for the hours and weeks granted. 21.250 [Repealed eff. 10/01/2020]

21.260 ALCOHOL AND DRUG EMERGENCY COMMITMENTS

A. Emergency commitment policies and procedures, based on and in compliance with Sections 27- 81-111 and 27-82-107, C.R.S., and these rules, shall be developed and implemented by the licensed withdrawal management programs to:

1. A scertain if grounds for commitment exist;

2. Assure that individuals and their legal representatives receive copies of the application for emergency commitment forms and be advised verbally and in writing of the right to challenge commitment through the courts;

3. Determine when grounds for emergency commitment no longer exist.

B. The treatment facility administrator shall designate, in writing, qualified staff, who meet the criteria established in Section 21.210.914(B), to assume responsibility for accepting, evaluating, informing, and providing treatment to individuals on emergency commitment.

C. Applications for emergency commitments shall be prepared on Department designated forms.

D. Daily evaluations for emergency commitment continuance shall be documented.

E. If individuals on an emergency commitment require treatment in other licensed withdrawal management programs, transfers may be managed by the programs that initially authorized the commitments.

F. When transferring individuals, withdrawal management programs shall use Department designated transfer forms. Completed copies shall be given to:

1. Individuals or their legal representatives;

2. The withdrawal management programs to which individuals are being transferred.

G. When minors are transferred, parents or legal guardians who have given permission for treatment shall receive copies of transfer forms.

H. When it is determined grounds for emergency commitment no longer exists, the individual shall be transferred to voluntary status and the emergency commitment discontinued and documented.

A copy of the form shall be given to the individual and made part of the treatment record. 21.270 ALCOHOL AND DRUG INVOLUNTARY COMMITMENTS [Eff. 5/1/16]

A. All agencies funded by the Department or by a designated Managed Service Organization shall be licensed to treat individuals on involuntary commitment in accordance with this section.

B. Involuntary commitment policies and procedures shall be developed and implemented based on and in compliance with Sections 27-81-112 and 27-82-108, C.R.S.

C. The Department shall be the legal custodian of individuals involuntarily committed to treatment.

D. Passes shall be issued to individuals on involuntarily commitments in residential settings only if they are directly related to treatment. Passes shall not be issued during the initial thirty (30) days of treatment except in emergencies and with Department approval.

E. T he following information shall be reported to the Department:

1. Non-compliance with program requirements and/or court orders;

2. Failure to appear for admission to treatment;

3. Leaving treatment in violation of court orders;

4. Failure to return from passes;

5. Treatment status every thirty (30) days.

F. Discharge summaries, as outlined in Section 21.190.6 shall be submitted to the Department, the referring source, and to the referral treatment or aftercare agency.

G. Requests for early discharge and/or transfer to other treatment programs shall be submitted to the Department for approval.

21.270.1 STAFF REQUIREMENTS

A. Primary counselors for individuals on involuntary commitment shall:

1. Be Colorado certified addiction specialists; or, 2. Be Colorado licensed addiction counselors; or, 3. Possess a clinical master’s degree; and, 4. Complete fourteen (14) hours of training in interviewing techniques related to engaging individuals in treatment.

B. Copies of course certificates and other relevant documentation shall be retained in counselor personnel files.

21.280 CARE AND TREATMENT OF PERSONS WITH A MENTAL HEALTH DISORDER IN A

DESIGNATED FACILITY

21.280.1 DEFINITIONS

“Facility” for the purposes of this section means any facility designated by the Department pursuant to Title 27, Article 65, C.R.S.

“Facility or community based personnel” means:

A. A professional person;

B. A registered professional nurse as defined in Section 12-38-103 (11), C.R.S. who by reason of postgraduate education and additional nursing preparation has gained knowledge, judgment, and skill in psychiatric or mental health nursing;

C. A licensed marriage and family therapist, licensed professional counselor, or addiction counselor licensed under Part 5, 6, or 8 of Article 43 of Title 12, C.R.S., who by reason of postgraduate education and additional preparation has gained knowledge, judgment, and skill in psychiatric or clinical mental health therapy, forensic psychotherapy, or the evaluation of mental health disorders; or, D. A licensed clinical social worker licensed under the provisions of Part 4 of Article 43 of Title 12, “Involuntary Medication” means psychiatric medication administered without an individual's consent.

“Li censed Independent Practitioner” for the purposes of this section means a practitioner permitted by law and by the agency to provide care, treatment, or services, without direction or supervision, within the scope of the practitioner license and consistent with assigned clinical responsibilities.

“Placement facility” means a public or private facility that has a written agreement with a designated facility to provide care and treatment to any individual undergoing mental health evaluation or treatment by a designated facility. A placement facility may be a general hospital, nursing care facility, or licensed residential child care facility.

“Professional person” means a person licensed to practice medicine in Colorado, a psychologist certified to practice in Colorado, or a person licensed and in good standing to practice medicine in another state or a psychologist certified to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in Colorado that is operated by the armed forces of the United States, the United States Public Health Service, or the United States Department of Veterans Affairs.

“Psychiatric medication” is a medication being used to treat psychiatric illness for the patient including, but not limited to, anti-psychotics, antidepressants, and other medications that may have other medical uses but are accepted within the medical profession for psychiatric use as well. ecure Treatment Facility” for the purposes of these rules, means the Robert L. Hawkins High Security Forensic Institute at the Colorado Mental Health Institute at Pueblo.

“Therapy or treatments using special procedures” means a therapy that requires an additional, specific consent, including electro-therapy treatment (electro-convulsive therapy), and behavior modifications using physically painful, aversive, or noxious stimuli.

“Unduplicated” means an individual is counted only once, no matter how many specific services the individual received during the calendar year.

21.280.2 ORGANIZATIONAL PROVISIONS 21.280.21 Employment of Persons Receiving Services in Designated Facilities [Eff. 11/1/13]

A. All labor, employment or jobs involving facility operation and maintenance which are of an economic benefit to the facility, shall be treated as work and shall be compensated according to applicable minimum wage or certified wage rates.

B. Maintaining a minimum standard of cleanliness and personal hygiene and personal housekeeping, such as making one's bed or cleaning one's area, shall not be treated as work and shall not be compensated.

C. Individuals shall not be forced in any way to perform work.

D. Privileges or release from a designated facility shall not be conditioned upon the performance of work.

E. Vocational programs and training programs must comply with all applicable federal and state F. Vocational programs are not subject to the provisions in Section 21.280.21, A, unless the program is of economic benefit to the facility.

G. All work assignments, together with a specific consent form, and the hourly compensation received, shall be noted in the individual’s record.

21.280.22 E nvironment and Safety [Eff. 11/1/13]

A. All individuals being treated under these regulations shall receive such treatment in a clean and safe environment with opportunities for privacy.

B. A facility shall only place an individual in a bedroom with video monitoring due to good cause and safety or security reasons. Individuals shall be notified when placed in bedrooms with video monitoring capabilities.

C. Each facility shall maintain reasonable security capabilities to guard against the risk of unauthorized departures. The least restrictive method to prevent an unauthorized departure shall D. An unlocked facility may place an individual in seclusion to prevent an unauthorized departure when such departure carries an imminent risk of danger for the individual or for others. Under those circumstances, the seclusion procedures in Section 21.280.42, Use of Seclusion, shall be followed.

E. Seclusion rooms must be a minimum of 100 square feet. 21.280.23 Facility Designated Pursuant to Title 27, Article 65, C.R.S., Care and Treatment of Persons with Mental Illness Data Requirements A. Each facility designated by the Department, pursuant to Title 27, Article 65 C.R.S, shall file an annual report with the Department. The report shall be submitted in the format and timeframe required by the Department. This data shall include individuals being treated in placement agencies under the auspices of the designated facility.

B. For each designated facility, the annual report shall include the name, county, and address of the facility, as well as facility type as defined in 27-65-102(7), C.R.S.

C. The data report requirements shall include the following types of information as listed in 1 through 4:

1. Seventy-Two (72) Hour Treatment and Evaluation (Mental Health Holds)

The facility is required to maintain a data set sufficient to report the following aggregate numbers to the Department annually by July 1, for the most recent, complete calendar year covering January 1 through December 31:

a. The total number of unduplicated individuals, as defined in Section 21.280.1, who were on a seventy-two hour hold status, as well as:

1) Total number of unduplicated individuals by gender;

2) T otal number of unduplicated individuals by race and ethnicity;

3) Total number of unduplicated individuals by age; and, 4) Total number of unduplicated individuals by county of residence.

B. The total number of seventy-two hour holds, as well as, the total number of seventy-two hour holds grouped by:

1) Who initiated the seventy-two hour hold (each hold can only meet the a) Certified peace officer;

b) Court; or, C) Facility or community based personnel as defined in section 21.280.1.

2) The reason(s) for the seventy-two hour hold (each hold can meet the requirements of multiple categories listed below):

a) Dangerous to self;

b) Dangerous to others; or, c) Gravely disabled.

3) Disposition of the seventy-two hour hold (each hold can only meet the A) Released without need for further mental health services;

B) Referred for further mental health care and treatment on a voluntary basis;

C) Certified for treatment pursuant to 27-65-107, C.R.S.; or, D) Transferred to another designated facility while still on the seventy-two hour hold.

C. The total number of involuntary transportation holds, as defined in Section 21.281.1, received by the facility, as well as total numbers by outcome of the required screening, including at least:

1) Total number of involuntary transportation hold screenings resulting in the placement of a seventy-two hour hold;

2) Total number of involuntary transportation hold screenings resulting in a referral for further mental health care and treatment on a voluntary basis:

3) Total number of involuntary transportation hold screenings resulting in a release without need for further mental health services.

2. Short and Long-Term Certifications The facility is required to maintain a data set sufficient to report the following aggregate numbers to the Department annually by July 1, for the most recent, complete calendar year covering January 1 through December 31:

a. The total number of unduplicated individuals, as defined in Section 21.280.1, who were on a certification, as well as:

1) T otal number of unduplicated individuals by gender;

2) Total number of unduplicated individuals by race and ethnicity;

3) Total number of unduplicated individuals by age; and, 4) Total number of unduplicated individuals by county of residence.

B. The total number of certifications, as well as, the total number of certifications grouped by:

1) Type of certification (each certification can only meet the requirements of one category listed below):

a) Short-term;

b) Extended short-term;

c) Long-term; or, d) Extended long-term.

2) Reason for the certification (each certification can meet the requirements of multiple categories listed below):

a) Dangerous to self;

b) Dangerous to others; or, c) Gravely disabled.

3) Outcome of the certification (each certification can only meet the A) Released without need for further mental health services;

B) Referred for further mental health care and treatment on a voluntary basis; or, c) Certification extended; or, d) Certification transferred.

3. Voluntary Individuals The facility is required to maintain a data set sufficient to report the following aggregate numbers to the Department annually by July 1 for the most recent, complete calendar year covering January 1 through December 31, the total number of unduplicated individuals, as defined in Section 21.280.1, who accessed mental health treatment voluntarily pursuant to 27-65-103, C.R.S., as well as:

A. Total number of unduplicated individuals by gender;

B. Total number of unduplicated individuals by race and ethnicity;

C. Total number of unduplicated individuals by age; and, D. Total number of unduplicated individuals by county of residence.

4. Additional Reporting Requirements The facility is required to maintain data sets sufficient to report the following aggregate numbers to the Department annually by July 1 for the most recent, complete calendar year covering January 1 through December 31.

a. I nvoluntary Medications Total number of involuntary psychiatric medication procedures, including type of order:

1) Emergency; or, 2) Court-ordered.

b. Involuntary Treatments 1) Total number of restraint and/or seclusion episodes.

2) Total number by type of restraint.

3) Length of seclusion and/or restraint episode per individual.

c. Total number of electroconvulsive therapy procedures.

d. Imposition of Legal Disability or Deprivation of a Right Total Number of court orders for:

1) Imposition of Legal Disability; and, 2) Deprivation of a Right.

D. Pursuant to § 27-65-121, C.R.S., and HIPAA, as defined in Section 21.100, the facility must maintain confidentiality over the data sets. The reports generated from these data sets are also confidential; but the Department may release aggregated information contained in the reports so long as the total number of individuals in any aggregate data group (including county or facility name) is greater than thirty (30). If the total number in such a data group is less than or equal to thirty (30), the Department may release this information by redacting such number. 21.280.24 Staff Training Requirements [Eff. 11/1/13]

In addition to Section 21.160, facilities designated under these rules shall develop a training curriculum and schedule in order to meet the following requirements. Facilities may choose to use a certification of competency in lieu of training, and shall develop appropriate policies, procedures and testing to assure competency.

A. Al l staff participating in the provision of the care and treatment for individuals with mental health disorders shall receive annual training or annual facility certification of competency on the provisions of these rules and the requirements of Section 27-65-101, et seq., C.R.S.

B. All staff who administer involuntary medications shall receive annual training or annual facility certification of competency on Section 21.280 of these rules and the legal rationale underlying involuntary medication of individuals.

C. All direct care staff shall receive annual training or annual facility certification of competency in the recognition and response to common side effects of psychiatric medications. These staff shall be trained to respond to emergency drug reactions in accordance with the facility's policies.

D. All staff who administer restraint/seclusion techniques shall receive annual facility training or annual certification of competency on lower level behavioral interventions and Section 21.280.4 of E. All staff involved in the administration of the treatment program shall receive annual training or annual facility certification of competency on alternative or representative medical decision making, including, but not limited to advance directives, medical durable powers of attorney, and F. S pecific staff of placement facilities, as determined by the designated facility, shall receive annual facility training or annual certification of competency on the provisions of these rules and the requirements of Section 27-65-101, et seq., C.R.S. 21.280.25 Placement Facilities [Eff. 5/1/16]

A. Facilities designated for seventy-two (72) hour evaluation and treatment, short-term, and longterm treatment may provide mental health services directly or through the use of placement facility contract. Whenever a placement facility is used there must be a written agreement with the designated facility. In either case, the designated facility is responsible for assuring an appropriate treatment setting for each individual and services provided in accordance with these rules. Whenever a placement facility is used, the designated facility shall be responsible for the care provided by the placement facility.

B. All agreements between designated facilities and placement facilities and all supplemental agreements and amendments shall be submitted in writing to the Department no later than ten (10) business days after the effective date of the agreement or amendment.

C. Only the following Colorado licensed facilities are eligible to be a placement facility:

1. Nursing homes;

2. Residential Child Care Facilities providing mental health services;

3. Non-psychiatric hospitals providing in-patient medical services.

4. Alternative Care Facilities.

D. Emergency departments are not eligible to be, nor are considered placement facilities.

E. Whenever a designated facility uses a placement facility, the agreement shall include:

1. An a nnual training plan for placement facility staff that provides at a minimum training regarding mental health disorders, these rules, Title 27, Article 65, C.R.S., and appropriate, safe behavioral interventions. The implementation of the training plan shall be monitored by the designated facility;

2. A requirement that supervision of direct care staff be provided by professional persons licensed in Colorado to practice medicine or a certified Colorado psychologist employed by or under contract with the designated facility, or designated professional person licensed in Colorado to practice medicine or a certified Colorado psychologist employed by the placement facility to be responsible for direct care supervision provided that the placement facility and the designated facility are operated by the same corporate entity;

3. A requirement that assures the necessary availability and supervision of placement facility staff in order to carry out the contract; and, 4. A requirement that the placement facility adheres to these rules through the placement facility agreement.

F. Placement facilities agreements shall be executed and signed bi-annually when the designated facility submits its application for designation.

G. A placement facility can be used by a designated facility, at its discretion under the provisions of these regulations, in order to provide care to any individual undergoing mental health evaluation or treatment. Designated facilities shall not place individuals in a placement facility unless all of the applicable provisions of these rules are met and placement in such facility is appropriate to the clinical needs of the individual. When a placement facility is required, the least restrictive facility possible and available must be used, consistent with the clinical needs of the individual.

H. A placement facility shall not provide services beyond the scope of its license. 21.280.26 Individual Rights of Persons Receiving Evaluation Care or Treatment Pursuant to Title 27, Article 65, C.R.S. [Eff. 11/1/13]

A. Individuals shall be informed they have the same rights as any individual, except as limited by law. Among these are the rights to:

1. Receive services in the least restrictive setting, subject to available funding.

2. Have an individualized service plan and the right to participate in the development and subsequent changes.

3. Review the clinical record, as allowed by law.

4. Designate a representative(s) verbally or in writing, to represent the individual’s interests in matters related to grievances.

5. Have access to a representative within the designated facility who provides assistance to file a grievance.

6. Be informed by the designated facility that there will be no retaliation against an individual for exercising his or her rights.

B. Facilities shall post individual rights in prominent places frequented by individuals receiving C. For Individuals receiving treatment in facilities designated pursuant to Title 27, Article 65, C.R.S.:

1. The facility shall furnish all individuals receiving evaluation, care or treatment under any provisions of Title 27, Article 65, C.R.S., with a written copy of the rights listed under Subsection 21.280.26, C, 2 (translated into a language that the individual understands) upon admission. If the individual is not able to read the rights, the individual shall be read the rights in a language that s/he understands. These rules shall be interpreted by the Department in accordance with a standard of reasonableness.

2. T he facility shall post the following list of rights (in appropriate languages) in prominent places frequented by individuals and their families receiving services:

a. To receive and send sealed correspondence. No incoming or outgoing correspondence shall be opened, delayed, held or censored by the personnel of the facility;

b. To have access to letter writing materials, including postage, and to have staff members of the facility assist him/her if unable to write, prepare and mail correspondence;

c. To have reasonable and frequent access to a telephone, both to make and receive calls in privacy;

d. To have frequent and convenient opportunities to meet with visitors. The facility may not deny visits by the individual’s attorney, religious representative or physician at any reasonable time. The facility will provide privacy to maintain confidentiality of communication between an individual and spouse or significant other, family member(s), staff member(s), attorney, physician, certified public accountant and religious representative, except that if disclosure is required by law, then such privacy may be terminated;

e. To wear his or her own clothing, keep and use his/her own individual possessions within reason and keep and be allowed to spend a reasonable sum of his/her own money;

f. To refuse to take psychiatric medications, unless the individual is an imminent danger to self or others or the court has ordered administration of such g. To not be fingerprinted unless required by law;

h. To refuse to be photographed except for facility identification and the administrative purposes of the facility. Photographs and/or video recordings shall be confidential and shall not be released by the facility except pursuant to court order. No other non-medical photographs and/or video recordings shall be taken or used without appropriate consent or authorization (Section 27-65-117(4), C.R.S.).

i. F or individuals who are under certification for care and treatment, to receive twenty-four (24) hour notice before being transferred to another designated or placement facility unless an emergency exists, and the right to have the transferring facility notify someone chosen by the individual about the transfer;

j. To confidentiality of treatment records except as required by law;

k. To accept treatment voluntarily, unless reasonable grounds exist to believe the individual will not remain in treatment on this basis;

l. To receive medical and psychiatric care and treatment in the least restrictive treatment setting possible, suited to meet the individual's needs and subject to available resources;

m. To request to see his/her clinical record, to see the records at reasonable times, and if denied access, to be given the reason upon which the request was denied and have documentation of such placed in the individual record;

n. To retain and consult with an attorney at any reasonable time; and, o. Every individual who is eighteen (18) years of age or older shall be given the opportunity to exercise his/her right to vote in primary and general elections. The staff of the designated or placement facility shall assist each individual in obtaining voter registration forms and applications for absentee or mail ballots, and in complying with any other prerequisite for voting.

D. W ith every mental health hold (M-1) and petition to court for involuntary treatment resulting in a change of legal status, the facility shall advise an individual of his or her rights set forth in this

Section 21.280.26, and there shall be evidence of such advisement in the individual’s clinical E. Individual Rights Restrictions in Facilities Designated Pursuant to 27-65 1. As set forth in Section 27-65-117,C.R.S., an individual's statutory rights, Section 21.280.26, C, 2, a-e may be limited or denied for good cause by the Colorado licensed physician or psychologist who is providing treatment, as follows:

a. Except as otherwise provided in Section 21.280.26, E, 2, each denial of an individual's right shall be made on a case by case basis and the reason for denying the right shall be documented in the individual record and shall be made available, upon request, to the individual or his/her attorney.

b. Except as otherwise provided in Section 21.280.26, E, 2, restrictions on rights in

Section 21.280.26, C, 2, a-e, shall be evaluated for therapeutic necessity on an ongoing basis and the rationale for continuing the restriction shall be documented at least every seven (7) calendar days.

2. Secure Treatment Facilities A Colorado licensed physician or psychologist treating persons in a secure treatment facility may limit or deny rights for good cause based upon the safety and security needs of the staff and other individuals in the facility. Safety and security policies applicable to the unit shall be incorporated into the individual’s service plan. The following procedures shall be adhered to:

a. T he Department shall approve of safety and security policies for each facility unit that places any limit on the rights set forth in Section 21.280.26 as well as the policy and criteria for placement of an individual committed under Title 27, Article 65, C.R.S., in secure treatment facilities.

b. The safety and security policies for each facility unit shall be posted in the unit.

The secure facility staff shall provide a copy of the unit policy upon an individual’s c. Any good cause restriction of rights based upon the safety and security policy of the facility unit shall be noted in the individual’s record. The order for restriction shall be signed by the Colorado licensed physician or psychologist providing care and treatment, and shall be reviewed at least every thirty (30) days.

d. No safety or security policy may limit an individual's ability to send or receive sealed correspondence. However, to prevent the introduction of contraband into the secure treatment facility, the policy may provide that the individual open the correspondence in the presence of unit staff.

e. No safety or security policy may limit an individual’s right to see his or her attorney, clergy, or physician at reasonable times. However, the safety and security policy may provide that advance notice be given to the secure treatment facility for such visits so that the secure facility can adequately staff for the private visit, and take any measures necessary to ensure the safety of the visit.

f. F or the purposes of this rule, placement of individuals in secure treatment facilities on units that are locked at night:

1) Individuals transferred to a secure treatment facility from the Department of Corrections, who are serving a sentence in the Department of Corrections, may be placed on units in which the bedroom doors are locked during sleeping hours.

2) All other individuals who are newly admitted to a secure treatment facility may be placed on units in which the bedroom doors are locked during sleeping hours, for a time period not to exceed sixty (60) calendar days.

After sixty (60) calendar days, these individuals will not be placed on a unit with locked doors during sleeping hours unless an individualized assessment is made and the treatment team determines that the individual is imminently dangerous to him/herself or to others.

3) Sleeping hours shall begin no earlier than 9:00 p.m., end no later than 8:00 a.m., and shall not exceed 8-1/2 hours.

4) Individuals shall be provided an effective means of calling for assistance when in a locked room during sleeping hours. The secure treatment facility shall provide staff to promptly assist an individual with his or her individual needs including, but not limited to, staff assigned to a day hall where staff will be able to hear and respond to individuals who knock on their room doors. An intercom call system may also be used. Staff shall monitor each individual’s well-being through visual observation checks every fifteen (15) minutes.

F. As s et forth in Sections 27-65-104 and 27-65-127, C.R.S., an individual's rights may be limited or denied under court order by an imposition of legal disability or deprivation of a right.

G. Information pertaining to the denial of any right shall be made available, upon request, to the individual or his/her attorney.

21.280.3 MEDICAL AND MEDICATION TREATMENT PROVISIONS 21.280.31 Medical/Dental Care [Eff. 11/1/13]

A. Seventy-Two (72) Hour Treatment and Evaluation Facilities The facility shall ensure the availability of emergency medical care to meet the individual needs of each individual. The facility shall have and adhere to a written plan for providing emergency medical care to include at least:

1. A qualified licensed independent practitioner responsible for the completion of physical examinations within twenty-four (24) hours of admission.

2. The availability of a physician or access to an emergency medical facility on a twenty-four (24) hour, seven (7) days a week basis.

3. Emergency medical treatment, when indicated, shall be accessed immediately (within one hour) upon determination that an emergency exists.

4. Whenever indicated, an individual shall be referred to an appropriate specialist for either further assessment or treatment. The facility shall be responsible for securing an appropriate assessment to determine the need for further specialty consultation. This B. Short-Term and Long-Term Treatment Facilities The facility shall ensure the availability of medical care and emergency dental care to meet the individual needs of each individual. The facility shall have and adhere to a written plan for providing medical and emergency dental care to include at least:

1. A qualified licensed independent practitioner responsible for the completion of physical examinations within twenty-four (24) hours of admission. Subsequent physical examinations shall be completed annually. This information shall be included in the 2. The availability of a qualified licensed independent practitioner or emergency medical facility on a twenty-four (24) hour, seven (7) days a week basis.

3. Emergency medical treatment, when indicated, shall be accessed immediately (within one hour) upon determination that an emergency exists.

4. Whenever indicated, an individual shall be referred to an appropriate specialist for either further assessment or treatment. The facility shall be responsible for securing an appropriate assessment to determine the need for further specialty consultation. This 5. Ongoing appraisals of the general health of each individual, including need for immunizations in accordance with applicable state and federal law and need for corrective and assistive devices such as glasses, hearing aids, prostheses, dentures, walkers, etc. This information shall be contained in the clinical record.

C. T he obligation to ensure the availability of emergency medical services shall not be construed as the obligation to pay for such services; however, the facility shall secure these services regardless of source of payment. 21.280.32 Psychiatric Medications [Eff. 11/1/13]

A. In all instances where prescription psychiatric medications are to be ordered as a part of a mental health treatment program, the following information shall be provided to the individual and legal guardian(s). For children under the age of fifteen (15), the following information shall be provided to the child's parent(s) or legal guardian(s). When an individual has designated another to act concerning medication issues pursuant to a medical durable power of attorney, advanced directive, or proxy, the information shall be provided to that individual also.

1. The name(s) of the medication being prescribed.

2. The usual uses of the medication(s).

3. The reasons for ordering the medication(s) for this individual.

4. A description of the benefits expected.

5. The common side effects and common discomforts, if any.

6. The major risks, if any.

7. The probable consequences of not taking the medication(s).

8. Any significant harmful drug or alcohol interactions, or food interactions.

9. Appropriate treatment alternatives, if any.

10. That s/he may withdraw agreement to take the medication at any time.

B. The facility shall have policies and procedures for documenting in the clinical record that the required information was given to the individual, custodian, or guardian and consent obtained before administration of medication(s).

C. The provider with prescriptive authority or his/her designee shall offer to answer inquiries regarding the medication(s).

D. No individual shall be threatened with or subjected to adverse consequences by facility staff solely because of a failure to accept psychiatric medication voluntarily.

E. If an individual has established an advance directive concerning psychiatric medication and the advance directive is still in effect, the Colorado licensed physician or psychologist shall follow the directive unless contraindicated in a psychiatric emergency.

F. Prescribing, Handling, Administration of Psychiatric Medication(s)

All psychiatric medication(s) shall be administered on the written order of a physician or other professional authorized by statute to order such medications. Verbal medication orders may be given according to facility policies.

1. The facility shall have written policies and procedures regarding Section A, above, and a. Documentation of the administration of medication, medication variances/errors, and adverse medication reactions related to medication administration;

b. N otification to a physician or other professional authorized by statute to order such medications in case of medication errors and/or medication reactions/events;

c. Discontinuance of medication;

d. Disposal of medications; and, e. Acceptance of verbal, fax, or electronically transmitted medication orders.

2. The facility shall note in the individual clinical record all prescription medications administered to the individual by the facility including:

a. The name and dosage of medication;

b. The reason for ordering the medication;

c. The time, date and dosage when medication(s) is administered;

d. The name and credentials of the individual who administered the medication;

e. The name of the prescribing professional authorized by statute to order such medication; and, f. If the medication is administered as an emergency medication or a court-ordered 21.280.33 Involuntary Psychiatric Medications [Eff. 11/1/13]

These rules do not apply to refusal of non-psychiatric medications or medical emergencies. If an individual refuses medications intended to treat general medical conditions and that refusal is likely to cause or precipitates a medical emergency, those professionals who are authorized to order and administer medications may take action in accordance with generally accepted medical practice in an emergency situation. 21.280.34 Psychiatric Emergency Conditions [Eff. 11/1/13]

A. Individuals who are detained pursuant to Sections 27-65-105, 106, 107, 108 or 109, C.R.S., and refuse psychiatric medication may be administered psychiatric medication(s) ordered up to twenty-four (24) hours without consent under a psychiatric emergency condition.

B. An emergency condition exists if:

1. The individual is determined to be in imminent danger of harming herself/himself or others, as evidenced by symptoms which have in the past reliably predicted imminent dangerousness in that particular individual; or, 2. By a recent overt act, including, but not limited to, a credible threat of bodily harm, an assault on another individual or self-destructive behavior.

C. A r easonable attempt to obtain voluntary acceptance of psychiatric medication shall be made prior to the use of involuntary medication. 21.280.35 Continuation of a Psychiatric Emergency A. If the psychiatric emergency has abated because of the effect of psychiatric medications and the physician is of the opinion that psychiatric medication is necessary to keep the emergency in abeyance beyond seventy-two (72) hours, then within that seventy-two (72) hours the following steps shall be taken:

1. The facility shall send a written request for a court hearing for an order to administer the medication involuntarily; and, 2. A documented concurring consultation with another physician shall be obtained. The consultation shall include an examination of the individual and a review of the clinical record including an assessment as to whether the psychiatric emergency condition continues to exist.

3. If a concurring consultation is not obtained within seventy-two (72) hours, then emergency psychiatric medication shall be discontinued until such concurring consultation is obtained and documented, except in cases where life threatening consequences could result from an abrupt medication discontinuation. Under these circumstances, the individual shall be safely taken off the medication according to standards of medical practice, with corresponding clinical documentation.

4. In no ca se shall an individual receive emergency psychiatric medication(s) involuntarily for a period exceeding ten (10) days without an order from a court of competent jurisdiction, including continuation orders from the court.

5. The individual shall be notified of the right to contact his or her attorney and/or the court of competent jurisdiction at the time the written request for court-ordered medication is made. This notification shall be documented in the clinical record. If an individual chooses to exercise this right, the designated facility shall aid the individual if necessary, in accomplishing the foregoing.

B. The specific facts outlining behaviors supporting the finding of the emergency condition shall be detailed in the clinical record. Every twenty-four (24) hours thereafter until such time a final court order is issued, the emergency is resolved, or the individual accepts psychiatric medications voluntarily, the facility shall document the behaviors that substantiated the need to continue the emergency medication, and the physician shall reorder the psychiatric medications.

C. During the course of emergency medication administration, the individual shall be offered the medication on a voluntary basis each time the medication is given. If the individual voluntarily consents to take the medication(s), and the attending physician determines that the individual will likely continue to accept the medication on a voluntary basis and no longer requires involuntary medications, this shall be documented in the record and the involuntary medication procedures shall be terminated.

D. If the individual again refuses to voluntarily accept medication(s) and his or her clinical condition returns to an emergency situation as defined in Section 21.280.34, the emergency psychiatric medication procedures may be re-instituted. 21.280.36 Non-Emergency Involuntary Medications [Eff. 11/1/13]

A. In non-emergency situations in which an individual who is detained pursuant to Sections 27-65- 106, 107, 108, or 109, C.R.S., would benefit from the administration of a psychiatric medication, but the individual does not consent, the facility shall petition the court to obtain permission to administer such medication. The following conditions must be documented in the petition:

1. The individual is incompetent to effectively participate in the treatment decision;

2. Treatment by psychiatric medication is necessary to prevent a significant and likely longterm deterioration in the individual's mental condition or to prevent the likelihood of the individual causing serious harm to him/herself or others;

3. A less intrusive appropriate treatment alternative is not available; and, 4. The individual's need for treatment by psychiatric medication is sufficiently compelling to override any bona fide and legitimate interest of the individual in refusing treatment.

B. The petition shall specify what class or name of psychiatric medication is being recommended as potentially beneficial to the individual.

C. No ps ychiatric medications shall be administered without the individual's consent until a court order is received authorizing involuntary use, except under emergency conditions under Section 21.280.34. 21.280.37 Involuntary Medication Data [Eff. 11/1/13]

If the facility uses a medication administration record or another mechanism which meets the criteria listed in Section B, below, can correlate this information as required in Section C, below, and places the information in the clinical record, that mechanism may be used in lieu of a separate log.

A. The designated facility must maintain a log of all cases where involuntary medications were administered.

B. The record shall contain, at a minimum, the following:

1. Individual's name and identifying number.

2. Specified use of involuntary medication.

3. Physician or other professional authorized by law ordering involuntary medication.

4. Date/time each involuntary medication was administered.

5. Date/time involuntary medication was discontinued.

6. Reason for discontinuation of involuntary medication(s).

C. The facility shall have the ability to determine, at a minimum, the aggregate number of individuals receiving emergency and involuntary psychiatric medications during a specified period of time, the start and stop dates for each individual's involuntary medication treatment, and shall incorporate the use of this data into the quality improvement program.

21.280.4 SECLUSION, RESTRAINT, AND PHYSICAL MANAGEMENT FOR 27-65

DESIGNATED FACILITIES [Eff. 11/1/13]

The following rules covering seclusion and restraint apply to all areas of the designated facility including emergency departments and to placement facilities. If a facility is authorized to use physical management, restraint or seclusion at the facility, the facility shall use physical management, restraint or seclusion only in accordance with the following rules unless the specific rules prohibit, limit or modify the requirements placed upon the facility.

A. I ndividuals being detained under Sections 27-65-105 through 109, C.R.S., may be secluded or restrained over their objection under the conditions in Section 21.280.4; otherwise, there must be a signed informed consent for such an intervention as outlined in Section 21.280.5 of these rules.

B. These rules do not supersede any requirements under Section 26-20-101, et seq., C.R.S.

C. Staff shall ensure that no individual will harm or harass an individual who is secluded and/or restrained.

D. These measures may only be used in accordance with a service plan developed in consultation with and based on a written order by a Colorado licensed physician or psychologist. The service plan, which shall document if less restrictive measures were unsuccessful, shall be evaluated by a Colorado licensed physician or psychologist every twenty four (24) hours. 21.280.41 Definitions [Eff. 11/1/13]

“Mechanical Restraint” means a physical device used to involuntarily restrict the movement of an individual or the movement or normal function of a portion of his or her body. Types of mechanical restraints include, but are not limited to: restraint sheets, camisoles, belts attached to cuffs, leather armlets, restraint chairs, and shackles.

“Physical Management” means the physical action of placing one’s hands on an individual. Physical management may be used to gain physical control in order to protect the person or others from harm after all attempts to verbally direct or de-escalate the person have failed. Physical management may be utilized when an emergency situation exists. The physical management continuum may include:

A. Utilizing transitional measures.

B. Placing one’s hands on a person to physically guide and/or physically control the person.

C. Use of an approved restraint method to control or contain the person.

D. Placing of a person into an approved prolonged restraint method.

E. Physical management may be used to move or escort a person into seclusion. Seclusion, in itself, is not a form of physical management.

“Physical Restraint” means the use of bodily, physical force to involuntarily limit a person’s freedom of movement, except that “ physical restraint” does not include the holding of a child by one adult for the

purpose of calming or comforting the child.

“Seclusion” means the confinement of a person alone in a room from which egress is prevented.

Seclusion does not include the placement of persons, who are assigned to an intake unit in a secure treatment facility, in locked rooms during sleeping hours pursuant to Section 21.280.26.E thru G.

21.280.42 U se of Seclusion [Eff. 11/1/13]

A. Seclusion may be used only for the purpose of preventing imminent injury to self or others, or to eliminate prolonged and serious disruption of the treatment environment. Any time an individual is placed alone in a room and not allowed to leave, it shall be construed as seclusion.

B. An unlocked designated facility may place an individual in seclusion to prevent an unauthorized departure when such departure carries an imminent risk of dangerousness for the individual or for others. Under those circumstances, the seclusion procedures in this section shall be followed.

C. Any decision to seclude shall be based on a current clinical assessment, and may also be based on other reliable information including information that was used to support the decision to take the individual into custody for treatment and evaluation. The fact that an individual is being evaluated or treated under Sections 27-65-105 through 27-65-109, C.R.S., shall not be the sole justification for the use of seclusion.

D. Seclusion shall be used only when other less restrictive methods have failed. Documentation of less restrictive methods and the outcome shall be contained in the clinical record.

E. S eclusion rooms shall be lighted, clean, safe, and have a window for staff to observe.

F. Seclusion shall only be ordered by a Colorado licensed physician or psychologist.

G. Seclusion shall not be used for punishment, for the convenience of staff, or as a substitute for a program of care and treatment. 21.280.43 Use of Restraint [Eff. 11/1/13]

Restraint may be used in emergency circumstances, wherein the individual presents a serious, probable imminent threat of bodily harm and has the ability to affect such harm.

A. The decision to restrain shall be based on a current clinical assessment, and may also be based on other reliable information including information that was used to support the decision to take the individual into custody for treatment and evaluation. The fact that an individual is being evaluated or treated under Sections 27-65-105 through 27-65-109, C.R.S., shall not be the sole justification for the use of restraint.

B. Mechanical restraints may be used only for the purpose of preventing such bodily movement that is likely to result in imminent injury to self or others. Mechanical restraint shall not be used solely C. Restraint of a single limb is not permitted, unless court-ordered or approved by the superintendent and the executive body of the secure treatment facility, utilizing the assessment standards set forth in Section 26-20-101, et seq., C.R.S.; Section 21.280.43, A, of these rules; and the secure treatment facility’s policies.

D. Restraint of an individual by a chemical spray is not permissible.

E. The type of restraint shall be appropriate to the type of behavior to be controlled, the physical condition of the individual, the age of the individual and the type of effect restraint may have upon F. R estraint shall be applied only if alternative interventions have failed. Alternative interventions shall be documented in the clinical record; however, alternative techniques are not required if the alternatives would be ineffective or unsafe, when the individual is physically combative or actively assaultive or self-destructive.

G. Justification for immediate use of restraint shall be documented in the clinical record.

H. Restraint shall only be ordered by a Colorado licensed physician or psychologist.

I. Restraint shall not be used for punishment, for the convenience of staff, or as a substitute for a program of care and treatment.

J. Restraint does not include restraints used while the facility is engaged in transporting an individual from one facility or location to another facility or location within a facility when it is within the scope of that facility's powers and authority to effect such transportation pursuant to Section 26-20-101, et seq., C.R.S. 21.280.44 Explanation to Individual [Eff. 11/1/13]

In any situation, information shall be given to the individual, and guardian when applicable, as soon as possible after s/he has been secluded or restrained. The individual shall be given a clear explanation of the reasons for use of such intervention, the observation procedure, the desired effect, and the circumstances under which the procedure will be terminated. The fact that this explanation has been given to the individual shall be documented in the clinical record.

In an em ergency situation, information given to the individual pursuant to this rule regarding the desired effect and the circumstances under which the procedure(s) will be terminated may not be as detailed as in a non-emergency situation. However, as the individual's condition improves, staff shall promptly supplement the information given and this shall be documented in the clinical record. 21.280.45 Continued Use of Seclusion and/or Restraint [Eff. 11/1/13]

A. Staff shall document efforts to assure that the use of seclusion/restraint shall be as brief as B. If the seclusion/restraint episode goes beyond one (1) hour, a Colorado licensed physician or psychologist must provide an order. A verbal order, including telephone or other electronic orders, may be used if followed by a written order by the Colorado licensed physician or psychologist.

C. Seclusion and/or restraint shall not be ordered on an “ as needed” basis.

D. If the individual has not been examined by a Colorado licensed physician or psychologist within the previous twenty-four (24) hours, seclusion and/or restraint continued in excess of four (4) hours will require a face-to-face examination and a new written order by Colorado licensed physician or psychologist. If there has been a documented examination by a Colorado licensed physician or psychologist within the previous twenty-four (24) hours, seclusion/restraint continued in excess of fourteen (14) hours will require a face-to-face examination and a new written order by a Colorado licensed physician or psychologist prior to each succeeding twenty-four (24) hours of seclusion/restraint to assure that the need for these interventions is still present. The reasons for continuation shall be documented in the clinical record by the Colorado licensed physician or psychologist.

E. An episode of seclusion/restraint is terminated when the individual has been out of seclusion/restraint for a continuous period of two (2) hours.

F. C ontinued seclusion/restraint in excess of twenty-four (24) hours shall require an administrative review by the medical/clinical director of the facility or his/her designee, other than the Colorado licensed physician or psychologist in charge of treatment. The reviewer shall be an individual with the authority and knowledge necessary to review clinical information and reach a determination that the extension of a seclusion and/or restraint episode beyond twenty four (24) hours is G. If the reviewer does not concur with the order for continuation of seclusion/restraint, the order shall be discontinued and the professional person in charge of treatment shall be notified of such discontinuation.

H. An administrative review shall be initiated at the conclusion of each twenty four (24) hour period of continuous use of seclusion/restraint, and shall be completed prior to the expiration of each twenty four (24) hour period. 21.280.46 Chart Documentation for the Use of Seclusion and/or Restraint [Eff. 11/1/13]

A. A staff member shall record each use of seclusion and/or restraint and the clinical justification for the use in the individual's chart. The justification shall include:

1. The individual's specific behavior(s) and the nature of the danger;

2. D escribe attempts made to control the individual's behavior prior to using seclusion and/or restraint;

3. Describe the circumstances under which seclusion/restraint will be terminated and evidence that these criteria were given to the individual; and, 4. Notification to a Colorado licensed physician or psychologist within one (1) hour of the seclusion/restraint intervention.

B. Administrative review shall document the clinical justification for the continued use of seclusion/restraint in the individual's chart. The justification shall include:

1. Documentation that the professional person ordering the continuous use of seclusion/restraint in excess of twenty-four (24) hours has conducted a face-to-face evaluation of the individual within the previous twenty-four (24) hours.

2. Documentation of the ongoing behaviors or findings that warrant the continued use of seclusion/restraint and other assessment information as appropriate.

3. Documentation of a plan for ongoing efforts to actively address the behaviors that resulted in the use of seclusion/restraint.

4. A determination of the clinical appropriateness of the continuation of seclusion/restraint.

5. A summary of the information considered by the reviewer and the result of the administrative review with the date, time and signature of the individual completing the C. Information regarding use of seclusion/restraint shall be readily accessible to authorized individuals for review. Facilities shall have the ability to gather data as follows:

1. Each seclusion/restraint episode including date and time the episode started and ended, specific to each individual.

2. Aggregated data to include total number of individuals secluded/restrained and average length of time of the episodes over the period of one year. 21.280.47 Observation and Care [Eff. 11/1/13]

A. An individual who is in seclusion/restraint shall be observed in person by staff at least every fifteen (15) minutes, and such observation, along with the behavior of the individual, shall be recorded each time. Unless contraindicated by the individual's condition, such observation shall include efforts to interact personally with the individual.

B. O ngoing provisions shall be made for nursing care, hygiene, diet and motion of any restrained limbs. For individuals in mechanical restraints, the facility shall provide relief periods, except when the individual is sleeping, of at least ten (10) minutes as often as every two hours, so long as relief from the mechanical restraint is determined to be safe. Staff shall note in the record relief periods granted. The individual shall have access to food at least every four (4) hours and shall have access to fluids and toileting upon request or during relief periods, but at least every two (2) hours, unless sleeping.

C. Cameras and other electronic monitoring devices shall not replace the face-to-face observations.

D. An individual in physical restraint shall be released from such restraint within fifteen (15) minutes after the initiation of physical restraint, except when precluded for safety reasons pursuant to

Section 26-20-101, et seq., C.R.S.

E. To the extent that the duties specified in Section 26-20-101, et seq., C.R.S. are more protective of individual rights, the provisions 26-20-101, et seq., C.R.S. shall apply. 21.280.48 Facility Policies and Procedures for Seclusion/Restraint [Eff. 11/1/13]

The fa cility shall have and shall implement written policies and procedures that describe the situations in which the use of seclusion and/or restraint are considered appropriate within each specific program and the staff members who can order their use. The policies and procedures shall include the requirements in

Section 21.280.4 of these rules and Section 26-20-101, et seq., C.R.S.

In the event a facility does not authorize the use of seclusion and/or restraint of any type, the policy statement shall note the prohibition.

The policies and procedures shall include implementing administrative review including a process for terminating the seclusion and/or restraint episode when the reviewer does not concur with the order for continuation. If the reviewer is not a Colorado licensed physician or psychologist, then the order must be discontinued by a Colorado licensed physician or psychologist.

21.280.5 THERAPY OR TREATMENT USING SPECIAL PROCEDURES 21.280.51 Informed Consent [Eff. 11/1/13]

Therapies using stimuli such as electroconvulsive therapy (ECT), and behavior modifications using physically painful, aversive or noxious stimuli, require special procedures for consent and shall be governed by this rule.

A. Prior to the administration of a therapy listed above, written informed consent shall be obtained and documented in the clinical record reflecting agreement by both the individual being treated and his/her legal guardian, if one has been appointed or alternative decision maker if one exists.

If the individual undergoing treatment using special procedures is a child age sixteen (16) to eighteen (18), the clinical record shall reflect informed consent by both the child and his/her guardian(s).

B. In th e case of electroconvulsive therapy, a consent form prescribed by the Department shall be used and procedures set forth in Sections 13-20-401through 13-20-403, C.R.S., shall be followed. An informed consent means:

1. It is freely and knowingly given and expressed in writing.

2. That the following has been explained to the individual:

a. The reason for such treatment information;

b. The nature of the procedures to be used in such treatment, including their probable frequency and duration;

c. The probable degree and duration of improvement or remission expected with or without such treatment;

d. The nature, degree, duration, and probability of the side effects and significant risks of such treatment commonly known by the medical profession, the possible degree and duration of memory loss, the possibility of permanent irrevocable memory loss, and the remote possibility of death;

e. The reasonable alternative treatments, if any, and why the Colorado licensed physician or psychologist is recommending the specific treatment;

f. That the individual has the right to refuse or accept the proposed treatment and has the right to revoke his consent for any reason at any time, either orally or in writing;

g. T hat there is a difference of opinion within the medical profession on the use of some treatments;

h. An offer to answer any inquiries concerning the recommended special procedures; and, i. The number of treatments expected over a specified period of time to achieve maximum benefit.

3. The consent agreement entered into by the individual or other individual(s) shall not include exculpatory language through which the individual or other individual(s) is made to waive, or appear to waive, any of his/her legal rights, or to release the facility or any other party from liability for negligence.

4. Informed consent for the special procedure shall be renewed each time the maximum number of treatments is given or the specified amount of time has expired. No informed consent for special procedures shall be valid for more than thirty (30) days.

5. No one under the age of sixteen (16) shall undergo electroconvulsive treatment.

6. Electroconvulsive treatment requires a concurring consultation by a licensed psychiatrist prior to administration of the treatment. Such consultation shall be noted in the clinical 7. All provisions of Sections 13-20-401 through 13-20-403, C.R.S., shall be followed. 21.280.52 Involuntary Treatment Using Special Procedures [Eff. 11/1/13]

In the event the individual or the legal guardian refuses to or cannot consent, treatments referenced in

Section 21.280.51 using special procedures shall be administered only under the following circumstances:

A. W ith a prior court order for the treatments using special procedure; or, B. In an emergency in which the life of the individual is in imminent danger because of the individual's condition. In an emergency situation in which the individual is unable to grant informed consent and sufficient time does not exist to petition the court for an order prior to the administration of the specific therapy, the individual's physician, in consultation with the director of the facility or his/her designee, may, after careful and informed deliberation and under procedures adopted by the facility, order a special procedure without consent. 21.280.53 Documentation of Special Procedures [Eff. 11/1/13]

Along with the evidence of informed consent as delineated in this section, the reason for the use of any special procedure shall be fully documented in the individual’s record. The administration and outcome of such special procedure shall also be documented in the clinical record. 21.280.54 Procedures [Eff. 11/1/13]

Each designated facility shall adopt written procedures for administration of special procedures in accordance with these rules and applicable statutes. 21.280.6 CONTINUITY OF CARE [Eff. 11/1/13]

Each facility shall adopt and implement a written policy for continuity of care. The policy shall include at a minimum the following:

A. Access to all necessary care and services within the facility, and coordination with any other current mental health care providers or other systems of care or support as appropriate.

B. Coordination of care with the individual's previous mental health care providers or medical providers as appropriate, including retrieval of psychiatric and medical records.

C. Coordination of the individual's care with family members, guardians and other interested parties as appropriate and in a manner that reflects the individual's culture and ethnicity.

D. The facility is not responsible for providing non-psychiatric medical care under these rules, but shall facilitate access to proper medical care and shall be responsible for coordinating mental health treatment with medical treatment provided to the individual.

21.280.7 TRANSFER OF CARE AND TRANSPORTATION 21.280.71 Transfer of Care [Eff. 11/1/13]

A. The individual shall only be transferred to another designated or placement facility when adequate arrangements for care by the receiving facility have been made and documented in the clinical record. Transfer coordination shall include at least one discharge planning conference, face-to-face or by telephone, with participants from both facilities and the individual and his/her guardian, whenever possible.

B. At least twenty-four (24) hours advance notice of transfer shall be given to individuals under certification, unless knowingly waived in writing by the individual and guardian as appropriate, except in cases of a medical emergency. Notice of such transfer shall also be provided to the court of competent jurisdiction and the individual's attorney.

C. T he transferring facility shall ask the individual to indicate two (2) individuals to whom notification of transfer should be given and shall notify such individuals within twenty-four (24) hours of notification to the individual. Such notification shall be made by the transferring facility with the appropriate written authorization. Actions taken under this section shall be documented in the 21.280.72 Transportation [Eff. 11/1/13]

Whenever transportation of an individual is required, the treating staff of the facility shall assess the individual for dangerousness to self or others and potential for escape. Whenever clinically and safely appropriate, the individual may be transported by other means such as ambulance, care van, private vehicle, and restraints shall not be used, unless authorized as necessary by the treating physician. If the treating staff assesses the individual as dangerous to self or others or as an escape risk, the staff may request transportation by the local Sheriff's Department.

A. A request for transportation from the Sheriff's Department shall be filed with the court of appropriate jurisdiction and shall include:

1. Statements from the treating Colorado licensed physician or psychologist supporting the need for transportation by the Sheriff's Department;

2. R ecommendations concerning the use of mechanical restraints and the impact that handcuffs or shackles would have on the individual;

3. Recommendations for soft restraints, not handcuffs or shackles, if the findings of the assessment support the use of mechanical restraint;

4. Recommendations concerning the placement and management of the individual during the time s/he will be absent from the designated facility due to court hearings;

5. Recommendations of considerations for management of the individual based on the individual's age, physical abilities, culture, medical and psychiatric status and/or stability.

B. Notice of the request for transportation by the Sheriff's Department shall be given to the individual and his/her attorney at least twenty-four (24) hours prior to the time it is filed with the court. This notice shall not be required during the time a seventy-two hour hold is in effect or in an emergency situation with an individual under certification or when the individual signs a waiver which has been clearly explained.

C. Requesting transportation by the Sheriff's Department does not require a finding of dangerousness to self or others or an escape risk if the Sheriff's Department is willing to transport the individual without the use of mechanical restraints. 21.280.8 CERTIFICATION FOR TREATMENT ON AN OUTPATIENT BASIS [Eff. 11/1/13]

An individual who has been treated as an inpatient under a short-term or long-term certification for mental health treatment at a designated facility may be treated on an outpatient basis if the following conditions are met:

A. A C olorado licensed physician or psychologist who has evaluated the individual and who is on the staff of the designated facility which has been treating the individual, determines that while the individual continues to meet the requirements for certification, professional judgment is that with appropriate treatment modalities in place the individual is unlikely to act dangerously in the community.

B. Certification on an outpatient basis is the appropriate disposition suited to the individual's needs.

C. The designated facility that will hold the certification on an outpatient basis has documentation of the results of a recent physical examination.

D. Arrangements have been made for the individual to have access to:

1. Case management;

2. Medication management;

3. Essential food, clothing, shelter; and, 4. Medical care and emergency dental care.

E. The service plan shall reflect the outpatient certification status, the arrangements under D, 1-4, above, and meet the requirements in Sections 21.190.4 and 21.280.92 Service Planning.

F. Content of the individual’s outpatient record shall meet the requirements in Sections 21.190 and 21.280.9, Documentation in Individual Records. 21.280.81 Enforcement of Certification [Eff. 11/1/13]

A. If the individual on outpatient certification substantially fails to comply with the requirements specified in his/her service plan, the Colorado licensed physician or psychologist or staff of the designated facility that holds the certification, shall make reasonable efforts, including outreach, to obtain the individual's compliance with the plan. As part of these efforts, reasonable attempts shall be made to advise the individual that s/he may be picked up and taken into custody for appraisal of the individual's need for continued certification and ability to receive treatment on an outpatient basis.

B. If the designated facility's medical director or the treating Colorado licensed physician or psychologist reasonably believes that there is a significant risk of deterioration in the individual's condition or that the individual may pose a risk of harm to self or the community, and reasonable efforts to obtain the individual's compliance with the service plan have been unsuccessful, the medical director or the treating professional person shall make arrangements to have the individual transported to a designated facility or the emergency room of a hospital. The individual shall be assessed for current clinical needs and modifications made in legal status or treatment as necessary, including readmission to an inpatient facility.

C. T he individual shall not be physically forced to take prescribed psychiatric medication during this appraisal process, unless an emergency situation exists or the individual is court-ordered to do so as set forth in Section 21.280.33 through 21.280.36.

D. Following the assessment, if the individual is not detained, the facility holding the certification shall arrange transportation for the individual to return to the individual's residence or other reasonable location, if the individual so desires.

21.280.9 DOCUMENTATION IN INDIVIDUAL RECORDS 21.280.91 Assessment [Eff. 11/1/13]

Records shall include:

A. Assessment information in accordance with Section 21.190.3.

B. Evidence of ongoing assessment that at a minimum shall be included in the monthly service plan review process.

C. Evidence of an assessment update for continued certification every six months for individuals being treated under an outpatient certification or a long-term certification. 21.280.92 Service Planning Requirements [Eff. 11/1/13]

Service plans shall follow requirements in 21.190.4 (noting the exception in 21.280.92, G, below, of monthly service plan reviews), and:

A. The service plan shall contain specific criteria required for discharge from treatment or to progress to less restrictive treatment alternatives.

B. For individuals receiving care through outpatient certification, the plan shall assure the individual has access to medical and emergency dental care, case management, medication management, food, clothing, and shelter.

C. If an individual is discharged during a seventy-two (72) hour hold without certification by the facility, and a service plan has not been completed, then pertinent information shall be included in the discharge summary.

D. The facility shall appoint a clinical staff person to be responsible for the formulation, implementation, review, and revision of the service plan. The name of the responsible staff person shall be specified in the plan and that individual shall sign the plan. The plan shall also be signed by the treating Colorado licensed physician or psychologist, if he or she is not the responsible staff person.

E. A physician or other professional person authorized by law to prescribe the medications shall be responsible for the component of the plan requiring medication management services.

F. Service plans shall be readily identifiable and shall be maintained in a place readily accessible to treatment staff.

G. The service plan shall be reviewed, and revised if necessary, at least monthly by the staff person responsible for the plan, the treating Colorado licensed physician or psychologist, the individual and the legal guardian. This review shall be documented in the record and include progress toward meeting the criteria for termination of treatment and the need for continued involuntary treatment if the individual is certified. If the monthly review is delayed, the reason for such delay shall be noted in the record and the review shall be completed as promptly as possible.

21.280.93 T reatment Progress and Documentation Requirements [Eff. 11/1/13]

Records shall contain treatment progress notes per Section 21.190.5 and the following:

A. Documentation of all treatment procedures including, but not limited to: brief physical restraint, seclusion, mechanical restraint, medications voluntary and involuntary, and other therapies or interventions.

B. Information regarding the serious injury of or by the individual and the circumstances and outcome.

C. Documentation of all transfers and reasons for transfer.

D. Legal status and all legal documents related to treatment under Section 27-65-101, et seq., E. Consultations and/or case reviews.

F. Pertinent information from outside agencies or persons or from the individual.

G. Correspondence to and from relevant agencies and individuals.

H. Monthly documentation of the results of a Colorado licensed physician or psychologist’s review of certification, effectiveness of mental health treatment, legal status of the individual and considerations of less restrictive treatment alternatives.

I. Consent forms as appropriate for alternative treatments or voluntary treatment.

J. Use or non-use of advance directives. 21.280.94 Discharge Planning Requirements [Eff. 11/1/13]

A. Records shall include documentation that written information has been given to the individual upon discharge. This information shall include provision of Section 21.190.6, and:

1. If the individual is being transferred to another facility, information regarding that transfer and the facility shall be included.

2. Information if the discharge is being made against the advice of the treating Colorado licensed physician or psychologist.

B. Discharge Summary Records shall contain a discharge summary to include the provisions of Section 21.190.62 and the following information:

1. A summary of treatment received including: involuntary treatments, advance directives, progress made, and case management activities.

2. For transfers between facilities, documentation of appropriate clinical information and coordination of services between the two facilities, including mode of transportation.

21.281 INVOLUNTARY TRANSPORTATION FOR IMMEDIATE SCREENING

21.281.1 DEFINITIONS

“Facility” means any outpatient mental health facility or other clinically appropriate facility designated by the office of behavioral health as a seventy-two (72) hour treatment and evaluation facility that has walk-in capabilities and provides immediate screenings. If such a facility is not available, an emergency medical services facility, as defined in Section 27-65-102(5.5), C.R.S., may be used. mmediate screening” means the determination if an individual meets criteria for seventy-two (72) hour treatment and evaluation.

“Intervening professional” as defined in section 27-65-105(1)(a)(II), C.R.S., means a certified peace officer; a professional person; a registered professional nurse as defined in section 12-38-103(11), C.R.S. who by reason of postgraduate education and additional nursing preparation has gained knowledge, judgment, and skill in psychiatric or mental health nursing; a licensed marriage and family therapist, licensed professional counselor, or addiction counselor licensed under Part 5, 6, or 8 of Article 43 of Title 12, C.R.S., who by reason of postgraduate education and additional preparation has gained knowledge, judgment, and skill in psychiatric or clinical mental health therapy, forensic psychotherapy, or the evaluation of mental health disorders; or a licensed clinical social worker licensed under the provisions of

Part 4 of Article 43 of Title 12, C.R.S.

“Involuntary transportation form” means the report and application allowing for immediate transport of an individual, in need of an immediate screening for treatment, to a clinically appropriate facility.

“Involuntary transportation hold” means the ability to transport an individual in need of an immediate screening to determine if the individual meets criteria for seventy-two (72) hour treatment and evaluation.

Pursuant to Section 27-65-105(1)(a)(I.5), C.R.S., an intervening professional may involuntary transport an individual in need of an immediate screening from the community to an outpatient mental health facility or other clinically appropriate facility. The involuntary transportation hold does not extend or replace the timing or procedures related to a seventy-two (72) hour treatment and evaluation hold or an individual’s ability to voluntarily apply for mental health services.

21.281.2 PROCEDURE

A. An individual may be placed on an involuntary transportation hold pursuant to section 27-65- 105(1)(a)(I.5), C.R.S.

1. The involuntary transportation form shall be completed by an intervening professional and contain:

a. The circumstances under which the individual’s condition was called to the intervening professional’s attention;

b. The date and time the individual was placed on the involuntary transportation hold;

c. The name of the facility to which the individual will be transported; and, d. The signature of the intervening professional placing the involuntary 2. A copy of the involuntary transportation form must be given to the facility and made part of the individual’s medical record.

3. A copy of the involuntary transportation form must be given to the individual who was placed on the involuntary transportation hold.

B. The involuntary transportation hold expires:

1. Six (6) hours after it was placed; or, 2. Upon the facility receiving the individual for screening; thereby resolving the involuntary C. The facility shall ensure that the immediate screening is completed to determine if the individual meets criteria for seventy-two (72) hour treatment and evaluation and follow standard procedures pursuant to section 27-65-105(1)(A)(I), C.R.S.

21.282 EM

ERGENCY MEDICAL SERVICES FACILITY DATA REPORTING REQUIREMENTS

A. An emergency medical services facility, as defined in 27-65-102(5.5), C.R.S., providing care to an individual pursuant to Title 27, Article 65, C.R.S. is required to maintain a data set sufficient to report the following aggregate numbers to the Department annually pursuant to 27-65-105(7), C.R.S., in the format and timeframe required by the Department.

B. For each facility, the annual report shall include:

1. The name, county, and address of each facility site where the service was provided.

2. The total number of unduplicated individuals, as defined in Section 21.280.1, who had a seventy-two hour hold resolved (this includes release without need for further mental health services, or referral for voluntary treatment) at the facility, as well as:

A. Total number of unduplicated individuals by gender;

B. Total number of unduplicated individuals by race and ethnicity;

C. Total number of unduplicated individuals by age; and, D. Total number of unduplicated individuals by county of residence.

3. The total number of seventy-two hour holds transferred to a designated facility for continued involuntary services.

4. The total number of involuntary transportation holds, as defined in Section 21.281.1, received by the facility, as well as total numbers by outcome of the required screening, including at least:

A. Total number of involuntary transportation hold screenings resulting in the placement of a seventy-two hour hold;

B. Total number of involuntary transportation hold screenings resulting in a referral for further mental health care and treatment on a voluntary basis: and, C. Total number of involuntary transportation hold screenings resulting in a release without need for further mental health services.

5. The total number of seventy-two hour holds where the involuntary status was resolved at the facility, as well as, the total number of seventy-two hour holds where the involuntary status was resolved at the facility grouped by:

A. Who initiated the seventy-two hour hold (each hold can only meet the 1) Certified peace officer;

2) C ourt; or, 3) Facility or community based personnel as defined in Section 21.280.1.

B. The reason for the seventy-two hour hold (each hold can meet the requirements of multiple categories listed below):

1) Dangerous to self;

2) Dangerous to others; or, 3) Gravely disabled.

C. Disposition of the seventy-two hour hold (each hold can only meet the 1) Released without need for further mental health services; or, 2) Referred for further mental health care and treatment on a voluntary C. Process of data reporting 1. Facilities must submit their annual data report to the Department by July 1 of each year covering the most recent, complete calendar year covering January 1 through December 31. The report must meet the requirements in section 24-1-136(9), C.R.S.

2. The Department will annually request from the Department of Public Health and Environment a list of licensed facilities that may provide emergency services pursuant to Title 27, Article 65, C.R.S. the facility list shall include, but is not limited to: general hospitals; hospital units; psychiatric hospitals; and, community clinics.

3. If a facility on the list provided by the Department of Public Health and Environment does not report to the Department, the Department will contact the facility to confirm that the facility did not provide involuntary care to an individual pursuant to Title 27, Article 65, C.R.S. during the reporting cycle. If a facility is found to have provided involuntary care to an individual pursuant to Title 27, Article 65, C.R.S. and did not submit an annual report, an annual report will be requested. If a facility refuses to provide the statutorily required report, the Department may submit a complaint to the Office of the Ombudsperson for Behavioral Health Access to Care.

D. Pursuant to § 27-65-121, C.R.S. and HIPAA, as defined in Section 21.100, the facility must maintain confidentiality over the data sets. The reports generated from these data sets are also confidential; but the Department may release aggregated information contained in the reports so long as the total number of individuals in any aggregate data group (including county or facility name) is greater than thirty (30). If the total number in such a data group is less than or equal to thirty (30), the Department may release this information by redacting such number.

21.290 ACUT

E TREATMENT UNITS 21.290.1 DEFINITIONS [Eff. 11/1/13]

“Acute Treatment Unit” (ATU) means a facility or a distinct part of a facility for short-term psychiatric care, which may include substance use disorder treatment. An ATU provides a twenty-four (24) hour, therapeutically planned and professionally staffed environment for individuals who do not require inpatient hospitalization but need more intense and individualized services, such as crisis management and stabilization services, than are available on an outpatient basis. The average lengths of services are from three (3) to seven (7) days.

“Auxiliary Aid” means any device used by individuals to overcome a physical disability and includes, but is not limited to, a wheelchair, walker or orthopedic appliance.

“Bedridden” means an individual who is unable to ambulate or move about independently or with the assistance of an auxiliary aid, who also requires assistance in turning and repositioning in bed.

“Director” means an individual who is responsible for the overall operation and daily administration, management, and maintenance of the facility.

“Emergency Contact” means one of the individuals identified on the face sheet of the individual record to be contacted in the case of an emergency.

“F acility” means an acute treatment unit.

“Licensee” means the individual or entity to whom a license is issued by the Colorado Department of Public Health and Environment pursuant to Section 25-1.5-103(1)(a), C.R.S., and certification as a 27-65 designated facility has been granted by the Department to operate a facility within the definition herein “Medical or Nursing Care” means care provided under the direction of a physician and maintained by onsite nursing personnel.

“Owner” means the entity in whose name the license and designation is issued. The entity is responsible for the financial and contractual obligations of the facility. “Entity” means any corporation, Limited Liability Corporation, firm, partnership, or other legally formed body, however organized.

“Personal services” means those services that the director and employees of an acute treatment unit provide for each individual including, but not limited to:

A. An environment that is sanitary and safe from physical harm;

B. Assistance with transportation whether by providing transportation or assisting in making arrangements for the individual to obtain transportation; and, C. Assistance with activities of daily living.

“Protective Oversight” means guidance as required by the needs of the individual or legal representative or as reasonably requested by the individual including the following:

A. Being aware of an individual’s general whereabouts, although the individual may travel independently in the facility; and, B. Monitoring the activities of the individual on the premises to ensure the individual’s health, safety, and well-being, including monitoring the individual’s needs and ensuring that s/he receives the services and care necessary to protect health, safety, and well-being. hort-Term Psychiatric Care” means services that average from three to seven (3-7) days provided to individuals with mental health disorders in accordance with Title 27, Section 65, C.R.S. 21.290.2 DESIGNATION OF ACUTE TREATMENT UNITS [Eff. 11/1/13]

Facilities applying for designation as an acute treatment unit (ATU) must be in compliance with Section 21.280 and the requirements in the following Subsections 21.290.21 through 21.290.58. 21.290.21 Director Minimum Education, Training and Experience Requirements [Eff. 11/1/13]

Any individual serving as a director shall meet the minimum education, training, and experience requirements in one of the following ways:

A. The director shall have received a Bachelor’s degree from an accredited college or university and have three years of verified experience in the human services field, one of which was in a supervisory or administrative position; or, B. The director shall have received a Master’s degree from an accredited college or university and have two years of verified experience in the human services field, one of which was in a supervisory or administrative position.

C. Training in the following areas:

1. Individual rights;

2. Environment and fire safety, including emergency procedures and First Aid;

3. A ssessment skills;

4. Identifying and dealing with difficult situations and behavior management; and, 5. Nutrition. 21.290.22 Director Responsibilities [Eff. 11/1/13]

The director shall be responsible for the following:

A. Overall direction and responsibility for the individuals, program, facility, and fiscal management;

B. Overall direction and responsibility for supervision of staff;

C. The selection and training of a capable staff member who can assume responsibility for management of the facility in the director’s absence; and, D. The establishment of relationships and maintaining contact with allied agencies, services, and mental health resources within the community. 21.290.23 Assistant or Acting Director [Eff. 11/1/13]

A. In each facility, there shall be a specifically designated staff member, age twenty one (21) or over, capable of acting as a substitute for the director during his/her absence. The duties and responsibilities of the acting director shall be clearly defined in order to avoid confusion and conflict among other staff and individuals.

B. If the director is regularly absent from the facility more than fifty percent (50%) of his/her working hours, an assistant director shall be appointed who meets the same qualifications as the director found at Sections 21.290.21. 21.290.24 Administrative Coverage [Eff. 11/1/13]

When there is a change in director, or when the director has left the facility permanently without a replacement, the facility shall notify the Department in writing, within twenty four (24) hours. When a possible change in director is anticipated, the facility shall notify the Department prior to the change.

Either th e director or assistant or acting director shall be available at all times. 21.290.25 Clinical Director [Eff. 11/1/13]

A. The clinical director is responsible for assuring that there is adequate training and supervision for staff.

B. Qualifications of a Clinical Director 1. The clinical director shall possess a Master’s degree or Ph.D. in a mental health related field or a Bachelor’s degree in a mental health related field and five (5) years of work experience.

2. Additionally, the clinical director shall receive training on:

a. Individual rights;

b. Environment and fire safety, including emergency procedures and First Aid;

c. Assessment skills; and, d. Identifying and treating individuals who have received diagnoses from the most current diagnostic and statistical manual of mental disorders and who display behaviors that are common to people with severe and persistent mental health 21.290.3 PERSONNEL 21.290.31 Physical or Mental Impairment [Eff. 11/1/13]

Any individual who is physically or mentally unable to adequately and safely perform duties that are essential functions may not be assigned duties as a direct care staff member or volunteer at an ATU. 21.290.32 Alcohol or Substance Use [Eff. 11/1/13]

The facility shall not employ or allow any individual who is under the influence of a controlled substance, as defined in Sections 18-18-203, 18-18-204, 18-18-205, 18-18-206, and 18-18-207, C.R.S., or who is under the influence of alcohol in the workplace. This does not apply to employees using controlled substances under the direction of a physician and in accordance with their health care provider’s instructions, as long as it does not pose a safety risk to the employee, other employees, or individuals. 21.290.33 Access to Policies and Procedures [Eff. 11/1/13]

A. The facility shall have a written statement of personnel policies that include:

1. S alary range and provisions for increases;

2. Hours of work and holiday, vacation, sick and other applicable leave information;

3. Conditions of employment, tenure and promotion;

4. Employment benefits; including medical/dental/life insurance, workers compensation insurance, retirement plan, and any other available benefits;

5. Employee performance evaluation procedures;

6. Grievance procedures that may be used by staff; and, 7. Discipline and/or termination procedures.

B. A copy of the personnel policy shall be given to each staff member at the time of his/her employment. 21.290.34 Specialized Training Requirements for ATU [Eff. 11/1/13]

A. In addition to the personnel training standards in Sections 21.160 and 21.280.24 for designated facilities, prior to providing direct care, the facility shall provide training on:

1. First Aid and injury response;

2. The care and services for the current individuals; and, 3. The recognition and response to common side effects of psychiatric medications, and response to emergency drug reactions in accordance with facility policies.

B. Within one month of the date of hire, the facility shall provide training for staff on each of the following topics:

1. Assessment skills;

2. Infection control;

3. Behavior management and de-escalation techniques, to include incidents involving suicide, assault, or elopement.

4. Health emergency response; and, 5. Behavioral/psychiatric emergency response training. 21.290.35 Staffing Requirements [Eff. 11/1/13]

A. The facility shall employ sufficient staff to ensure that the provision of services meets the needs of individuals. The facility shall maintain at least a one to six (1:6) trained staff member(s) to individual resident ratio at all times.

B. In determining the staffing levels, the facility shall give consideration to factors including, but not 1. Services to meet the individuals’ needs; and, 2. Services to be provided under the individual service plan.

C. Each facility shall ensure that, at minimum, an individual qualified as described in Section 21.290.57 is available to administer medications at all times.

D. Residents of the facility may volunteer in performing housekeeping duties and other tasks suited to the individual’s abilities; however, these persons who provide services for the facility on a regular basis may not be included in the facility’s staffing plan in lieu of facility employees.

E. V olunteers may be utilized in the facility, but may not be included in the facility’s staffing plan in lieu of facility employees.

21.290.4 POLICIES AND PROCEDURES FOR ATU 21.290.41 Emergency Plan and Fire Escape Procedures [Eff. 11/1/13]

A. Emergency plan: The emergency plan shall include planned responses to fire, gas explosion, bomb threat, power outages, and tornado. Such plan shall include provisions for alternate housing in the event evacuation is necessary.

B. Fire escape procedures: The fire escape procedures shall include a diagram developed with local fire department officials which shall be posted in a conspicuous place.

C. Within three (3) days of admission, emergency procedures, including the plan and diagram of fire exits, shall be explained to each individual. 21.290.42 Serious Illness, Serious Injury, or Death [Eff. 11/1/13]

A. The policy shall describe the procedures to be followed by the facility in the event of serious illness, serious injury, or death of persons receiving services, including incident reporting B. The policy shall include a requirement that the facility notify an emergency contact when the individual’s injury or illness warrants medical treatment or face-to-face medical evaluation. In the case of an emergency room visit or unscheduled hospitalization, a facility must notify an emergency contact immediately. 21.290.43 Physical Health Assessment [Eff. 11/1/13]

The facility shall develop policies and procedures that identify when a physical health assessment by a qualified licensed independent practitioner will be required, including the following indicators:

A. Within twenty-four (24) hours of admission;

B. A significant change in the individual’s condition;

C. Evidence of possible infection (open sores, etc.);

D. Injury or accident sustained by the individual that might cause a change in the individual’s condition;

E. Known exposure of the individual to a communicable disease; or, F. Development of any condition that would have initially precluded admission to the facility. 21.290.44 Smoking [Eff. 11/1/13]

A. F acilities’ policies for smoking shall address individuals, staff, volunteers and visitors, and shall comply with applicable state laws and regulations.

B. Prior to admission or employment, individuals and staff shall be informed of any prohibitions. 21.290.45 Discharge [Eff. 11/1/13]

A. The facility's discharge policy shall include all of the following:

1. Circumstances and conditions under which the facility may require the individual to be involuntarily transferred or discharged;

2. An explanation of the notice requirements;

3. A description of the relocation assistance offered by the facility; and, 4. The right to call advocates, such as the Governor’s protection and advocacy for individuals with mental health disorders, the adult protection services of the appropriate county department of social or human services, and/or the Colorado Department of Human Services, Office of Behavioral Health.

B. Disclosure to Individuals Upon admission, the facility shall document that the individual or legal representative, as appropriate, has read or had explained the discharge policy. 21.290.46 Management of Personal Funds and Personal Property [Eff. 11/1/13]

The facility shall develop written policies that include the procedures for managing individual funds or property.

A. Upon admission, a written inventory of all personal belongings shall be conducted. This inventory shall be signed and reviewed by facility staff and the individual, and shall be maintained in the individual’s clinical record.

B. All inventoried items shall be stored in a secure location during the individual’s stay in the facility.

C. All inventoried property shall be returned to the individual upon discharge. The individual and facility staff shall sign the inventory form indicating that all items were returned.

21.290.5 ADMINISTRATIVE FUNCTIONS 21.290.51 Admissions [Eff. 11/1/13]

A. The facility shall develop written admission criteria based on the facility’s ability to meet the individual’s needs. Admission criteria shall be based upon a comprehensive pre-admission assessment of the individual’s mental health, physical health, substance use, and capacity for self- care. The assessment shall determine the level of intervention and supervision required, including medication management, behavioral health services and stabilization prior to return to the community.

B. Ac ute treatment units shall not admit individuals with a mental health disorder into a locked setting unless there is no less restrictive alternative and unless they are otherwise in compliance with the requirements of Title 27, Article 65, Colorado Revised Statutes.

C. Individuals may be admitted to a locked setting as a voluntary or involuntary individual. If voluntary, the individual shall sign a form that documents the following information:

1. The individual is aware that the facility is locked.

2. The individual may exit the facility with staff assistance and/or permission.

3. The individual may leave the facility at any point in time, unless he/she presents as a danger to self or others, or is gravely disabled as defined in Section 27-65-101, et seq., D. An individual who is imminently suicidal or homicidal shall only be admitted to the locked facility, upon completion of the facility’s assessment and the facility’s determination that the individual’s safety and the safety of others can be maintained by the facility. If an individual is admitted and facility staff determine that his/her behavior cannot be safely and successfully treated at the ATU, then staff shall make arrangements to transfer the individual to the nearest hospital for further assessment and disposition.

E. A fa cility shall not admit or keep any individual who meets the following exclusion criteria:

1. Is consistently incontinent unless the individual or staff is capable of preventing such incontinence from becoming a health hazard.

2. Is under the age of eighteen (18).

3. Is bedridden with limited potential for improvement.

4. Has a communicable disease or infection that is:

a. Reportable under the Department of Public Health and Environment's regulations (6 CCR 1009-1 and 2); and, b. Potentially transmittable in a facility, unless the individual is receiving medical or 5. Has acute withdrawal symptoms, is at risk of withdrawal symptoms, or is incapacitated due to a substance use disorder.

F. Facilities shall not admit an individual diagnosed with a developmental disability unless he/she has a mental health disorder and has been diagnosed using the most current diagnostic and statistical manual of mental disorders, and whose behaviors can be managed and/or modified by facility staff during the designated length of stay, and whose behaviors will not endanger the safety of the individual, staff or other individuals.

G. The facility shall maintain a current list of individuals and their assigned room. 21.290.52 Acknowledgements and Disclosures [Eff. 11/1/13]

There s hall be written evidence of consent to treat as outlined in Section 21.170.4 and the following upon admission to the individual or individual’s legal representative, as appropriate:

A. Acknowledgements shall specify the understanding between the parties regarding, at a minimum:

1. Charges;

2. Services included in the rates and charges;

3. Types of services provided by the facility, those services which are not provided, and 4. Transportation services;

5. Therapeutic diets;

6. A physically safe and sanitary environment;

7. Personal services;

8. Protective oversight;

9. Social and recreational activities; and, 10. A provision that the facility must give individuals thirty (30) calendar days’ notice of closure.

B. Disclosure to individuals shall include:

1. Management of personal funds and property;

2. Facility rules, established pursuant to Section 21.290.53;

3. Staffing levels based on individual needs;

4. Types of daily activities, including examples of such activities that will be provided. 21.290.53 Facility Rules [Eff. 11/1/13]

The facility shall establish written policies, which shall list all possible actions that may be taken by the facility if any policy is knowingly violated by an individual. Facility policies may not violate or contravene any rule herein, or in any way discourage or hinder an individual’s rights.

The facility shall prominently post its policies in writing, which shall be available at all times to individuals.

Such policies shall address at least the following:

A. Smoking;

B. Cooking;

C. Visitors;

D. Telephone usage including frequency and duration of calls;

E. Use of common areas, including the use of television, radio;

F. Consumption of alcohol and/or illicit drugs;

G. Dress;

H. Pets, which shall not be allowed in the facility; however, in no event shall such rules prohibit service or guide animals. 21.290.54 Content of Record [Eff. 11/1/13]

Records s hall include Section 21.190.2, Content of Records, and the following:

A. Demographic and medical information;

B. A cover sheet to contain the following information:

1. Individual’s full name, including maiden name if applicable;

2. Individual’s sex, date of birth, marital status and social security number, where needed for Medicaid or employment purposes;

3. Individual’s current address of residence;

4. Date of admission;

5. Name, address and telephone number of relatives or legal representative(s), or other individual(s) to be notified in an emergency;

6. Name, address and telephone number of individual’s primary physician, and case manager if applicable, and an indication of religious preference, if any, for use in 7. Individual’s diagnoses, at the time of admission;

8. Current record of the individual’s allergies;

C. Medication administration record;

D. Physician’s orders. 21.290.55 Service Planning [Eff. 11/1/13]

The facility shall develop and implement a written service plan in accordance with Section 21.190.4 and include the following:

A. An initial written safety and stabilization plan for each individual detailing risk issues and the stabilization process resulting in discharge shall be completed at the time of admission.

B. Within twenty four (24) hours of admission, an individualized service plan for each individual shall be written and shall include, but not be limited to:

1. Special dietary instructions, if any;

2. Any physical or cognitive limitations; and, 3. A description of the services which the facility will provide to meet the needs identified in the comprehensive assessment.

C. The individual may request a modification of the services identified in the service plan at any time.

D. The individual and his/her service plan shall be reassessed on an ongoing basis to address significant changes in the individual’s physical, behavioral, cognitive and functional condition, and identify the services that the facility shall provide to address the individual’s changing needs. The service plan shall be updated to reflect the results of the reassessment.

21.290.56 D ischarge [Eff. 11/1/13]

A. An individual shall be discharged for one or more of the following reasons:

1. When the facility cannot protect the individual from harming him or herself or others;

2. When the facility is no longer able to meet the individual’s identified needs;

3. When the individual is no longer in need of this level of care; or, 4. Failure of the individual to comply with facility rules, which contain notice that discharge may result from violation of same.

B. Notice of discharge shall be provided to the individual or individual’s legal representatives as follows:

1. At least twenty-four (24) hours in advance of discharge or transfer, in accordance with the rules governing the care and treatment of persons with a mental health disorder in Sections 21.280.7 and 21.280.8.

2. In cases of a medical or psychiatric emergency, the emergency contact shall be notified as soon as possible.

C. Discharge shall be coordinated with the individual, and, with permission, the individual’s family, legal representative, or appropriate agency. 21.290.57 Medication 21.290.571 Storage, Disposition, and Disposal [Eff. 11/1/13]

A. Storage and Disposition 1. All personal medication must be surrendered to the facility to be logged in and stored by the facility. Individuals are not allowed to self-administer medication in the facility.

2. Personal medication shall be returned to the individual or individual’s legal representative, upon discharge or death, except that return of medication to the individual may be withheld if specified in the individual’s service if a physician or other authorized medical practitioner has determined that the individual lacks the decisional capacity to possess or administer such medication safely.

3. Medications shall be labeled with the individual’s full name, pursuant to Article 42.5 of Title 12.

4. An y medication container that has a detached, excessively soiled or damaged label shall be returned to the issuing pharmacy for re-labeling or disposed of appropriately.

5. All medication shall be stored in a manner that ensures the safety of all individuals.

6. Medication shall be stored in a central location, including refrigerators, and shall be kept under lock and shall be stored in separate or compartmentalized packages, containers, or shelves for each individual in order to prevent intermingling of medication.

7. Individuals shall not have access to medication that is kept in a central location.

8. Medications that require refrigeration shall be stored separately in locked containers in the refrigerator. If medication is stored in a refrigerator dedicated to that purpose, and the refrigerator is in a locked room, then the medications do not need to be stored in locked containers.

9. Prescription and over the counter medication shall not be kept in stock or bulk quantities, unless such medication is administered by a licensed medical practitioner.

B. Disposal 1. The return of medication shall be documented by the facility.

2. Medication that has a specific expiration date shall not be administered after that date 21.290.572 Administration of Medication [Eff. 11/1/13]

Facilities shall follow psychiatric medication standards as outlined in Section 21.280.32 and the following:

A. To be qualified to administer medication, an individual shall be a licensed practical nurse, registered nurse, physician, physician’s assistant, or pharmacist.

B. Only a licensed nurse may accept telephone orders for medication from a physician or other authorized practitioner. All telephone orders shall be evidenced by a written and signed order and documented in the individual’s record and the facility’s medication administration record.

C. These rules apply to medications and treatment which do not conflict with state law and regulations pertaining to acute treatment units and which are within the scope of services provided by the facility, as outlined in the individual agreement or the facility rules.

D. The facility shall be responsible for complying with physician orders associated with the administration of medication or treatment. The facility shall implement a system that obtains clarification from the physician, as necessary and documents that the physician:

1. Has been asked whether refusal of the medication or treatment should result in physician notification.

2. Has been notified, where such notification is appropriate.

3. Has provided documentation of such notification shall be made in the individual’s clinical 4. C oordinates with external providers or accepts responsibility to perform the care using facility staff.

5. Trains staff regarding the parameters of the ordered care as appropriate.

6. Documents the delivery of the care, including refusal by the individual, of the medication or treatment. 21.290.58 Administration of Oxygen [Eff. 11/1/13]

Individuals may administer oxygen, if the individual is able to manage the administration himself or herself and staff shall assist with the administration as needed for safety, when prescribed by a physician and if the facility follows appropriate safety requirements regarding oxygen herein.

A. Oxygen tanks shall be secured upright at all times to prevent falling over and secured in a manner to prevent tanks from being dropped or from striking violently against each other.

B. Tank valves shall be closed except when in use.

C. Transferring oxygen from one container to another shall be conducted in a well-ventilated room with the door shut. Transfer shall be conducted by a trained staff member or by the individual for whom the oxygen is being transferred, if the individual is capable of performing this task safely.

When the transfer is being conducted, no individual, except for an individual conducting such transfer, shall be present in the room.

D. T anks and other oxygen containers shall not be exposed to electrical sparks, cigarettes or open flames.

E. Tanks shall not be placed against electrical panels or live electrical cords where the cylinder can become part of an electric circuit.

F. Tanks shall not be rolled on their side or dragged.

G. Smoking shall be prohibited in rooms where oxygen is used or stored. Rooms in which oxygen is used shall be posted with a conspicuous “ no smoking” sign.

H. Tanks shall not be stored near radiators or other heat sources. If stored outdoors, tanks shall be protected from weather extremes and damp ground to prevent corrosion.

21.400 BEHAVIORAL HEALTH CRISIS RESPONSE SYSTEM 21.400.1 DEFINITIONS [Eff. 11/1/16]

“Assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment and referral. Assessments establish justification for services.

“Chief complaint/presenting problem” means the reason/concern/motivation which prompts the client to seek services or that which their referral source identifies as the issue which requires intervention, usually in the person’s own words. Also includes, onset, duration, other symptoms noted, progression of the problem, solutions attempted at alleviating the problem, how the person’s life has been impacted and how the person views responsibility for the problem. This information can be from a referral source, family member or other professional. risis stabilization unit” or “ CSU” means a facility, utilizing a restrictive egress alert device, which serves individuals requiring 24-hour intensive behavioral health crisis intervention for up to five days and cannot be accommodated in a less restrictive environment. Crisis stabilization units are licensed by the Colorado department of public health and environment as an acute treatment unit, pursuant to 6 CCR 1011-1,

Chapter 6, or as a Community Clinic, pursuant to 6 CCR 1011-1, chapter 9.

“Integrated care model” means the systematic coordination of mental health, substance use, and primary care services.

“Licensed mental health professional” means a psychologist licensed pursuant to Section 12-43-301, et seq., C.R.S., a psychiatrist licensed pursuant to Section 12-36-101, et seq., C.R.S., a clinical social worker licensed pursuant to Section 12-43-401, et seq., C.R.S., a marriage and family therapist licensed pursuant to Section 12-43-501, a professional counselor licensed pursuant to Section 12-43-601, et seq., C.R.S., or an addiction counselor licensed pursuant to Section 12-43-801, et seq., C.R.S.

“Peer specialist,” or peer support specialist, recovery coach, peer and family recovery support specialist, peer mentor, family advocate or family systems navigator, means an individual who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings. A family advocate or family systems navigator uses his or her lived experience of having a family member with a mental illness or substance use disorder and the knowledge of the behavioral health care system gained through navigation and support of that family member. eer support” means recovery-oriented services provided by peer specialists that promote selfmanagement of psychiatric symptoms, relapse prevention, treatment choices, mutual support, enrichment, and rights protection. Peer support also provides social supports and a lifeline for individuals who have difficulties developing and maintaining relationships.

“Physician” is defined in Section 27-65-102(16), C.R.S.

“Restrictive egress alert device” means a device used to prevent the elopement of a resident who is at risk if he or she leaves the facility unsupervised. Egress alert devices are not considered restrictive when used only to alert staff regarding the ingress and egress of residents, visitors, and others.

“Screening” means a brief process used to identify current behavioral health needs, including assessment, referral, or immediate intervention services, and is typically documented through the use of a standardized instrument.

“Skilled professional” means a person who has a minimum of a master’s degree in a behavioral health field, has completed a pre-service training program specific to their modality of service and has clinical crisis intervention experience.

“Supervision” means weekly clinical guidance from a licensed mental health professional.

“Triage” means a dynamic process of evaluating and prioritizing the urgency of crisis intervention needed based on the nature and severity of the individuals’ presenting situation.

“Trauma informed” means being aware of and responsive to the presence of trauma and the potential effects of past and current traumatic experiences in an individual’s life.

“Warm line/support line” means a telephonic service where individuals can “opt in” from the statewide crisis line to receive individualized screening and resources by peer specialists.

21.400.2 G

ENERAL PROVISIONS [Eff. 11/1/16]

A. The Behavioral Health Crisis Response System is based on the following principles, established pursuant to Section 27-60-103(1)(a)(I) through (VII), C.R.S.:

1. Cultural competence;

2. Strong community relationships;

3. The use of peer supports;

4. The use of evidence based practices;

5. Building on existing foundations with an eye towards innovation;

6. Utilization of an integrated system of care; and, 7. Outreach to students through school-based clinics.

B. Each component within the behavioral health crisis response system must be capable of serving:

1. Children, adolescents, adults and older adults;

2. Individuals with co-occurring conditions; including:

a. Mental health conditions;

b. Substance use disorders;

c. Medical needs;

d. Intellectual/developmental disabilities;

e. Physical disabilities;

f. Traumatic brain injuries; and/or, g. Dementia.

3. Individuals demonstrating aggressive behavior;

4. Individuals who are uninsured or unable to pay for services; and, 5. Individuals who may lack Colorado residency or legal immigration status.

C. Each component within the Behavioral Health Crisis Response System must provide services in a culturally competent manner.

D. Each modality of service within the Behavioral Health Crisis Response System must incorporate peer support into the services they provide, when clinically appropriate. 21.400.3 TELEPHONE CRISIS SERVICES [Eff. 11/1/16]

The Department shall maintain a comprehensive telephonic system capable of assessing any individual experiencing a self-defined crisis situation and making appropriate referrals. Telephone crisis services must be accessible to all individuals throughout the state of Colorado 24 hours per day, 7 days per week, and 365 days per year.

A. The telephone crisis service must provide:

1. Screening and triage;

2. Psycho-social support;

3. Connection to appropriate resources;

4. Follow-up capability to callers as clinically appropriate; and, 5. Access to a support line (also known as a warm line) provided by peer specialists. Peer specialists must have the ability to seamlessly transfer individuals to the crisis line when urgent clinical intervention is warranted.

B. T he telephone crisis service must be staffed by skilled professionals capable of assessing and making culturally competent, appropriate referrals.

C. The telephone crisis service must use trauma-informed screenings and assessments and incorporate this information into safety planning, referrals and follow-up interventions.

D. The telephone crisis service must initiate mobile crisis services when appropriate and be linked with walk-in crisis service facilities. 21.400.4 WALK-IN CRISIS SERVICES [Eff. 11/1/16]

Walk-in crisis services facilities offer confidential, in-person support for anyone experiencing a selfdefined crisis. Every walk-in crisis services facility must have the ability to provide information and referrals to anyone in need, including, if appropriate, access and clinically appropriate transportation to crisis stabilization for up to five days in a crisis stabilization unit.

A. Each walk-in crisis services facility, including crisis stabilization units, must be designated pursuant to Title 27, Article 65, C.R.S., Care and Treatment of Persons with Mental Illness, and be in compliance with Section 21.280.

B. Walk-in crisis services must employ an integrated care model based on evidence-based practices that consider an individual’s physical and emotional health.

C. Walk-in crisis services must include screening, assessment, and referrals to appropriate resources.

1. Screening.

a. Screening must collect at least the following information from an individual seeking crisis services:

1) Identifying information;

2) Chief complaint/presenting problem;

3) Medical concerns/chronic health issues; and, 4) Current healthcare providers.

b. Screenings must be reviewed by a skilled professional who is licensed or 2. Assessment.

A full assessment must be administered in accordance with Section 21.190.3, if clinically indicated by the initial screening in Section 21.340.4(C)(1).

3. Referrals.

The facility shall refer all individuals seeking crisis services to appropriate resources based on the level of care indicated by the screening or assessment.

D. Crisis stabilization units 1. Services provided on a crisis stabilization unit must include:

a. Full psychiatric evaluation;

1) By a physician or other professional authorized by statute to order medications; and, 2) Within 24 hours of admission.

b. Medical and medication treatment in accordance with Section 21.280.3;

c. Service planning in accordance with Section 21.190.4;

d. Peer support, when clinically appropriate;

e. Treatment, to include:

1) Individual counseling; and/or, 2) Groups.

f. Coordination with medical services;

g. Case management;

h. Service coordination and referral; and, i. Discharge planning.

2. Crisis stabilization unit staffing requirements a. In addition to the walk-in crisis service staffing requirements listed in 21.400.41, crisis stabilization units must have:

1) Access to a physician or other professional authorized by statute to order medications upon admission; and, 2) At minimum, one on-site staff member qualified to administer medications. 21.400.41 Walk-In Crisis Services Staffing Requirements [Eff. 11/1/16]

A. A walk-in crisis services facility must be staffed 24 hours per day, 7 days per week, and 365 days per year.

B. A walk-in crisis services facility must employ sufficient staff to ensure that the provision of services meets the needs of individuals. At minimum, a facility must have two staff on-site at all times.

C. A walk-in crisis services facility must be staffed by skilled professionals who are licensed or D. If a walk-in crisis services facility is staffed by unlicensed skilled professionals, a licensed mental health professional must be on-call and able to respond to the facility within thirty (30) minutes.

E. A w alk-in crisis services facility must have the ability to provide peer support on-site when clinically appropriate. 21.400.5 MOBILE CRISIS SERVICES AND UNITS [Eff. 11/1/16]

Mobile crisis services provide a timely in-person response to a behavioral health crisis in the community.

Mobile crisis services must collaborate with telephone crisis services, walk-in crisis services, and crisis residential and in-home respite services.

A. A mobile crisis unit must have the capacity to:

1. Intervene wherever the crisis occurs;

2. Serve individuals unknown to the system;

3. Coordinate multiple simultaneous requests for services; and, 4. Work closely with police, crisis hotlines, schools, and hospital emergency departments;

B. A mobile crisis unit must operate 24 hours per day, 7 days per week, and 365 days per year in providing community-based crisis intervention, screening, assessment, and referrals to appropriate resources.

1. In screening the individual in crisis, the mobile crisis unit must collect at least the following information:

a. Identifying information;

b. Chief complaint/presenting problem;

c. Medical concerns/chronic health issues; and, d. Current healthcare providers.

2. The mobile crisis unit must administer a full assessment in accordance with Section 21.190.3 if clinically indicated by the initial screening in Section 21.400.5(C)(1).

C. A mobile crisis unit must be staffed by skilled professionals who are licensed themselves or D. If a mobile crisis staff member is an unlicensed skilled professional, he or she must have, at minimum, immediate phone access to a licensed mental health professional.

E. A mobile crisis unit must utilize peer supports, in conjunction with a skilled professional, in a mobile response when clinically appropriate. 21.400.6 RESIDENTIAL AND IN-HOME RESPITE CRISIS SERVICES [Eff. 11/1/16]

Residential an d in-home respite crisis services allow an individual experiencing a crisis to stabilize, resolve problems, and link with resources for ongoing support in a safe environment.

A. Residential and in-home respite services include a range of short-term, not to exceed 14 calendar days, services 24 hours per day, 7 days per week, and 365 days per year.

B. In order to be eligible for residential or in-home respite services, an individual experiencing a behavioral health crisis must:

1. Be referred by a walk-in crisis services professional or a mobile crisis services professional;

2. Agree to residential or in-home respite services;

3. Not meet emergency procedure criteria outlined in Section 27-65-105, C.R.S., Care and Treatment for Persons with Mental Illness;

4. Present a minimal risk of significant withdrawal complications;

5. Cooperate with program guidelines; and, 6. Be able and willing to participate in forming a service plan.

C. Residential and in-home respite providers will utilize peer specialists to provide support, when 21.410 COMMUNITY TRANSITION SPECIALIST PROGRAM A. Pursuant to Title 27, Article 66.5, C.R.S. the Community Transition Specialist Program is a statewide program that receives referrals from hospitals and withdrawal management facilities and coordinates services for individuals prior to their release or discharge to the community.

B. The Office is responsible for the administration and oversight of the Community Transition Specialist Program. Pursuant to § 27-66.5-103(5), C.R.S., the Office may contract with a vendor to provide the referral and coordination services required for statewide implementation of the Community Transition Specialist Program. The Office shall coordinate the vendor-provided services with other relevant state supported programs and services.

C. The Community Transition Specialist Program will coordinate services for individuals meeting the

section 27-66.5-102(3), C.R.S. definition of a “high-risk individual”. “High-risk individual” means a person who:

1. Is under:

A. An emergency procedure for a seventy-two-hour hold pursuant to section 27-65- 105, C.R.S.;

B. A certification for short-term treatment or extended short-term treatment pursuant to section 27-65-107, C.R.S. or section 27-65-108, C.R.S.;

C. Long -term care and treatment pursuant to section 27-65-109, C.R.S.;

D. An emergency commitment pursuant to section 27-81-111, C.R.S. or section 27- 82-107, C.R.S.; or, E. An involuntary commitment pursuant to section 27-81-112, C.R.S. or section 27- 82-108, C.R.S.;

2. Has a significant mental health or substance use disorder, which means:

A. The individual has had two (2) or more seventy-two hour holds or emergency commitments in the previous twelve (12) months;

B. The individual has been certified for short-term treatment pursuant to section 27- 65-107, C.R.S., certified for extended short-term treatment pursuant to section 27-65-108, C.R.S. or, ordered for long-term care and treatment pursuant to

section 27-65-109, C.R.S. one (1) or more times in the previous twelve (12) months; or, C. The individual has been arrested or detained two (2) or more times related to an alcohol or substance use disorder in the last twelve (12) months and does not have a probation or parole officer; and, 3. Is not currently engaged in consistent behavioral health treatment, which means the individual has not received any local or available outpatient behavioral health treatment services in the last forty-five (45) calendar days or has been terminated from outpatient behavioral health services within the last forty-five (45) calendar days. Outpatient behavioral health treatment services do not include crisis services, emergency care, withdrawal management services, initial intake appointments, assessments, or inpatient 21.500 RECOVERY RESIDENCE CERTIFICATION PROGRAM 21.500.1 STATUTORY AUTHORITY The statutory authority to promulgate these rules is set forth in Sections 25-1.5-108.5(4), C.R.S. and 27- 80-122(4), C.R.S.

21.500.2 DEFINITIONS

“Recovery residence certifying body” means an entity that has been approved by the office of behavioral health to certify recovery residences pursuant to 25-1.5-108.5, C.R.S.

“Recovery residence”, “sober living facility”, or “ sober home” as defined in 25-1.5-108.5(1), C.R.S., means any premises, place, facility, or building that provides housing accommodation for individuals with a primary diagnosis of a substance use disorder that: is free from alcohol and nonprescribed or illicit drugs; promotes independent living and life skill development; and provides structured activities and recovery support services that are primarily intended to promote recovery from substance use disorders. A “recovery residence” does not include: a private residence in which an individual related to the owner of the residence by blood, adoption, or marriage is required to abstain from substance use or receive behavioral health services for a substance use disorder as a condition of residing in the residence; the supportive residential community for individuals who are homeless operated under Section 24-32-724, C.R.S. at the Fort Lyon property for the purpose of providing substance abuse supportive services, medical care, job training, and skill development for the residents; a facility approved for residential treatment by the office of behavioral health in the department of human services; or permanent supportive housing units incorporated into affordable housing developments. he NARR Standard” means the National Standard for Recovery Residences Version 3.0 (2018) established by the National Alliance of Recovery Residences, which is hereby incorporated by reference.

No later additions or amendments are incorporated. The National Standard for Recovery Residences Version 3.0 (2018) is available at https://narronline.org and is also available for public inspection at the Colorado Department of Human Services, Office of Behavioral Health, 3824 West Princeton Circle, Denver, Colorado 80236, during regular business hours.

21.500.3 RECOVERY RESIDENCE CERTIFYING BODY APPROVAL PROGRAM

A. Recovery residence certifying body obligations prior to approval 1. A recovery residence certifying body applicant must submit an application to the office of behavioral health for approval as a recovery residence certifying body. The application must contain information on how the recovery residence certifying body applicant will meet the standards established in Section 21.500.3(B).

B. Recovery residence certifying body obligations after approval 1. A recovery residence certifying body must ensure that any premises, place, facility, or building they certify meets minimum standards that provide safe and healthy housing environments that support individuals in achieving and sustaining substance use disorder recovery.

2. A recovery residence certifying body must ensure that each recovery residence that it certifies in Colorado, complies with The NARR Standard as defined in 21.500.2 for providing the appropriate level of support and housing accommodations for individuals with a primary diagnosis of a substance use disorder.

3. A recovery residence certifying body must ensure recovery residences comply with the standards established in 25-1.5-108.5, C.R.S.

4. A recovery residence certifying body must have written policies and procedures that must be posted on the recovery residence certifying body’s website. At minimum, the written policies and procedures must include:

a. The certification process;

b. Application submission requirements, including the cost for certification;

c. How certification fees relate to service delivery and how recovery residences are informed about changes to certification fees;

d. The application review process;

e. The approval, revocation, denial, suspension, limitation, or modification process for certification;

f. The right and process to appeal decisions made by the recovery residence certifying body;

g. Re-a pplication timeframes; and, h. How grievances will be managed.

5. A recovery residence certifying body must maintain a website that contains, at minimum:

a. Information on how a recovery residence can apply for certification, as outlined in 21.500.3(b)(3);

b. The standards a recovery residence must meet to obtain differing levels of certification as defined by The NARR Standard as defined in 21.500.2, including the cost of certification for each level.

c. Board information as outlined in 21.500.3(B)(5);

d. Contact information for how individuals can submit a grievance to the recovery residence certifying body; and, e. A list of certified recovery residences to ensure people throughout Colorado have access to information and locations of certified recovery residences; and, f. The written policies and procedures outlined in 21.500.3(B)(3).

6. A recovery residence certifying body must have a board that has approval oversight of the recovery residence certifying body’s practices, policies, and procedures. At minimum, the recovery residence certifying body must ensure:

a. A representative from the office of behavioral health is on the board;

b. A minimum of twenty-five percent (25%) of board members must represent recovery residences that are certified and do not otherwise have a conflict of interest with the certifying body;

c. The board includes at least two board members that represent individuals in recovery. The representatives for individuals in recovery must not own, volunteer at, or be employed by the recovery residence certifying body or a certified recovery residence;

d. That board members disclose any potential conflict of interest and have standards for how a conflict of interest is acknowledged, determined, and reconciled in regard to the execution of board duties;

e. That board meetings are open to the public, except as to the portion of the meeting that information that is confidential pursuant to state or federal statute is being discussed; and, f. That board information is publicly posted on the recovery residence certifying body’s website, including:

1) A l ist of board members, each board member’s representative role on the board, and each board member’s term limit;

2) The board member application and selection process;

3) Board bylaws;

4) Board meeting dates, times, and locations posted at least one (1) week prior to the board meeting; and, 5) Board agendas and minutes.

7. On or before February 1, of each year, a recovery residence certifying body must submit an annual report to the Office of Behavioral Health that covers the previous calendar year. At minimum, the annual report must include:

a. The total number of recovery residences certified in Colorado, as of the previous January 1.

b. The percentage of certified recovery residences which are also members of the approved recovery residence certifying body’s association;

c. The total number of recovery residences which applied for certification in the previous calendar year;

d. The total number of recovery residences which applied for certification and were granted certification;

e. The total number of recovery residences which applied for certification and were denied certification, including the reason(s) why each recovery residence was denied;

f. The total number of recovery residences which certification was revoked, denied, suspended, or modified, including the reason(s) for the certification change;

g. The total number of grievances received, including the topic and outcome of each grievance;

h. Increases or decreases in certification fees, including justification for each fee change; and, i. Any changes to the makeup, structure, and/or duties of the certifying body’s board.

C. An approval from the Office of Behavioral Health as a recovery residence certifying body is not time limited, with the exception that at the Office of Behavioral Health’s discretion, an approval as a recovery residence certifying body may be revoked, denied, suspended, or modified. Written notification of the basis for action must be sent by certified mail to the last known address of the recovery residence certifying body. If the affected recovery residence certifying body disagrees with the decision, it has the right to appeal to the Colorado Department of Personnel and Administration, Office of Administrative Courts in accordance with the regulations set forth at 2 CCR 502-1 § 21.105, except that the time for answering the notice of charges will be thirty (30) days after the mailing of such notice. An affected recovery residence certifying body may subsequently seek judicial review of the Office of Behavioral Health’s action in accordance with

Section 24-4-101, et seq., C.R.S.

21.500.4 R

ECOVERY RESIDENCE CERTIFICATION GRANT PROGRAM

Subject to available appropriations as established in 27-80-122(3), C.R.S., a recovery residence may be eligible for a grant from the Office of Behavioral Health to pay a portion of, or all, application for certification and/or membership fees and/or dues required by a recovery residence certifying body.

21.500.41 RECOVERY RESIDENCE CERTIFICATION GRANT PROGRAM CRITERIA

A. A recovery residence seeking a recovery residence certification grant must complete, in its entirety, the recovery residence certification grant application available on the Colorado Department of Human Services website.

B. A recovery residence certification grant must only be used to pay fees related to gaining certification and/or membership from a recovery residence certifying body, which may include the payment of membership dues.

C. A recovery residence certification grant application must be submitted to the Office of Behavioral Health by the last business day of each month.

D. Recovery residence certification grant applications received by the Office of Behavioral Health within the time frame established in 21.500.41(C), must be reviewed by the Office of Behavioral Health to determine approval or denial. Grants will be awarded in alignment with state fiscal rules created pursuant to 24-30-202, C.R.S.

E. R ecovery residence certification grant applications that are not complete, contain inaccurate or false information, or express intent to use the recovery residence certification grant money in a manner that does not comply with state statutes or regulations, may be denied.

F. A recovery residence which previously received a recovery residence certification grant must submit a new application each time they are seeking another recovery residence certification grant.

G. A recovery residence which applies for a recovery residence certification grant must provide the office of behavioral health with documentation of the paid certification fees and/or membership dues from the approved recovery residence certifying body. A recovery residence that does not provide the required documentation may have their current or any subsequent recovery residence certification grant applications denied.

H. The Office of Behavioral Health’s decision regarding the recovery residence certification grant application is a final agency decision. If the affected recovery residence disagrees with the final agency decision, it may seek judicial review of the Office of Behavioral Health’s action in accordance with Section 24-4-101, et seq., C.R.S.

21.700 (NONE) _________________________________________________________________________

Editor’s Notes

History Rules SB&P, 19.500 eff. 11/01/2007.

Rules SB&P, 19.421.3 eff. 09/01/2013.

Entire rule eff. 11/01/2013.

Rules SB&P, 21.900-21.950 emer. rules eff. 11/06/2015.

Rules SB&P, 21.900-21.950 eff. 02/01/2016.

Rules SB&P, 21.000-21.120.35, 21.190-21.210.59, 21.230-21.280.25, 21.330-21.330.2 eff. 05/01/2016.

Rules SB&P, 21.120.3-21.120.31, 21.400 eff. 11/01/2016.

Rules 21. 240.1, 21.240.85 eff. 07/01/2017.

Rule 21.281 eff. 06/01/2018.

Rules 21.100, 21.120.36 eff. 08/01/2018.

Rules 21.160.2 A.3, 21.200.53 K.1 emer. rules eff. 08/03/2018.

Rules 21.160.2 A.3, 21.200.53 K.1 emer. rules eff. 11/02/2018.

Rules 21.100, 21.120.1 G, 21.120.24 A, 21.120.24 C-F, 21.120.42 A-G, 21.140 A.2, 21.170.1 A, 21.170.3 A, 21.200.53 K.6, 21.210.1 E.1.a, 21.210.2 A.1-2, 21.210.43 A, 21.210.51 D, 21.210.52 C, 21.210.53 C, 21.210.54 D, 21.210.55, 21.210.56 I, 21.210.57 G, 21.210.58 D, 21.210.59, 21.230.1 D, 21.240.5 F, 21.240.6 A, 21.240.82 B.5, 21.240.83 B, 21.280.1, 21.280.23, 21.282, 21.410 eff. 01/01/2019.

Rules 21.160.2 A.3, 21.200.53 K.1, 21.200.4 eff.02/01/2019.

Rules 21.160.1 A.4, 21.250.5 C, 21.260 B, 21.500 eff. 12/01/2019.

Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.26 D, 21.120.4 D-E, 21.120.42 E, 21.170.4, 21.200.13 B, 21.200.4, 21.200.41, 21.240.1, 21.280.35 A.4, 21.300.22 C, 21.300.23 D, 21.200.5, 21.320.31 A.5 emer. rules eff. 04/03/2020.

Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.26, 21.120.4 D-E, 21.120.42 E, 21.170.4, 21.200.13 B, 21.200.4, 21.200.41, 21.240.1, 21.280.35 A.4, 21.300.22 C, 21.300.23 D, 21.200.5, 21.320.31 A.5 eff. 08/01/2020.

Rules 21.100, 21.210, 21.210.1 A-E, 21.210.43-21.210.924, 21.260 B eff. 10/01/2020. Rules 21.250, 21.310 repealed eff. 10/01/2020.

Rules 21.

300.1, 21.300.2, 21.300.21-21.300.23, 21.300.24 A.2, 21.300.3 A, 21.300.3 C, 21.300.3 I-J,

21.300.6, 21.300.7, 21.300.8 A, 21.320, 21.320.1, 21.320.2, 21.320.31, 21.320.32, 21.320.41,

21.320.42 D, 21.320.5, 21.320.61, 21.320.62, 21.320.63 A, 21.320.63 B.2, 21.320.7, 21.320.81, 21.320.9 eff. 03/02/2021.

Rules 21.100, 21.210.1 C, 21.240.3 D, 21.240.85 E, 21.270.1 A, 21.330-21.331.3 eff. 04/01/2021. Rules 21.330.3-21.330.92 repealed eff. 04/01/2021.

Rules 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.4 D-e, 21.120.42 E, 21.240.1 emer. rules eff. 08/06/2021.

Rules 21.100, 21.120.1 D, 21.120.22 B, 21.120.23 C, 21.120.4 D-E, 21.120.42 E, 21.200.11, 21.200.12, 21.200.13 C, 21.240.1 eff. 11/01/2021.

Rules 21.300.1, 21.300.21, 21.300.22 D-F, 21.300.23-21.300.25, 21.300.9, 21.320.1, 21.320.2 A-B, 21.320.21, 21.320.31, 21.320.32, 21.320.41, 31.320.5 A, 31.320.61, 21.320.62, 21.320.63 A, 21.320.64, 21.320.7 G, 21.320.81 eff. 02/01/2022.

Rules 21.330.1, 21.330.31, 21.330.32 eff. 03/02/2022. Rules 21.330.4, 21.331-21.331.3 repealed eff. 03/02/2022.

Rules 21.600-21.600.9 eff. 07/01/2022.

Rules 21.800-21.900 repealed eff. 07/30/2023.

Rules Chapters 1-12 eff. 01/01/2024.

Rules 1.2, 2.5.1 D.12.12.1 C.5.d(1), 2.12.1 D, 2.12.2 A, 2.12.3 A, 2.13.1 A.3, 2.13.1 A.5, 2.24.1 B, 2.27.5 A, 3.4 A, 4.2.4 F, 4.3.4 G, 5.2.2 E, 6.3.3 A-B, 6.3.4 B, 6.3.4 D-E, 6.5.4 A, 6.6.2 A, 6.6.4 C, 10.6 C, 10.7 C, 10.8 C, 11.3.1 B, 11.8.3 A-B, 11.8.4 A, 11.9.6, 11.10.1, 11.13, 11.17.2 E, 12.3.2 B.8.d(1), 12.5.1 E, 12.5.4, 12.6.1 F-J, Chapter 13, Chapter 14 eff. 08/01/2025. Rules 21.200.4, 21.200.41- 45, 21.200.47-48, 21.200.481-482 recodified as 2 CCR 502-6 eff. 08/01/2025.

Rules 2.15 A-B, 11.16.8 D, Chapter 15 eff. 01/01/2026.

##### **2 CCR 502-2** COLORADO MENTAL HEALTH SYSTEM [Repealed eff. 11/01/2013] {#sec-2-ccr-502-2 omnilex-key=us-co-regs-official--department-9--2 CCR 502-2}

DEPARTMENT OF HUMAN SERVICES

Behavioral Health COLORADO MENTAL HEALTH SYSTEM - Repealed eff. 11/01/2013 2 CCR 502-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS, AND SPECIFIC STATUTORY

AUTHORITY

Rewrite of all sections to the Mental Health Services rules and regulations were final adoption following publication at the 10/6/95 Executive Director rule-making session, with an effective date of 12/1/95 (CSPR# 95-7-10-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Rules regarding the Colorado mental health system, as originally found in 2 CCR 502-2, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 11/01/2013.

##### **2 CCR 502-3** CHILD MENTAL HEALTH TREATMENT ACT [Repealed eff. 11/01/2013] {#sec-2-ccr-502-3 omnilex-key=us-co-regs-official--department-9--2 CCR 502-3}

DEPARTMENT OF HUMAN SERVICES

Behavioral Health CHILD MENTAL HEALTH TREATMENT ACT - Repealed eff. 11/01/2013 2 CCR 502-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

The addition of a new section to the Mental Health Services rules was adopted as emergency on 6/4/99 by the State Board of Human Services, with an effective date of 7/1/99 (CSPR# 99-5-5-1). Statement of

Basis and Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs. Department of Human Services.

Revisions to the Mental Health Services rules were adopted emergency and final on 8/6/99 by the State Board of Human Services, with an effective date of 7/1/99 and 8/6/99 (CSPR# 99-5-5-1). Statement of

Basis and Purpose. Regulatory Analysis and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the Child Mental Health Treatment Act rules, Sections 20.000 through 20.800, were final adoption following publication on 2/1/2008 by the State Board of Human Services, with an effective date of 4/1/2008 (Rule-making# 07-10-11-1). Statement of Basis and Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Rules regarding the child mental health treatment act, as originally found in 2 CCR 502-3, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Rules 20.100 – 20.800 eff. 04/01/2008.

Entire rule repealed eff. 11/01/2013.

##### **2 CCR 502-4** PUBLIC MENTAL HEALTH SYSTEM [Repealed eff. 11/01/2013] {#sec-2-ccr-502-4 omnilex-key=us-co-regs-official--department-9--2 CCR 502-4}

DEPARTMENT OF HUMAN SERVICES

Behavioral Health PUBLIC MENTAL HEALTH SYSTEM - Repealed eff. 11/01/2013 2 CCR 502-4 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE

Addition of rules concerning Competency Evaluations in Criminal Cases, Sections 21.900 through 21.950, were final adoption following publication on 8/6/2010 by the State Board of Human Services, with an effective date of 10/1/2010 (Rule-making# 09-6-10-1). Statement of Basis and Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Rules regarding public mental health system/competency evaluations in criminal cases, as originally found in 2 CCR 502-4, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 10/01/2010.

Entire rule repealed eff. 11/01/2013.

Annotations

Rule 21.920 D (adopted 08/06/2010) was not extended by Senate Bill 11-078 and therefore expired 05/15/2011.

##### **2 CCR 502-5** Behavioral Health Executive Director Rules {#sec-2-ccr-502-5 omnilex-key=us-co-regs-official--department-9--2 CCR 502-5}

DEPARTMENT OF HUMAN SERVICES

BEHAVIORAL HEALTH EXECUTIVE DIRECTOR RULES

2 CCR 502-5 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Addition of Sections 20.000 through 20.600 were final adoption following publication at the 7/10/2015 Executive Director rule-making session (Rule-making# 15-4-10-1), with an effective date of 9/1/2015.

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

Revisions to Sections 20.000 through 20.500 were final adoption following publication at the 12/4/2015 Executive Director rule-making session (Rule-making# 15-9-1-2), with an effective date of 2/1/2016.

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

20.100 EXECUTIVE DIRECTOR RULES – THE PROCEDURE FOR AWARDING GAMBLING

ADDICTION GRANTS

20.100.1 DEFINITIONS

“Behavioral Health Professional” means a psychologist licensed pursuant to Part 3 of Article 43 of Title 12, C.R.S.; a clinical social worker licensed pursuant to Part 4 of Article 43 of Title 12, C.R.S.; a marriage and family therapist licensed pursuant to Part 5 of Article 43 of Title 12, C.R.S.; a professional counselor licensed pursuant to Part 6 of Article 43 of Title 12, C.R.S.; a social worker licensed pursuant to Part 4 of

Article 43 of Title 12, C.R.S.; or an addiction counselor licensed or certified pursuant to Part 8 of Article 43 of Title 12, C.R.S.

“Entity or Program” means any facility, agency, private practice, or individual behavioral health professional that provides gambling addiction counseling services.

20.100.11 GENERAL PROVISIONS

Pursuant to Section 12-47.1-701(2)(a)(III), C.R.S., of the moneys transferred to the limited gaming impact account and the gambling addiction account, two percent (2%) shall be used to award grants for the provision of gambling addiction counseling, including prevention and education, to Colorado residents.

20.100.2 GRANT ADMINISTRATION

A. Eighty-five percent (85%) of the moneys in the gambling addiction account must be awarded, as Gambling Addiction Counseling Grants, to provide direct gambling addiction counseling services.

B. Ten percent (10%) of the moneys in the gambling addiction account must address prevention and education. This will be done by awarding Gambling Addiction Training Grants.

C. Five percent (5%) of the moneys in the gambling addiction account may be used by the Colorado Department of Human Services to cover the direct and indirect cost of administering the grant program.

20.100.3 GAMBLING ADDICTION COUNSELING GRANT CRITERIA

A. Gambling Addiction Counseling Grant Awards Gambling Addiction Counseling Grants must be awarded to entities or programs that:

1. Are state or local public or private; and, 2. Are in good standing with their licensing agency; and, 3. Provide direct gambling addiction counseling services to Colorado residents; and, 4. Employ or are seeking to employ behavioral health professionals who are nationally certified Gambling Counselors to provide the gambling addiction counseling services.

Behavioral health professionals providing the gambling addiction counseling services must be in good standing with the Colorado Department of Regulatory Agencies (DORA).

B. Gambling Addiction Counseling Grant Application Procedure 1. Gambling Addiction Counseling Grant Applications Information on where to apply for a Gambling Addiction Counseling Grant will be posted on the Office of Behavioral Health website.

2. Gambling Addiction Counseling Grant Application Contents Applications for a Gambling Addiction Counseling Grant must include, but not be limited to, the following information:

a. Proof that the criteria in Section 20.100.3, A, is met; and, b. The amount of moneys being requested to provide gambling addiction counseling services.

3. Timelines for Gambling Addiction Counseling Grant Application Gambling Addiction Counseling Grant applications may be solicited on dates determined by the Office of Behavioral Health.

20.100.31 AWARDING GAMBLING ADDICTION COUNSELING GRANTS

Subject to available funds, the Office of Behavioral Health will award Gambling Addiction Counseling Grants in accordance with the Colorado Procurement Code, Articles 101 through 112 of Title 24, C. R. S.

20.100.32 GAMBLING ADDICTION COUNSELING GRANT AWARDEE DATA REPORTING

REQUIREMENTS

All awardees will be required to submit data to the Office of Behavioral Health, to include, but not limited to:

A. Number of clients served;

B. Dollar amounts of services provided; and, C. Availability of other payor sources.

20.100.4 GAMBLING ADDICTION TRAINING GRANTS AND CRITERIA FOR GRANT

AWARDEES

A. Gambling Addiction Training Grants must be used to:

1. Cover the cost of approved gambling specific training or education; or, 2. Cover the cost of approved supervision/consultation with an international gambling counselor board approved clinical consultant; or, 3. Cover the cost of the National Certified Gambling Counselor exam; or, 4. Cover the initial cost of certification to become a National Certified Gambling Counselor.

B. Gambling addiction training grant applicants must meet the following requirements:

1. Bachelor’s degree or higher in a behavioral health field; and, 2. Certified Addiction Counselor II or higher and/or a behavioral health professional as defined in Section 20.100.4; and, 3. Meet at least half of the National Certified Gambling Counselor (NCGC), as revised June 15, 2015, hours requirements.

C. Gambling Addiction Training Grant Application Procedure 1. Gambling Addiction Training Grant Applications Information on where to apply for a Gambling Addiction Training Grant will be posted on the Office of Behavioral Health website.

2. Gambling Addiction Training Grant Application Contents Applications for a Gambling Addiction Training Grant must include, but not be limited to, the following information:

a. Proof that the criteria in Section 20.100.4, B, is met; and, b. The training/supervision/testing requirement(s) that the grant moneys will cover.

3. Timelines for Gambling Addiction Training Grant Application Gambling Addiction Training Grant applications may be solicited on dates determined by the Office of Behavioral Health.

20.100.41 GAMBLING ADDICTION TRAINING GRANT AWARDING PROCEDURE

Awarding Procedure:

Subject to available funds, the Office of Behavioral Health will award Gambling Addiction Training Grants in accordance with the Colorado Procurement Code, Articles 101 through 112 of Title 24, C. R. S.

20.100.42 GAMBLING ADDICTION TRAINING GRANT VERIFICATION PROCEDURE

Verification shall be provided to the Office of Behavioral Health by the Gambling Addiction Training Grant awardees confirming that training/supervision/testing or other approved Gambling Addiction Training Grant activity was completed in the fiscal year that money was awarded.

A. The Gambling Addiction Training Grant awardee shall send documentation of completed training/supervision/testing or other approved Gambling Addiction Training Grant activities to the Gambling Addiction Grant program administrator at the Office of Behavioral Health within thirty (30) calendar days after the completion of the training/supervision/testing or other approved Gambling Addiction Training Grant activity.

B. The Office of Behavioral Health will seek repayment of the funds awarded to individuals who received them but did not obtain National Certification as a Gambling Counselor (NCGC) within three (3) years.

20.100.5 APPEALS PROCESS FOR GAMBLING ADDICITON COUNSELING GRANTS AND

GAMBLING ADDICTION TRAINING GRANTS

All appeals for the denial of a Gambling Addiction Counseling Grant or a Gambling Addiction Training Grant will follow the appeal process set forth in the Colorado Procurement Code, Article 109 of Title 24, C.R.S.

20.100.6 REPORTING

The Office of Behavioral Health must submit a yearly report, by January 1, to the Health and Human Services Committee of the Senate and House of Representatives. These reports must detail:

A. The amount of moneys allocated to the gambling addiction account;

B. The number of grant applications received; and, C. The amount of money requested; and, D. The total amount of money awarded; and, E. The persons receiving the grants; and, F. The dollar amounts awarded to each person.

20.200 EXECUTIVE DIRECTOR RULES – CERTIFIED ADDICTION COUNSELOR (CAC) CLINICAL

TRAINING PROGRAM APPROVED TRAINER FEES

20.200.1 DEFINITIONS

“Co-trainers” means both trainers must be in attendance for the full approved training; each has specific approved curriculum sections to teach, and neither is approved to teach the class independently of the other.

“Single trainer” means the trainer is responsible for training the entire approved curriculum.

20.200.2 GENERAL PROVISIONS

An applicant applying for CAC clinical training program approved trainer status shall submit a complete application with required documentation and a one-time fee established pursuant to 27-80-111, C.R.S.

20.200.3 CAC CLINICAL TRAINING PROGRAM APPROVED TRAINER FEES

A. An applicant applying as a single trainer shall submit a one-time fee of one hundred fifty dollars ($150.00).

B. An applicant applying as co-trainers shall submit a one-time application fee of two hundred dollars ($200.00). _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 09/01/2015.

Entire rule eff. 02/01/2016.

Entire rule eff. 09/01/2018.

##### **2 CCR 502-6** Behavioral Health Administrative Rules {#sec-2-ccr-502-6 omnilex-key=us-co-regs-official--department-9--2 CCR 502-6}

DEPARTMENT OF HUMAN SERVICES

BEHAVIORAL HEALTH ADMINISTRATIVE RULES

2 CCR 502-6 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

Chapter 1: General Statutory Authority and Definitions 1.1 Statutory Authority A. Pursuant to Section 27-50-107, C.R.S., the State Board of Human Services, created pursuant to

Section 26-1-107, C.R.S., is the type 1 board for promulgating, revising, and repealing BHA rules.

B. Pursuant to Section 27-50-107, C.R.S., BHA may promulgate rules as necessary to implement Behavioral Health Administrative Service Organizations and care coordination services. 1.2 Definitions A. “Behavioral Health Administration” or “BHA” as defined in Section 27-50-101(2), C.R.S., means the Behavioral Health Administration established in Section 27-50-102, C.R.S.

B. “Behavioral Health Administrative Services Organization” or “BHASO” means a regionally based behavioral health organization that administers and maintains adequate networks of behavioral health safety-net services and care coordination as described in Sections 27-50-301 through 304, C.R.S.

C. “Behavioral Health Entity” has the same meaning as defined in section 27-50-101(4), C.R.S.

D. “Commissioner” as defined in Section 27-50-101(9), C.R.S., means the commissioner of the Behavioral Health Administration appointed pursuant to Section 27-50-103, C.R.S.

Chapter 2: Behavioral Health Administrative Services Organization Requirements 2.1 Statutory Authority A. Pursuant to Section 27-50-107, C.R.S., BHA may promulgate rules as necessary to implement Behavioral Health Administrative Service Organizations and care coordination services. 2.2 Form and Manner to Apply to be a Behavioral Health Administrative Services Organization (BHASO)

A. Pursuant to Section 27-50-402, C.R.S., BHA shall determine, by rule, the form and manner a qualified public or private corporation; for-profit or not-for-profit organization; or public or private agency, organization, or institution may apply to be a Behavioral Health Administrative Services Organization (BHASO).

B. At least once every five (5) years any qualified public or private corporation; for-profit or not-forprofit organization; or public or private agency, organization, or institution may apply through a competitive bid process pursuant to the Colorado Procurement Code, Colorado Revised Statutes, Articles 101 to 112 of Title 24, to apply to be a Behavioral Health Administrative Services Organization.

C. The commissioner shall select a BHASO based on factors of selection that include:

1. The applicant’s experience working with publicly funded clients, including expertise in treating priority populations determined by BHA;

2. The applicant’s experience working with and engaging relevant stakeholders in the service area, including behavioral health providers, state and local agencies, and the local community, including advocacy organizations and clients of behavioral health services;

3. The extent to which real or perceived conflicts of interest between the applicant and behavioral health facilities or behavioral health providers are mitigated; and 4. The extent to which the applicant’s board complies with conflict of interest policies, including the following:

a. The board shall not have more than fifty percent (50%) of contracted providers as board members;

b. Providers who have ownership or board membership in a BHASO shall not have control or decision-making authority in the establishment of provider networks; and c. An employee of a contracted provider of a BHASO shall not also be an employee of the BHASO unless the employee is the clinical officer or utilization management director of the BHASO. If the individual is also an employee of a provider that has board membership or ownership in the BHASO, the BHASO shall develop policies approved by the commissioner to mitigate any conflict of interest the employee may have.

5. The extent to which the applicant’s board membership reflects the diversity and interests of relevant stakeholders, including, but not limited to, representation by individuals with lived behavioral health experience and family of individuals with lived behavioral health experience.

Chapter 3: Administration and Implementation of the System of Care for Children and Youth 3.1 Statutory Authority A. Pursuant to section 27-64.5-102(2), C.R.S., BHA is required to promulgate rules for the administration and implementation of the system of care for children and youth. 3.2 Definitions A. “Child” has the same meaning as defined in section 19-1-103(21), C.R.S.

B. “Child with Serious Emotional Disturbances (SED)” means a child or youth that has a mental, behavioral or emotional disorder, which: (1) has been diagnosed through the current diagnostic and statistical manual of mental disorders, as incorporated by reference below, the DC 0 to 5, as incorporated by reference below, or international classification of diseases, as incorporated by reference below, by a licensed mental health professional, and (2) has experienced functional impairments, which interferes with the child’s functioning in family, social relationships, school, or community, and (3) experienced the emotional disturbance over the past twelve (12) months prior to application on a continuous or intermittent basis, as determined and documented by a licensed mental health professional. SED shall not include a primary diagnosis of substance-related disorders, or primary conditions or problems classified in the DSM as “other conditions that may be a focus of clinical attention.” DSM: the diagnostic and statistical manual of mental disorders, fifth edition, text revised (DSM-5-TR) (2022) is hereby incorporated by reference. No later editions or amendments are incorporated. The DSM-5-TR is available online with an account at https://psychiatryonline.org/doi/book/10.1176/appi.books.9781615375363 and is also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St., C140, Denver, Colorado 80246, during regular business hours.

DC 0-5: The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5; Zero to Three, 2016) is hereby incorporated by reference. No later editions or amendments are incorporated. It is available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St., C140, Denver, Colorado 80246, during regular business hours. Additional resources may be found at https://www.zerotothree.org/our-work/learn-professional-development/dc0-5-manualand-training/ International Classification Of Diseases: The International Classification Of Diseases, 11th Revision (ICD-11) (2022) is hereby incorporated by reference. No later editions or amendments are incorporated. The ICD-11 is available online at https://icd.who.int/en/ and is also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 S. Ash St., C140, Denver, Colorado 80246, during regular business hours.

C. “Colorado Child and Adolescent Needs and Strengths Tool (CANS)” is an evidence-based, validated, decision-support tool designed to identify the strengths and needs of children, youth, and their families and facilitate the linkage between the process and the design of individualized service plans including the application of evidence-based practices. The CANS supports level-ofcare decision-making, facilitates quality improvement initiatives, and allows for the monitoring of service outcomes. Incorporated by reference CANS: the Colorado Child Adolescent Needs and Strengths (CANS) tool (2023) is hereby incorporated by reference. No later editions or amendments are incorporated. The CANS tool is available online at https://sites.google.com/state.co.us/cans/home and is also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 s.

Ash St., C140, Denver, Colorado 80246, during regular business hours.

D. “Complex Trauma” means exposure to either multiple or prolonged traumatic events, often invasive and interpersonal in nature, or a single episode traumatic experience, that have a profound and prolonged impact on normal emotional, neurological, or behavioral development, such as witnessing the death of a caregiver; or physical, sexual, or emotional abuse or neglect resulting in the individual’s loss of a developmentally appropriate sense of a well-ordered and safe environment.

E. “Enhanced Standardized Assessment” means an assessment process that includes a biopsychosocial assessment and the use of child and adolescent needs and strengths tool (CANS), as incorporated by reference in section 3.2(c), used to make recommendations regarding the appropriate level of care and inform treatment planning necessary for children and youth with complex and unmet behavioral health treatment needs, developed pursuant to section 27-64.5-102(1)(a), C.R.S.

F. “Youth” has the same meaning as defined in section 19-1-103(145), C.R.S. 3.3 Eligibility and Determination of Eligibility A. The enhanced standardized assessment shall be administered to determine eligibility for participating in the system of care services.

1. All personnel conducting the enhanced standardized assessment shall be certified by BHA to complete the enhanced standardized assessment.

2. The Colorado Child and Adolescent Needs and Strengths tool (CANS), as incorporated by reference in section 3.2(c), must be administered as part of the enhanced standardized assessment.

3. All personnel conducting the enhanced standardized assessment shall maintain CANS certification.

4. All personnel conducting the enhanced standardized assessment shall use the BHAdesignated enhanced standardized assessment and CANS forms, as incorporated by reference in section 3.2(c).

B. The populations eligible for the system of care components established by section 27-64.5- 102(1), C.R.S. shall include individuals that are under twenty-one (21) years old, determined eligible through the enhanced standardized assessment process established in section 27-64.5- 102(1)(a), C.R.S., and may meet at least one of the following criteria:

1. Meets the criteria to be considered a child with serious emotional disturbances (SED);

2. Is experiencing complex trauma as determined and documented by a licensed mental health professional;

3. Dual diagnosed with a mental health condition and a substance use disorder and/or intellectual/developmental disability;

4. At risk of a psychiatric hospitalization due to serious emotional or behavioral health challenges;

5. At risk of placement outside the home due to serious emotional or behavioral health challenges; and/or 6. Is involved with one or more youth-serving systems or at risk of involvement in one or more youth-serving systems, including, but not limited to:

a. Crisis services b. Emergency services c. Juvenile justice system d. County department of human or social services e. Special education system 3.4 Requirements for Residential Treatment Providers A. Residential treatment providers participating in the system of care for children and youth must obtain cultural competency related to the provision of services by requiring applicable treatment staff to receive certification from the residential child care provider training academy established in section 26-6-923, C.R.S.

Chapter 4: Children and Youth Mental Health Treatment Act 4.1 Definitions A. “Ability to pay” means the amount of income and assets of the legally responsible person(s) available to pay for the individual cost of Children and Youth Mental Health Treatment Act funded services.

B. “Care Management”, as defined in section 27-67-103(1.5), C.R.S., includes, but is not limited to, consideration of the continuity of care and array of services necessary for appropriately treating a child or youth and the decision-making authority regarding the child's or youth's placement in and discharge from behavioral health services.

C. “Child at Risk of Out-of-Home Placement” means a child or youth who, although not otherwise categorically eligible for Medicaid, meets the following criteria:

1. Has been diagnosed as a person with a mental health disorder, as defined in section 27- 65-102(22), C.R.S. or experiencing negative social determinants of health as documented by a Z code in ICD-10-CM, as incorporated by reference below, and the diagnostic statistical manual of mental health disorders, as incorporated by reference in

section 3.2(b); International Classification Of Diseases: The International Classification Of Diseases, 11th revision (ICD-11) (2022) is hereby incorporated by reference. No later editions or amendments are incorporated. The ICD-11 is available online at https://icd.who.int/en/ and is also available for public inspection and copying at the Colorado Department of Human Services, Behavioral Health Administration, 710 s. Ash St., C140, Denver, Colorado 80246, during regular business hours.

2. The child or youth requires a level of care that is provided in a residential child care facility pursuant to section 25.5-6-903, C.R.S., or that is provided through communitybased programs, and who, without such care, is at risk of unwarranted child welfare involvement or other system involvement, as described in section 27-67-102, C.R.S., in order to receive funding for treatment.

3. If the child or youth is determined to be in need of placement in a residential child care facility, they shall apply for supplemental security income, but any determination for supplemental security income must not be a criterion for a child or youth to receive services pursuant to Article 67 of Title 27;

4. The child or youth is a person for whom there is no pending or current action in dependency or neglect pursuant to Article 3 of Title 19; and 5. The child or youth is younger than eighteen (18) years of age, but they may continue to remain eligible for services until their twenty-first (21st) birthday.

D. “Categorically Medicaid Eligible” means a person has met the criteria for categorically needy as defined in section 25.5-4-103(4), C.R.S.

E. “Cost of Care” includes residential and community-based services not covered by private insurance, the family, or Medicaid.

F. “Community-Based Services” means any intervention that is designed to be an alternative to residential or hospital level of care in which the child or youth resides within a non-institutional setting and includes, but is not limited to, therapeutic foster care, intensive in-home treatment, intensive case management, and day treatment.

G. “County Department” as defined in section 27-67-103(5), C.R.S. means the county department of human or social services.

H. “Dependent” means a person who relies on the responsible person(s) for financial support.

I. “Face-to-Face Enhanced Standardized Assessment” means a formal and continuous process of collecting and evaluating information about an individual for service planning, treatment, referral, and funding eligibility as outlined in 2 CCR 502-1 § 8.4, and takes place at a minimum upon a request from the responsible person(s) for funded services through the Children And Youth Mental Health Treatment Act, section 27-67-101, C.R.S. through section 27-67-109, C.R.S.

Information collected through an enhanced standardized assessment establishes justification for services and funding and is sent to the responsible person(s) pursuant to section 27-67- 104(1)(a), C.R.S. The child or youth must be either physically in the same room as the licensed mental health professional or interviewed remotely using video technology during the face-to-face enhanced standardized assessment. If an in-person interview is clinically indicated or requested by the responsible person(s), the face-to-face enhanced standardized assessment must occur inperson. If the governor or local government declares an emergency or disaster, telephone may be used. Telephone shall only be used as necessary because of circumstances related to the disaster or emergency.

J. “Family Advocate” has the same meaning as provided in section 26-5-117(6)(a), C.R.S.

K. “Family Systems Navigator” has the same meaning as provided in section 26-5-117(6)(b), C.R.S.

L. “First-Level Appeal” as defined in section 27-67-103(8), C.R.S., means the initial process a Medicaid member is required to enact to contest a benefit, service, or eligibility decision made by Medicaid or a Medicaid managed care entity.

M. “Funded Provider” means any entity contracted with the mental health agency to provide community-based services or residential treatment through the Children and Youth Mental Health Treatment Act.

N. “Licensed Mental Health Professional” means a psychologist licensed pursuant to section 12-245- 304, C.R.S., a psychologist candidate pursuant to section 12-245-304, C.R.S. that is supervised by a licensed psychologist, a psychiatrist licensed pursuant to section 12-240-107, C.R.S., a clinical social worker licensed pursuant to section 12-245-404, C.R.S., a marriage and family therapist licensed pursuant to section 12-245-504, C.R.S., a licensed marriage and family therapist candidate pursuant to section 12-245-504, C.R.S. that is supervised by a licensed marriage and family therapist, a professional counselor licensed pursuant to section 12-245-604, C.R.S., a licensed professional counselor candidate pursuant to section 12-245-604, C.R.S. that is supervised by a licensed professional counselor, or a social worker licensed by pursuant to

section 12-245-404, C.R.S., that is supervised by a licensed clinical social worker.

O. “Mental Health Agency” as defined in section 27-67-103(10), C.R.S., means a behavioral health services contractor through the Behavioral Health Administration serving children and youth statewide or in a particular geographic area, and with the ability to meet all expectations of Article 67 of Title 27, C.R.S.

P. “Plan Of Care” is a BHA developed document that at a minimum includes the anticipated frequency and costs of services to be provided for the duration of the plan of care. The plan of care is also a schedule of the fees to be paid by the responsible person(s) including, but not limited to, the estimated amount of supplemental security income payable to the residential facility if awarded to the child at risk of out-of-home placement or another provider, and sliding scale fees payable to the contractor, if applicable.

Q. “Professional Person” as defined at section 27-67-103(11), C.R.S. means a person licensed to practice medicine in this state, a psychologist certified to practice in this state, or a person licensed and in good standing to practice medicine in another state or a psychologist certified to practice and in good standing in another state who is providing medical or clinical services at a treatment facility in this state that is operated by the armed forces of the United States, the United States Public Health Service, or the United States Department Of Veterans Affairs.

R. “Residential Treatment” means services provided by a qualified residential treatment program, as defined in section 26-5.4-102(2), C.R.S., or psychiatric residential treatment facility, as defined in

section 25.5-4-103(19.5), C.R.S.

S. “Responsible Persons” means parent(s) or legal guardian(s) of a child or youth.

T. “Routine Situation” means a condition where the child or youth is unlikely to become a danger to themselves or others.

U. “State Department” means the State Department of Human Services.

V. “Urgent Situation” means a situation where it is reasonable to believe a child or youth is likely to become a danger to themselves or others. 4.2 Application for Funding from the Children and Youth Mental Health Treatment Act A. A responsible person(s) may apply to a mental health agency on behalf of a child or youth for mental health treatment services for the child or youth pursuant to section 27-67-104, C.R.S., if the responsible person(s) believes the child or youth is at risk of out-of-home placement.

B. The responsible person’s request for services, appeal, and objective third party review under

section 27-67-104, C.R.S. may be done with the assistance of a family advocate, family system navigator, nonprofit advocacy organization, or county department.

1. The mental health agency shall provide the contact information for the organization contracted with BHA to provide these services, free of charge, to the responsible person(s) before the enhanced standardized assessment occurs.

2. BHA is not obligated to pay for any services provided by entities with which they do not contract.

C. The mental health agency is responsible for evaluating the child or youth and clinically assessing the child’s or youth’s need for mental health services and, when warranted, to provide treatment services as necessary and in the best interests of the child or youth and the child’s or youth’s family.

D. When evaluating the child or youth to determine eligibility, the mental health agency shall conduct a face-to-face enhanced standardized assessment pursuant to section 27-67-104(1)(a), C.R.S. determination of level of care need and eligibility need will be completed jointly by the mental health agency and BHA.

E. When evaluating a child or youth for eligibility, the mental health agency shall evaluate all areas outlined in 2 CCR 502-1 § 8.4.

F. The mental health agency is responsible for the provision of the treatment services and care management, including any community-based care, residential treatment, or any other postresidential follow-up services that may be appropriate for the child’s or family’s needs.

G. A face-to-face enhanced standardized assessment and eligibility determination shall be completed within the following time periods after a request for funding has been made by a responsible person(s).

1. In an urgent situation, a face-to-face enhanced standardized assessment shall be completed by the mental health agency within three (3) working days of the initial assessment request by the responsible person(s). The mental health agency shall continue to provide care management while funded services are identified and provided.

If a responsible person(s) requests that the enhanced standardized assessment be completed within three (3) working days, the enhanced standardized assessment must be completed within three (3) working days.

2. In routine situations, a face-to-face enhanced standardized assessment shall be completed within ten (10) working days of a responsible person’s request for services through the Children and Youth Mental Health Treatment Act.

3. If the mental health agency requires additional time to make a decision following an enhanced standardized assessment and the responsible person(s) agrees, then the mental health agency may take up to an additional five (5) working days. The initial extension may be extended for an additional five (5) working days at the request of the responsible person(s), but the request should take up to but no more than twenty (20) working days from the initial request. If the responsible person(s) does not agree, the notification timelines referenced above remain in effect.

H. The mental health agency’s decision shall be communicated orally and in writing to the responsible person(s) within the time allowed for the completion of the enhanced standardized assessment. Oral notice shall be made in person or using video technology with the responsible person(s) when possible.

I. A mental health agency’s written decision shall contain the following:

1. Notice of the applicable criteria for mental health treatment;

2. The factual basis for the decision; and 3. The appeals procedures outlined in 2 CCR 502-6 § 4.4(c). 4.3 Process of Determining Ability to Pay and Adjusted Charge for Treatment Services A. The mental health agency shall determine the cost of care for children and youth that receive funding through the Children and Youth Mental Health Treatment Act. All insurance and other eligible benefits shall be applied first to the cost of care. A responsible person(s) who fails to utilize available insurance and other benefits for payment will nevertheless be considered as having insurance and other benefits available for payment.

B. Every month, the mental health agency shall determine the responsible person(s) fee by calculating seven percent (7%) of the total cost of all Children and Youth Mental Health Treatment Act funded services for the responsible person(s), excluding the costs of the enhanced standardized assessment and all care management.

C. If the responsible person(s) is unable to pay the seven percent (7%), the mental health agency shall consider the responsible person(s) “ability to pay” as defined in section 4.1, total number of dependents, the mental health needs of those dependents, all current outstanding medical liabilities, expected length of services, and the education costs for the dependents in order to adjust the responsible person(s) fee. The mental health agency shall receive approval or denial from BHA for all fee adjustments.

D. Responsible person(s) fee shall be no less than fifty dollars ($50) per month.

E. Every month, the mental health agency shall collect fees directly from the responsible person(s) or monitor that the third-party provider has collected the responsible person(s) fee.

F. The funded provider may reserve the right to take any necessary action regarding delinquent payments by the responsible person(s).

G. The responsible person(s) shall sign a financial agreement indicating an understanding of their financial responsibilities as described, above, to be eligible for funding through the Children and Youth Mental Health Treatment Act.

H. Within ten (10) working days after the child’s admission to residential treatment, the responsible person(s) shall apply for supplemental security income (SSI) on behalf of a child approved for funding under the Children and Youth Mental Health Treatment Act.

I. If awarded supplemental security income, the responsible person(s) shall disclose the award amount to the mental health agency.

J. If awarded supplemental security income, it is the responsibility of the responsible person(s) to notify the social security administration immediately upon the child or youth’s discharge from residential services.

K. If awarded supplemental security income, and awarded Medicaid, Medicaid will be used to fund treatment costs while in residential treatment. The parental responsible person(s) fee, supplemental security income, all other funding sources, and the Child and Youth Mental Health Treatment Act will fund room and board.

L. If denied supplemental security income, the Children and Youth Mental Health Treatment Act will fund room and board and behavioral health treatment services that would otherwise have been funded by supplemental security income and Medicaid. 4.4 Appeal of the Reduction, Termination, or Denial of Mental Health Services Funded by the Children and Youth Mental Health Treatment Act A. Except as provided below, the mental health agency shall follow the notification process as defined in section 2 CCR 502-6 § 4.2.H-I.

B. Oral and written notification shall be given for ongoing service determinations that reduce, increase, or terminate funded services.

C. A responsible person(s) may request an appeal of a decrease, increase, or denial of Children and Youth Mental Health Treatment Act fund services or a recommendation that a child or youth is discharged from funded services, and the following shall apply:

1. If the responsible person(s) notifies the mental health agency of a desire to appeal a decision before termination of services, BHA and the mental health agency shall continue to fund services until the appeal process below has been exhausted;

2. The responsible person(s) shall notify the mental health agency orally or in writing within fifteen (15) working days of a written decision of a desire to appeal a decision;

3. The mental health agency shall have two (2) working days within which to complete an internal appeal review process and communicate a decision to the responsible person(s) orally and in writing; and 4. The mental health agency’s written decision notice of action shall contain the information required in section 21.200.43, 4.2 (e), along with the process for clinical review in section 4.4, C-E below.

D. If the mental health agency requires more than two (2) working days to complete the internal review, and the responsible person(s) is in agreement, then the mental health agency may take up to but no more than five (5) working days to complete the review.

E. Within five working days after the mental health agency's final denial or recommendation for discharge, a parent or guardian may request an objective third party at BHA who is a professional person to review the action of the mental health agency. Such a request may be oral or in writing, but if completed orally it must be confirmed in writing and shall be made to the commissioner of BHA or BHA’s ombudsman.

F. Unless waived by the responsible person(s), said clinical review shall include:

1. A review of the mental health agency’s denial of services;

2. An evaluation of the child, done either physically in the same room as the professional person or interviewed remotely using video technology. The evaluation shall be done in person if clinically indicated or requested by the responsible person(s); and 3. A review of the evidence provided by the responsible person(s). The responsible person(s) shall be advised of the name and credentials of the reviewing professional, as well as any mental health agency affiliations of the reviewing professional. The responsible person(s) shall have an opportunity to request an alternate reviewing professional at BHA at that time, so long as any delay caused by the request is waived by the responsible person(s).

G. Within three (3) working days of the receipt of the request for clinical review, a decision shall be communicated orally and in writing by the professional person to the responsible person(s), BHA and the mental health agency. The written decision shall include the relevant criteria and factual

basis. If the clinical review finds residential or community-based services to be necessary and that Children and Youth Mental Health Treatment Act funding is necessary, the mental health agency shall provide services to the child within twenty-four (24) hours of the said decision. If mental health treatment providers are not available within twenty-four (24) hours and communitybased services are recommended, the state level review must recommend appropriate alternatives, up to and including emergency hospitalization, if appropriate. If residential treatment is not available within twenty-four (24) hours and placement in residential treatment is recommended, the state level review must recommend appropriate alternatives, including emergency hospitalization, if appropriate, if the child is in need of immediate placement out of the home.

H. The decision from the objective third party, at BHA who is a professional person, shall constitute a final agency action for funding through the Children and Youth Mental Health Treatment Act. 4.5 Third Party Review Process for a Medicaid Child or Youth A. The responsible person(s) of a Medicaid child or youth who is at risk of out-of-home placement may request, within five (5) days after all first-level Medicaid appeals processes are exhausted, an objective third party at BHA who is a professional person to review the service request made to Medicaid. The review must be conducted by a professional person as outlined in section 21.200.45 4.4 within three (3) working days of the date of request. This review does not obligate funding of services. 4.6 Dispute Resolution Process Between County Departments and Mental Health Agencies A. If a dispute exists between a mental health agency and a county department regarding whether mental health services should be funded under the Children and Youth Mental Health Treatment Act or by the county department, one or both may request BHA to convene a review panel consisting of family advocates, a representative from the State Department’s Division Of Child Welfare, a representative from BHA, an independent mental health agency if available, a professional person, and an independent county department to provide dispute resolution. BHA shall obtain documentation from independent agencies and individuals that no conflict of interest exists pertaining to the specific child/youth being reviewed.

B. The request to invoke the dispute resolution process shall be in writing and submitted within five (5) calendar days of either the mental health agency or county department recognizing a dispute exists.

C. The written request for dispute resolution shall include at a minimum, the following information:

1. The county department and mental health agency involved in the dispute, including a contact person at each;

2. The child’s or youth’s name and age;

3. The responsible person(s) address, phone number, and e-mail address;

4. Pertinent information regarding the child/youth including, but not limited to, medical or mental health status/assessment;

5. The reason for the dispute, any efforts to resolve the matter locally, and any pertinent information regarding the child/youth;

6. Information about the child’s/youth’s mental health status pertaining to the dispute; and 7. The responsible person(s) perspective on the matter, if known.

D. BHA shall provide written notice to both the mental health agency and a county department that BHA will convene a review panel to resolve the dispute.

E. Each side will have an opportunity to present its position to the review panel. Interested parties will be allowed to present written or oral testimony at the discretion of the review panel.

F. The review panel shall have five (5) working days to complete the dispute process and issue its determination in writing to the disputing county department and mental health agency and the responsible person(s). The review panel's decision shall constitute a final decision which binds the agency determined responsible for the provision of necessary services.

G. If the panel deems that neither the mental health agency nor the county department is responsible for the provision of funding for the treatment of the child, then the panel shall provide a rationale for their determination. The panel shall offer recommendations for other funding sources and treatment modalities. 4.7 Responsibilities of Mental Health Agencies In addition to the requirements and/or responsibilities established through applicable law, the mental health agency shall provide Children and Youth Mental Health Treatment Act funded services to children and youth who are eligible as outlined in Chapter 4 and the Children and Youth Mental Health Treatment Act.

A. Children and Youth Mental Health Treatment Act services include, but are not limited to:

1. Clinical behavioral health assessments completed by a licensed mental health professional;

2. Community-based services;

3. Care management services;

4. Coordination of residential treatment services; and 5. Non-residential mental health transition services for children and youth.

B. The mental health agency shall provide Children and Youth Mental Health Treatment Act eligibility, service, and financial information to BHA in an agreed upon format.

C. The mental health agency shall report information to the BHA as required and outlined in section 27-67-105, C.R.S.

D. The mental health agency shall determine the fee for the responsible person(s) and submit the financial agreement to BHA for state approval.

E. The mental health agency shall submit all eligibility assessments to BHA before funding approval or denial.

F. If a child has been determined eligible under the Children and Youth Mental Health Treatment Act, the mental health agency shall submit a plan of care for approval to BHA before providing services. If necessary services are not immediately available, the mental health agency shall submit an alternative plan of care and provide interim services as appropriate.

G. The mental health agency shall maintain a comprehensive clinical record for each child receiving services through Children and Youth Mental Health Treatment Act funding consistent with 2 CCR 502-1 §§ 4.3-4.4. Such records shall be made available for BHA review. The plan of care in the clinical record shall reflect any services provided directly by the center, including any care coordination, as defined in 2 CCR 502-1 § 1.2, services provided, and relevant documentation submitted by a third-party provider. The goal of those care management services may be, at least in part, to oversee the delivery of services by third party providers to assure that adequate progress is achieved and may reference the state plan of care and the provider’s clinical service plan. _________________________________________________________________________ Editor’s Notes

History New rule eff. 05/01/2023.

Entire rule eff. 08/01/2025.

## **503** Division for Developmental Disabilities (Volume 16)

##### **2 CCR 503-1** DEVELOPMENTAL DISABILITIES SERVICES (VOLUME 16) [Repealed eff. 05/15/2014] {#sec-2-ccr-503-1 omnilex-key=us-co-regs-official--department-9--2 CCR 503-1}

DEPARTMENT OF HUMAN SERVICES

Division for Developmental Disabilities (Volume 16)

DEVELOPMENTAL DISABILITIES SERVICES (VOLUME 16) - Repealed eff. 05/15/2014 2 CCR 503-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS, AND SPECIFIC STATUTORY

AUTHORITY

Rewrite of all sections to the Developmental Disabilities Services rules and regulations were final adoption following publication at the 8/4/95 Executive Director rule-making session, with an effective date of 10/1/95 (CSPR# 95-5-5-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revision to Section 1.2, "Definitions" of the Developmental Disabilities Services rules and regulations were final adoption following publication at the 12/1/95 Executive Director rule-making session, with an effective date of 2/1/96 (CSPR# 95-9-27-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Rewrite of all sections to the Developmental Disabilities Services rules and regulations were final adoption following publication at the 12/1/2000 State Board of Human Services rule-making session, with an effective date of 2/1/2001 (CSPR# 00-7-19-1). Statement of Basis Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Performance Improvement, Boards and Commissions Division, State Board Administration.

Addition of section 16.131 was adopted as emergency at the 6/4/2004 State Board of Human Services

rule-making session, with an effective date of 6/4/2004 (Rule-making# 03-6-25-1). Statement of Basis

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Performance Improvement, Boards and Commissions Division, Addition of section 16.131 was final adoption of emergency rules at the 7/9/2004 State Board of Human Services rule-making session, with an effective date of 6/4/2004 (Rule-making# 03-6-25-1). Statement of

Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Performance Improvement, Boards and Commissions Division, Revision to section 16.440 were final adoption following publication at the 12/3/2004 State Board of Human Services rule-making session, with an effective date of 2/1/2005 (Rule-making# 04-8-26-1).

Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Performance Improvement, Boards and Commissions Division, State Board Administration.

Addition of Section 16.714 was adopted on an emergency basis at the 12/7/2007 State Board of Human Services rule-making session, with an effective date of 1/1/2008 (Rule-making# 07-10-23-1). Statement of

Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Human Resources, Compliance and Regulatory Affairs, Boards and Commissions Division, State Board Administration.

Revisions to Section 16.714 were final (permanent) adoption of emergency rules at the 1/11/2008 State Board of Human Services rule-making session, with an effective date of 1/11/2008 (Rule-making# 07-10- 23-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Human Resources, Compliance and Regulatory Affairs, Boards and Commissions Division, State Board Administration.

Revision of Section 16.120 was adopted following publication at the 8/1/2008 State Board of Human Services rule-making session, with an effective date of 10/1/2008 (Rule-making# 08-5-7-1). Statement of

Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Human Resources, Compliance and Regulatory Affairs, Boards and Commissions Division, State Board Administration.

Revisions of Sections 16.120 and 16.700-16.710, deletion of Sections 16.711-6.714, and addition of Sections 16.900-16.994 were adopted following publication at the 7/8/2011 State Board of Human Services rule-making session, with an effective date of 9/1/2011 (Rule-making# 11-4-8-1). Statement of

Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office Employment and Regulatory Affairs, Division of Boards and Revision of Section 16.120 and addition of Sections 16.650-16.654 were adopted following publication at the 12/2/2011 State Board of Human Services rule-making session, with an effective date of 2/1/2012 (Rule-making# 11-7-29-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions and repeals of Sections 16.223, 16.225, 16.229, 16.231-16.233, 16.241, 16.323, 16.334, 16.613-16.614, 16.627, and 16.913 were final adoption following publication at the 4/6/2012 State Board of Human Services rule-making session, with an effective date of 6/1/2012 (Rule-making#12-1-31-1).

Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and

Section 16.120 was revised, and Sections 16.900 through 16.994 were deleted and moved to new

Section 7.900, et seq. (12 CCR 2509-10) per final adoption following publication at the 5/3/2013 State Board of Human Services rule-making session, with an effective date of 7/1/2013 (Rule-making#13-1-10- 1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Revisions of Sections 16.120, 16.210, 16.420, and 16.480 were final adoption following publication at the 6/7/2013 State Board of Human Services rule-making session, with an effective date of 8/1/2013 (Rulemaking#12-12-12-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Repeal of Section 16.131 was final adoption following publication at the 9/6/2013 State Board of Human Services rule-making session, with an effective date of 11/1/2013 (Rule-making#13-7-12-1). Statement of

Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, Repeal of 2 CCR 503-1 in it’s entirety (Sections 16.100 through 16.800) was final adoption following publication at the 3/7/2014 State Board of Human Services rule-making session, with an effective date of 5/15/2014 (Rule-making#13-12-4-1). Statement of Basis Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. 16.100 (None) _________________________________________________________________________ Editor’s Notes

History Emer. Rule 16.714 eff. 01/01/2008.

Rule 16.714 eff. 03/01/2008.

Rule 16.120 eff. 10/01/2008.

Rules 16.120, 16.710 – 16.714, 16.900, SB&P eff. 09/01/2011.

Rules SB&P, 16.120, 16.650 - 16.654 eff. 02/01/2012.

Rules SB&P, 16.231-233, 16.241, 16.613, 16.913 eff. 06/01/2012; Repealed Rules 16.223, 16.225, 16.229, 16.323, 16.334, 16.627 eff. 06/01/2012.

Rule 16.653 eff. 01/01/2013.

Rules SB&P, 16.120 eff. 07/01/2013; rule 16.900 repealed eff. 07/01/2013.

Rules SB&P, 16.120, 16.210, 16.420, 16.480 eff. 08/01/2013.

Rule SB&P eff. 11/01/2013; rule 16.131 repealed eff. 11/01/2013.

Entire rule repealed eff. 05/15/2014.

## **504** Division of Youth Corrections

##### **2 CCR 504-1** Parental Fee Assessment {#sec-2-ccr-504-1 omnilex-key=us-co-regs-official--department-9--2 CCR 504-1}

DEPARTMENT OF HUMAN SERVICES

Division of Youth Corrections PARENTAL FEE ASSESSMENT 2 CCR 504-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Repeals of 2 CCR 504-1, sections 1.0 through 11.4, and revision of 17.100 were final adoption following publication at the 5/4/2012 State Board meeting (Rule-making# 12-2-7-1), with an effective date of 7/1/2012. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporate by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. 17.100 PARENTAL FEE FOR JUVENILE PLACEMENTS [Rev. eff. 7/1/12]

When a juvenile is committed to the Department, the Department may, based upon the parent’s ability to pay, require the parent of the child to pay a fee to cover the costs of the placement. The Department shall utilize the parental fee requirements found at Section 7.404, et seq. (12 CCR 2509-5), as applicable to each juvenile in placement. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 07/01/2012.

## **505** Office of Civil and Forensic Mental Health

##### **2 CCR 505-1** Civil and Forensic Mental Health {#sec-2-ccr-505-1 omnilex-key=us-co-regs-official--department-9--2 CCR 505-1}

DEPARTMENT OF HUMAN SERVICES

CIVIL AND FORENSIC MENTAL HEALTH

2 CCR 505-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 21.800 UNIFORM METHOD OF DETERMINING ABILITY TO PAY FOR ANY PERSON WHO RECEIVES SERVICES FROM ANY PUBLIC INSTITUTION SUPERVISED BY THE DEPARTMENT OF HUMAN SERVICES FOR THE CARE, SUPPORT, MAINTENANCE, EDUCATION OR TREATMENT OF THE MENTALLY ILL OR DEVELOPMENTALLY DISABLED 21.810 STATUTORY AUTHORITY The statutory authority for these rules and regulations is found at Sections 27-92-101 through 27-92-109, C.R.S.

21.820 DEFINITIONS

“Ability to Pay” is the amount of the legally responsible person's income and assets available to pay for the individual cost of care, support, maintenance, treatment, and education at the institution.

“Adjusted Assets” is the balance of the assets of the legally responsible person(s) after allowed asset deductions.

“Adjusted Charge” is the charge for hospital care, support, maintenance and treatment, up to but not exceeding the ability to pay of the responsible person(s).

“Adjusted Income” is the balance of the total gross monthly income of the legally responsible person(s) after allowed income deductions.

“Allowed Asset Deduction” includes liabilities; the value of the equity in the home; assets which are specifically targeted for retirement and which are not available for other purposes; and the Supplemental Security Income (SSI) asset allowance for each legally responsible parent, patient, spouse, and other dependent.

“Allowed Income Deduction” includes withholding taxes, employee union or association dues, mandatory retirement deductions, health insurance premiums, conservator fees, one-twelfth of the federal personal exemption allowance for each dependent, and child support and/or alimony payments.

“Colorado Net Taxable Income” refers to the calculation on the State of Colorado Income Tax Form, and reportable under Colorado law, which is used as the base against which state tax liability is determined.

“Cost of Care” refers to the full rate multiplied by the number of days of care provided.

“Department” refers to the Colorado Department of Human Services.

“Dependent” is an individual who qualifies as a dependent under Internal Revenue Service (IRS) regulations for federal income tax purposes.

“Executive Director” refers to the Executive Director of the Department.

“Federal Personal Exemption Allowance” refers to the dollar amount allowed by the IRS for each dependent.

“Full Rate” refers to the institution's daily rate, which is determined periodically, based on the cost for care, support, maintenance, treatment and education of patients, as approved by the Executive Director.

“Institution” refers to any public institution of this state supervised by the Department of Human Services for the care, support, maintenance, education, or treatment of the mentally ill or developmentally disabled.

“Insurance and Other Benefits” includes all insurance, health maintenance organizations, Medicare, Medicaid, and any other resources covering the cost of care, support, maintenance, or treatment by the institution.

“Legally Responsible Person(s)” is the patient, fiduciary, spouse, and parent(s) of children under 18 years of age, as applicable.

“Patient” refers to any person admitted, committed or transferred to any public institution of this state supervised by the Department of Human Services for the care, support, maintenance, education or treatment of the mentally ill or developmentally disabled.

“Personal Needs Allowance” refers to the uniform dollar amount determined by the Department to be available to each patient receiving income from a benefit or employment, which may be used for items not provided by the institution.

“SSI Asset Allowance” refers to the maximum dollar amount of assets that an individual is allowed to retain and still qualify for the Supplemental Security Income (SSI) Program.

21.830 INTRODUCTION

These rules are intended to provide the method used to assess charges at the public institutions under the supervision of the Department of Human Services for the care, support, maintenance, education, or treatment of the mentally ill or developmentally disabled. No person shall be denied admission because of inability to pay. These rules and regulations do not apply to individuals at these institutions who are receiving services under federally funded programs whose rules conflict with these rules.

21.840 PROCESS OF DETERMINING ABILITY TO PAY AND ADJUSTED CHARGE

A. Insurance and Other Benefits Insurance and other benefits shall be applied first to the cost of care. Insurance and other benefits for any patient shall be billed at the cost of care. A legally responsible person who fails to cooperate in making existing insurance and other benefits available for payment will nevertheless be considered as having benefits available for payment.

B. Calculation of Ability to Pay The ability to pay shall be calculated taking into consideration the factors in Section 27-92-104, C.R.S., and using the schedule in Section 21.860 of these rules and regulations.

C. Determination of Adjusted Charge The adjusted charge shall be the balance of the cost of care after insurance and other benefits have been deducted, or the ability to pay, whichever is less. If the legally responsible person(s) does not cooperate in making insurance and other benefits available, the legally responsible person(s) will be billed for the amount equal to the dollar value of the insurance or benefits in addition to the lesser of the balance of the cost of care or the ability to pay. If the dollar value of insurance and other benefits cannot be determined, the legally responsible person(s) will be billed the full cost of care.

D. Modifications A legally responsible person whose income is substantially reduced as a result of changed financial circumstances after the ability to pay has been determined, may request a redetermination and provide the hospital with evidence of financial change so that a new ability to pay may be determined based on current income and assets. Should there be an increase in income, assets, insurance or other benefits, this information must be reported to the institution within sixty (60) calendar days of the changed financial circumstances so that an appropriate redetermination of the ability to pay can be made.

21.850 FACTORS AFFECTING THE DETERMINATION OF ABILITY TO PAY

The following factors are considered in the determination of ability to pay, in accord with Section 27-92- 104, C.R.S.

A. Length of a Patient's Care and Treatment To avoid undue hardship on patients and/or their families, the ability to pay is reduced after the sixth calendar month of treatment.

B. Medical and Physical Condition of Dependents To avoid undue hardship on families, monthly payments for medical services for dependents with serious mental or physical conditions may be deducted from income when the adjusted income is determined, provided adequate supporting documentation is submitted to the institution.

21.860 SCHEDULE FOR DETERMINING THE ABILITY TO PAY

The ability to pay of the legally responsible person(s) is the sum of the monthly adjusted income and the monthly adjusted assets available to pay for the cost of care, support, maintenance, treatment, and education at the institution.

The monthly adjusted assets considered available to pay for care, support, maintenance and treatment is one (1) percent of adjusted assets.

The following table is used to calculate the monthly adjusted income considered available to pay for care, support, maintenance, treatment, and education.

MONTHLY ADJUSTED INCOME AVAILABLE TO PAY FOR CARE, SUPPORT, MAINTENANCE,

TREATMENT AND EDUCATION

Adjusted Income 1st - 6th Calendar Months 7th and Subsequent Calendar Months Percent of Adjusted Income Available $0-$ 499 20% 15% $500-$ 999 30% 25% $1,000 - $1,499 35% 30% $1,500 - $1,999 40% 35% $2,000 and above 45% 40% 21.870 ADDITIONAL FACTORS AFFECTING THE ABILITY TO PAY AND THE ADJUSTED CHARGE A. For legally responsible parents of children under eighteen (18) years of age, the monthly adjusted income available in the seventh and subsequent calendar months shall be one percent of Colorado Net Taxable Income.

B. For single patients receiving only fixed income benefits, or when a husband and wife both reside in an institution or other health care facility and receive only fixed income benefits, the monthly adjusted income available will be the amount of these benefits, less the personal needs allowance and any other applicable deductions.

21.900 COMPETENCY EVALUATIONS IN CRIMINAL CASES

These rules are established to create standards for psychologists and psychiatrists wishing to become approved as evaluators of competency to proceed.

21.910 DEFINITIONS

“Approved evaluator” means an evaluator who is currently employed by CDHS; or has completed the application process through the Court Services Division and is providing services under an active purchase order or a personal services contract, or as a fellow in forensic psychology or psychiatry training.

“Board Certification” in forensic psychiatry or forensic psychology means recognition of specialized training and knowledge in the field of forensic psychiatry by the American Board of Psychiatry and Neurology (ABPN), or in the field of forensic psychology by the American Board of Forensic Psychology (ABFP); no amendments or editions are incorporated.

“Competency Evaluator” means a licensed physician who is a psychiatrist or a licensed psychologist, each of whom is trained in forensic competency assessments, or a psychiatrist who is in forensic training and practicing under the supervision of a psychiatrist with expertise in forensic psychiatry and who is an approved evaluator, or a psychologist who is in forensic training and is practicing under the supervision of a licensed psychologist with expertise in forensic psychology and who is an approved evaluator.

“Competent to Proceed” means that the defendant does not have a mental disability or developmental disability that prevents the defendant from having sufficient present ability to consult with the defendant's lawyer with a reasonable degree of rational understanding in order to assist in the defense, or prevents the defendant from having a rational and factual understanding of the criminal proceedings.

“Court-Ordered Competency Evaluation” means a court-ordered examination of a defendant either before, during, or after trial, directed to developing information relevant to a determination of the defendant’s competency to proceed at a particular stage of the criminal proceeding, that is performed by a competency evaluator and includes evaluations concerning restoration to competency.

“Forensic” means relating to or dealing with the application of scientific knowledge to the legal issues of defendants in criminal proceedings.

“Incompetent to proceed” means that, as a result of a mental disability or developmental disability, the defendant does not have sufficient present ability to consult with the defendant's lawyer with a reasonable degree of rational understanding in order to assist in the defense, or that, as a result of a mental disability or developmental disability, the defendant does not have a rational and factual understanding of the criminal proceedings.

21.920 APPLICATION PROCESS

Individuals other than independent contractors or those providing services under an active purchase order or personal services contract wishing to become an approved evaluator shall contact the Director of Court Services for application information, and the following shall be submitted:

A. A completed application form;

B. Verification of licensure as a psychiatrist or psychologist;

C. Verification of board certification in forensic psychiatry from the ABPN or board certification in forensic psychology from the ABFP, when relevant;

D. Proof of current malpractice insurance;

E. A minimum of two work samples, preferably forensic reports;

F. A minimum of three professional references.

21.930 TRAINING

21.931 APPROVED EVALUATORS

A. All approved evaluators shall have received training as specified in these rules, consisting of at least six hours of instruction. This initial training shall, at a minimum, cover the following elements:

1. Legal background and legal standards for competency to proceed and competency to stand trial;

2. Forensic versus clinical evaluation, ethical issues and challenges in competency evaluations, dual relationships, constitutional protections for defendants, informed consent in defendants with severe mental illnesses, and communication with attorneys;

3. Interviewing for competency to proceed;

4. Assessment of malingering;

5. Use of third-party (collateral) data and resources;

6. Working with the difficult defendant;

7. Evaluating developmentally delayed defendants;

8. Special issues in evaluating juveniles;

9. Writing the competency or restoration report;

10. Acting as an expert witness; and, 11. Unique requests from the court, such as for evaluations for competency to waive the right to counsel.

B. Exemptions to Initial Training 1. Evaluators who are board certified in forensic psychiatry by the ABPN or board certified in forensic psychology by the ABFP shall be considered exempt from this initial training requirement.

2. Evaluators who are in forensic training and practicing under the supervision of a licensed psychiatrist who is an approved evaluator and who has expertise in forensic psychiatry, or a licensed psychologist who is an approved evaluator and who has expertise in forensic psychology, may practice without the initial training; however, it is expected that these evaluators will receive equivalent education during the course of their training programs.

3. Independent contractors or individuals providing services under an active purchase order or personal services contract are not subject to the training requirements in Section 21.931, A.

C. Ongoing Training Approved evaluators other than independent contractors or individuals providing services under an active purchase order or personal services contract shall participate in at least four hours of ongoing training annually. Training will be made available at least annually by staff of the Court Services Division; alternative training to fulfill this requirement may be substituted for that offered by the Court Services Division, with prior approval from the Director of Court Services.

21.932 MENTORING

Mentoring shall be made available to approved CDHS-employed evaluators. Mentoring will be provided by senior clinical staff whenever possible.

A. Approved CDHS-employed evaluators wishing to participate in mentoring will be provided the opportunity to observe one or more evaluations being conducted by senior clinical staff, and to conduct one or more evaluations while being observed by senior clinical staff.

21.940 STANDARDS FOR CONDUCTING EVALUATIONS AND ESTABLISHING A REPORT

Each report shall conform with the requirements for report content as set forth in Section 16-8.5-105(5), C.R.S., and in accordance with best practices for forensic assessment of competency to stand trial.

21.950 QUALITY ASSURANCE

All approved evaluators shall have one or more of their competency or restoration reports reviewed at least annually by a senior Court Services Division evaluator or his or her designee.

A. All approved evaluators shall have their first two reports reviewed by the senior Court Services Division evaluator, or his or her designee, with additional reports being reviewed as necessary.

B. Any and all reports submitted by approved evaluators are subject to review. __________________________________________________________________________ Editor’s Notes

History New rule eff. 07/30/2023.

## **1008** Alcohol and Drug Abuse Division

##### **6 CCR 1008-1** ALCOHOL AND OTHER DRUG ABUSE/DEPENDENCE TREATMENT STANDARDS [Repealed eff. 11/01/2013] {#sec-6-ccr-1008-1 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-1}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division ALCOHOL AND OTHER DRUG ABUSE/DEPENDENCE TREATMENT STANDARDS - Repealed eff. 11/01/2013 6 CCR 1008-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

Alcohol and Other Drug Abuse Treatment rules of the Alcohol and Drug Abuse Division (ADAD) were originally adopted 5/18/76 by the Department of Health, with an effective date of 8/1/76. Subsequent revisions of these rules were adopted 4/15/81, effective 5/30/81; 4/17/85, effective 5/30/85; 5/21/86, effective 7/30/86; 3/16/88, effective 4/30/88; 1/18/89, effective 3/2/89; and, 3/18/92, effective 4/30/92.

These rule sections were rewritten and final adoption following publication at the 1/9/98 State Board of Human Services meeting, with an effective date of 3/1/98 (CSPR# 97-4-11-1). Statement of Basis and

Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

These rule sections were rewritten and final adoption following publication at the 5/7/99 State Board of Human Services meeting, with an effective date of 7/1/99 (CSPR# 99-2-10-1). Statement of Basis and

Purpose, Regulatory Analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of sections 15.100 through 15.118 were adopted following publication at the 11/1/2002 State Board of Human Services meeting, with an effective date of 1/1/2003 (Rule# 02-6-19-1). Statement of

Basis and Purpose, regulatory analysis, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Re-write of Treatment Rule Sections 1.0 through 14.2, which were replaced by Sections 15.200 through 15.230.3, were adopted following publication at the 1/6/2006 State Board of Human Services meeting, with an effective date of 3/2/2006 (Rule-making# 05-8-22-1). Statement of Basis and Purpose, regulatory analysis, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Rules regarding alcohol and drug abuse, as originally found in 6 CCR 1008-1, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 11/01/2013.

##### **6 CCR 1008-2** LICENSING OF ADDICTION PROGRAMS USING CONTROLLED SUBSTANCES [Repealed eff. 11/01/2013] {#sec-6-ccr-1008-2 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-2}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division LICENSING OF ADDICTION PROGRAMS USING CONTROLLED SUBSTANCES - Repealed eff. 11/01/2013 6 CCR 1008-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

Rules concerning the Licensing and Registration of Researchers, Analytical Laboratories, and Addiction Programs Using Controlled Substances (6 CCR 1008-2) were adopted on 7/28/71, effective 10/1/71 by the Department of Health. Revisions to pp. 1-10 were adopted 3/26/83, effective 4/30/83. Revisions to pp. 1-6 were adopted 12/16/92, effective 1/30/93. Contact the Colorado Department of Public Health and Environment for these materials.

Re-write of Section 6 CCR 1008-2 (22.000 through 22.800) was adopted as emergency at the 8/3/2007 State Board of Human Services meeting, with an effective date of 9/1/2007 (Rule-Making# 07-3-22-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, State Board Administration.

Rules regarding licensing of addiction programs using controlled substances, as originally found in 6 CCR 1008-2, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule emer. rule eff. 09/01/2007. Entire rule eff. 10/30/2007.

Entire rule repealed eff. 11/01/2013.

##### **6 CCR 1008-3** ADDICTION COUNSELOR CERTIFICATION AND LICENSURE [Repealed eff. 11/01/2013] {#sec-6-ccr-1008-3 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-3}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division ADDICTION COUNSELOR CERTIFICATION AND LICENSURE - Repealed eff. 11/01/2013 6 CCR 1008-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

Revision of the section on Counselor Certification of the Alcohol and Drug Abuse Division standards and regulations were final adoption following publication at the 6/7/96 Executive Director rule-making session, with an effective date of 8/1/96 (CSPR# 95-11-8-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions of the Counselor Certification regulations were final adoption following publication at the 5/7/99 State Board of Human Services rule-making session, with an effective date of 7/1/99 (CSPR# 99-2-3-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions of the Addiction Counselor Certification rules were final adoption following publication at the 12/7/2001 State Board of Human Services rule-making session, with an effective date of 2/1/2002 (CSPR# 01-8-27-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

An entire re-write of the Addiction Counselor Certification and Licensure rules were adopted following publication at the 1/9/2004 State Board of Human Services rule-making session, with an effective date of 3/1/2004 (Rule-making* 03-10-22-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to the Addiction Counselor Certification and Licensure rules, Sections 14.100 through 14.900 were adopted following publication at the 9/7/2007 State Board of Human Services rule-making session, with an effective date of 11/1/2007 (Rule-making# 07-3-23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to the Addiction Counselor Certification and Licensure rules, Sections 14.100 through 14.920 were adopted following publication at the 7/9/2010 State Board of Human Services rule-making session, with an effective date of 9/1/2010 (Rule-making# 10-3-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Rules regarding addiction counselor certification, as originally found in 6 CCR 1008-3, are repealed in their entirety and rewritten as a consolidation of Behavioral Health rules in 2 CCR 502-1 as adopted following publication at the 9/6/2013 State Board of Human Services meeting, with an effective date of 11/1/2013 (Rule-making# 13-3-4-1). Statement of Basis and Purpose, fiscal impact, and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 11/1/2007.

Entire rule eff. 09/01/2010.

Entire rule repealed eff. 11/01/2013.

##### **6 CCR 1008-4** DRUG PRECURSORS [Repealed eff. 06/01/2012] {#sec-6-ccr-1008-4 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-4}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division DRUG PRECURSORS - Repealed eff. 06/01/2012 6 CCR 1008-4 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________ Editor’s Notes

History Repealed eff. 06/01/2012.

##### **6 CCR 1008-5** CERTIFICATION AND LICENSURE OF LEVEL I AND LEVEL II ALCOHOL AND DRUG DRIVING SAFETY EDUCATION/TREATMENT PROGRAMS [Repealed eff. 06/01/2012] {#sec-6-ccr-1008-5 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-5}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division CERTIFICATION AND LICENSURE OF LEVEL I AND LEVEL II ALCOHOL AND DRUG DRIVING SAFETY EDUCATION TREATMENT PROGRAMS - Repealed eff. 06/01/2012 6 CCR 1008-5 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________ Editor’s Notes

History Repealed eff. 06/01/2012.

##### **6 CCR 1008-6** CERTIFICATION AS ALCOHOL AND DRUG EVALUATION SPECIALIST [Repealed eff. 12/01/1998] {#sec-6-ccr-1008-6 omnilex-key=us-co-regs-official--department-9--6 CCR 1008-6}

DEPARTMENT OF HUMAN SERVICES

Alcohol and Drug Abuse Division CERTIFICATION AS ALCOHOL AND DRUG EVALUATION SPECIALIST - Repealed eff. 12/01/1998 6 CCR 1008-6 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, REGULATORY ANALYSIS AND SPECIFIC STATUTORY

AUTHORITY

Revisions to pages 1-5 were adopted as emergency 6/16/82, effective 7/1/82; pages 1-5 adopted as emergency 9/8/82, effective 9/8/82; pages 1-5 adopted 9/8/82, effective 11/1/82; and, pages 1-12 adopted 12/15/93, effective 3/2/94 by the Department of Health (annotation: formerly Department of Highways regulation at 2 CCR 602-1).

Deletion of this section was final adoption following publication at the 10/2/98 State Board of Human Services meeting, with an effective date of 12/1/98 (CSPR# 98-7-27-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services. _______________________________________________________________________________ Editor’s Notes

History

## **2501** Human Services Administration (Volume 1)

##### **9 CCR 2501-1** Rule Manual Volume 1, General Policies and Administration {#sec-9-ccr-2501-1 omnilex-key=us-co-regs-official--department-9--9 CCR 2501-1}

DEPARTMENT OF HUMAN SERVICES

Human Services Administration

RULE MANUAL VOLUME 1, GENERAL POLICIES AND ADMINISTRATION

9 CCR 2501-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE AND SPECIFIC STATUTORY AUTHORITY OF REVISIONS

MADE TO VOLUME 1

Deletion of sections 1.300 - 1.306 were adopted final following publication at the 9/9/88 State Board meeting with an effective date of 11/1/88 (CSPR# 88-5-23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revision of sections 1.200 - 1.202.34 were adopted final following publication at the 9/7/90 State Board meeting with an effective date of 11/1/90 (CSPR# 90-3-6-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revision of section 1.500 was adopted final following publication at the 5/6/94 Executive Director meeting with an effective date of 7/1/94 (CSPR# 93-11-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Deletion of sections 1.100 through 1.907 and subsequent forms (the entire manual) were final adoption following publication at the 7/12/96 State Board meeting with an effective date of 9/1/96 (CSPR# 96-5-6- 1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Creation of sections 1.100 through1.152 were final adoption following publication at the 7/9/2010 Executive Director rule-making session, with an effective date of 9/1/2010 (Rule-making# 10-3-19-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Revision of sections 1.142, 1.151 and 1.152 were final adoption following publication at the 12/3/2010 Executive Director rule-making session, with an effective date of 2/1/2011 (Rule-making# 10-9-24-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

1.100 GENERAL POLICIES AND ADMINISTRATION

1.110 STATE DEPARTMENT OVERSIGHT AND CORRECTIVE ACTION PROCESS

Rule Volume 1 consists of Executive Director rules in its entirety.

Colorado Department of Human Services has a statutory responsibility to provide supervision to the county departments. This responsibility includes ensuring that the county departments comply with requirements provided by Federal laws and regulations, State statutes, Executive Director and State Board of Human Services rules, and contract and grant terms. Because of the nature of Colorado’s structure being state supervised and county administered, it is critical that there is a communication protocol in place to address identified issues. CDHS promotes a collaborative and participatory model for engagement throughout the system to enhance accountability and transparency.

A. For issues identified through a multitude of processes that are brought to the attention of the state or counties for response, there is a continuum of actions by the State Department dependent upon the county’s response to the identified issue. The first and lowest level of action is informal and consultative in nature.

B. The second level of action is technical or regulatory. This level includes any routine monitoring, quality assurance reviews, and audits conducted by the Colorado Department of Human Services. In this secondary and/or routine monitoring, existing policies and procedures will continue.

C. The last or third level of action occurs when issues are severe in nature and/or lower level interventions have not been effective in correcting the problem or issue and shall include:

1. Program Intervention.

2. Corrective Action Processes as defined in Section 1.150.

3. Sanctions as defined in Section 1.152. In the event these rules conflict and cannot be harmonized with existing Colorado Department of Human Services rules, these rules shall control and the applicable program area shall initiate a rule-making to modify the program area-specific rule language that is in conflict, with exception of federal requirements as found in Section 1.151.

D. The Colorado Department of Human Services, Corrective Action Process Practice Handbook, is incorporated by reference to provide further guidance; no later editions or amendments are included. The material may be examined by contacting the Colorado Department of Human Services, Director of the Administrative Review Division, 4045 S. Lowell Blvd., Denver, Colorado; or at a state publications library.

1.120 AUTHORITY

Section 26-1-111(2)(d)(I), Colorado Revised Statutes, stipulates that the State Department shall: “Provide services to county governments including the organization and supervision of county departments for the effective administration of public assistance and welfare functions as set out in the rules of the Executive Director and the rules of the State Board pursuant to Section 26-1-107 as to program scope and content, including assistance payments, food stamps, and social services, and compilation of statistics and necessary information relative to assistance payments, food stamps, social services, child welfare services, including out-of-home placement services, rehabilitation, programs for the aging, and veterans' programs throughout the state, and obtaining federal reimbursement moneys available under the Title IV- E program created under the federal "Social Security Act", as amended, based on out-of-home placements and alternative care treatment by county departments of children eligible for Title IV-E federal assistance, which moneys shall be allocated to counties to help defray the costs of performing its functions; except that nothing in this paragraph (d) shall be construed to allow counties to continue to receive an amount equal to the increased funding in the event the said funding is no longer available from the federal government.”

1.130 STATE DEPARTMENT OBJECTIVES

State Department objectives in implementing the Corrective Action Process are to:

A. Improve service delivery to clients;

B. Assure fiscal accountability; and, C. Strengthen the management and supervision capabilities of the State Department.

1.140 DEFINITIONS 1.141 Program Definition The Corrective Action Process (CAP) is intended to create a process/procedure to assure county departments of human/social services bring issues of noncompliance into compliance within specified time frames. Identification of issues of noncompliance may occur through:

A. Routine monitoring by State staff;

B. Specially scheduled program or management reviews;

C. Observation;

D. Complaints or grievances. 1.142 General Definitions [Rev. eff. 2/1/11]

The following are definitions of commonly used terms in this manual:

“Corrective action” means a formal, systemic process employed to correct county department of human/social services’ noncompliance with State Department rules, Federal and State laws, contract terms and grant terms.

“Corrective Action Plan” (CAP) means a written plan to correct areas of noncompliance that clearly identifies areas needing improvement, action steps to be taken for each area, dates by which action steps are to be implemented, staff responsible for the “CAP” , indicators of progress towards compliance, outcome measures for identifying compliance, and a timeframe for achieving compliance.

“Disallowance” means to prohibit funds paid retrospective to the date the ineligibility or noncompliance occurred.

“Noncompliance” means not meeting requirements identified by State Department rules, Federal and State statutes, contract terms, and grant terms.

“Sanction” means an action taken by the State Department upon a confirmed finding of a county department’s noncompliance. State Department actions may ultimately result in financial sanctions or state operation of programs as set forth in the Human Services Code, Section 26-1-109(4)(b), (c), (d), (e), C.R.S.

“State Department” means the Colorado Department of Human Services.

1.150 CORRECTIVE ACTION PROCESS FOR THE COLORADO DEPARTMENT OF HUMAN

SERVICES 1.151 Corrective Action Process Components [Rev. eff. 2/1/11]

Federal guidelines and rules would take precedence, if different than state rules.

The components of the Corrective Action Process are:

A. Schedule the Audit or Review State Department staff shall notify the County Director in writing, through the use of certified mail, of the scheduled monitoring visit. Notification should be provided in a manner that allows the county department sufficient time to prepare, but shall not occur any closer than two (2) weeks prior to the audit/review. The notification shall include any and all information necessary for the county department to adequately prepare for the audit or review.

Emergent situations may warrant an audit or review that commences without a two-week notice.

In this case, the county will still be notified.

If the county department has scheduling conflicts that would preclude it from being able to participate in the audit or review, it must immediately notify the State Department staff who are coordinating the review in order to negotiate a new audit or review date.

B. Entrance Conference State Department staff shall schedule an entrance interview with the County Director and/or staff selected by the County Director. As warranted, State staff or the County Director may chose to invite local officials such as County Commissioners or Mayors. The purpose of the entrance interview is to introduce staff, explain the reason for the audit or review, review the process and schedule, establish procedures for gathering additional information and documentation during the review, review the tools used to monitor and evaluate compliance with the standards, and answer any questions.

C. Audit or Review The audit or review shall be planned to minimize disruption to the normal activities of the county department. This component includes on-site review and data collection. The county department shall provide access to staff and records that the reviewer(s) determines necessary to achieve audit or review objectives, in a format that may be specified by the reviewer(s). Discrepancies identified during the audit or review shall be discussed with county staff to determine if all relevant data has been considered.

D. Presentation of Preliminary Findings Upon completion of the on-site monitoring activities, the State staff shall, within twenty (20) state working days of the completion of the audit or review, draft a Preliminary Report and provide a copy of the report to the county department sent by certified mail to the County Director. The Preliminary Report shall include the audit or review findings based on the review instrument or tool(s) used. If a county department is found to be out of compliance in any area, such area shall be highlighted in the preliminary report.

E. County Department Response The County Director or his/her designee shall, within twenty (20) state working days of the date the Preliminary Report was mailed, respond in writing to the State Department. The response shall include information regarding agreement or disagreement with the findings, any identified areas of non-compliance, requirements for CAPs, or any objection to specific wording. Any designee appointed by the county director to act on his/her behalf shall be a county employee approved by the county commissioners, city mayor, or city council persons as appropriate. If the county director appoints a designee to act on his/her behalf, this shall also be put in writing and submitted to the State Department.

If the county department does not respond in writing within twenty (20) state working days of the date the preliminary findings were mailed, the Preliminary Report shall be considered the Final Report.

F. Exit Conference State Department staff will schedule an Exit Conference with the county department in order to discuss the Preliminary Report and the county department’s response within twenty (20) calendar days from the end of the time frame for a county response as indicated in Section 1.151, E. The following persons, at a minimum, shall attend the exit conference: the State staff responsible for the audit or review or their designee, the County Director and/or his/her designee(s), State Department program staff with responsibility for any rules reviewed, State staff who conducted the review, and the regional Field Administrator. State staff may also invite appropriate local officials such as County Commissioners, City Mayors or Council Persons, County Administrators or others as deemed appropriate.

G. Final Report Within twenty (20) state working days of the Exit Conference, State staff shall create a Final Report and provide a copy of the report to the county department and the County Commissioners, City Mayors or Council Persons, Council Administrators or others as deemed appropriate.

H. County Department Appeal Upon receipt of the Final Report, the county department may appeal the findings of the Final Report to the Executive Director of the Colorado Department of Human Services. Within twenty working days of the date the Final Report was mailed (through certified mail), the County Director may request a review of the findings by the Executive Director of the State Department. The county department’s request shall identify the specific findings under dispute and provide data, statements of evidence or other evidence and the documentation to support the appeal. The Executive Director of the State Department, or his/her designee, shall respond in writing to the county department within twenty (20) state working days of the date the appeal letter was received. All decisions by the Executive Director or his/her designee shall be considered the final decision. If the county department does not appeal the findings in the final report, the right to appeal is forfeited.

As applicable, the State would modify the Final Report based on the Executive Director’s decision. If the Final Report requires the county department to complete a CAP, the timeline for submitting the CAP does not begin until after the appeal has been heard and formal notification of such has been mailed to the county department.

I. Corrective Action Plan If necessary, a Corrective Action Plan shall be submitted by the county department of human/social services to the State Department.

1. Upon receiving the Final Report, and if the Report requires the submittal of a Corrective Action Plan, the county department shall prepare and return a Corrective Action Plan to the State Department within twenty (20) state working days of the date the Final Report was mailed. If the county department filed a formal appeal to the Executive Director of the Department Human Services that was denied, the CAP must be submitted within twenty (20) state working days of the date the formal notice of denial was sent by certified mail.

2. The written CAP shall be completed on the CAP form provided by the State Department and shall identify areas of non-compliance, action steps to be taken for each area, dated by which action steps are to be implemented, indicators of progress toward compliance, dates for progress reports, and a date for achieving compliance.

3. Within twenty (20) state working days from the date the state designated lead received the county CAP, the State Department shall notify the county department of acceptance or denial of the CAP and request modifications deemed necessary.

4. If a county department does not submit a CAP within the twenty (20) state working days, the State Department shall follow the sanction process as described in Section 1.152.

5. If the county department needs additional time to meet any of the deadlines provided in this

Rule Volume 1, the county director may submit a request in writing to the Department, providing the reasons that an extension of time is necessary and a proposed date for the submittal of required documents or plan. The Department will respond to the request for an extension with five (5) state working days of the date the denial was mailed to the county department.

If the county department needs to modify a CAP, the county director may submit a request in writing to the Department, providing the reasons that a modification is necessary and a proposed date the Department received the request.

a. If the request for a modification is denied, the CAP shall remain as previously approved.

b. If approved, the county will be required to submit a modified CAP Form to the Department by the proposed date.

c. If the county does not submit the revised CAP Form within the timeline approved, the original CAP will continue to be in force.

6. At the time the State Department accepts the CAP, questioned costs and/or sanctions will be processed in accordance with accounting policy and procedures.

J. Corrective Action Plan Monitoring Monitoring of the Corrective Action Plan shall begin within twenty (20) state working days following State approval of the plan and continues through the completion of the plan. Monitoring may include, but not be limited to, case and record reviews, onsite conferences, staff interviews, data analysis, and direct observation. At any time during the monitoring of the Corrective Action Process, the Department may provide technical assistance, training and other assistance as needed. At any time during the monitoring process, but no later than the agreed end of the Corrective Action Plan timeframe, the State Department shall notify the county department of the status for final compliance. If compliance has been achieved, written notification shall be provided to the Executive Director, the Deputy Executive Director, the County Director, Board of County Commissioners, and other as deemed appropriate. If the county department remains in noncompliance, sanctions will be imposed.

K. The confidentiality of records audited or reviewed in the course of a program intervention or in the course of the corrective action process will be maintained as required by the statutes and rules governing the specific program area or areas being audited or reviewed. The confidentiality of a program intervention or corrective action process will be maintained as authorized under Colorado law.

Records can be disclosed as authorized under the Colorado Open Records Act or other similar federal and state laws.

1. If the county or state department receives an open records request of audited or reviewed records, the county or state department shall process the request as required by the statutes and rules governing the specific program area or areas being audited or reviewed.

2. If the county or state department receives an open records request of records specific to a program intervention for the Corrective Action Process, the county or state department shall process the request as required by the statutes and rules governing the specific program area or areas being audited or reviewed and the county department will notify the state department within twenty-four hours of the request. 1.152 Sanctions [Rev. eff. 2/1/11]

If a county department does not meet the requirements of this Rule Volume 1 or fails to comply with an approved Corrective Action Plan, the State Department may impose any financial sanction as set forth in the Human Services Code, Section 26-1-109(4)(b), (c), (d), (e), C.R.S. These sanctions may include, but not be limited by, the following:

A. Disallowance of State funds equal to the salary of the County Director of Human/Social Services from the grant which the CAP is issued.

B. The State Department to undertake the administration of the public assistance or welfare program for which the county department has not met the requirements of a Corrective Action Plan.

Notwithstanding the provisions of this Rule Volume 1, if the circumstances of noncompliance, as defined herein, creates or has the potential to create a risk of imminent harm to a person or damage to property, the State Department may take action, as it deems appropriate, consistent with Colorado Human Service Code, Section 26-1-101, et seq., C.R.S. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 09/01/2010.

Sections SB&P, 1.142, 1.151 – 1.152 eff. 02/01/2011.

## **2502** County Personnel and Merit System (Volume 2)

##### **9 CCR 2502-1** Rule Manual Volume 2, County Personnel Rules {#sec-9-ccr-2502-1 omnilex-key=us-co-regs-official--department-9--9 CCR 2502-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 2, COUNTY PERSONNEL RULES

9 CCR 2502-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT AND SPECIFIC STATUTORY

AUTHORITY OF REVISIONS MADE TO VOLUME 2

Revisions to sections 2.221; 2.241.1; 2.240.21 through 2.240.9 were finally adopted at the 12/6/85 State Board meeting with an effective date of 2/1/86 (Document 2). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.221; 2.221.1; 2.221.22; 2.421.5; 2.423.4; 2.425.2; were finally adopted and sections 2.600 through 2.610.2 were deleted at the 12/6/85 State Board meeting with an effective date of 2/1/86 (Document 1). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 2.113.13, 2.113.14; 2.113.32; 2.212 were finally adopted at the 7/11/86 State Board meeting with an effective date of 9/1/86 (Document 1). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Rewrite of Volume 2 Staff Manual was finally adopted at the 11/7/86 State Board meeting with an effective date of 1/1/87 (Document 16). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 2.040 through 2.980 were finally adopted following publication at the 5/1/87 State Board meeting, with an effective date of 7/1/87 (Document 1). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to section 2.272 were finally adopted following publication at the 6/5/87 State Board meeting with an effective date of 9/1/87 (Document 11). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 2.000 through 2.980 were finally adopted following publication at the 9/11/87 State Board meeting, with an effective date of 11/1/87 (Document 23). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.272 and 2.424 through 2.428 were finally adopted following publication at the 11/6/87 State Board meeting, with an effective date of 1/1/88 (Documents 2 and 5). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 2.000 – 2.031, 2.800 – 8.822 and 2.980 were finally adopted following publication at the 5/6/88 State Board meeting, with an effective date of 7/1/88 (CSPR# 87-12-29-1). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 2.221 – 2.242, 2.531 – 2.532, 2.642 – 2.660, 2.800 – 8.811, 2.850 – 2.880, 2.930 and “Definitions” were finally adopted following publication at the 11/4/88 State Board meeting, with an effective date of 1/1/89 (CSPR# 88-8-26-1, 88-8-26-2. and 88-8-29-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions and additions to sections 2.000 – 2.031, 2.035, 2.424 – 2.426 and 2.531 – 2.532 were finally adopted following publication at the 2/3/89 State Board meeting, with an effective date of 4/1/89 (CSPR# 88-11-2-1 and 88-11-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 2.532 were adopted emergency at the 6/2/89 State Board meeting, with an effective date of 6/2/89 (CSPR# 89-4-26-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 2.532 were final adoption of emergency at the 7/7/89 State Board meeting, with an effective date of 6/2/89 (CSPR# 89-4-26-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 2.000 – 2.031 were final adoption following publication at the 10/6/89 State Board meeting, with an effective date of 12/1/89 (CSPR# 89-2-22-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 2.035, 2.246–2.261, 2.272, 2.531–2.532 and 2.812 were final adoption following publication at the 11/3/89 State Board meeting, with an effective date of 1/1/90 (CSPR#'s 89-7-31-1 and 89-8-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 2.272 were final adoption following publication at the 2/2/90 State Board meeting, with an effective date of 4/1/90 (CSPR# 89-12-13-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Revisions to sections 2.900 – 2.910 and 2.920 – 2.930 were final adoption following publication at the 10/5/90 State Board meeting, with an effective date of 12/1/90 (CSPR# 90-2-1-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.200 – 2.264, 2.272, and Definitions were final adoption following publication at the 11/2/90 State Board meeting, with an effective date of 2/1/91 (CSPR# 90-8-7-2). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.000 – 2.031, 2.032, 2.222 – 2.240 and 2.270 – 2.272 were final adoption following publication at the 11/1/91 State Board meeting, with an effective date of 1/1/92 (CSPR#'s 91-8-20-2 and 91-8-20-3). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 2.400 and 2.429 through 2.453 were adopted emergency at the 12/6/91 State Board meeting, with an effective date of 1/1/92 (CSPR# 91-11-18-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 2.400 and 2.429 through 2.453 were final adoption of emergency at the 1/10/92 State Board meeting, with an effective date of 1/1/92 (CSPR# 91-11-18-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.400 – 2.423 and 2.700 – 2.741 were final adoption following publication at the 1/10/92 State Board meeting, with an effective date of 3/1/92 (CSPR# 91-9-24-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 2.272 were final adoption following publication at the 5/1/92 State Board meeting, with an effective date of 7/1/92 (CSPR# 92-2-26-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Revisions to sections 2.300 – 2.321, 2.524 – 2.532, 2.653 – 2.741, and 2.822 – 2.840 were final adoption following publication at the 10/2/92 State Board meeting, with an effective date of 12/1/92 (CSPR# 92-7- 27-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 2.272 were final adoption following publication at the 11/6/92 State Board meeting, with an effective date of 1/1/93 (CSPR# 92-7-27-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Revisions to sections 2.100 – 2.112, 2.300 – 2.335, 2.354 – 2.423, and 2.524 – 2.730 were final adoption following publication at the 11/5/93 State Board meeting, with an effective date of 1/1/94 (CSPR# 93-8-9- 1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 2.200 – 2.221, 2.251 – 2.264, 2.800 – 2.890, and “Definitions” were final adoption following publication at the 12/3/93 State Board meeting, with an effective date of 2/1/94 (CSPR# 93-8- 26-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 2.100 – 2.110, 2.246, 2.341 – 2.354, 2.427 – 2.453, 2.600 – 2.642, 2.700 – 2.750, 2.822 – 2.830, and “Definitions” were final adoption following publication at the 3/4/94 State Board meeting, with an effective date of 5/1/94 (CSPR# 93-12-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to section 2.272 were final adoption following publication at the 8/5/94 State Board meeting, with an effective date of 11/1/94 (CSPR# 94-5-13-3). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.270 through 2.272 were final adoption following publication at the 11/4/94 State Board meeting, with an effective date of 1/1/95 (CSPR# 94-8-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to sections 2.040 – 2.264, 2.354 – 2.453, 2.532, 2.632 – 2.660, 2.742, 2.921 – 2.930, and “Definitions” were final adoption following publication at the 8/4/95 State Board meeting, with an effective date of 10/1/95 (CSPR# 95-4-21-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.272 and 2.920 were final adoption following publication at the 11/3/95 State Board meeting, with an effective date of 1/1/96 (CSPR#'s 95-7-28-1 and 95-8-22-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.270 through 2.272 were final adoption following publication at the 11/8/96 State Board meeting, with an effective date of 1/1/97 (CSPR# 96-8-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to sections 2.246, 2.272, 2.600 through 2.636, and 2.900 through 2.980 were final adoption following publication at the 3/7/97 State Board meeting, with an effective date of 5/1/97 (CSPR# 96-12- 27-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.000 through 2.030 were final adoption following publication at the 8/1/97 State Board meeting, with an effective date of 10/1/97 (CSPR# 97-6-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to sections 2.200 and 2.272 were final adoption following publication at the 11/7/97 State Board meeting, with an effective date of 1/1/98 (CSPR# 97-7-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to section 2.200 Table of Contents and sections 2.230 – 2.232 were final adoption following publication at the 10/2/98 State Board meeting, with an effective date of 12/1/98 (CSPR# 98-8-4-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.272 through 2.280, 2.341 through 2.351, 2.520 through 2.531, and 2.620 through 2.640 were final adoption following publication at the 11/6/98 State Board meeting, with an effective date of 1/1/99 (CSPR#s 98-8-21-1 and 98-8-26-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 2.272 through 2.280 were final adoption following publication at the 11/5/99 State Board meeting, with an effective date of 1/1/2000 (CSPR# 99-7-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Entirely rewritten manual was final adoption following publication at the 05/04/2001 State Board meeting, with an effective date of 7/1/2001 (CSPR# 00-10-23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement. Boards and Commissions Division.

2.000 COUNTY PERSONNEL

2.100 COUNTY RESPONSIBILITIES

Effective January 1, 2001, statutory authority for State administered county merit systems was repealed.

Each county shall provide for a merit system for the selection, retention, and promotion of employees of the county department of human/social services. The county's merit system for personnel administration shall meet the criteria set forth in these rules and the Federal Regulations issued by the Office of Personnel Management of the U.S Department of Health and Human Services found at 5 C.F.R Section 900.601 et seq (2018) which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S Services Administration, Office of Communications, 5600 Fishers Lane, Rockville, MD 20857, or at http://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Community Partnerships, 1575 Sherman St. Denver, CO 80203, during regular business hours.

A county may combine with another county or group of counties to form a district to provide a merit system for its employees.

2.200 MINIMUM CRITERIA FOR THE COUNTY MERIT SYSTEM

The county merit system shall provide for the following:

A. The recruitment, selection, and advancement of employees shall be on the basis of relative abilities, knowledge, and skills, including open consideration of qualified applicants for initial appointment.

B. The system shall provide equitable and adequate compensation.

C. The employees shall be trained as needed to assure high quality of performance.

D. The system shall provide for retaining employees on the basis of the adequacy of their performance, correcting inadequate performance, and separating employees whose inadequate performance cannot be corrected.

E. The system shall assure fair treatment of applicants and employees in all aspects of personnel administration without regard to political affiliation, race, color, national origin, sex, religious creed, age, or disability and with proper regard for the privacy and constitutional rights of such persons as citizens. This fair treatment principle shall include compliance with all Federal equal opportunity and nondiscrimination laws.

F. The system shall assure that employees are protected against coercion for partisan political purposes and are prohibited from using their official authority for the purpose of interfering with or affecting the results of an election or a nomination for office. 2.210 Certification of Merit System Every two years beginning January 1, 2025 each county shall annually submit to the Colorado Department of Human Services a certification that the above criteria are being maintained by the county department of human/social services. This certification must be received as prescribed by the State Department on or before January 1 of every other year beginning January 2025. The certification must be validated by the county board of commissioners or designee.

2.300 MINIMUM QUALIFICATIONS FOR COUNTY MERIT SYSTEM POSITIONS

Minimum qualifications for certain positions are established as determined by the State Board of Human Services to necessitate uniform standards. 2.320 Minimum Qualifications for Professional Services in Child Welfare or Adult Protective Services The county merit system shall adhere to the following minimum qualifications or standards in the hiring, retention, and promotion of employees who supervise or provide professional services in child welfare, as outlined in 12 CCR 2509-7, 7.603.1, or adult protective services, as outlined in 12 CCR 2518-1, 30.310. 2.330 Waiver Process If proven recruitment difficulties exist, county departments may request a waiver of educational and/or training requirements as per 12 CCR 2509-7, 7.603.1 (G-H) for child welfare services and as per 12 CCR 2518-1, 30.310 (B) for adult protective services.

2.400 MAXIMUM SALARY REIMBURSEMENT LEVEL FOR COUNTIES

The maximum salary reimbursement level shall not exceed the amount authorized for salaries by the county's merit system. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 11/01/2018.

Rule 2.210 eff. 03/01/2024.

## **2503** Income Maintenance (Volume 3)

##### **9 CCR 2503-1** (Reserved for Future Use) {#sec-9-ccr-2503-1 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-1}

DEPARTMENT OF HUMAN SERVICES

RESERVED FOR FUTURE USE

9 CCR 2503-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.100 (RESERVED FOR FUTURE USE) _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Sections 3.600, 3.602, 3.625, 3.626, 3.631, 3.632 eff. 08/01/2007.

Section 3.490.21-22 emer. rules eff. 07/13/2007.

Section 3.400.19 eff. 09/01/2007.

Sections 3.490.21, 3.490.22 eff. 09/30/2007.

Sections 3.636-3.638 emer. rule eff. 10/01/2007.

Section 3900 eff. 11/01/2007; Section 3.210.37 repealed eff. 11/01/2007.

Sections 3.636-3.638 eff. 11/30/2007.

Sections 3.120, 3.130, 3.608, 3.610, 3.612, 3.618, 3.750-3.770, 3.810 eff. 12/01/2007.

Section 3.360.44 emer. rule eff. 01/01/2008.

Section 3.360.44 eff. 03/01/2008.

Sections 3.614-3.617 emer. rules eff. 09/05/2008.

Sections 3.140, 3.705, 3.710, 3.711 eff. 10/01/2008.

Sections 3.614-3.617, 3.720, 3.730, 3.736, 3.738, 3.751, 3.752, 3.754, 3.755, 3.756, 3.758, 3.760 eff. 11/01/2008.

Section 3.140.1 eff. 01/01/2009.

Sections 3.360.44, 3.614.21, 3.614.41, 3.615, 3.616 emer. rules eff. 01/01/2009.

Section 3.639 emer. rule eff. 01/09/2009.

Sections 3.360.44, 3.614.21, 3.614.41, 3.615, 3.616 eff. 03/02/2009.

Sections 3.639, 3.900-3.922 eff. 04/01/2009.

Sections SB&P, 3.755.43 emer. rules eff. 03/06/2009.

Sections 3.903, 3.919 emer. rules eff. 04/03/2009.

Sections SB&P, 3.755.43 eff. 06/01/2009.

Sections 3.605, 3.638 emer. rules eff. 06/05/2009.

Sections 3.903, 3.919 eff. 07/01/2009.

Sections 3.200.41(L), 3.626.12-3.626.15 and 3.626.21 eff. 08/01/2009.

Sections 3.605, 3.638 eff. 09/01/2009.

Sections SB&P, 3.140.171(F), 3.600.14, 3.710.31(G-H), 3.711.11, 3.711.22, 3.751.1(B), 3.752.1- 3.752.23, 3.752.25(A), 3.754.1, 3.755.13-3.755.21(D), 3.755.41, 3.756.16, 3.756.19-3.756.2, 3.758.47, 3.759.32, 3.760.31 eff. 10/01/2009.

Sections SB&P, 3.600.12(A), 3.612.1 (HH), 3.711.11 emer. rules eff. 12/04/2009.

Sections SB&P, 3.600.12(A), 3.612.1 (HH), 3.711.11 eff. 03/02/2010.

Sections SB&P, 3.639.12-14 eff. 05/16/2010.

Sections SB&P, 3.604.2, 3.604.4, 3.604.52, 3.625.7, 3.626.1 eff. 06/01/2010.

Sections SB&P, 3.140.171-3.140.18, 3.360.6-3.360.63, 3.360.65, 3.360.68 emer. rules eff. 07/01/2010.

Sections SB&P, 3.720.21 (Deleted), 3.720.4, 3.721, 3.730.3-3.730.42, 3.730.6-3.730.8 emer. rules eff. 07/09/2010.

Sections SB&P, 3.752.22 (C), 3.758.47 Step A eff. 09/01/2010.

Sections SB&P, 3.140.171-3.140.18, 3.360.6-3.360.63, 3.360.65, 3.360.68, 3.720.4, 3.721, 3.730.3- 3.730.42, 3.730.6-3.730.7 eff. 10/01/2010.

Sections SB&P, 3.612.1 emer. rule eff. 11/05/2010.

Sections SB&P, 3.110.6, 3.110.7, 3.120.24, 3.140.16, 3.200.12-3.200.13, 3.210.4, 3.500.5-3.500.51, 3.500.53, 3.500.61, 3.600.12(B-E), 3.600.14, 3.601.1, 3.603.1, 3.603.3-5, 3.603.8, 3.604.1, 3.604.4, 3.605-3.607.22.D, 3.609.1, 3.609.2, 3.609.3, 3.612, 3.612.1, 3.612.2, 3.612.3, 3.613.2, 3.613.3, 3.614.17, 3.614.23, 3.614.24, 3.616, 3.617.1, 3.617.2, 3.620.1-3.620.6, 3.622.2, 3.631.1, 3.810, 3.810.13, 3.810.32, 3.810.4, 3.810.7, 3.810.74, 3.811.11, 3.811.2, 3.811.21, 3.820.2;

emer. rules eff. 01/07/2011; Repealed 3.608 emer. rule eff. 01/07/2011.

Sections SB&P, 3.612.1, 3.612.1(II) eff. 02/01/2011.

Sections SB&P, 3.140.173 eff. 04/01/2011.

Sections SB&P, 3.110.6, 3.110.7, 3.120.24, 3.140.16, 3.200.12-3.200.13, 3.210.4, 3.500.5-3.500.51, 3.500.53, 3.500.61, 3.600.12(B-E), 3.600.14, 3.601.1, 3.603.1, 3.603.3-5, 3.603.8, 3.604.1, 3.604.4, 3.605-3.607.22.D, 3.609.1, 3.609.2, 3.609.3, 3.612, 3.612.1, 3.612.2, 3.612.3, 3.613.2, 3.613.3, 3.614.17, 3.614.23, 3.614.24, 3.616, 3.617.1, 3.617.2, 3.620.1-3.620.6, 3.622.2, 3.631.1, 3.810, 3.810.13, 3.810.32, 3.810.4, 3.810.7, 3.810.74, 3.811.11, 3.811.2, 3.811.21, 3.820.2 eff. 05/01/2011. Section 3.608 repealed eff. 05/01/2011.

Sections SB&P, 3.600.12, 3.711.11, 3.903, 3.904.1, 3.907, 3.908.1, 3.913, 3.916.1, 3.919, 3.919.E.4, 3.919.F.7-8, 3.921-3.922 emer. rules eff. 06/10/2011.

Sections SB&P, 3.140.12-3.140.12.C, 3.902-3.922 eff. 07/01/2011.

Sections SB&P, 3.140.12.D-14, 3.600.12, 3.711.11, 3.750.15, 3.751.1, 3.751.33, 3.752.1, 3.752.22 C-E, 3.752.23.L, 3.752.26-3.752.27, 3.752.28.C, 3.754.1, 3.755.21.C, 3.755.42, 3.755.6-3.756.11, 3.756.2-3.757.12, 3.758.16-17, 3.758.32, 3.758.47 (Step F)-3.758.48, 3.760.16, 3.760.43.K-P, 3.903, 3.904.1, 3.907, 3.908.1, 3.913, 3.916.1, 3.919, 3.919.E.4, 3.919.F.7-8, 3.921-3.922 eff. 09/01/2011.

Sections 3.720.1-3.720.31, 3.720.33, 3.720.4-3.720.5, 3.721.11, 3.721.21, 3.721.23, 3.721.25, 3.721.4- 3.721.62, 3.730-3.730.1, 3.730.21-3.730.22, 3.730.42-3.730.43, 3.730.5, and 3.731-3.738 eff. 01/01/2012.

Sections SB&P, 3.140.12, 3.750.14, 3.758.1, 3.759.3, 3.760.15 eff. 02/01/2012; Sections 3.751.56. 3.757.13-3.757.15, 3.760.22 repealed eff. 02/01/2012.

Sections SB&P, 3.740-3.746 emer. rules eff. 03/23/2012.

Sections SB&P, 3.710.11, 3.711, 3.711.1 eff. 05/01/2012; Sections 3.710.12-3.710.13, 3.710.22- 3.710.24, 3.710.32-3.710.33, 3.711.11-3.711.12 repealed eff 05/01/2012.

Sections SB&P, 3.360.44, emer. rules eff. 07/01/2012.

Sections SB&P, 3.740, 3.810.76.A, 3.811.21.E, 3.904.1.A-E, 3.905.C.7-8, 3.906.C, 3.907.C, 3.911.E, 3.913.T-AA.2 eff. 07/01/2012.

Sections SB&P, 3.100-3.100.21, 3.110-3.110.33, 3.120-3.120.14, 3.120.27, 3.120.31, 3.130-3.130.12, 3.130.31-33, 3.130.6 eff. 09/15/2012. Sections 3.100.3, 3.110.4-3.110.53, 3.120.28, 3.130.52 repealed eff. 09/15/2012.

Section SB&P eff. 03/02/2013.

Section SB&P eff. 04/01/2013.

Section SB&P emer. rule eff. 04/05/2013.

Section SB&P eff. 05/01/2013.

Section SB&P eff. 07/01/2013.

Section SB&P eff. 08/07/2013.

Section SB&P eff. 11/01/2013.

Section SB&P emer. rule eff. 01/01/2014.

Entire rule eff. 03/02/2014.

Section SB&P emer. rule eff. 05/02/2014.

Section SB&P eff. 08/01/2014.

Section SB&P emer. rule eff. 08/06/2014.

Section SB&P eff. 10/01/2014.

Section SB&P eff. 12/01/2014.

Section SB&P emer. rule eff. 01/01/2015.

Section SB&P eff 03/20/2015.

Section SB&P eff 04/01/2015.

Section SB&P eff 06/01/2015.

Section SB&P emer. rule eff. 06/05/2015.

Section SB&P eff. 07/01/2015.

Section SB&P eff. 09/01/2015.

Section SB&P eff. 10/01/2015.

Section SB&P eff. 11/01/2015.

Section SB&P emer. rule eff. 12/04/2015.

Section SB&P eff. 01/01/2016.

Section SB&P eff. 03/01/2016.

Section SB&P eff. 04/01/2016.

Entire rule repealed eff. 11/01/2018.

Annotations

Rule 3.639.12 (adopted 02/06/2009) was not extended by Senate Bill 10-060 and therefore expired 05/15/2010.

##### **9 CCR 2503-2** (Reserved for Future Use) {#sec-9-ccr-2503-2 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-2}

DEPARTMENT OF HUMAN SERVICES

Income Maintenance (Volume 3)

RESERVED FOR FUTURE USE

9 CCR 2503-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.200 (RESERVED FOR FUTURE USE) _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Sections 3.200, 3.200.4, 3.220.12, 3.220.21 – 22, 3.250.13 – 14, 3.250.23 – 25, 3.250.37, 3.250.42 eff. 09/15/2012. Section 3.200.26 repealed eff. 09/15/2012.

Entire rule eff. 03/02/2014.

Entire rule repealed eff. 11/01/2018.

##### **9 CCR 2503-3** Colorado Refugee Services Program (crsp) {#sec-9-ccr-2503-3 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-3}

DEPARTMENT OF HUMAN SERVICES

Income Maintenance (Volume 3)

COLORADO REFUGEE SERVICES PROGRAM (CRSP)

9 CCR 2503-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.300 COLORADO REFUGEE SERVICES PROGRAM (CRSP)

3.310 PROGRAM SUMMARY

The Colorado Department of Human Services, through the Colorado Refugee Services Program (CRSP), is the single State agency with responsibility for the overall supervision and coordination of this program in Colorado, and for the development and supervision of the annual state plan for Colorado. CRSP operates under the Refugee Act of 1980 and Title IV of the Immigration and Nationality Act (INA), as amended.

CRSP serves eligible populations (see General Definitions in section 3.320) who are residents of Colorado for up to five years after their date of entry into the United States or the date status was granted.

These eligible populations are considered qualified aliens and are exempt from the five year bar for public assistance (with exceptions under the category of Unaccompanied Refugee Minors). These populations may access public assistance programs provided by the Colorado Department of Human Services and the Colorado Department of Health Care Policy and Financing, such as, but not limited to: Colorado Works/TANF, SNAP/Food Assistance, and medical programs provided through the Colorado Department of Health Care Policy and Financing.

For Unaccompanied Refugee Minors (URM), CRSP can serve this population through the URM program until the youth turns twenty-one (21) years of age. If needed, a URM who is no longer in the URM program can receive CRSP services for up to five years after receiving status that enables him/her to receive services through the Office of Refugee Resettlement (ORR).

3.320 GENERAL DEFINITIONS

3.321 CRSP ELIGIBLE POPULATIONS

The following categories of people are eligible for CRSP, CDHS, and HCPF services.

A. A “refugee” means the same as in 8 U.S.C. 1101(a)(42) and accompanying notes to 8 U.S.C 1101.

B. An “asylee” is a person who has been granted asylum by the U.S. Citizenship and Immigration Service (USCIS) while residing in the United States. An asylee meets the same definition as a refugee and has been granted asylum status. Individuals admitted to the United States who are classified by USCIS as “applicants for asylum” are not eligible for CRSP benefits unless they are Cuban or Haitian (refer to Sections 3.321 C, and 3.330 D).

C. “Cuban and Haitian Entrants” are:

1. Any individual granted parolee status by the Department of Homeland Security (DHS) as a Cuban/Haitian Entrant (status pending) or granted any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the status of the individual at the time assistance or services provided.

2. A national of Cuba or Haiti who was paroled into the United States and has not acquired any other status under the Immigration and Nationality Act (INA), and with respect to whom a final, nonappealable and legally enforceable order of removal, deportation or exclusion has not been entered.

3. A national of Cuba or Haiti who is the subject of removal, deportation or exclusion proceedings under the INA and with respect to whom a final, nonappealable, and legally enforceable order of removal, deportation or exclusion has not been entered.

4. A national of Cuba or Haiti who has an application for asylum pending with Department of Homeland Security, United States Citizenship and Immigration Services (USCIS) or Department of Justice (DOJ)/Executive Office for Immigration Review (EOIR) and with respect to whom a final, nonappealable, and legally enforceable order of removal, deportation or exclusion has not been entered. For documentation requirements, refer to

section 3.330, D.

D. “Certain Amerasians from Vietnam” are certain persons from Vietnam who:

1. Are admitted to the United States as immigrants and were born in Vietnam after January 1, 1962 and before January 1, 1976; and, 2. Were fathered by a citizen of the United States.

E. “Victims of Severe Forms of Trafficking” are persons who have been certified as such by the U.S.

Department of Health and Human Services (HHS), and are eligible for benefits and services to the same extent as refugees. Victims of trafficking can be adults or minors. Family members who obtain derivative status from the trafficked person are also eligible for both benefits and services.

F. Iraqi and Afghan individuals who have been employed by, or on behalf of, the U.S. military, or on behalf of the U.S. government, or families of such individuals, who are now in danger and have been admitted to the United States under a Special Immigrant Visa (SIV). For verification requirements (refer to section 3.330, G.)

G. “Afghan humanitarian parolee” refers to Afghan individuals who have been granted humanitarian parole status by the U.S Department of Homeland Security and who qualify for refugee benefits under Pub. L. 117-43, § 2502 (Sept. 30, 2021), no later additions or amendments are incorporated. This public law is available at no cost from www.uscode.house.gov. This public law is also available for public inspection and copying at the Colorado Department of Human Services, Colorado Refugee Services Program, 1575 Sherman St., Denver, CO 80203, during regular business hours.

H. Afghan individuals granted special immigrant parolee (SQ/SI) or conditional permanent resident (CPR) status by the U.S. Department of Homeland Security (see section 3.330, H.,I., for verification requirements).

I. “Ukrainian humanitarian parolee (UHPs)” refers to citizens or nationals of Ukraine who the Department of Homeland Security (DHS) has paroled into the United States between February 24, 2022, and September 30, 2023, due to urgent humanitarian reasons or for significant public benefit who qualify for refugee benefits under Pub. L. 117-128, § 401 (May 21, 2022), no later additions or amendments are incorporated. This public law is available at no cost from www.uscode.house.gov. This public law is also available for public inspection and copying at the Colorado Department of Human Services, Colorado Refugee Services Program, 1575 Sherman St., Denver, CO 80203, during regular business hours.

J. Non-Ukrainian individuals who last habitually resided in Ukraine, who DHS has paroled into the United States between February 24, 2022, and September 30, 2023, due to urgent humanitarian reasons or for significant public benefit.

K. A spouse or child of an individual described in section I) or J) who is paroled into the United States after September 30, 2023.

L. A parent, legal guardian, or primary caregiver of an unaccompanied refugee minor or an unaccompanied child described in section I) or J) who is paroled into the United States after September 30, 2023.

M. Unaccompanied refugee minors (URMs) are minors identified overseas who are eligible for resettlement in the United States, but do not have a parent or a relative available who is committed to providing for the minor’s long-term care. Upon arrival in the United States, these refugee youth are placed into the URM program and receive refugee foster care services and benefits. Youth who have an immigration status that enables them to become eligible for ORR services (for verification of status for program eligibility, see section 3.330), or who enter the United States with or without family but experience a family breakdown or cannot return home, may also be eligible to participate in the URM program if approved by ORR.

N. An I-551 (“green card”) holder who held one of the previously identified statuses is eligible to apply for both CDHS and CRSP benefits and services.

3.330 VERIFICATION OF STATUS FOR PROGRAM ELIGIBILITY

Applicants for assistance under the Colorado Refugee Services Program must possess in their name, documentation provided by the United States Citizenship and Naturalization Service (USCIS) under the Immigration and Nationality Act (INA) with one of the following statuses:

A. Admitted as a refugee under Section 207 of the INA; shall present documentation including: RE- 1, RE-2, RE-3, RE-4, RE-5 on an I-94 form; an Employment Authorization Document with codes A03 or A04; DHS form I-571; I-730 approval letter of refugee status; or Visa 93 on the I-94 arrival/departure card, may contain the words “Section 207”.

B. Granted as an asylee under Section 208 of the INA; may have an I-94 form with Section 208 notation or, as an alternative, the individual may have a letter from the U.S. Department of Justice Executive Office for Immigration Review immigration judge indicating that final asylum has been granted and the date of asylum status. The applicant could also have a written decision from the Board of Immigration Appeals (BIA), under Section 208 of the INA. Documentation could also state AS-1, AS-2, AS-3 on an I-94 form. An Employment Authorization Document with code A05;

DHS form I-571; order of an immigration judge granting asylum under Section 208 of the INA; asylum approval letter from USCIS asylum office; I-730 approval letter; or Visa 92 on the I-94 arrival/departure record, which may contain the words “Section 208”.

C. Paroled as a refugee or asylee under Section 212(d)(5) of the INA. The applicant shall present documentation such as or including an I-766 Employment Authorization Document with a code A04.

D. Cuban/Haitian Entrants, parolees, or asylum seekers have an I-94 form with a stamp indicating “Cuban/Haitian Entrant” or a notation indicating “parolee,” with a notation of 212(d)(5)(a), or stating humanitarian or public interest parole (note: I-94 may be expired), any documents indicating pending exclusion or deportation proceedings; any documents indicating a pending asylum application, including a receipt from an USCIS asylum office indicating filing of Form I-589 application for asylum; Form I-688B Employment Authorization Document coded 274a.12(a)(4) or 274a.12(c)(11) or I-766 Employment Authorization Document with code A04, A10, C8, C10, or C11; or I-551 with an adjustment code of CH6, HA6, or HB6; or Cuban or Haitian passport with a 212(d)(5) stamp dated on or after Oct 10, 1980.

A national of Cuba or Haiti who is the subject of removal, deportation, or exclusion proceedings under INA may present one of the following documents: DHS form I-221; DHS form I-862; DHS form I-220A; DHS form I-122; DHS form I-221S; copy of DHS form I-589 date stamped by EOIR; copy of DHS form I-485 date stamped by EOIR; EOIR-26; I-766 Employment Authorization Document with code C10; other applications for relief that have been date stamped by EOIR; or other document pertaining to an applicant’s removal, exclusion or deportation proceedings. If you encounter one of these documents, please contact the Colorado Refugee Services Program at CDHS for additional guidance on eligibility determination as additional verification steps may need to take place.

There may be other possible documents presented by Cuban or Haitian Entrants, parolees, or asylum seekers. If you have questions regarding documents presented by Cuban or Haitian Entrants/parolees, you may call the Colorado Refugee Services office for additional information and guidance on eligibility determination.

E. Certain Amerasians with the following codes: AM-1, AM-2, AM-3, AM-6, AM-7, AM 8 on one of the following documents: Form I-551, temporary I-551 stamp in a Vietnamese or United States passport, I-94 form or any verification from the USCIS or other authoritative government document, such as Vietnamese or United States passports.

F. Adult Victims of a Severe Form of Trafficking will have an original certification letter from the U.S.

Department of Health and Human Services certifying the person as a Victim of a Severe Form of Trafficking. Children under eighteen (18) years of age who have been subjected to trafficking do not need to be certified in order to receive benefits. For minors, the Office of Refugee Resettlement (ORR) will issue an ORR eligibility letter stating that the person is a Victim of a Severe Form of Trafficking. Confirmation of the certification letter or eligibility letter may be made by calling the trafficking verification line 1-866-401-5510 and notifying ORR of the benefits for which the individual has applied. Certification and eligibility letters do not expire. Individuals who have received derivative T- status will produce documents with one of the following statuses: T-2, T-3, T-4, T-5, or T-6.

Persons with derivative T-status/visas do not receive and are not required to present a certification or eligibility letter to demonstrate eligibility for benefits and services. For derivative statuses, the date of eligibility for benefits and services is the notice date on the I-797 form, the approval of that person’s status, or the date of entry/admission on the person’s passport or I-94 arrival record. Additional documentation presented may also include an Employment Authorization Document with a code (A)(16) or (C)(25)

G. Iraqi and Afghan special immigrant visa holders (SIVs), who meet one of the criteria listed below:

1. A holder of an Iraqi or Afghan passport with a Department of Homeland Security visa noting the individual has been approved for admission under one of the Immigrant Visa (IV) categories of SI1, SI2, SI3, SQ1, SQ2, and SQ3, and a Department of Homeland Security admission stamp on the passport or a CBP form I-94 noting date of entry.

2. A holder of a USCIS Form I-551 (“green card,” permanent resident card, or resident alien card) showing Iraqi or Afghan nationality, or an Iraqi or Afghan passport showing one of the following immigrant visa categories: SI6, SI7, SI9, SQ6, SQ7, or SQ9.

H. A person paroled into the United States between July 31, 2021, and September 30, 2022, with:

1. CBP form I-94 noting Humanitarian Parole (per INA section 212(d)(5)(a)); or 2. A foreign passport with DHS/CBP admission stamp noting “OAR,”; or 3. A foreign passport with DHS/CBP admission stamp noting “OAW”; or 4. A foreign passport with DHS/CBP admission stamp noting “DT”; or 5. DHS/CBP/or DHS/USCIS temporary form I-551 alien documentation identification and telecommunication (ADIT) stamp.

I. A holder of:

1. A CBP form I-94 (DHS arrival/departure record) noting special immigrant (SQ/SI) parole; or 2. Foreign passport with DHS/CBP admission stamp or DHS form I-551 (“green card,” permanent resident card, or resident alien card) noting that the individual has been classified under IV (immigrant visa) category CQ1, CQ2 or CQ3; or 3. DHS/CBP/ or DHS/USCIS temporary form I-551 alien documentation identification and telecommunication (ADIT) stamp.

J. United States citizenship and immigration service (USCIS) form I-94 noting humanitarian parole (per INA section 212(d)(5)(a)) or 8 U.S.C § 1182(d)(5)) if paroled into the United States between February 24, 2022, and September 30, 2023, or foreign passport with DHS/CBP admission stamp noting “DT” or a foreign passport with DHS/CBP admission stamp noting Uniting for Ukraine or “U4U” or a foreign passport with DHS/CBP admission stamp noting Ukrainian humanitarian parolee or “UHP” or form I-765 employment authorization document (EAD) receipt notice with code C11 or form I-766 employment authorization document (EAD) with the code C11.

K. Any one of the forms or stamps listed above for UHPs and documentation of last habitual residence in Ukraine.

L. Unaccompanied Refugee Minors (URMs) who meet the definition above will have one of the following statuses: refugee, asylee, Cuban/Haitian entrant, victim of trafficking, Amerasian, Iraqi or Afghani special immigrant visa holder, Special Immigrant Juvenile Status (SIJS), U visa holder, or has legal permanent resident status that previously held one of the statuses mentioned.

If the URM has SIJS status, documentation presented will be one of the following: I-797, notice of action indicating status (i.e., evidence of approved I-360, or evidence of approved I-360 and approved I-485); visa indicating SIJS status with SL class of admission; I-1551 indicating SIJS status with SL class of admission.

If the URM has a U-visa, documentation presented will be one of the following: I-797 notice of action indicating U status; a U-visa; or an I-94 arrival/departure record showing admission in U status. Please note: U-visa holders are not considered “qualified aliens” status for federal public benefits. It does qualify the person to be “lawfully present” for potential state benefits.

M. An I-551 form (“green card”, permanent resident card or resident alien card) with class of admission codes AS-6, AS -7, AS -8, RE-6, RE -7, RE -8, RE -9, CH-6, HA6, HB6, GA6, GA7, GA8, ST6, ST7, ST8, ST0, ST9, SI6, SI7, SI9, SQ6, SQ7, SQ9, AM-1, AM-2, AM-3, AM6, AM-7, or AM 8. The unexpired I-551 stamp may be located in a foreign passport.

If not eligible for the assistance of TANF/Colorado Works, individuals with this immigration status may be eligible for Refugee Cash Assistance (RCA) through the Colorado Refugee Services Program if income and program eligibility criteria are met. Persons must be enrolled in one of the refugee resettlement agencies in order to access RCA.

Individuals admitted to the United States who are classified by USCIS as "Applicants for Asylum" are not eligible for CRSP benefits. Once granted asylum, those individuals are eligible. The exception to this rule is Cuban and Haitian individuals applying for asylum; however, they must produce documents as described above.

CRSP follows the federal guidance on eligible populations, status and documentation in the office of refugee resettlement state letter # 16-01, dated 10/02/2015, located on the federal government web site at: https://www.acf.hhs.gov/orr/policy-guidance/status-and-documentation-requirementsorr-refugee-resettlement-program No later editions or amendments are incorporated. Copies may be reviewed during normal business hours by contacting the Refugee Services Coordinator in the Office of Economic Security, Colorado Refugee Services Program, 1575 Sherman St, Denver, Colorado 80203. If there is an eligibility question, please contact the Colorado Refugee Services Program for assistance.

3.340 REFUGEE MEDICAL ASSISTANCE (RMA)

3.341 OVERVIEW

Each individual member of a household that applies for medical assistance must first be screened for eligibility under the State Medicaid/Health First Colorado Program. If the individual is determined ineligible for Medicaid/Health First Colorado, then a determination of eligibility under the Refugee Medical Assistance (RMA) Program must be made. A “household” is defined as a single adult with no children, a married couple, a single parent with minor children, or a married couple with minor children.

Any individual of a household who is not eligible for Medicaid/Health First Colorado shall be considered for Refugee Medical Assistance (RMA). RMA is limited to the time period of twelve months after receiving a status that is eligible for CRSP services and benefits (refer to section 3.330 for verification of status for program eligibility).

Persons applying for Refugee Medical Assistance will use the State prescribed application for Medicaid/Health First Colorado. Applicants will first be screened for State Medicaid/Health First Colorado programs in accordance with the Colorado Department of Health Care Policy and Financing’s Medical Assistance Manual (10 CCR 2505-10). Copies of Colorado Department of Health Care Policy and Financing’s Medical Assistance Manual are available for public inspection by contacting the Colorado State Refugee Coordinator during regular business hours at the Colorado Department of Human Services, Colorado Refugee Services Program, 1575 Sherman Street, Denver, Colorado 80203; or at a state publications depository library. No later editions or amendments are incorporated.

In accordance with federal law, in providing Refugee Medical Assistance to refugees, Colorado will provide at least the same services in the same manner and to the same extent as under the state’s Medicaid/Health First Colorado program. 3.342 Initial Refugee Medical Assistance Determination, Eligibility, and Definitions Refugees residing in the U.S. fewer than twelve months after arrival into the United States, as well as asylees, Cuban/Haitian Entrants/parolees, certain Amerasians, victims of severe forms of trafficking, Iraqi and Afghan special immigrant visa holders, and certain Humanitarian Parolees who are within twelve months of being granted status who lose their eligibility for Medicaid/Health First Colorado because of earnings from employment, will be transferred to RMA without an eligibility determination and the two hundred percent (200%) of poverty rule shall not be applied. The increased earnings from employment shall not affect the refugee’s continued medical assistance (RMA) eligibility while within the person’s twelve months of the RMA eligibility period.

A. RMA shall continue until the individual eligible for refugee services reaches the end of twelve (12) month eligibility period.

B. Initial RMA eligibility determination (where the applicant was not previously eligible for Medicaid/Health First Colorado) is based on two hundred percent (200%) of the federal poverty level.

1. In determining eligibility for and receipt of RMA, the following are not considered: in-kind services and shelter provided to an applicant by a sponsor or local resettlement agency.

Payments, such as refugee cash assistance, matching grant, or reception and placement, received from the refugee resettlement agency are exempt from RMA income determinations.

2. Determination of RMA eligibility will be based on an applicant’s income on the date of application.

3. Denial or termination of Refugee Cash Assistance does not cause denial or termination of RMA benefits. _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History

Rule 3.360.44 eff. 09/15/2012.

Rules 3.360.42, 3.360.44 emer. rules eff. 01/01/2013.

Rules 3.360.42, 3.360.44 eff. 03/02/2013.

Rule 3.360.44 emer. rule eff. 04/05/2013.

Rule 3.360.44 eff. 07/01/2013.

Rules 3.360.44, 3.360.62, 3.360.65 emer. rules eff. 01/01/2014.

Entire rule repealed eff. 03/02/2014.

Entire rule recodified from 9 CCR 2503-7 eff. 09/01/2016.

Rules 3.321 F-J, 3.330 G-K emer. rules eff. 12/03/2021.

Rules 3.321 F-J, 3.330 G-K eff. 03/02/2022.

Rules 3.321 A,G,I-N, 3.330 J-M emer. rules eff. 10/03/2022.

Rules 3.321 A,G,I-N, 3.330 J-M eff. 11/30/2022.

Rules 3.310, 3.341, 3.342 emer. rules eff. 01/06/2023.

Rules 3.310, 3.341, 3.342 eff. 03/30/2023.

##### **9 CCR 2503-4** (Reserved for Future Use) {#sec-9-ccr-2503-4 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-4}

DEPARTMENT OF HUMAN SERVICES

Income Maintenance (Volume 3)

(Reserved for Future Use)

9 CCR 2503-4 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.400 (Reserved for Future Use) [Rev. eff. 3/2/14] _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the History link located above the rule text.

Rule section 3.000 – 3.100, et seq. has been recodified as 9 CCR 2503-1, GENERAL RULES.

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, GENERAL FINANCIAL ELIGIBILITY CRITERIA.

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, OLD AGE PENSION.

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, AID TO THE NEEDY DISABLED AND AID TO THE BLIND.

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, (Reserved for Future Use).

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, OTHER ASSISTANCE PROGRAMS.

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History

Section 3.460.45 emer. rule eff. 04/05/2013.

Section 3.460.45 eff. 07/01/2013.

Section 3.460.45 emer. rule eff. 01/01/2014.

Entire rule repealed eff. 03/02/2014.

##### **9 CCR 2503-5** Adult Financial Programs {#sec-9-ccr-2503-5 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-5}

Department of Human Services ADULT FINANCIAL PROGRAMS 9 CCR 2503-5 [Editor's Notes follow the text of the rules at the end of this CCR Document.] 3.500 Adult Financial Programs- Adult Financial Programs consist of the Old Age Pension (OAP) program, Aid to the Needy Disabled (AND) program consisting of AND-State Only (AND-SO) and AND-Colorado Supplement (AND-CS), Home Care Allowance (HCA), and Burial Assistance 3.510 DEFINITIONS “Actual value” means the value of real property, as reported by the county assessor.

“Adequate” (related to notice) means a written notice sent to the client which details any determination of eligibility, as well as a change or discontinuation of grant payments and the reason for that change.

“Administrative disqualification hearing” (ADH) means a disqualification hearing against an individual accused of wrongfully obtaining or attempting to obtain assistance.

“Administrative error claim” means a grant payment was overpaid and a claim validated based on an error on the part of the county department of human services.

“Administrative Law Judge” (ALJ) means an Administrative Law Judge appointed pursuant to Section 24-30-1003, C.R.S.

“Adult Financial approved setting” means a facility with this specific designation by the State Department.

“Anticipated income” means income which can be anticipated with reasonable certainty concerning the amount and month in which it is to be received.

“Applicant” means any individual or family who individually or through a designated representative or someone acting responsibly for him or her has applied for benefits under the programs of public assistance administered or supervised by the State Department pursuant to Title 26, Article 2, C.R.S., as defined at Section 26-2-103(1), “Application” means an initial or redetermination request on State approved forms (paper or electronic) for a grant payment and/or services.

“Approval” means assistance is authorized by the county department.

“Assets” means the same as resources.

“Authorized representative” means someone acting reasonably for the client with the

authority to make decisions on behalf of the client and who has taken responsibility for the case including but not limited to signing documents and speaking with county departments. The authorization must be in writing and signed by the client.

"Available" (related to funds or assets) means accessible or could be accessible, when the client has a legal interest in a sum (the equity value of a resource), and has the legal ability to make such sum available for support and maintenance.

“Bona fide loan” means a borrower receives money (from relatives, friends or others) which creates a loan if there is an understanding between the parties that the money borrowed is to be repaid and it is recognized as an enforceable contract under Colorado law. The transaction which creates a loan can be in the form of a written or verbal agreement if enforceable under Colorado law. Absent a negotiable instrument, a bona fide loan must still be convertible to cash in order to be considered a resource. The obligation to repay cannot be contingent on future income that might be received by the borrower. The written or verbal agreement must be in effect at the time of the transaction and there must be a reasonable plan for repayment. ”Case Management Agency” (CMA) means a public or private not-for-profit or for-profit organization contracted with the State of Colorado to provide case management services and activities, pursuant to section 25.5-6-1702(2), C.R.S. (2025).

“Cash surrender value” means the dollar value at which a resource could be sold or cashed in.

“Certification period” means the time period for which an Adult Financial client is approved to receive grant payments before a redetermination is required.

“Claim” means an overpayment of a grant payment that needs to be researched and validated by the county department.

“Clear and convincing” means evidence is stronger than “a preponderance of evidence” and is unmistakable and free from serious or substantial doubt.

“Client” means a current or past applicant or a current or past recipient of an Adult Financial grant payment.

“Client error claim” means a grant payment was overpaid and a claim was validated based on unintentional or willful withholding of information on the part of the client.

“Client Statement” means a written or verbal declaration made by an applicant or recipient of Adult Financial benefits regarding income, resources, or other eligibility factors.

“Collateral contact” means a person outside the client’s household (excluding sponsor(s) and landlord who also live in the home) who has first-hand knowledge of the client’s circumstance and provides a verbal or written confirmation thereof. This confirmation may be made either in person, in writing, electronically submitted, or by telephone. Acceptable collateral contacts include but are not limited to: employers, landlords, social/migrant service agencies, and medical providers who can be expected to provide accurate third party verification. The name/title of the collateral contact as well as the information obtained must be documented in the statewide automated system.

"Convertible asset" means any asset which can be converted into cash and is defined by its cash value. This includes a savings or checking account, other accessible electronic currency and/or cryptocurrency, stocks, bonds, mutual fund shares, 401Ks, 457Ks, IRAs, Certificates of Deposit (CDs), PERA accounts, gold/silver, cryptocurrency, pensions, and other retirement or investment accounts and investment vehicles.

“Countable income” means all earned and/or unearned income considered available to the client, spouse of the client, or sponsor(s) of the client after the application of valid exemptions, disregards, and deductions.

“Countable resource” means resources considered available to the client, spouse of the client, or sponsor(s) of the client after the application of valid exemptions, disregards, and deductions.

“County department” means the county department of human/social services.

“Creditor” means a person or company, aside from the Colorado Department of Human Services, to whom money is owed.

“Date of entry” or “date of admission” means the date established by the United States Citizenship and Immigration Services (USCIS), formerly known as the Immigration and Naturalization Service (INS), as the date the sponsored noncitizen was admitted for permanent residence.

“Denial” means that the client was not eligible for a grant payment upon application.

“Demonstrable evidence” means evidence that a Colorado Works case is closed due to refusal to comply with the Workforce program.

“Disabling condition” means a medical impairment which prevents an individual from engaging in work.

“Disaster assistance” means a cash payment to a client to cover needs and/or expenses related to a county, Governor, or federally declared disaster.

“Discontinuation” means that the client who is currently receiving a grant payment is no longer eligible and his or her grant payment will be stopped.

“Earned Income” means payment in cash or in-kind received by a client, spouse of a client, or sponsor(s) of the client for services performed as an employee or as a result of the client, spouse of the client, or sponsor(s) of the client being engaged in selfemployment.

“Effective date of eligibility” means the first date a client is eligible for the public assistance program.

“Eligibility requirements” means State Department criteria used to determine client eligibility or ineligibility to receive assistance and/or services.

“Eligible client” means a client whose countable resources are below the resource limit, whose countable income is below the grant standard, and who meets all non-financial eligibility criteria.

“Encumbrance” means the valid and legal outstanding payments, loans, or liens on a given resource.

“Estate” means the property of the decedent, trust, or other person whose affairs are subject to the Colorado Probate Code, Title 15, Article 10, of the Colorado Revised Statutes, as originally constituted and as it exists from time to time during administration, as defined in Section 15-10-201(17), C.R.S.

“Equity value” means actual value less encumbrances.

“Exempt income” means any income that is not countable income for the purpose of eligibility.

"Exempt resource" means any resource with a value that is not countable for the

purpose of determining eligibility.

“Face value” means the value predominantly stamped or printed on the resource verification (insurance policy, bonds, stocks, etc.) which represents the future potential worth of the resource, but does not usually represent the true value of the item due to activities that can reduce or increase the value (loans, dividends, etc.).

“Facility” means the residence of a client where the intent is either to care for or provide treatment to the client. Facilities include general medical and surgical hospitals, nursing homes, regional centers, group and host homes, and mental health institutions.

Facilities do not include penal institutions, such as Federal and State prisons or county, local, municipal jails, and community corrections residential programs.

“Fair Market Value” means the median resale market value of a resource.

“Federal Poverty Guidelines” also called Federal Poverty Level (FPL) means the income level for a household as set forth in the Federal Register 90 FR 5917 (January 17, 2025) which is hereby incorporated by reference. This rule does not contain any later amendments or editions. These guidelines are available for no cost at https://www.federalregister.gov/documents/2025/01/17/2025-01377/annual-update-ofthe-hhs-poverty-guidelines. These guidelines are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular “Fleeing felon” means a person fleeing to avoid prosecution or custody or confinement after conviction for a felony.

“Fraud” means any person who obtains or any person who willfully aids or abets another to obtain public assistance as defined in Title 26 of the C.R.S. to which the person is not entitled or in an amount greater than that to which the person is justly entitled or payment of any forfeited installment grants or benefits to which the person is not entitled or in a greater amount than that to which the person is entitled, by means of a willfully false statement or representation, or by impersonation, or by any other fraudulent device, as described in Section 26-1-127(1), C.R.S.

“Good cause” means circumstances beyond the control of the client. Good cause includes, but is not limited to, documented and verifiable medical emergencies or hospitalization, a client who has a disability or other medical condition(s) requiring additional time and/or assistance, a delayed appointment with the Social Security Administration beyond the client's control, or other good cause determined reasonable by the county department using the prudent person principle. The following circumstances do not constitute good cause: an excessive workload of a party or his or her representative or attorney; when a party obtains legal representation in an untimely manner; a party’s failure to either receive or timely receive, a timely mailed initial decision, or other timely mailed correspondence from the Office of Administrative Courts and/or the Office of Appeals, or from the county department, when a party has failed to advise the Office of Administrative Courts, the county department, or the Office of Appeals of a change of address or failed to provide a correct address; or any other circumstance which was foreseeable or preventable.

“Grant payment” means the Adult Financial program payment and may also be referred to as the benefit.

“Grant standard” means the maximum Adult Financial grant payment that can be provided to a client based on each specific Adult Financial program.

“Health Care Policy and Financing” (HCPF) means the Colorado Department of Health Care Policy and Financing.

“Homeless” means a person with no permanent living arrangement, i.e., no regular nighttime or fixed place of residence. He or she is neither a member of a household nor a resident of an institution. This can mean someone who sleeps in a doorway; supervised shelter designed for temporary accommodations; a halfway house or similar facility that provides temporary residence; a place not designed for or ordinarily used as regular sleeping accommodations for human beings, such as parks, bus stations, etc.; or a person who stays with a succession of friends or relatives and has no permanent living arrangement.

“IM-14” means the Authorization for Reimbursement of Interim Assistance available at the county department or found within the statewide automated system.

“IM-19” means the Apportionment Notice available at the county department or found within the statewide automated system.

“Immediate family” means people with the following relationships to the client: spouse, minor and adult children, stepchildren, adopted children, parents, adoptive parents, and the spouses of those persons.

“Income” means any financial gain by means of money payment or in-kind payment.

“In-kind” means something of value received for the benefit of a client, spouse of a client, or sponsor(s) of a client and is considered either earned or unearned income.

Examples of this are food or shelter that the client received for free or at fair market value or less.

“Intent” and/or “Intentionally” means a person’s conscious objective is to cause the specific result, whether or not the result occurred, as described in Section 18-1-501(5), “Intentional Program Violation” (IPV) occurs when an individual makes a false or misleading statement or fails to disclose by misrepresentation or concealment of facts, or acts in a way that is intended to mislead or conceal any eligibility factor on any application or other written and/or electronic communication for the purpose of establishing or maintaining eligibility to:

1. Receive a grant payment for which the client is not eligible; or, 2. Increase a grant payment for which the client is not eligible; or, 3. Prevent a denial, reduction or termination of a grant payment.

“Involuntary transfer” means the loss of a resource due to fraud, theft, financial exploitation, or legal action such as judgment, foreclosure, or tax sale, provided that the client can demonstrate that:

A. Every reasonable effort has been made to recover the property through court action or other procedures; or, B. The client is unable to pursue recovery; or, C. Pursuit of lost resources or income would constitute a safety issue.

“Irregular” (related to income) means income which an individual cannot reasonably expect to receive on a monthly basis.

“Legal fiduciary” means a person or agency who holds the legal power to act on behalf of a client and is required to act in the best interest of the client.

“Liable individual” means a person financially responsible for an overpayment including the client, sponsor(s) of a client, a payee, parents of dependent children, and/or other persons determined to be financially liable by a court.

“Life Estate” means a legal estate planning procedure in which the client transfers real property to another individual but retains the right of occupancy and income from the property during the client's lifetime. The life estate's duration is limited to the life of the client. The client, during his or her life, retains the use and possession of the property, the rights to rents and profits, and the costs of maintaining the property. The client cannot sell or waste the property without the consent of the person(s) to whom the property was transferred.

“Local service delivery agency” means an agency operating on behalf of the county department or State Department to determine all or part of a client’s eligibility for Adult “Marriage” (for the purpose of these rules) means a marriage as defined in Section 14- 2- 104(1), C.R.S., a common law marriage as defined in Section 14-2-104(2), C.R.S., and a civil union, as defined in Section 14-15-103(1), C.R.S.

“Material fact” means information that has logical connection to the consequences and/or the decision being determined and the nature of the information or fact is such that a reasonable person under the circumstances would attach importance to it in determining his or her course of action.

“Medical provider” means a Colorado licensed physician, psychiatrist, licensed psychologist, licensed clinical social worker, licensed professional counselor, physician assistant, advanced practice nurse, or registered nurse. The physician may be a general practitioner or a specialist. A medical provider determining blindness shall be an ophthalmologist or optometrist licensed in Colorado. A medical provider may be licensed in a bordering state when the nearest Colorado provider is more than one hour from the client's home and the provider in the bordering state is closer.

“Non-citizen” means any person who is not a citizen of the United States.

“Non-recipient spouse” means the client's spouse who is not receiving an Adult Financial grant payment.

“Ownership” means lawful title to, legal right of possession of, or legal interest in a property.

“Overpayment” means a grant payment was made in excess of the amount a client was eligible for.

“Payment Floor Standard” means the minimum Adult Financial grant payment that an eligible Old Age Pension (OAP), Aid to the Needy Disabled-Colorado Supplement (AND-CS), or Home Care Allowance (HCA) client may receive. The payment floor standard is updated annually for each program based on the cost-of-living adjustment.

“Periodic payments” means payments that are irregular or a one-time payment.

“Personal Needs Allowance” (PNA) means a payment to a client who is currently in a facility to cover additional hygiene costs not usually supplied by the provider.

"Personal property” means all tangible items a person owns that are not considered real property, cash, or a convertible asset.

“Potential income” means a benefit or payment to which the client, spouse of a client, or sponsor(s) of a client may be entitled and could secure, such as spousal support, annuities, pensions, retirement or disability benefits, veterans compensation and pensions, workers' compensation, Social Security retirement or disability benefits, Supplemental Security Income (SSI) benefits, and unemployment compensation.

“Potential resource” means a resource to which the client, spouse of a client, or sponsor(s) of a client has the legal ability to acquire or reacquire rights of ownership, such as inheritances, real and personal property, cash and convertible assets, and settlements.

“Preponderance of evidence” means that the evidence must preponderate over, or outweigh, evidence to the contrary.

“Prudent Person Principle” means that, based on experience and knowledge of the program, the county department exercises a degree of discretion, care, judiciousness, and circumspection, as would a reasonable person, in a given case.

“Qualified non-citizen” also called qualified alien means an individual who is not a citizen or national of the United States and who was lawfully admitted to the United States by the United States Citizenship and Immigration Services (USCIS) as an actual or prospective permanent resident or whose physical presence is known and allowed by the USCIS. This definition of a qualified non-citizen is consistent with the definition of ‘qualified alien’ in 8 U.S.C. § 1641 and the language, including all notes, in 8 U.S.C. § 1101.

“Questionable” means the information provided is unclear or conflicting or the county has reason to believe the facts presented are contrary to the information provided by the client.

“Real property” means houses; land, including land rights such as oil, mineral and water rights; and outbuildings and other objects affixed to land.

“Received” (for the purpose of income and resources) means the date on which the income and/or resource is actually received or legally becomes available for use, whichever occurs first, whether reported timely by the client or not.

“Received” (as it applies to receipt of verification, documentary evidence, and reported changes in circumstances) means the date the verification, documentary evidence, and reported changes were received by the county department.

“Recovery” means the collection of a valid claim to repay grant payments to which a client was not entitled.

“Redetermination” means a case review/determination of necessary information and verifications to determine ongoing eligibility and may also be called renewal or recertification.

"Resources" or “assets” means real property, personal property, and cash or convertible assets held as of the first day of a calendar month or as of the date of application, less the value counted as income in the same month.

“Scheduled appointment” or “scheduled interview” means an appointment or interview set using a State prescribed or State approved appointment notice provided to the “Shelter costs” means mortgage payments, property insurance (if required), home owner association dues, rent, gas, electricity, heating fuel, water, sewer, garbage collection service, and real property taxes. Telephone, internet and television provider services are not allowable shelter costs.

“Signature” means handwritten signatures, electronic signature techniques, recorded telephonic signatures, or documented gestured signatures. A valid handwritten signature includes a designation of an x.

“Sponsor” means any person(s) who executed an affidavit of support (USCIS form I-864 or I-864A) (October 17, 2024) or another form deemed legally binding by the Department of Homeland Security on behalf of a non-citizen as a condition of the noncitizen's date of entry or admission into the United States as a permanent resident.

USCIS forms I-864 and I-864A (October 17, 2024) are hereby incorporated by reference. This rule does not contain any later amendments or editions. These forms are available at no cost from https://www.uscis.gov/i-864. These forms are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

“SSI benefit standard” means the maximum monthly Federal amount for an SSI recipient as listed in Federal Regulations found at 20 C.F.R. 416.405-415 (September 2025), which are hereby incorporated by reference. This rule does not contain any later amendments or editions. These regulations are available for no cost at https://www.ecfr.gov/current/title-20/chapter-III/part-416/subpart-D?toc=1. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

“State Department” or “the Department” means the Colorado Department of Human Services.

“State Supplementary Payment” means the amount that is added to an Old Age Pension (OAP), Aid to the Needy Disabled-Colorado Supplement (AND-CS), or Home Care Allowance (HCA) client's benefit if their regular grant payment is less than the payment floor standard.

“Statewide automated system” means the electronic platform used to calculate public assistance program benefits and grant payments.

“Termination” means that the client who is currently receiving Adult Financial program grant payments is no longer eligible and his or her grant payments will be stopped.

“Timely notice” means the county shall generate a notice to the client at least eleven (11) calendar days prior to the initiation of any decrease, suspension, termination, or discontinuance in grant payments or services. This shall be sent to his or her last known address.

“Traditional verification” means methods of verification that are acceptable at application and at every twenty-four (24) month redetermination, i.e., verification documents and collateral contacts.

“Transfer Without Fair Consideration” (TWFC) means a property transaction in which the proceeds of the transfer, assignment, or sale are less than the actual value of the resource.

“Twenty-four (24) month redetermination” means a redetermination that requires an interview and traditional verification methods, and recurs every twenty-four (24) months after application.

“Unearned income” means any income that is not earned through employment or selfemployment, as described in 3.520.785.

“Unintentional” or “without intent” means an act, or something done or performed that was not voluntary or intended.

"Value (for cash and convertible assets)" means the current redemption rate, less encumbrances.

“Value (for real and personal property)” means the actual value of the property less encumbrances.

“Verification” means confirming statements, application information, and other case information by obtaining written, audio, or other evidence or information that proves such fact or statement to be true.

“Verified upon receipt” means information that is provided directly from the primary source and is not questionable and no additional verification is required.

“Willful” means that a person is aware that his or her conduct is practically certain to cause the result as described in Section 18-1-501(6), C.R.S.

“Willful withholding of information” includes:

A. Willful misstatement including understatement, overstatement, or omission, whether verbal or written, made by a client in response to verbal or written questions from the county department;

B. Willful failure by a client to report changes in income or other circumstances which may affect the amount of grant payment; and/or, C. Willful failure by the client to report receipt of a grant payment made by the county department to the client which the client knew represented an “Withdraw” or “Withdrawal” means an application is not processed because the client who submitted the application withdraws his or her request for assistance prior to eligibility determination, or requests his or her grant payment be discontinued.

3.520 GENERAL REQUIREMENTS, CASE PROCESSING, AND CASE ACTIONS

3.520.1 GENERAL REQUIREMENTS

A. Information concerning public assistance programs shall be available to all persons in the community. Available information shall include:

1. Benefits and programs available;

2. Eligibility requirements;

3. Related services;

4. Rights and responsibilities of clients;

5. The Property Tax/Rent/Heat Credit (PTC) rebate eligibility information available through the Colorado Department of Revenue; and, 6. Earned Income Tax Credit (EITC).

B. The county department shall:

1. Receive and date all applications and assist the client to complete the application and secure documentation when needed;

2. Provide language translation via an interpreter, as needed;

3. Inform the client of his or her responsibility to accurately and fully complete the application and provide documents to substantiate eligibility factors;

4. Inform the client that he or she may use friends, relatives, or other persons to assist in the completion of the application and their right to designate an authorized representative as described in section 3.510;

5. Inform the client, in writing at the time of application, that the county department shall use the client's Social Security Number (SSN) to obtain information available through the Income and Eligibility Verification System (IEVS) to verify income and that such information may be shared with other assistance programs, other states, the Social Security Administration, the Department of Labor and Employment, and the Child Support Services program;

6. Conduct an evaluation of needs related to the client’s health and wellbeing. Based on identified needs, the county worker will refer the client to other agencies or services available in the community, such as food banks, Area Agencies on Aging (AAA), Aging And Disability Resources for Colorado (ADRC), or the Division of Vocational Rehabilitation (DVR);

7. Refer the client to the other benefits for which he or she may be eligible;

8. Inform the client that he or she may terminate the application process at any time;

A decision by the client to “withdraw” shall be treated as a denial by the county department. The client shall be notified of the county department's action by the State approved Notice of Action form within ELEVEN (11) calendar days of the action.

9. Review applications, make necessary collateral contacts or request any needed verification, and determine eligibility for assistance; and, 10. Calculate all claims, initiate recoveries, and prepare for and appear at all appeals.

C. The county department shall require a written application, signed under penalty of perjury, using the State Department's prescribed public assistance application form. The date of application shall be the first working day the county department receives a signed application form, indicating the client's desire to receive public assistance benefits. Incomplete applications shall be denied following the policies outlined in Section 3.554. For clients who have been committed to a facility by order of the district or probate court or who have been made a ward of the State, application for an Adult Financial program shall be completed by the facility's administration or the client's guardian. The application form shall be used as the primary source of information and to be considered complete, shall contain, at a minimum the name of the applicant and signature of the applicant, parent, legal guardian, facility administration or authorized representative and an address for the applicant which can include general delivery or a county office. If an address is not provided, another means of contact such as phone number or email address shall be utilized to obtain an address.

A client who may be partially or totally illiterate can satisfy the signature requirement by:

1. Making a mark on the signature line.

2. The mark shall be witnessed by at least one other individual. The witness shall provide his or her own signature and address next to the client’s mark in the signature block.

3. A county department staff member may act as witness if he or she is not related to the client.

D. The client shall be required to answer all applicable questions on the application form. Any questions not answered in writing on the application shall be asked of the client during the interview and the client must provide an answer at that time.

The response must be documented on the application or entered into the statewide automated system.

E. Clients shall be provided the opportunity to register to vote during initial application and at each redetermination.

F. The county department shall adhere to the requirements of the Colorado Address Confidentiality Program (ACP) as defined in Section 24-30-2101, C.R.S. The ACP provides survivors of domestic violence, sexual offenses, and/or stalking with a legal substitute address for creating public records and interacting with all State and local government agencies.

G. The client has the right to decide how to use his or her grant payment. The county department shall not:

1. Impose any restriction, either direct or implied, on a client’s use of his or her grant payment including, but not limited to, requesting a client to provide receipts or proof of how the money has been spent; or, 2. Require the client to account for the use of the grant payment, except for the Electronic Benefits Transfer (EBT) card point of sale limitations listed in 26-2-104(2), C.R.S.; or, 3. Give assistance to creditors in the collection of the client’s debts.

H. Each client of financial assistance provided under Adult Financial programs, shall receive prior written notice of any agency action affecting his or her eligibility for or receipt of grant payments.

1. The client shall be notified in writing of county department approval of:

a. An application for financial assistance through the Adult Financial programs;

b. An increase in the amount of grant payment. To the extent practicable, notice shall be in his or her primary language and shall be mailed or delivered within eleven calendar days after the determination is made. If the client needs assistance in understanding the action, the action shall be explained verbally.

c. If the client is dissatisfied with the effective date of eligibility, or the amount or type of assistance authorized, he or she has the right to a county conference and/or state level fair hearing.

2. A client shall be given notice of any action by the county department, or any person or agency acting on its behalf, which adversely affects the client’s eligibility for, or right to grant payments authorized under the Adult Financial programs. Failure to give notice of an adverse action shall be grounds for setting aside the action on appeal. The notice must meet the following standards:

a. The notice must be in writing; and, b. It must describe clearly and in plain language the action to be taken and the reason(s) for the action; and, c. It must refer specifically by number to the Section(s) of the State Department's rules that require or permit the action being taken, or cite the specific changes in Federal or State law requiring the action; and, d. It must state the effective date of the proposed action; and, e. It must explain the client’s right to request a county conference and state level fair hearing, the time period for requesting a conference or hearing, and the steps which must be taken to obtain a conference or hearing; and, f. It must explain the client's right to continued grant payments and the obligation to repay if it is determined that the client was not eligible to receive them; and, g. It must inform the client of his or her right to be represented or assisted by legal counsel, a relative, a friend or a spokesperson of his or her choosing; and, h. To the extent practicable, notice shall be in his or her primary language. If he or she is illiterate, the action shall also be explained verbally.

3. Any negative action taken on the case shall be preceded by a timely notice period of at least eleven (11) calendar days. The 11 day timely notice period constitutes the period during which assistance is continued and no negative action is to be taken during this time unless described in 4. When changes in either State or Federal law require grant payment adjustments for all persons receiving Adult Financial assistance, adequate notice shall include:

a. A statement of the intended action;

b. The reasons for such action;

c. The specific change in law requiring such action; and, d. The circumstances under which a county conference and/or state level fair hearing may be obtained and financial assistance continued. A county conference or state level fair hearing need not be granted unless the reason for an individual appeal is incorrect grant computation.

I. A client who disagrees with a proposed action has the right to:

1. A county conference that must be requested no later than ninety (90) calendar days from the date the notice of action is mailed to the client;

2. A state level fair hearing before an ALJ which can be requested if the client does not wish to utilize the county conference to resolve the dispute or is dissatisfied with the outcome of the county conference. The client must submit a written request for a fair hearing by mail or delivery to the OAC no later than ninety (90) calendar days from the date the notice of action is mailed to the client;

3. Judicial review of the final agency decision in the appropriate State district court, after exhausting the administrative appeal rights granted under these rules; and, 4. Continued grant payments as described in Section 3.554.

J. Client confidentiality must be treated as follows:

1. All information obtained by the county department concerning a client of Adult Financial programs is confidential information.

a. The county department shall inform county officials and other persons who have dealings with the department as to the confidential nature of personally identifiable information, which may come into their possession through transaction of department business.

When a county worker consults a bank, current/ former employer of a client, another social agency, and other similar agencies, to obtain information or eligibility verification information, the identification of the county worker as an employee of the county department can, in itself, disclose that an application for assistance has been made by a client. In this type of contact, as well as other community contacts, the department shall maintain confidentiality whenever possible.

b. Ensuring privacy while interviewing and the continuous confidentiality of information is essential. This involves both office facilities and county worker discretion. Office procedures and facilities should be such that information is not inadvertently revealed to persons not concerned with the affairs of a particular client. The county worker must also use discretion in mentioning department business outside the office.

2. General information not identified with any client is not confidential and may be released for any purpose.

3. Information secured by the county department for the purpose of determining eligibility and need is confidential.

4. Unless disclosure is specifically permitted by the State Department, the following types of information are the exclusive property of, and are restricted to use by, the State and county departments:

a. Names and addresses of Adult Financial clients, and/or the grant payment amount;

b. Information contained in applications, reports of medical examinations, correspondence, and other information concerning any person from whom, or about whom, information is obtained by the county department;

c. Records of State or county departmental evaluations of the above information.

d. All information obtained through the Income and Eligibility Verification System (IEVS).

5. No one outside the State or county department shall have access to records of the department except for the following individuals: those executing the Income and Eligibility Verification System (IEVS); Child Support Services officials; the SSA; Federal and State auditors and private auditors for the county; and Case Management Agencies (CMA). These individuals shall have access only for purposes necessary for the administration of the program.

a. Client records may be used as exhibits for administrative, civil and/or criminal proceedings when the proceedings relate directly to the receipt of Adult Financial programs.

b. Additional individuals shall have access to the client’s records as long as the client is notified and his or her prior permission for release of information is obtained, unless the information is to be used to verify income or eligibility under administration of the IEVS.

c. If the information is needed to provide benefits to a client in an emergency situation, and the client is physically or mentally incapacitated to the extent that he or she cannot sign the release form, and time does not permit obtaining the client’s consent prior to release of information, the county department must notify the client within eleven (11) calendar days after supplying the information. If the applicant or client does not have a telephone or cannot be personally contacted within eleven (11) days, the county department must send written notification containing the required information. The verbal or written notification shall include the name and address of the agency that requested the information, the reason the information was requested and a summary of the information released.

d. The following individuals shall have access to the records of the department, excluding IEVS information, if the previously identified consent or notice conditions are met:

1. A district attorney upon presentation of a written request accompanied by evidence that fraud is the reason for the request.

2. A county human services board member, as described in

Section 26-1-116, C.R.S.

e. When a county board member or a district attorney needs information about a client that is not in the possession of the county department, the requestor, with the aid of the county department, may contact the State Department to inquire as to the appropriate methods of securing it.

f. The release of records is strictly conditioned upon the information being used solely for the purpose authorized and the person requesting the information must certify the use to be made of the information and that it will not be disclosed or used for any other

purpose.

6. County departments shall not release information regarding applicants or clients to law enforcement agencies unless a valid search warrant is received by the county or State Department, except as provided in Section 3.520.1.J.5.a.

7. Upon request to the State Department by the Colorado Bureau of Investigation, with the responsibility for location and apprehension of fleeing felons (i.e., a person with an outstanding felony arrest warrant), the addresses of a fleeing felon who is a client of Adult Financial programs shall be released pursuant to Section 26-1-114(3)(A)(III) C.R.S.

8. The client shall have an opportunity to examine such pertinent records concerning him or her as constitutes a basis for adverse action and in the case of a county conference or a state level fair hearing. Other requests for information by the client shall be honored only when the client makes the request in person and his or her identity is verified or the request is in the form of a written and signed statement.

The client may designate an individual, firm, or agency to represent him or her at conferences and hearings. The client must put the designation of such representative in writing. The representative shall have access to all pertinent records.

9. The client may give a formal written release for disclosure of information to other agencies, such as hospitals or advocate agencies. If the client is not present, or the opportunity to agree or object to the use or disclosure cannot practicably be provided because of the client’s incapacity or an emergency circumstance, the department may, in the exercise of professional judgment, determine whether the disclosure is in the best interests of the client and, if so, disclose only the minimum protected health information necessary that is directly relevant to the client’s care.

10. Information provided to agencies and/or individuals must be limited to the specific information required to determine eligibility, conduct ongoing case management, or otherwise necessary for the administration of the Adult Financial program. Information obtained through IEVS will be stored and processed so that no unauthorized personnel can acquire or retrieve the information. County departments are responsible for limiting IEVS data to only those individuals requiring access to determine eligibility or otherwise administer the programs.

All persons with access to information obtained pursuant to the income and eligibility verification requirements will be advised of the circumstances under which access is permitted, how data will be utilized, confidentiality of data, and the sanctions imposed for illegal use or disclosure of the information.

K. County departments and contractors are to administer Adult Financial programs in such a manner that no person will, on the basis of race, color, religion, creed, national origin, ancestry, sex/gender (including transgender status), pregnancy, age, sexual orientation, gender identity, political affiliation, or physical or mental disability, or any other protected groups as described in the State Department’s anti-discrimination policy, be excluded from participation, be denied any aid, care, or services, or other benefits of, or be otherwise subjected to discrimination in his or her interactions with Adult Financial programs.

1. The references to “aid” includes all forms of assistance, including information and referral services.

2. The county department shall not, directly or through contractual or other arrangements, on the basis of race, color, religion, creed, national origin, ancestry, sex/gender (including transgender status), pregnancy, age, sexual orientation, gender identity, political affiliation, or physical or mental disability, or any other protected status:

a. Provide any aid to an individual that is different, or is provided in a different manner, from that provided to others;

b. Subject an individual to segregation barriers or separate treatment in any manner related to access to or receipt of assistance, care, services, or other benefits;

c. Restrict an individual in any way in the enjoyment or any advantage or privilege enjoyed by others receiving aid provided under Adult Financial programs;

d. Treat an individual differently from others in determining whether he or she satisfies any eligibility or other requirements or conditions which individuals must meet in order to receive aid, services, care, or other benefits provided under Adult Financial programs;

e. Deny an individual an opportunity to participate in assistance programs through the provision of services or otherwise, or afford him or her an opportunity to do so which is different from that afforded to others under programs of assistance.

f. Deny an individual the opportunity to participate as a member of a planning or advisory body that is an integral part of the program.

3. No distinction is permitted in relation to the use of physical facilities, intake and application procedures, caseload assignments, determination of eligibility, and the amount and type of benefits extended by the county department to clients.

4. The county department shall ensure that other non-federal agencies, persons, contractors and other entities with which it contracts business are in compliance with the above prohibition against discrimination requirements on a continuing basis. The county department staff is responsible for being alert to any discriminatory activity of other agencies and for notifying the State Department concerning the situation.

5. The State Department, through its various contacts with agencies, persons, and referral sources, will be continuously alert to discriminatory activity and will take appropriate action to ensure compliance with these prohibitions against discrimination. The county department, on notification by the State Department, will also terminate payments to the offender or association with any agency, person, or resource being used that has been found by the State Department or the Colorado Civil Rights Division to continue discriminatory activity in regard to applicants or clients.

6. An individual who believes he or she is being discriminated against may file a complaint with the county department, the State Department, the Colorado Civil Rights Division, or directly with the Federal government.

When a complaint is filed with the county department, the county director is responsible for initiating an immediate investigation of the matter and taking necessary corrective action to eliminate any discriminatory activities found. If such activities are not found, the individual is given a written explanation of the outcome. If the person is not satisfied, he or she is requested to direct his or her complaint, in writing, to the State Department, Communications Section, which will be responsible for further investigation and other necessary action.

3.520.2 DOCUMENTATION

A. The county department shall create a case record upon initial application and maintain the record while the case is open for assistance. The major purposes of a case record shall be:

1. To assist the county department in reaching a valid decision concerning eligibility and for the amount of grant payment a client is eligible to receive;

2. To ensure eligibility is based on factual information;

3. To provide for continuity of assistance when a worker is absent, when a case is reopened, and when a case is transferred from one county department to another; and, 4. To provide accountability for the county department's actions.

B. The county department shall document all income, resources, and non-financial eligibility information into the statewide automated system.

1. The county department shall not omit case information from the statewide automated system based on the assumption that the information is unnecessary for eligibility determination.

2. All case information used to determine eligibility and changes in basic biographical information shall be updated at the time of redetermination.

C. The county department shall document all case actions in case comments. This information shall include actions taken by the county department, the basis of such actions, and the result or outcome of the action taken on the case and must also include:

1. All case decisions related to prudent person principle;

2. All decisions related to the disposition of claims;

3. Any atypical interactions with the client;

4. Actions related to a county conference and/or state level fair hearing;

5. Cause of untimely processing of the application or redetermination;

6. Other information that would be critical to document county department actions and/or would be necessary to justify case decisions during a case review, audit, appeal, or lawsuit; and, 7. Information pertaining to eligibility, verifications, and collateral contacts.

D. Unless otherwise specified in rule, all forms, packets, notices, and applications, shall be State-prescribed or State approved.

E. The county department shall be responsible for securely storing paper and/or electronic case records and other confidential material to prevent accidental or intentional disclosure or access by unauthorized persons. If a county department shares building space with other county offices, case materials shall be stored in locked files.

F. Case records are the property of and shall be restricted to use by the State Department and county department.

G. Case files shall be kept for a minimum of three (3) years beyond the year of the case closure date unless there has been a claim, audit, negotiation, litigation or other action started before the expiration of the three-year period. In such cases, the retention period shall initiate at the conclusion of the claim, audit, negotiation, litigation, or other action.

3.520.3 PROGRAM REVIEW AND OVERSIGHT

A. The county department shall be subject to the provisions outlined in Section 26- 1- 111, C.R.S., requiring the State Department to ensure that the county department complies with requirements provided by statute, State Board of Human Services and Executive Director rules, Federal laws and regulations, and contract and grant terms.

B. The county department shall be subject to routine quality control and program monitoring by the State Department, to minimally include:

1. Targeted review of the statewide automated system documentation;

2. Review and analysis of data reports generated from the statewide automated system;

3. Case file review;

4. Targeted program review conducted via phone, email, or survey; and, 5. Onsite program review.

C. The focus of State Department monitoring shall be to identify:

1. Compliance with program statutes and rules;

a. The county department shall provide written responses to the State regarding action taken to correct areas of non-compliance. The State Department must approve the action(s) taken.

b. The county department shall provide to the State a written plan, including steps and measures, to mitigate the error(s) from recurring. This plan must be approved by the State Department.

2. Best practices that can be shared with other county offices;

3. Training needs; and, 4. Performance outcomes.

D. The county department shall be subject to a performance improvement plan to correct areas of identified non-compliance.

E. The county department shall be subject to corrective action and sanction as outlined in Section 1.100, et seq. (9 C.C.R. 2501-1), General Policies and Administration, in case of failure to make improvements required under the performance improvement plan.

F. County department supervisory personnel and/or quality assurance staff shall review eligibility determinations (certifications, denials, and/or pending cases) monthly for the purposes set forth in 3.520.3.C. Supervisory personnel and/or quality assurance staff shall:

1. Review a minimum number of cases, including specific programs and/or actions, per month as outlined annually by the State Department based on the county department’s Adult Financial caseload size. The State Department will notify the county of the minimum number of cases to be reviewed via memorandum. The county may elect to:

a. Create a plan to pull a random sample that includes at least the minimum number of Adult Financial cases set forth by the State Department in its memorandum and submit that plan to the State for approval.

b. Use the State prescribed random sample.

2. Determine the correctness of eligibility determinations;

3. Ensure correction of any errors within ten (10) business days or the time frame specified within the approved review plan; and, 4. Maintain a record of the cases reviewed for audit purposes, including audit results and any required actions taken by the county. County departments must keep case file reviews for a minimum of three (3) years.

5. Report these results and actions to the State on a monthly basis via the State prescribed process.

3.520.4 APPLICATION PROCESSING

The county department shall process applications as expeditiously as possible but no later than forty-five (45) calendar days following the date the application was filed.

Applications meeting the criteria identified in Section 3.520.1.C, shall be processed as follows:

A. Record the date the signed application was received by the county department.

B. Review the application for completeness for all programs applied for and/or any programs not applied for but that the client is potentially eligible for.

C. Schedule an interview with the client if the interview is not taking place immediately.

1. The client shall be offered an in-person interview. If the client does not elect an in-person interview, the county shall schedule and conduct a phone interview.

2. The client shall be provided written notice of the interview at least four (4) calendar days of the scheduled interview. The client may provide a written or verbal waiver that written notice of the scheduled interview is not necessary when the county department is able to conduct the interview during application processing. Notice shall include:

a. The date and time for the interview;

b. Identification of any documentation that may be needed;

c. The opportunity to reschedule the appointment or make other arrangements in the event of good cause.

3. When the client does not keep the interview appointment and does not request an alternate time or arrangement, as described in this section, grant payments will be denied.

4. The interview must be documented and shall include:

a. An explanation of the various assistance programs available to the applicant, even if not specifically applied for, and an opportunity to apply for those additional programs not in the client’s original application;

b. An explanation of the eligibility process and the eligibility requirements;

c. A review of the application with the client to:

1) Confirm all information on the application;

2) Answer questions not completed on the application; and, 3) Provide the client an opportunity to clarify unclear, inconsistent, inaccurate, or questionable statements.

4) For Aid to the Needy Disabled State Only (AND-SO), provide the client with a medical disability certification form. Provide, explain and obtain necessary signatures on the Authorization for Reimbursement of Interim Assistance form (IM-14), as defined in Section 3.510, and explain the requirement to apply for Supplemental Security Income (SSI).

d. A request for verification of application declarations.

1) The client has the primary responsibility to provide information necessary to establish eligibility.

2) The county department shall assist the client to obtain verification through collateral contacts, interfaces, or a home visit.

e. Discussion of the client's rights and responsibilities that must include:

1) The client's responsibility to notify and provide verification to the county department in writing by the 10th of the month following the month in which the change occurred of any change in resources or income or other change in circumstances which affects eligibility or grant payment 2) The client’s right to confidentiality of records and information.

3) The client's right to non-discrimination provisions, including the process in Section 3.520.1.K.6, for filing discrimination complaints.

4) The client's right to a county conference or state level fair hearing.

5) The client's right to review and copy his or her case file.

f. An explanation provided regarding the process of utilizing the EBT card. This explanation shall include:

1) Identification of the following establishments in which clients shall not be allowed to access cash grant payments through the EBT service from Automated Teller Machines (ATM) and Point of Sale (POS) devices:

a) Licensed gaming establishments;

b) In-State simulcast facilities;

c) Tracks for racing;

d) Commercial bingo facilities;

e) Stores or establishments in which the principal business is the sale of firearms;

f) Retail establishments licensed to sell malt, vinous, or spirituous liquors;

g) Establishments licensed to sell medical marijuana or medical marijuana-infused products, or retail marijuana or retail marijuana products, effective June 30, 2015;

h) Establishments that provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment, effective June 30, 2015.

2) An explanation that the cash grant payment portion issued on the EBT card may be suspended with identified misuse as outlined in Section 3.520.4.C.4.f.

g. An assessment of other needs the client may have and appropriate referrals to community resources, including food banks, Area Agencies on Aging (AAA), Aging and Disability Resources for Colorado (ADRC), Centers For Independent Living, the Division of Vocational Rehabilitation (DVR), Low Income Energy Assistance Program (LEAP), phone assistance, and the Property Tax/Rent/Heat Credit (PTC) Rebate eligibility information.

h. An opportunity to register to vote.

5. County departments shall require no more than one interview per application.

a. The county department shall secure signed copies of any other forms necessary to determine eligibility. If the client refuses to sign any required forms, the case shall be denied or discontinued b. If the client wishes to apply for Adult Financial benefits while applying for or already receiving benefits under a different program, such as food assistance, the county department may accept the client’s verbal or written request for Adult Financial benefits and use the client’s existing application or redetermination for the other program’s benefits if received within sixty (60) calendar days of the request; otherwise a new application will be required. The county department must verify and document any changes that occurred between the initial application submission or redetermination and the request for Adult Financial grant payments. A verbal request to apply for an Adult Financial program shall be documented in the statewide automated system and the date of the request will secure the application date for the client.

6. When the client does not keep a scheduled interview appointment and has not contacted the county department to reschedule, as specified in this

section, the county department shall deny the application following the policies outlined in Section 3.554.

a. If the client makes a request for Adult Financial grant payments following the county department’s denial of his or her application based on the client failing to attend the interview appointment, the following shall occur:

1) If the client has good cause as outlined in Section 3.510 and notifies the county department that he or she wishes to continue his or her application for Adult Financial grant payments within thirty (30) calendar days of the denial, the county department shall reschedule the interview and the initial application date shall be used. During the interview, the county department must verify and document any changes that occurred between the initial application submission and the client’s request to continue the application process. If the continued application results in a denial for any reason and the client makes a subsequent 2) If the client does not have good cause and notifies the county department that he or she wishes to continue his or her application for Adult Financial grant payments within thirty (30) calendar days of the denial, the current application may be used and the date of application shall be the most recent date the client requested to continue his or her application for Adult Financial grant payments. The county department shall reschedule the interview and must verify and document any changes that occurred between the initial application submission and the request to continue that application. If the request to continue the application results in a denial for any reason and the client makes a subsequent 3) If the client requests grant payments after thirty (30) calendar days from the date of the initial denial, he or she must submit a new application.

D. Verify statements made by the client on the application and during the interview using the statewide automated system interfaces described in Section 3.520.5, gathered from other collateral contacts or requested from the client.

1. If the client is missing any verification, the county department shall request additional and/or required verifications from the client. The request shall include:

a. A specific list of verifications necessary to determine eligibility;

b. The due date for when the verifications must be returned, which shall be eleven (11) calendar days from the date the verification was requested in writing unless otherwise specified in Section 3.540; and, c. Notification that if the client fails to return the verifications by the due date, the county department shall process the application without those verifications, which may lead to a denial of grant 2. The client shall be advised that a collateral contact or home visit may be used to confirm questionable evidence, to investigate potential fraud, or when documentary evidence is insufficient to make a determination of eligibility or grant payment amount or cannot otherwise be obtained. If a collateral contact is needed, the county department shall:

a. Request the name of an appropriate collateral contact from the client; or, b. Independently determine an appropriate collateral contact; or, c. Substitute a home visit when an appropriate collateral contact cannot be identified; or, d. Deny an application following the policies outlined in Section 3.554 if a collateral contact refuses to provide documentation of essential verifications and the applicant is unwilling to cooperate in obtaining such documentation.

1) The client’s authorization for the collateral contact to release such information or documentation alone does not constitute cooperation if the county department requests further assistance from the client. Documentation of lack of cooperation must be entered in the case record.

2) However, if the client is willing to cooperate, but unable to obtain the information or documentation from the collateral contact, the county shall assist him or her in gaining the information or documentation required to make a determination of eligibility. If the county is also unable to obtain the information or documentation, eligibility will be determined based on the information provided.

e. Maintain client confidentiality to the greatest extent possible when using a collateral contact for verification.

3. Record the date each verification document was received by the county department office.

4. Upon receipt of the required verifications, the county department shall enter verifications into the statewide automated system. Once all verifications have been entered, the county department shall review the results, verify accuracy, and determine eligibility. If a client fails to timely return verifications, the case may be denied following the policies outlined in Section 3.554.

a. If the client provides new information regarding a change in circumstances after he or she was determined ineligible, the change in circumstances shall be treated as follows:

1) If the change in circumstances occurred within thirty (30) calendar days of the denial, the client’s original application may be used and the date of the application shall be the date all verifications were received supporting the new circumstance. The county department shall verify and document any changes that occurred between the original application submission and the new request to continue his or her application. The county department shall enter the verifications into the statewide automated system, review the results, verify accuracy, and determine eligibility. If the client’s request to continue his or her application results in a denial for any reason and the client makes a subsequent 2) If the client identifies a change in circumstance more than thirty (30) calendar days from the date of the denial, he or she must submit a new application.

5. When the client does not submit the required verifications, and the case is denied or discontinued:

a. If a client returns the required verifications within thirty (30) calendar days of the denial or discontinuation and good cause is provided for the delayed submission, the county department shall utilize the current application date and shall enter the verifications into the statewide automated system. When all verifications have been entered, the county department shall review the results, verify accuracy, and determine eligibility. If that request to continue the application results in a denial for any reason and the client makes a subsequent request for Adult Financial grant payments, a new b. If the client does not have good cause and returns the required verifications within thirty (30) calendar days of the denial, that application may be used and the date of the application shall be the date all verifications were received. The county department shall enter the verifications into the statewide automated system. When all verifications have been entered, the county department shall review the results, verify accuracy, and determine eligibility. If that request to continue the application results in a denial for any reason and the client makes a subsequent request for Adult Financial grant payments, a new application shall be required.

c. If the client provides the verifications more than thirty (30) calendar days from the date of the denial, he or she must submit a new application.

6. If a client believes that the value used by the county department for income or resource calculation was incorrect, the client may request verbally or in writing to have his or her case reevaluated by the county within thirty (30) calendar days of the denial. The county department shall evaluate and request additional documentation if needed. If an incorrect determination was made, the county department shall correct the case and grant payments shall be recalculated and issued based on the original application date.

7. Delay in processing the application shall not be allowed for any of the a. When the client has applied for a Social Security Number and is awaiting action by the SSA; or, b. When the county department is awaiting receipt of information from the State Verification Exchange System (SVES).

E. Provide a notice of action to the client by mail, electronic notification, or in person using the State Department's prescribed form explaining the eligibility determination results and the client's appeal rights as outlined in Section 3.586, et seq.

3.520.5 INTERFACE VERIFICATIONS

Interfaces are acceptable verification sources for the Adult Financial programs.

Appropriate interfaces for verification purposes are described below.

A. The Income and Eligibility Verification System (IEVS) provides for the exchange of information on clients with the SSA and the Colorado Department of Labor and Employment (DOLE). The county department shall query IEVS, using the client's, client's spouse's, and client's sponsors' SSNs. Source agency records shall be matched on a regular basis to identify potential earned and unearned income, and resources:

1. The following data shall be considered verified upon receipt:

a. SSA (Beneficiary and Earnings Data Exchange (BENDEX) and State Data Exchange (SDX)) Social Security benefits, SSI, pensions, self-employment income, federal employee earnings;

b. Unemployment benefits (UIB).

2. DOLE wage data shall not be considered verified upon receipt.

a. Additional verification must be obtained to verify wage information.

The county department shall request this information be provided by the client and/or his or her employer in writing. This information must be provided within eleven (11) days following the date of the county’s request or the case will be discontinued or denied b. The county department shall query DOLE at initial application and at redetermination.

3. Prior to approval of grant payments, the county department shall, at a minimum, verify potential income or unemployment benefits for the client, client's spouse, and sponsor(s).

4. The county department shall act on all information received through IEVS within forty five (45) calendar days of receipt.

5. The county department shall not delay processing of IEVS beyond fortyfive (45) calendar days on more than twenty (20) percent of the information targeted for follow-up, if:

a. The reason that the action cannot be completed within forty-five (45) calendar days is the nonreceipt of requested third party verification; and, b. Action is completed promptly, when third party verification is received or at the next time eligibility is redetermined, whichever is earlier. If action is completed when eligibility is redetermined and third party verification has not been received, the county department shall make its decision based on information provided by the client and any other information in its possession.

6. At initial application and at redetermination, a client shall be notified through a written statement provided on or with the application form that (1) the information available through IEVS will be requested, and that such information will be used for determination of eligibility; (2) the information in IEVS must be verified through sources, such as collateral contacts with the client, when discrepancies are found by the county department; and, (3) that the verified information may affect the client’s eligibility and grant payment amount.

a. All verification types obtained by a collateral contact to validate or invalidate any IEVS discrepancy shall be documented;

b. Case documentation shall be available in the case file or statewide automated system documenting the action taken on the case within forty-five (45) calendar days of initial receipt. Case documentation must include the purpose of the review of the IEVS, the action taken on the case, and how the county department made the determination and whether that determination supports the county’s action on the case.

B. The State Verification Exchange System (SVES) may be used to verify social security number, SSA income, and Supplemental Security Income application status. SVES may also be used to identify potential marital status, potential resources, and other potential sources of income; additional verification may be necessary.

C. The county department shall query the Public Assistance Reporting Information System (PARIS) at initial application and at redetermination to determine whether the client is receiving benefits in another state, veterans' benefits, or military wages or allotments. This information is not considered verified upon receipt and additional verification must be obtained to verify the information provided in PARIS. The county department shall request this information be provided by the client and/or the other state, veteran’s agency, or military branch in writing.

D. For AND only the county department shall query the Systematic Alien Verification for Entitlements (SAVE) at initial application and at redetermination. Information obtained through SAVE is considered verified upon receipt. The purpose of the save query is to:

1. Determine whether a qualified non-citizen has a sponsor(s); and, 2. Verify the non-citizen registration number provided by the client and, if the number and name submitted do not match, refer the client to resolve the discrepancy, and if unable to resolve, take prompt action to terminate assistance to the client following the policies outlined in Section 3.554;

3. Determine the non-citizen's immigration status.

E. The Colorado Department of Revenue, Division of Motor Vehicles (DMV), may be used by the county department to verify identity.

3.520.6 NON-FINANCIAL ELIGIBILITY REQUIREMENTS

3.520.61 NON-FINANCIAL ELIGIBILITY REQUIREMENTS

To be eligible for Adult Financial programs, a client shall:

A. Be eighteen (18) through fifty-nine (59) years of age for AND-SO (unless diagnosed with blindness, then age zero (0) through 59 years of age); age 0 through 59 years of age for AND-CS; and age sixty (60) years of age or older for OAP; and, B. Be a resident of Colorado, except that inmates of a city, municipal, county, State, or Federal correctional institution, and fleeing felons, shall not be eligible for Adult Financial programs; and, C. For AND only, be a citizen of the United States or be a qualified non-citizen or legal immigrant as outlined in Sections 3.520.67; and, D. For AND only, have a valid SSN, as outlined in Section 3.520.65; and, E. For AND only, have a disability, as outlined in Section 3.541; and, F. Not be currently receiving or eligible for financial assistance from Colorado Works, as outlined in Section 3.520.71.F; and, G. Apply for and accept all retirement and public assistance benefits for which they may be eligible, unless good cause is provided as to why such benefits were not applied for or accepted; and, H. Pursue and accept all other potential income and resources that may be available, as outlined in Section 3.520.71; and, I. Meet all other program eligibility requirements, including income and resource limits.

3.520.62 AGE REQUIREMENTS

The county department shall verify the client's age by viewing the statewide automated system interface information or any of the following documents:

A. Birth certificate;

B. Valid Colorado State identification or driver's license;

C. Valid out of state identification or driver's license;

D. Naturalization, immigration, or passport papers;

E. Legal documents from vital statistics;

F. Social Security information (SOLQ, SVES, SDX, and BENDEX);

G. School records;

H. Baptismal certificates or other well documented church records;

I. Genealogy records or other well documented family records of birth;

J. Voting records; or, K. United States census records.

3.520.63 MARITAL STATUS

A. The county department shall determine and verify if questionable the client's marital status as one of the following:

1. Single, never married;

2. Married;

3. Widowed; or, 4. Divorced or legally separated.

B. If married, both spouses may apply for and/or receive Adult Financial programs.

Each spouse shall have a separate case.

C. If the client is divorced, legally separated or widowed, and this status is questionable, the client shall provide verification in the form of:

1. Legal court documents or alternate verification from a vital statistic source substantiating divorce or legal separation; or, 2. Death certificate or obituary of the client’s spouse.

D. Clients who are not legally separated or divorced are considered married.

3.520.64 RESIDENCY REQUIREMENTS

A. To be eligible for Adult Financial programs, a client shall be a resident of Colorado.

B. Residency is established on the first day the client declares him/herself to be a resident of Colorado.

1. A person shall not acquire residence while the person has established his or her permanent place of residence in another state or country.

2. A person receiving financial assistance from another state shall not be eligible for Adult Financial programs in Colorado during any month in which a payment is made by the other state.

C. The client shall live in the county in which the application is made.

1. A client who resides in a county but who is homeless or does not have a fixed mailing address shall be considered eligible for assistance, provided all other eligibility requirements are met.

2. Clients who do not have a fixed address may provide a postal box within their county as their mailing address, or may use the county department as their mailing address. It shall be the client's responsibility to go to the postal box or the county department to check for and pick up their mail.

Failure to regularly check for and pick up mail shall not be grounds for appealing timely notice.

D. A client who moves out of Colorado or is shown to be a resident of another state shall not be considered a resident of Colorado. A move or residence in another state may be established by actions such as:

1. Purchasing or obtaining a lease of a dwelling unit in another state;

2. Household effects, equipment, and personal belongings being removed to another state;

3. Obtaining a driver's license or state-issued identification card in another state;

4. Registering to vote in another state;

5. Applying for or receiving local, state, or Federal assistance in another state;

6. Registering vehicles of any type in another state;

7. Securing a resident hunting or fishing license in another state;

8. Using an address in another state; or, 9. Statements or other positive acts indicating that the client has taken up residence in another state.

E. A client who is out of State temporarily shall be considered a resident, with the following exceptions:

1. A client who leaves the country for a period of thirty (30) or more consecutive days creates a rebuttable presumption (unless the client 2. A client who leaves the State for a period of ninety (90) or more consecutive days creates a rebuttable presumption (unless the client Financial programs. An exception to this is for individuals temporarily out of the State to receive documented medical treatment.

3. A client who leaves the State for a period of more than one hundred eighty (180) days in any calendar year, even if that time has not been consecutive time away, creates a rebuttable presumption (unless the client 4. A client who leaves the State to care for an immediate family member injured in the line of military duty for a period of one hundred eighty (180) or more consecutive days creates a rebuttable presumption (unless the client comes forward with enough information to prove otherwise) that the client shall no longer be considered a resident and shall be ineligible for Adult Financial programs.

F. When a determination of principal place of residence is difficult to secure due to conflicting documentation, other sources shall be used to gather verification and make a decision, such as addresses obtained from voter registrations, tax returns, Social Security and Medicare, a driver's license, car registrations, or other statements or documents. The county department shall use the prudent person principle to weigh the documentation and/or verification and make a decision regarding residency.

G. The burden to prove residency shall be on the client. If a client refuses to provide requested or necessary documentation or information to verify residency, Adult Financial grant payments shall be denied following the policies outlined in 3.520.65 SOCIAL SECURITY NUMBERS (SSN)

A. Each Adult Financial program client who has a social security number (SSN) or is eligible to obtain a SSN shall provide his or her SSN to the county department.

1. If a client has multiple numbers, all numbers shall be required.

2. If a client is unable to provide their SSN, the client shall be required to apply for a SSN at the local Social Security office and provide the county department with verification of application for an SSN. This requirement does not apply to OAP clients who are non-citizens or qualified noncitizens.

3. When a client is eligible for a SSN, refusal or failure to apply for or provide their SSN shall result in denial for Adult Financial programs.

4. Upon proof of application for an SSN, the time required for issuance of the number or to secure verification of the number shall not be used as a

basis for delaying action on the Adult Financial program application.

B. The county department shall verify the client's SSN with the SSA in accordance with procedures established by the State Department for the SVES.

1. The county department shall accept as verified a SSN that has been confirmed by the SVES.

2. When the county department receives notification that an SSN cannot be verified or is otherwise discrepant (e.g., name or number do not match SSA records), the county department shall:

a. Conduct a case record review to confirm that the SSN in the case record matches the SSN submitted to the SSA for verification.

1) If an error occurred in the original submittal (e.g., digits transposed, incorrect name submitted) the county department shall correct the error and resubmit the SSN through SVES for verification.

2) If no error is identified, the county department shall advise the client in writing that the SSN could not be verified, and instruct the client to contact the local Social Security office to resolve the discrepancy.

b. Make every effort to assist the client to obtain available documents required by the SSA.

3. For clients eligible to receive a SSN, if the client is unable to provide his or her valid SSN, the application shall be denied or the case terminated 3.520.66 IDENTITY In order to verify clients identity, the client shall produce and provide to the county department:

A. A valid Colorado driver's license or a Colorado identification card issued pursuant to Article 2 of Title 42, C.R.S.; or, B. A United States military card or military dependent's identification card; or, C. A United States Coast Guard Merchant Mariner Card; or, D. A Native American tribal document;

E. Any other document authorized by rules adopted by the Colorado Department of Revenue pertaining to driver’s licenses and identification cards found at 1 C.C.R. 204-30, Rule 16 (rules for exceptions processing) (August 14, 2025), which is hereby incorporated by reference. No later editions or amendments are incorporated. These rules are available for public inspection at the Colorado Department of Revenue, 1375 Sherman St., Denver, CO 80261 or for no cost at https://www.sos.state.co.us/CCR/DisplayRule.do?action=ruleinfo&ruleId=3202.

Copies of these rules are available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman St., Denver, CO 80203, during regular business hours.

3.520.67 CITIZENSHIP, QUALIFIED NON-CITIZENS, AND NON-CITIZENS

A. The following are citizens of the United States and are eligible to apply for AND.

1. Persons born in the United States, Puerto Rico, Guam, Virgin Islands (U.S.), American Samoa, or Swain's Island;

2. Persons who have become citizens through the naturalization process;

3. Persons born to U.S. citizens outside the United States with appropriate documentation.

B. The county department shall verify citizenship for AND when:

1. The claim of citizenship is inconsistent with statements made by the client or with other information on the current or previous applications; or, 2. The claim of citizenship is inconsistent with information received from another source.

C. Citizenship may be verified by a birth certificate, possession of a U.S. passport, a certificate of U.S. citizenship (issued by USCIS), a certificate of naturalization (issued by USCIS), a certificate of birth abroad of a citizen of the United States (issued by the Department of State), or Identification Cards for U.S. citizens (issued by USCIS). Documents that are acceptable as verification of citizenship can be found in the Federal Regulations at 45 C.F.R. 1626.6 (September 2025), which is hereby incorporated by reference. This rule does not contain later amendments or editions. These regulations are available at no cost at https://www.ecfr.gov/current/title-45/subtitle-B/chapter-XVI/part-1626/section- 1626.6. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

D. Verification of citizenship by the county department shall not result in discrimination based on race, religion, ethnic background or national origin, and groups such as migrant farm workers or Native Americans shall not be targeted for special verification. The county department shall not rely on a surname, accent, or appearance that seems foreign to find a claim to citizenship questionable. Nor shall the county department rely on a lack of English speaking, reading, or writing ability as grounds to question a claim to citizenship.

E. Qualified non-citizens who are considered legal immigrants by USCIS are eligible to apply for Adult Financial programs and all non-citizens are eligible to apply for O A P.

F. Qualified non-citizens applying for AND shall present documentation from USCIS showing the client's non-citizen status. All documents shall be verified through SAVE (Systematic Alien Verification for Entitlements) to determine the validity of the document.

G. The following non-citizens and temporary residents shall not be eligible for AND.

1. A non-citizen with no status verification (undocumented) from the USCIS;

2. A non-citizen granted a specific voluntary departure date;

3. A non-citizen without a current qualified status, regardless of application status; or, 4. A citizen of foreign nations residing temporarily in the United States on the

basis of a visa issued to permit employment, education, or a visit.

3.520.68 FIVE YEAR BAR FROM ELIGIBILITY

A. Qualified non-citizens arriving in the U.S. on or after August 22, 1996, are barred from receiving AND for five years beginning on the qualified non-citizen's date of admission into the United States for legal permanent residence, as verified through SAVE.

3.520.69 SPONSORSHIP OF QUALIFIED NON-CITIZENS

This section shall apply to qualified non-citizens who entered the country on or after August 22, 1996.

A. If a client is a sponsored qualified non-citizen, he or she shall be responsible for the provision of any information and documentation related to the sponsor(s) and shall obtain cooperation from the sponsor(s) necessary to determine:

1. The identity and current address and contact information of the sponsor(s);

2. The relationship of the sponsor(s) to the qualified non-citizen;

3. Income and resources of the sponsor(s), which may be deemed available to the qualified non-citizen or recovered for repayment of grant payments paid to or on behalf of the qualified non-citizen.

B. It shall be presumed that an affidavit of support demonstrates the sponsor's ability to make income and resources available to a non-citizen whom he or she sponsors at a minimum of one hundred twenty-five percent (125%) of the Federal Poverty Guidelines, as defined in 3.510. Sponsors are expected to meet their financial commitments to the qualified non-citizen whom they sponsor and for whom they signed an affidavit of support until such time as the:

1. Qualified non-citizen has obtained U.S. citizenship;

2. Qualified non-citizen has worked, or can be credited with forty (40) qualifying quarters of coverage under Title II of the Federal Social Security Act, 42 U.S.C. Section 413 (2018);

3. Qualified non-citizen leaves the United States and gives up lawful permanent resident status;

4. Qualified non-citizen dies;

5. Sponsor of the qualified non-citizen dies. The death of one sponsor does not terminate the support obligation of a joint sponsor. The sponsor's estate shall be required to repay public benefits; or 6. Qualified non-citizen becomes subject to removal proceedings, but he or she applies for and obtains a new grant of admission status in those proceedings based on a new affidavit of support, if one is required.

C. Income and resources of the sponsor(s) shall be deemed to the client, as follows:

1. Sponsor deeming shall not apply to qualified non-citizens admitted as refugees or as political asylees. A non-citizen whose status as a political asylee or refugee has not yet been determined or finalized because his or her application to become a qualified noncitizen is in a pending status or for some other reason shall not be considered a qualified non-citizen admitted as a political asylee or refugee, and therefore, such non-citizen is not eligible to receive grant payments.

2. Sponsors who signed sponsorship agreements prior to December 19, 1997, shall not be subject to resource and income deeming.

3. Effective December 19, 1997 through December 31, 2013, sponsor deeming shall apply only to the qualified non-citizen's spouse and/or nonrelative sponsor(s) identified in sponsorship agreements signed on or after December 19, 1997.

a. A relative is defined as any relation by blood, adoption, or marriage.

b. Kinship relations by marriage continue to exist even if the marriage is terminated by death or divorce.

4. Effective January 1, 2014, sponsor deeming shall apply to all of the qualified non-citizen's sponsors identified in sponsorship agreements signed on or after December 19, 1997, no matter the sponsor's relationship to the client.

5. Because the sponsor, not the non-citizen, is solely liable for repayment, the sponsor cannot use the sponsored non-citizen's grant payments to repay the payments.

D. If the qualified non-citizen fails to provide information related to the sponsor(s), as outlined in Section 3.520.69.A, assistance shall be denied or discontinued If it is determined that the client received Adult Financial program grant payments because the client failed to provide necessary information related to the sponsor(s) or the sponsor(s) failed to cooperate with the county department in determining income and resources that are required to be deemed to the client, the county department shall recover such funds, as outlined in Section 3.520.69.C.

E. Income and resources shall be deemed as outlined in Sections 3.534, 3.520.69.B, and 3.520.72.

3.520.7 FINANCIAL ELIGIBILITY REQUIREMENTS

3.520.71 FINANCIAL ELIGIBILITY REQUIREMENTS

A. To receive Adult Financial program assistance, the client shall meet all financial requirements in addition to all other program eligibility requirements. The client shall:

1. Have countable resources below the resource limit as outlined in Section 3.520.72; and, 2. Have income below the income limit, as outlined in Section 3.520.78; and, 3. Make reasonable attempts to pursue all available potential income and resources at the client's disposal.

B. The AND-SO client shall apply for Supplemental Security Income (SSI) benefits.

If the client has work hours during his or her lifetime, the client shall also apply for Social Security Disability Insurance (SSDI). The client shall report any denial for SSI benefits. The client shall appeal all negative decisions regarding their SSI eligibility. Failure to appeal all negative decisions within thirty (30) calendar days of such decision, unless additional time is given for good cause, shall result in denial or discontinuation of and grant payments.

If the client is approved for SSI and SSDI benefits at the same time and is given the choice between the two (2) benefit options, he or she must contact the county department to determine if any interim assistance he or she received from the county is required to be repaid. If repayment is required, the client shall be advised that he or she must accept the SSI benefits and that if he or she voluntarily withdraws his or her SSI application, withdrawal would violate the Authorization for Reimbursement of Interim Assistance, as outlined in Section 3.545.

For OAP, the client shall apply for and accept Social Security and/or SSI benefits if determined eligible, as follows:

1. Clients sixty (60) years of age and older who report a disability may be eligible for SSI or SSDI.

2. Clients sixty (60) years of age and older may be eligible for Social Security survivor benefits.

3. Clients sixty-two (62) years of age and older may be eligible for early Social Security retirement benefits; otherwise the client shall provide documentation from the SSA that he or she is ineligible due to insufficient work hours.

4. Clients sixty-five (65) years of age and older may be eligible for SSI benefits when the client's income from any source is less than the SSI benefit standard, as defined in Section 3.510, plus $20.00.

C. For all Adult Financial programs other than AND-SO, clients referred to the SSA to apply for any SSA related benefit shall be required to provide verification of application for such benefits within eleven (11) calendar days of his or her application for SSA benefits.

For AND-SO, clients referred to the SSA to apply for any SSA related benefit shall be required to provide verification of application for such benefits within sixty (60) calendar days from the initial interview date with the county department. The client will have up to sixty days of conditional approval from the date of the initial interview with the county department for AND-SO. Subsequent applications for AND-SO submitted by the client shall not be approved prior to receipt of proof of application for SSA benefits. Subsequent applications for AND- SO require verification of application for SSA benefits within thirty (30) calendar days.

D. For OAP, if the client has or is eligible to obtain a SSN they shall apply for SSI, unless the client is a non-citizen or qualified non-citizen that does not qualify to receive a SSN. A client with a SSN and shall timely schedule and complete any and all scheduled interviews with the SSA, and in the event of a denial by SSA, the OAP client shall continue to appeal all negative decisions from the SSA until a final resolution is reached and no further right to appeal exists. However, the requirement to continue to appeal all negative decisions may be excused if any of the following apply:

1. The client's and the client's spouse's gross income exceeds the maximum allowed for SSI for an individual or a couple; or, 2. The client's and the client's spouse's total resources exceed that allowed for SSI for an individual or a couple; or, 3. The client is not disabled as defined in Section 3.541; or, 4. As otherwise directed by the SSA; or, 5. Good cause exists as defined in Section 3.510.

E. Clients newly approved for SSI benefits who have been charged an in-kind support and maintenance (ISM) deduction by the SSA shall apply to SSA to remove the ISM as soon as the client begins paying his or her fair share for shelter costs. The county department shall deduct an identical ISM amount for Adult Financial programs until the SSA ISM is removed.

F. The client shall apply for and accept TANF/Colorado Works when he or she might be eligible, as follows:

1. An Adult Financial program client with a dependent child is required to apply for and accept, if eligible, TANF/Colorado Works financial benefits.

a. A grandparent or any other specified caretaker who is not a parent is not required to be a member of the TANF/Colorado Works case when they are not requesting assistance for himself or herself.

b. A TANF/Colorado Works client is not required to apply for an extension to be potentially eligible for Adult Financial program grant c. The TANF/Colorado Works funds received for the support of a child are not used in determining the specified caretaker's eligibility for Adult Financial program grant payments.

2. The client shall be ineligible for Adult Financial program grant payments if his or her TANF/Colorado Works case was denied or discontinued:

a. Due to a sanction, demonstrable evidence, or disqualification; or, b. Because the client withdrew from the program prior to exhausting all benefits.

c. After becoming ineligible due to the reasons outlined in Section 3.520.71.f.2, above, the ineligibility period shall continue until the sanction, demonstrable evidence, or disqualification is removed; or until the client is found otherwise ineligible for TANF/Colorado Works benefits.

G. The client or legal fiduciary shall take reasonable steps to apply for and accept any other income for which the client is eligible. Clients referred to pursue other income shall be required to provide verification of application for or pursuit of such income. Grant payments shall not be approved prior to receipt of proof of application or pursuit of other income, unless it is demonstrated that good cause exists.

1. If the client or legal fiduciary refuses or fails to make a reasonable effort to secure potential income, such income shall be considered as if available to the client, and timely notice shall be given regarding a proposed action to deny, reduce, or terminate assistance.

2. If the client or legal fiduciary secures the potential income prior to the effective action date identified in the notice, the proposed action to deny, reduce, or terminate assistance shall be withdrawn by the county, and the case shall be updated. Grant payments may still be denied, reduced, or discontinued due to a change in income.

H. The client or legal fiduciary shall take reasonable steps to obtain and accept any other potential resources for which the client is eligible. Clients referred to pursue other resources shall be required to provide verification of the pursuit of such resource. Grant payments shall not be approved prior to verification of the attempt to sell, liquidate, or legally acquire a resource, unless the client demonstrates that good cause exists.

1. If the client or legal fiduciary refuses or fails to make a reasonable effort to secure potential resource(s), such resource(s) shall be considered as if available to the client, and timely notice shall be given regarding a proposed action to deny, reduce, or terminate assistance.

2. If the client or legal fiduciary secures the potential resource(s) prior to the effective action date identified in the notice, the proposed action to deny, reduce, or terminate assistance shall be withdrawn by the county, and the case shall be updated. Grant payments may still be denied, reduced, or discontinued due to a change in resource(s).

3.520.72 RESOURCES

A. Unless otherwise specified, a resource is countable, and together with all other countable resources of the client, spouse, and sponsor(s) shall be considered against the resource limit. The resource limit is:

1. $2,000 for:

a. An unmarried client;

b. An unmarried sponsor; and, c. A married sponsor whose spouse is a co-sponsor. Each sponsor shall receive the $2,000 resource limit for a combined resource limit of $4,000.

2. $3,000 for:

a. A married client; or, b. A married sponsor whose spouse is not a co-sponsor.

B. Countable resources include, but are not limited to:

1. Equity value of real property that is not used as the primary home or not exempt as income-producing.

2. Proceeds from the sale of the primary home that are in excess of the cost of expenses incurred to purchase or build a replacement home.

3. Personal property or the proceeds from the sale of personal property, such as mobile homes or recreational vehicles not used as the primary home and not exempt as income producing.

4. Personal property or the proceeds from the sale of personal property, such as motor vehicles, recreational off road vehicles, boats, trailers, or similar that are not exempt per Section 3.520.77 or exempt as income producing.

5. Cash and convertible assets including but not limited to: cash on hand, a savings or checking account, other accessible electronic currency and/or cryptocurrency, stocks, bonds, mutual fund shares, 401Ks, 457Ks, IRAs, Certificates of Deposit (CDs), PERA accounts, gold/silver, pensions, and other retirement or investment accounts and investment vehicles.

6. Mortgages, promissory notes, and similar properties that can be converted to cash.

7. Cash surrender value of all life insurance policies as outlined in Section 3.520.75.

8. Prepaid revocable funeral or burial expense contracts or trust deposits, as outlined in Section 3.520.77.G-H.

9. The value of the burial space in excess of that required to meet the burial needs of the immediate family, as outlined in Section 3.520.77.I.

10. Proceeds of fire or casualty insurance payments that were in excess of the expenses incurred to repair or replace the damaged, lost, or stolen property.

11. Proceeds of a loan when those proceeds were not expended to meet the

purpose of the loan or proceeds of a loan with no bona fide debt repayment schedule.

12. The estate and all resources identified in the estate inventory for a client adjudicated incapacitated by a court.

13. Trusts, both revocable and irrevocable, will be countable as resources or income according to the guidelines of SSA, except as prohibited by Sections 15-14-412.5 through 15-14-412.9, C.R.S. (2025) and is consistent with the provisions of Federal Guidelines found in the SSA Programs Operations Manual System (POMS) at SI CHI01120.201 (October 26, 2022) and SI 01120.200 (May 6, 2024), which are hereby amendments or editions. These guidelines are available for no cost at https://secure.ssa.gov/poms.NSF/lnx/0501120201CHI and https://secure.ssa.gov/apps10/poms.nsf/lnx/0501120200. These guidelines are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

a. When all or a portion of the corpus of a trust, cannot be paid to or for the benefit of the client, the portion that cannot be paid is considered a transfer of resources for less than fair market value and a penalty shall be assessed as outlined in Section 3.520.76.D.

b. Refusal of a trustee to make payments to or for the benefit of the client does not exempt the trust from being a countable asset and the full amount of the trust shall be considered available as a resource to the client.

c. If a client places an exempt resource in a trust the resource exemption may still apply to that resource.

C. If it is determined that a married couple is legally separated as identified in

Section 3.520.63, sole ownership of property by the non-recipient spouse does not affect the client's eligibility for assistance.

D. The county department shall obtain verification of all resources and associated values.

1. The county department shall include case notes describing verification documentation in the statewide automated system.

2. Original copies of verification documents shall be returned to the client.

3. The client's authorization on the application or redetermination form shall be obtained to contact a collateral contact for valuation information or 4. After resources have been verified at application, client statement is acceptable until each twenty-four (24) redetermination. Resources must be reverified by traditional verification methods at every twenty-four (24) month redetermination. All new resources must be verified by traditional verification methods when reported.

5. Client statement is acceptable as verification for cash.

E. A sponsor(s)'s resources are only counted toward the non-citizen client they sponsor. Resources are attributed to the sponsor in the same manner as the non-citizen client, as outlined in Section 3.520.7. All countable resources over the sponsor(s) resource limit, as outlined in Section 3.520.72.A, are then deemed to the non-citizen client. The deemed amount from the client’s sponsor(s) is then added to the non-citizen client’s countable resources and compared to the noncitizen client’s resource limit, as outlined in Section 3.520.72.A.

F. If a client is approved for Supplemental Security Income (SSI) as verified through the SVES interface, there shall be no additional requirement to verify resources at application, unless the resources reported are questionable.

1. If the county department has obtained or received information related to resources that is contrary to the SVES interface, the county department shall independently verify the information; and, 2. The county department shall forward such contrary information to the local SSA office.

3.520.73 CASH AND CONVERTIBLE ASSETS

A. Checking and savings accounts or other accessible electronic deposits:

1. The current amount in a savings or checking account or other accessible electronic deposits is determined by verifying ownership and the available balance:

a. From a copy of a current statement of the account; or, b. With the financial institution online, by phone, or in writing.

2. The balance in a joint account shall be considered available to the client in proportion to the number of persons on the account.

a. If the co-owner of the joint account is the client's legal fiduciary, such as a guardian, conservator, or power of attorney, the account shall be considered to be 100% owned by the client and all funds in the account shall be considered available to the client.

b. If the client establishes by a preponderance of evidence that the intent of ownership is other than the client's equal and proportionate share of the account balance, the county department shall apply the prudent person principle to the evidence to determine the amount to be considered available to the client.

c. In cases where the client has no interest in the account, the county department shall request a change in the account designation removing the client's name, and submit the original and revised account records showing the change was made.

B. Convertible assets 1. The value of a retirement or pension account is determined as follows:

a. The gross value of the account, less any taxes due, is the amount that is countable as a resource, regardless of whether the client, spouse of the client, or sponsor(s) of the client is receiving any monthly income from the account.

b. If the client is not able to provide the amount of taxes that are due, the value shall be determined by deducting 20% from the gross value of the account.

2. The fair market value of stocks, mutual fund shares, municipal, corporate or government bonds, and other securities is based on the price as of the opening of the market on the date their value is determined by the county department. The market price is obtained from the published quotations on the internet or by contacting a local securities firm.

a. The value of stocks traded over-the-counter is expressed on a “bid” and “asked” basis. In such cases, the bid price is used to determine the market value.

b. When stocks or other securities have no locally determinable value, the market value is requested from the issuing company. The office of the Secretary of State in each state will supply the address of the issuing company and information as to whether the stock is still on the market.

3. The current cash value of U.S. savings bonds, treasury notes, and similar investment vehicles is determined from the value tables appearing on the bonds themselves, through the online treasury direct system, or by contacting a financial institution.

4. The equity value of mining claims and oil, mineral or water rights, if assessed separately from land, is determined by using the equity value established by the current market value.

C. A county department may selectively contact one or more financial institutions to establish whether a client has any account at the institution or has an account in addition to one declared. The client's signature on the application provides authorization to make such contacts.

3.520.74 REAL PROPERTY AND PERSONAL PROPERTY

3.520.741 REAL PROPERTY

A. The value of the home in which the client and their spouse have ownership interest and that serves as the client’s primary place of residence is exempt as described in 3.520.77.C. Client statement is acceptable as verification of the value of the client’s primary residence.

B. In order for real property to be considered a resource, the following shall be determined:

1. The actual value less encumbrances of the ownership interest:

a. Actual value of real property may be obtained by using the actual value reported by a county assessor or from the most recent property assessment notice.

b. The assessed value shall be verified from a copy of the most recent property assessment notice or with the county assessor's office on the Internet, by phone, personal contact, or in writing.

c. Encumbrances include mortgages, liens, judgments, delinquent taxes, loan agreements, and other forms of indebtedness.

Encumbrances shall be verified by such methods as collateral contact, county recorder records, bank records, and other credible sources. Only direct and documented encumbrances against a specific item or property shall be considered in determining its equity value. Verbal agreements of indebtedness shall not be accepted.

2. The negotiability of the ownership interest (that is, there are no legal restrictions from selling the client's property interest); and, 3. The ability to sell the property interest (that is, that the ownership interest can, in fact, be sold on the open market at any price).

C. The degree of the ownership interest is determined by the type of ownership.

Generally, the types of ownership are:

1. Sole ownership, in which the client, the client’s spouse, or sponsor(s) is the only owner. if the client, spouse, or sponsor(s) has the right to dispose of the property, the actual value less encumbrances of the property is determined and counted as a resource;

2. Shared ownership, in which the property is owned by the client, spouse, or sponsor(s) and one or more individuals. The actual value less encumbrances is determined and charged in proportion to the client, client’s spouse, or sponsor(s)’s share of ownership. There are two kinds of shared ownership:

a. Joint ownership or ownership in common, in which the property's actual value less encumbrances is divided equally among the owners; and, b. Tenancy in common, in which the property's actual value less encumbrances is divided by the number of owners in proportion to their stated interest (which may not necessarily be equal).

D. Negotiability and, if applicable, the ability to sell the property interest at a reasonable price must be determined. Negotiability refers to the client, client’s spouse, or sponsor(s)’s legal right to dispose of an ownership interest; ability to sell refers to the client, client’s spouse, or sponsor(s) legal ability to sell.

Reasonable price is determined to be two-thirds of the actual value.

1. Negotiability - there may be legal reasons why a client, client’s spouse, or sponsor(s) may not be able to sell the property interest, such as when the estate is in probate or there is a lawsuit pending against the property. The refusal of co-owners to consent to the sale of a property interest is not a legal restriction of the client, client’s spouse, or sponsor(s)’s right to sell.

2. If the co-owner of the property uses the property as the principal place of residence and sale of the property would cause undue hardship, the client, client’s spouse, or sponsor(s)’s equity in the property shall be exempted, unless the co-owner is the spouse or sponsor(s). Undue hardship for this

purpose is defined as:

a. The co-owner uses the property as his or her primary residence;

b. The co-owner would have to move as a result of the sale of the property; and, c. The co-owner has no other available housing, including relatives or income to rent at fair market value; and, d. The co-owner documents, in writing, his or her undue hardship allegations; and, e. Using prudent person principle, the county department determines the undue hardship allegations to be reasonable.

3. If the client, client’s spouse or sponsor(s) cannot sell the property for twothirds of the actual value, the property shall be exempted provided there continues to be reasonable efforts to sell the property such as listing the property with an agency or by advertising in the local media.

a. The county department shall verify on a quarterly basis that a reasonable effort is being made to sell the property.

b. The property shall not be exempted if the county department, using prudent person principle, determines the client, client’s spouse, or sponsor(s) is not making a reasonable effort to sell.

c. If the client, client’s spouse, or sponsor(s) rejects an offer to purchase the property that is at least two-thirds the actual value of the property, the entire equity value of the property shall be considered a countable resource.

4. If the property interest cannot be disposed of because of legal technicalities, the client, client’s spouse, or sponsor(s)’s equity value is not a countable resource. The county department shall verify any limitations that prevent the disposition of the property and document those limitations in the statewide automated system case comments.

3.520.742 PERSONAL PROPERTY

A. The actual value of any personal property which is assessed for taxation, such as a mobile home, house trailer, or property used in a trade or business, is determined by using the actual value reported by a county assessor or by obtaining a copy of the most recent property assessment notice. If the actual value is not on the assessment notice, the value may be determined by:

1. Verifying the actual valuation from a copy of the most recent property assessment notice or with the county assessor's office on the Internet, by phone, by other personal contact, or in writing; or, 2. When personal property valuation is necessary, and the usual means of valuation is not possible, the county department shall use available local resources or the classified ad section of the local or other State newspaper or the Internet to determine and verify the actual value.

3. To determine the equity value of personal property, first determine the actual value; then subtract encumbrances.

B. The vehicle with the highest value is exempt as described in 3.520.77.A, and therefore may be verified with client statement. The actual value of any additional personal property which is not assessed for taxation is determined by obtaining the appraised value less liabilities, i.e., vehicles, farm equipment and livestock or inventories of merchandise and materials, such as art, jewelry or valuable collections, as appraised by a verifiable, industry recognized source.

1. The actual value of automobiles and trucks is determined by using the trade-in fair condition value as provided by an auto valuation company, such as Kelly Blue Book or NADA guides. Unless questionable, it shall be presumed that the value of the vehicle is four hundred dollars ($400) when the information is not found in Kelly Blue Book or Nada guides.

2. For personal property which has not been assessed for taxation, the client shall submit verification of the appraised value based on written statements received from the following:

a. Assessment standards obtained from the State or county assessor's office; or, b. Valuation obtained from a local merchant, the Internet or other reliable source.

C. Personal property may be exempted if the client, client’s spouse, or sponsor(s) has made an attempt to sell and has been unable to do so.

1. Failure to sell personal property at the asking price or for a reasonable value shall not exempt the resource from the client’s countable resources.

Under such circumstances, the county department shall determine whether the property could be sold for two-thirds of the actual value.

2. If the client, client’s spouse, or sponsor(s) receives an offer for at least two-thirds of the actual value and refuses to sell the property, the property shall not be exempted.

3. If the client, client’s spouse, or sponsor(s) cannot sell the property for twothirds of the actual value, the property shall be exempted provided there continues to be reasonable efforts to sell the property, such as by listing the property with an agency or by advertising in the local media.

a. The county department shall verify on a quarterly basis that a reasonable effort is being made to sell the property.

b. The property shall not be exempted if the county department, using prudent person principle, determines the client, client’s spouse, or sponsor(s) is not making a reasonable effort to sell.

c. If the client, client’s spouse, or sponsor(s) rejects an offer to purchase the property that is at least two-thirds the actual value of the property, the entire equity value of the property shall be considered a countable resource.

D. The client, client’s spouse, or sponsor(s) shall have the right to submit evidence establishing a lesser property value. Such value may be established as zero. The county department shall evaluate the evidence and determine the property value.

3.520.75 LIFE INSURANCE

A. Life insurance policies owned by the client, client’s spouse, or sponsor(s) that have a cash surrender value available (CSV) must be evaluated for THE original face value at the time of purchase and for the current CSV.

B. Term life insurance policies should be reviewed to determine if a CSV exists.

C. The county department shall obtain the most recent documentation related to the policies, to include active status, liens or encumbrances, current CSV, and annual dividend statements.

D. If the total face value of all life insurance policies owned by a client and his or her spouse is equal to $1,500 or less, the full CSV of all policies is exempt.

Sponsor(s) are allowed the same exemption.

E. For OAP only, if the total face value of all life insurance policies owned by a client and his or her spouse is equal to more than $1,500 and the CSV of all policies combined is $250,000 or less, then the following applies:

1. If all policies were purchased more than forty-eight (48) months prior to the eligibility determination date, and no further contributions or payments to the policies have been made in the past 48 months, all CSV is exempt; or, 2. If there have been additional monies contributed or payments made to any of the policies within 48 months of the eligibility determination date, those additional monies contributed are counted toward the resource limit; the original cash value amount prior to the 48 month period remains exempt; or, 3. If any of the policies were purchased within the 48 months prior to eligibility determination date, the total CSV is a countable resource; and, 4. Sponsor(s) are allowed the same exemptions.

F. For OAP only, if the total face value of all life insurance policies owned by a client and his or her spouse is equal to more than $1,500 and CSV of all policies combined is more than $250,000, then the following applies:

1. If all policies were purchased more than 48 months prior to eligibility determination date, and no further contributions or payments to the policies have been made in the past 48 months, the CSV over $250,000 is countable; the first $250,000 is exempt; or, 2. If there have been additional monies contributed or payments made to any of the policies within 48 months of eligibility determination date, those additional monies contributed are counted toward the resource limit and the CSV over $250,000 is countable; the original cash value amount prior to the 48 month period remains exempt; or, 3. If any of the policies were purchased within the 48 months prior to eligibility determination date, the total CSV is a countable resource; and, 4. Sponsor(s) are allowed the same exemptions.

G. The original face value of a policy may be increased because of dividends and reinvestment of dividends. This increased face value shall not be used to determine eligibility. The original face value of the policy shall be used to determine whether the CSV of the policy is exempt.

H. Use the following chart to estimate a life insurance policy's CSV if not available from the client, client’s spouse, or sponsor(s):

YEARS LIFE INSURANCE

POLICY HAS BEEN IN

EFFECT

ESTIMATED CSV IS THIS

PERCENTAGE OF FACE

VALUE:

20 OR MORE 60% 15-19 50% 11-14 45% 6-10 30% 4-5 20% 3 10% 2 5% 1 0%

3.520.76 TRANSFERS WITHOUT FAIR CONSIDERATION (TWFC)

A. Transfers of resource ownership may occur through transactions such as sale of property; trade or exchange of one property for another; spend-down of cash; giving away cash; transferring any financial instrument (e.g., stocks, bonds); or, giving away property (including adding another person's name as an owner of the property). A transfer of a resource shall be considered a TWFC if the transfer was:

1. Voluntary; and, 2. Without fair and valuable consideration, and, 3. Made within thirty-six (36) months prior to the application date or while receiving Adult Financial program grant payments; and, 4. For the purpose of rendering the client eligible for assistance. The county will evaluate evidence provided by the client to determine if the transfer of resources was exclusively for a purpose other than to qualify for benefits.

a. The county department shall make a rebuttable presumption that the transaction was made for the purpose of becoming or remaining eligible for Adult Financial program benefits when the transfer was made any time during the thirty-six (36) month period immediately prior to the filing of application for assistance or during such time that assistance was being received.

b. A client shall be given the opportunity to disprove the presumption.

The presumption shall be nullified if the client can demonstrate with evidence to the county department that the transfer was for another

purpose.

1) The client's primary purpose cannot be to acquire money or profit from the transaction; and, 2) The client shall provide written documentation of any agreement made in relation to the transfer of property, that was created at the time of the agreement to transfer property; and, 3) The county department shall weigh the evidence and use the prudent person principle to determine whether there is sufficient evidence to disprove the presumption.

B. Circumstances at the time of the transaction may indicate a reasonable rationale for a client's willingness to accept a sum which is less than a fair consideration based on a hardship just prior to the transaction. Hardships include:

1. A period of unemployment resulting in an inability to meet monthly bills, and costs of subsistence; or, 2. An accident or severe illness resulting in a need of funds to meet large expenditures for medical care and services; or, 3. Other hardship deemed reasonable by the county department using the C. A documented involuntary transfer of a resource shall not affect eligibility.

Transfers that would be considered involuntary are:

1. Loss of property through fraud, provided that the client can demonstrate that every reasonable effort has been made to recover the property by court action or other procedures as indicated; or, 2. Loss of property through legal action such as judgment, foreclosure, delinquent tax sale; or, 3. Other involuntary transfer identified and determined reasonable by the county department using the prudent person principle.

D. The county department shall determine the eligibility penalty as a result of a TWFC as follows:

1. Determine the actual value of the resource less encumbrances and subtract the amount the client received for the resource from the determined actual value. This is the uncompensated value.

2. Determine the current Adult Financial Program grant standard. This is the TWFC monthly penalty value.

3. Divide the uncompensated value by the TWFC monthly penalty value and round down to the nearest whole number.

4. This equals the number of months of ineligibility for Adult Financial Program grant payments.

5. The penalty period begins the month following the date of transfer. If there are multiple transfers, the period of ineligibility would begin the month following the end date of the first transfer’s period of ineligibility.

6. If the client transfers a resource and the entire resource is returned in the same month, the period of ineligibility does not apply.

a. If the client transfers a resource and the entire resource is returned in a subsequent month, the period of ineligibility continues through the month the resource is returned (even if the resource is returned on the first day of the month). The period of ineligibility due to the transfer ends as of the month following the month the resource is returned. In that month, the returned resource is counted towards the client's resource limit.

b. If the entire resource is not returned, the period of ineligibility does not end. Instead, recompute the uncompensated value based on how much of the resource was not returned. Then, recompute the period of ineligibility based on the adjusted uncompensated value.

If additional funds are subsequently returned, it will be necessary to recompute the uncompensated value again.

E. A period of ineligibility can be from 1 month up to a maximum of 36 months depending on the amount of the uncompensated value for each resource transferred. A period of ineligibility cannot exceed 36 months regardless of the uncompensated value of the transfer. Months in the period of ineligibility can coincide with months of ineligibility for other reasons.

3.520.77 EXEMPT RESOURCES

Resources that shall be exempt and not counted toward the resource limit for an individual or married couple include:

A. The vehicle with the highest value is exempt if it is used for the transportation of the client or a member of the household.

B. Household goods and personal effects found in or on the primary residence, that the client uses on a regular basis. The client needs household goods for maintenance, use, and occupancy of the premises as a home. This also includes personal effects which are ordinarily worn or carried by the client, or items that have an intimate relation to the client. This does not include effects that the client holds because of the value or as an investment, which are countable as personal property as outlined in Section 3.520.742.

C. A home in which a client and his or her spouse have an ownership interest and that serves as the client's principal place of residence. This property includes the shelter in which the client resides, the land on which the residence is located, and related outbuildings.

1. The home is not a countable resource regardless of its value. However, when there is an income producing property located on or adjacent to the home property, the income producing resource shall not qualify under the home exemption unless assessed collectively with the principal home.

2. When a client or his or her spouse requires long-term medical care that is outside the client's county of residence, the home continues to be exempt so long as there is intent for the client and/or spouse to return to the home at the conclusion of medical treatment.

3. When a client requires care in a long-term care facility, the home continues to be exempt so long as there is intent for the client to return to the home.

a. This intent to return home applies to the home in which the client or spouse was living prior to being admitted to the facility or to the replacement home. Such intent is documented by the following:

1) A written statement from the client indicating the intent to return home for any reason; or, 2) A written statement from the client's spouse, legal fiduciary, doctor, or authorized representative indicating the client's intent to return home.

b. An arrangement by the client for occupancy of the home by another person, either on a rental basis, rent free, or in exchange for home maintenance, during a period of temporary absence shall not affect the home property exemption.

4. The home of an OAP-C client, as defined in Section 3.530.1, shall be exempt as a resource during the period of commitment.

5. If a client's home can no longer be excluded due to a change in his or her principal place of residence, the equity value of the property shall count as a resource.

D. Part or all of the value of property may be exempt if it is essential to the selfsupport of the client. To determine whether property is producing income or being used in a trade or business, the county department shall obtain a copy of the most recent tax returns from the client. If a return has not yet been filed, obtain a current estimate of income and a copy of the previous year's return. Property used for self-support activities include:

1. Property used in self-employment.

a. To be considered a valid trade or business as self-employment, the activity shall be:

1) Currently ongoing rather than in the stage of preparation or inactivity; and, 2) Intended to make a profit.

b. The cash and convertible assets considered necessary for use in the trade or business shall be excluded.

c. If property has been but is not currently in use, the exemption for such property shall continue for twelve (12) months if there is a reasonable expectation that the use of the property will resume within that time. The exemption is for twenty-four (24) months where non-use is due to a disabling condition.

2. Property owned by the client that is necessary to perform a job for wages, such as tools, safety equipment, or uniforms. If property has been but is not currently in use the exemption for such property shall continue for twelve (12) months if there is a reasonable expectation that the use of the property will resume within that time. The exemption is for twenty-four (24) months where non-use is due to a disabling condition.

3. Non-business property used to produce goods necessary for the client's daily activities.

a. A maximum of six thousand dollars ($6,000) of the equity value of such property shall be exempt as a resource. Any equity value in excess of $6,000 shall be a countable resource.

b. Examples of this type of property include land which is used to produce vegetables or livestock only for personal consumption in the client's household, and personal property necessary to perform that function (e.g., a garden tractor, a boat used for subsistence fishing), but do not include vehicles, boats used for leisure or recreation, or other special vehicles.

c. If property has been but is not currently in use, the exemption for such property shall continue for twelve (12) months if there is a reasonable expectation that the use of the property will resume within that time. The exemption period shall be twenty-four (24) months where nonuse is due to a disabling condition.

4. Non-business, income-producing property shall be exempt, but the income shall be countable.

a. If a client owns non-business, income-producing property, a maximum of six thousand dollars ($6,000) of the equity value of such property is an exempt resource, as long as the property produces a net annual income of at least six percent (6%) of the excluded equity. If the equity value of such income-producing, nonbusiness property exceeds $6,000, only the equity value above $6,000 will be counted as a resource. If there is more than one potentially exempt property, the rate-of-return requirement applies individually to each. However, the total combined exemption for all such properties shall not exceed $6,000.

b. “Non-business” means that the property is not used in a trade or business as defined in Section 3.520.76. Non-business, incomeproducing property may include but is not limited to houses or apartments for rent and land other than home property.

c. If non-business, income-producing property is not producing net income of at least six percent (6%) of the excluded equity, the entire equity value is counted as a resource. However, the exemption for up to $6,000 of the property's equity may continue if the property is earning less than 6% due to circumstances beyond the client's control (e.g., crop failure, illness, etc.), and there is a reasonable expectation that, within twenty-four (24) months, the property will again produce a 6% return.

5. A permit, license, or other similar authority granted by a governmental agency to engage in an income-producing activity is not a countable resource.

E. Proceeds from fire or casualty insurance shall be considered exempt to the extent that they are used to restore or replace an exempt resource. This exemption shall be allowed for up to three (3) months for restoration or replacement of exempt personal property and six (6) months for restoration or replacement of exempt real property from the date the client receives such sums.

1. Establishing eligibility for the duration of the replacement exemption requires:

a. Obtaining appropriate documentation to verify the amount of proceeds and date they were received; and, b. Obtaining the client's signed statement verifying that the proceeds will be used for restoration or replacement of exempt property.

2. The county department must contact the client upon the expiration of the allowable time period to verify that restoration or replacement has occurred. Restoration or replacement shall be considered to occur when payment for such is made or contracted in writing to be made.

3. When the allowable time period ends, proceeds in excess of payments made or contracted to be made must be counted as a resource in the month following the month in which the time period expired, unless good cause for an extension is determined by the county department using the F. Proceeds from sale of the home property, relocation payments, or condemnation awards from a governmental agency shall be considered exempt to the extent that they are used to purchase or build a replacement home. This exemption is allowed for up to six (6) months from the date the client receives such sums.

Proceeds of a home sale are the net payments received by the seller after satisfaction of all actual encumbrances and sales expenses.

1. Establishing eligibility for and the duration of the replacement exemption requires:

a. Obtaining appropriate documentation to verify the amount of proceeds and date they were received; and, b. Obtaining the client's signed statement verifying that the proceeds will be used for restoration or replacement of exempt property.

2. The client must be contacted upon the expiration of the allowable time period to verify that replacement has occurred. Replacement shall be considered to occur when payment for such is made or contracted in writing to be made.

3. When the allowable time period ends, proceeds in excess of payments made or contracted to be made must be counted as a resource in the month following the month in which the time period expired, unless good cause for an extension is determined by the county department using the G. Burial trusts are considered as follows:

1. For all trusts, the agreement does not have to be preexisting and need not have been purchased in Colorado.

2. An irrevocable burial trust cannot be terminated, sold, or transferred. An irrevocable burial trust plus any accrued interest is exempt if all of the following criteria are met:

a. The trust is made with a Federally insured bank or savings and loan association, or with a trust company under supervision of the State banking commissioner;

b. The trust is irrevocable during the lifetime of the client and is to be paid by the trustee only upon death of the client for the purpose of burial expense;

c. The trust provides for payment of the trust funds without limitation as to place of burial or provider of related services. In any case, however, the client is not precluded from indicating a preference as to place of burial or provider of related services; and d. The trustor and the beneficiary of the trust cannot be one and the same. If he or she is both the trustor and the beneficiary, the value exceeding $1500 is a countable resource.

3. A revocable burial trust can be terminated, sold, or transferred. A revocable burial trust is exempt if the value of the trust does not exceed one thousand five hundred dollars ($1,500). Any interest on the exempt $1,500 is also exempt. Any amount over $1,500 is a countable resource.

H. Prepaid burial contracts are exempt if any of the following conditions are met:

1. The prepaid burial contract is irrevocable.

2. The prepaid burial contract is revocable and does not exceed one thousand five hundred dollars ($1,500). Any amount in excess of $1,500 shall be a countable resource.

a. Only the paid-up amount of the contract, not the face value, is taken into consideration;

b. Any interest on the exempt $1500 is also exempt.

I. The value of burial spaces required to meet the burial needs of the immediate family as well as brothers, sisters, and spouses of those persons, even if not living in the home. A burial space includes:

1. Burial plot;

2. Gravesite;

3. Crypt;

4. Mausoleum;

5. Casket;

6. Urn;

7. Niche;

8. Other repository customarily and traditionally used for the decedent's bodily remains;

9. Vaults;

10. Headstones, markers, or plaques;

11. Arrangements for the opening and closing of the gravesite; and, 12. Contracts for care and maintenance of the gravesite.

J. Any retroactive SSI or Social Security retirement or disability benefits still remaining after the month of receipt shall be exempt as a resource for nine months following the month they are received.

K. An income tax refund, including the Property Tax/Rent/Heat Credit (PTC) rebate, shall be exempt in the month received. Any remaining balance shall be counted as a resource after twelve (12) months.

L. Monies from a bona fide loan are exempt in the month received. Any remaining balance shall be counted as a resource in the following month(s).

M. Monies specifically placed in an Achieving a Better Life Experience (ABLE)

Account, as described in the Achieving a Better Life Experience Act of 2014, 26 U.S.C. Section 529a (2018).

3.520.78 TYPES OF INCOME

3.520.781 INCOME

A. If a client's total countable income equals or exceeds the Adult Financial program grant standard, the client shall not be eligible for that specific Adult Financial program.

B. Income eligibility determination utilizes four types of income:

1. Earned income;

2. In-kind earned income;

3. Unearned income; and, 4. In-kind unearned income.

C. Certain income shall be exempt and shall not be considered as countable income, in part or in whole, as outlined in Section 3.520.786.

D. Certain income shall have deductions, herein termed as income “disregards,” applied before determining total countable income as outlined in Sections 3.533, 3.544, or 3.549.

E. Certain income shall be deemed from the client’s spouse, parent, and/or sponsor to determine the client’s total countable income as outlined in Sections 3.534, 3.544 or 3.549.

F. The total countable income of the client shall be deducted from the AND or OAP grant standard to determine the grant payment amount.

G. All income shall be countable in the month it is actually received or legally becomes available, whichever comes first, with the following exceptions:

1. Income that can be anticipated with reasonable certainty concerning the amount and the month it is expected to be received shall be counted in the month anticipated.

2. The anticipated monthly income shall be based on the income received in the previous month, except when the previous month does not provide an accurate indication of anticipated income, or under other circumstances as specified below:

a. For new or changed income, a period shorter than a month may be used to project a monthly amount;

b. For contract employment, such as in some school systems, where the employees derive their annual income in a period shorter than a year, the income shall be prorated over the term of the contract, provided that the income from the contract is not earned on an hourly or piecework basis;

c. For regularly received self-employment income, net income will usually be prorated and counted as received in a three (3) month period, except for farm income. For further information see Section 3.520.783.

d. For all other cases where receipt of income is reasonably certain but the monthly amount is expected to fluctuate, a period of twelve (12) months shall be used to arrive at an average monthly amount;

e. Income from rental property shall be considered self-employment income provided the client actively manages the property at least an average of twenty (20) hours per week.

1) Income from rental property shall be considered unearned income if the client is not actively managing the property an average of at least 20 hours per week.

2) Rental income, as self-employment or as unearned income, shall be averaged over a twelve month period to determine monthly income.

3) Income from jointly owned property must be considered as a percentage at least equal to the percentage of ownership or, if receiving more than percentage of ownership, the actual amount received.

f. For cases where a change in the monthly income amount can be anticipated with reasonable certainty, such as with Social Security cost of living adjustments (COLA), or other similar benefit increases, the expected amount shall be considered in determining a countable monthly income for the month received.

3.520.782 EARNED INCOME

A. Earned income is gross monetary wages received for services performed as an employee or as profit from self-employment.

B. In-kind earned income is non-monetary benefits received for services performed as an employee or as self-employment profit, such as shelter as payment for building maintenance or babysitting or other barter goods in exchange for 1. In-kind income received in exchange for employment is employment income and shall have the appropriate earned income disregards applied to the total value of the income.

2. The amount considered as earned income when the client, client’s spouse, or sponsor(s) is paid in-kind shall be the value of the item supplied. The current market value of the item is used if the value of the item is not provided.

3.520.783 SELF-EMPLOYMENT INCOME

A. An individual involved in a profit making activity shall be classified as selfemployed.

B. To determine the net profit of a self-employed client, client’s spouse, or sponsor(s), deduct the cost of doing business from the gross income.

1. Cost of doing business expenses include, but are not limited to, the rent of business premises, wholesale cost of merchandise, utilities, interest, taxes, labor, and upkeep of necessary equipment.

2. Depreciation of equipment shall not be considered as a business expense.

3. The cost of and payments on the principal of loans for capital assets or durable goods shall not be considered as a business expense.

4. Personal expenses such as personal income tax payments, meals, and transportation to and from work are not business expenses.

C. Some types of self-employment income shall be calculated using a method specific to the type of self-employment, as follows:

1. Farm income shall be considered on a yearly basis. Net income for the prior year shall be determined and averaged for the succeeding year and counted as earned income. When a client, client’s spouse, or sponsor(s) ceases to farm, the income is no longer deducted from the grant standard.

2. Rental income shall be considered as follows:

a. When the client, client’s spouse, or sponsor(s) actively manages a self-owned rental property at least twenty (20) hours a week, treat rental income as self-employment income. Average the rental income over a twelve (12) month period to determine monthly earned income.

b. Board (to provide a person with regular meals only) payments to the client, client’s spouse, or sponsor(s) shall be considered earned income in the month received. For each boarder, calculate documentable expenses directly related to provision of board.

Subtract the result from the board payment to determine the countable earned income.

c. Room (to provide a person with lodging only) payments to the client, client’s spouse, or sponsor(s) shall be considered earned income in the month received. For each boarder calculate the documentable expenses directly related to the provision of the room. Subtract the result from the room payment to determine the countable earned income.

d. Room and board (to provide a person regular meals and lodging) payments shall be considered earned income in the month received. For each boarder, calculate the documentable expenses directly related to the provision of room and board. Subtract the result from the room and board payment to determine the countable earned income.

3. Appropriate allowances for cost of doing business for a client, client’s spouse, or sponsor(s) who is/are a licensed child care provider are:

a. For the first child for whom day care is provided, deduct $55; and, b. For each additional child deduct $22.

c. Subtract the total allowances from the documented expenses to determine the earned income.

d. If the client, client’s spouse, or sponsor(s) can document a cost of doing business that is greater than the amounts above, the procedure, described in Section 3.520.783.B, shall be used to calculate earned income.

D. The net profit amount, secured after the appropriate deductions, is earned income.

E. Self-employment verification may consist of tax documents, self-employment ledgers, receipts, or other documents used for verifying and documenting the self-employment income and expenses. If, at the time of the county department’s eligibility determination, a client is recently self-employed or does not have adequate documentation of the self-employment income and expenses, the county department shall use the best information available to determine the monthly income. The client shall be encouraged to keep records of income and expenses for subsequent certifications. No specific verification shall be required and the documentation provided by the client shall be accepted unless questionable.

F. All self-employment income shall be considered income in the month received. If receipt of self-employment income is irregular, it shall be averaged over a twelvemonth period. The twelve-month period can either be the previous tax year (January to December) or the most recent twelve-months prior to the application date.

3.520.784 DONATED WORK HOURS AND VOLUNTEERISM

A. Work hours or personal services, for which monetary compensation is not realized, provided to a business, to a person who is self-employed, or to any other person or business in need of a regular, temporary, or non-traditional employee, such as a seasonal worker, shall be considered countable earned income when the work:

1. Is regular and scheduled; and, 2. Is a necessary service; and, 3. If not performed by the client, client’s spouse, or sponsor(s) someone would have to be hired to perform the work; and, 4. Is greater than five (5) hours per week.

B. If donated work hours or personal services meet these requirements, the value of these hours is determined by:

1. The going rate in the community for similar work; or, 2. The current minimum wage standard, whichever is greater.

C. Volunteerism for the betterment of the community less than an average of thirty (30) hours per week shall not be considered income. Volunteerism for the betterment of the community includes but is not limited to:

1. Visiting persons in nursing homes, hospitals, etc.;

2. Delivering meals to homebound persons;

3. Providing limited transportation to medical appointments for disabled or aging persons; or, 4. Other opportunities deemed volunteerism for the betterment of the community by the county department using the prudent person principle.

3.520.785 COUNTABLE UNEARNED INCOME

A. Unearned income is monetary benefits not earned through employment or selfemployment, such as Social Security or other retirement benefits, interest, or investment income.

B. Countable unearned income includes the following and any other payments that could be construed to be a gain or benefit to the client, client’s spouse, or sponsor(s) and which are not earned income.

1. Benefits issued by the SSA.

a. Lump sum payments shall be counted as income in the month received. Any unspent amount will be treated as a resource after nine (9) months.

b. If the SSA is recovering any portion of the payment from the client, client’s spouse, or sponsor(s) due to an overpayment of benefits, Adult Financial program grant payments shall be calculated based on the gross payment, not the received amount.

2. Pension or retirement payments made by a former employer or from any insurance or other public or private fund.

3. Disability or survivor's benefits made by an employer or from any insurance or other public or private fund.

4. Veteran compensation and pension based on service in the armed forces.

Such payments may be made by the U.S. Veterans Administration (VA), another country, a state or local government, or other organization. Any portion of a VA pension paid to a veteran for support of a dependent shall be considered countable unearned income to the dependent rather than to the veteran.

5. Railroad retirement payments, such as sick pay, annuities, pensions, and unemployment insurance benefits, which are paid by the Railroad Retirement Board (RRB) to a client, client’s spouse, or sponsor(s) who is or was a railroad worker, or to such worker's dependents or survivors.

6. Unemployment Compensation.

7. Union strike benefits.

8. Amounts withheld from unearned income because of a garnishment.

9. Workers' Compensation payments awarded under Federal and State law to an injured employee. Payments for medical, legal, or related expenses incurred by the client, client’s spouse, or sponsor(s) in connection with such claim are deducted prior to determining the amount of countable unearned income.

10. Dividends and interest received on financial accounts, savings bonds, leases, etc.

11. Annuity payments. Payments should be accepted as frequently as possible, e.g. monthly, quarterly, or annually. A lump sum should only be accepted if the previously identified increments are unavailable.

12. Inheritance.

13. Gifts and prizes.

14. Proceeds of a life insurance policy to the extent that they exceed the amount expended by the beneficiary for the purpose of the insured recipient's last illness and burial which are not covered by other benefits.

15. Proceeds of a health insurance policy or personal injury lawsuit to the extent that they exceed the amount to be expended or are required to be expended for medical care.

16. VA educational assistance (G.I. Bill) payments or other military or veterans benefits, which are conditional upon school attendance, are income to the extent that they exceed expenses necessary for school attendance.

17. Income from jointly owned property in a percentage at least equal to the percentage of ownership or, if receiving more than percentage of ownership, the actual amount received.

18. Lease bonuses (oil or mineral) received by the lessor as an inducement to lease land for exploration are income in the month received.

19. Oil or mineral royalties verified through tax documents such as the 1099 from the prior year shall be considered averagable income.

20. Income from rental property is considered as unearned income when the client is not actively managing the property on an average of at least twenty (20) hours a week. Rental income is countable to the extent it exceeds allowable expenses. Allowable expenses are maintenance, taxes, management fees, interest on mortgage, and utilities paid, and do not include the purchase of the rental property and payments on the principal of loans for the rental property.

21. Income derived from monies (or other property acquired with such monies) received pursuant to the “Civil Liberties Act of 1988” (by eligible persons of Japanese ancestry or certain specified survivors, and certain eligible Aleuts), P.L. 100-383 (HR 442) (August 10, 1988), which is hereby amendments or editions. These regulations are available in person at the Office of Federal Register, 800 North Capitol Street NW, Suite 700, Washington, DC 20002 during regular business hours or by mail at the Office of Federal Register, The National Archives and Records Administration, 8601 Adelphi Road, College Park, MD 20740-6001 or at https://www.congress.gov/bill/100th-congress/house-bill/442. These regulations are available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular 22. Payments received from trusts. Such payments can be on behalf of, or to or for the benefit of the client, client’s spouse, or sponsor(s), excluding medical or personal attendant care.

23. Alimony and spousal support.

24. Minimum monthly maintenance needs allowance (MMMNA) retained from an institutionalized spouse’s income.

25. Current child support payments received for the client.

3.520.786 EXEMPT INCOME

Certain earned and unearned income that is not countable to the client, client’s spouse, or sponsor(s) in whole or in part is exempt. Such exempt income is limited to the A. Income tax refunds, including the Property Tax/Rent/Heat Credit (PTC) rebate, in the month received. Any remaining funds shall be a countable resource after twelve (12) months.

B. The value of any third party payment for medical care paid on behalf of the client.

This exemption also applies to room and board furnished during medical confinement and paid for by a third party.

C. Home energy assistance granted to the client by a private non-profit organization or home energy supplier, whether in-kind or by voucher or vendor payment.

D. Emergency or general assistance, other than home energy assistance, received on a one time basis in-cash or in-kind from the county department or other agencies.

E. Personal care or home care allowance grants paid to the client from a Federal, State or local government program to purchase in-home supportive services shall be exempt as income. However, if the non-recipient spouse is the provider and receives the payment from the client for in-home services it shall be classified as employment income and is subject to deeming.

F. VA Aid and Attendance is exempt income to the client if used for medical supplies and medical or attendant care not covered by Medicare, Medicaid, or other health insurance programs. The remainder is countable and deducted from the assistance grant.

G. Educational loans and grants.

H. Work study income.

I. Income and resources set aside as part of a Plan to Achieve Self Support (PASS) approved by the SSA.

J. Compensation received by the client pursuant to the Colorado Crime Victim Compensation Act in Article 4.1 of Title 24, C.R.S.

K. Unearned income as defined in the Social Security Program Operations Manual System (POMS), Section SI 00830.099 Guide to Unearned Income Exclusions (effective January 20, 2011) and consistent with the provisions of Federal Regulations found at 20 CFR 416.1124 (September 2025), which are hereby incorporated by reference. This rule does not contain any later amendments or editions. These guidelines are available for no cost at https://secure.ssa.gov/poms.NSF/lnx/0500830099!OpenDocument&Click=(POM S); while the regulations are available for no cost at https://www.ecfr.gov/current/title-20/chapter-III/part-416/subpart-K/subject-group- ECFR57d93e39d624237. These guidelines and regulations are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

L. Reverse mortgage loan payments.

M. Payments received for providing foster care. Any amount paid to a provider of foster care in excess of the foster care payment not intended for the care of the child is countable income to the provider.

N. Child support payments made to the client, client’s spouse, or sponsor(s) for another person. These payments can either be current or arrearage payments.

O. Infrequent or irregular income of less than $60 in a calendar quarter.

P. Child support arrears payments received for the client.

3.520.79 IN-KIND SUPPORT AND MAINTENANCE (ISM) FOR OAP AND AND-

CS ONLY

A. For certain clients who are not paying their fair share of shelter costs, an ISM amount shall be determined and counted as unearned income. Client statement is acceptable as verification for reporting shelter costs.

B. The ISM calculation does not apply to a client:

1. Who is residing in and owning his or her primary residence; or, 2. Who is receiving subsidized housing; or, 3. Who is homeless; or, 4. Who is paying his or her fair share of shelter costs when shelter costs are market value or greater, even if the fair share is less than the current ISM a. Fair share is calculated by totaling shelter costs and dividing by the number of people living in the household.

b. Market value is the amount a landlord or property manager would charge if the dwelling were rented on the open market. Rent may include heating fuel, gas, electricity, water, sewage and garbage collection; or, 5. Who is paying shelter costs in an amount equal to or greater than the current maximum ISM amount, whether or not the costs are the client's fair share or market value; unless, 6. A client is receiving SSI and being charged an ISM by the SSA. The client shall be charged a matching ISM for Adult Financial programs, unless good cause is provided due to SSA backlog.

a. The client shall be instructed to work with the SSA to remove or reduce the ISM once the client is paying his or her fair share of shelter costs.

b. Once the SSA removes or reduces the ISM, the client shall report the change in order to have the Adult Financial ISM removed or reduced.

C. If the client's declared monthly shelter costs are less than the current maximum ISM amount established for the shelter component and the client is not paying his or her fair share, the county department shall determine the ISM amount to be applied, as follows:

1. If the client's shelter costs are less than the current market value, then the amount the client is actually paying is subtracted from the current maximum ISM amount. The result is counted as in-kind unearned income to the client.

2. If the shelter costs are market value but the client is paying less than his or her fair share, then the amount the client is actually paying is subtracted from the client's fair share amount or the current maximum ISM amount, whichever is less. The result is counted as in-kind unearned income to the 3. If the client is paying no shelter costs, and all shelter costs are supplied in full, then the current maximum ISM amount is counted as in-kind unearned income to the client.

D. If the client has an established life estate and the client's shelter costs are being provided in full, an ISM shall be calculated.

E. The Adult Financial programs maximum ISM shall be determined as follows:

1. The ISM includes shelter costs.

2. The ISM is calculated by multiplying the current SSI benefit standard, as defined in Section 3.510, by 33.33%, then adding a $20.00 disregard and rounding to the nearest whole dollar.

3.530 OLD AGE PENSION (OAP) PROGRAM

The Old Age Pension (OAP) program provides financial assistance and may provide health care benefits for low-income Colorado residents who are sixty (60) years of age or older who meet all financial and non-financial eligibility requirements.

A. The total monthly OAP grant standard, as set by the State Board of Human Services, is $1,032 effective January 1, 2026.

B. Effective January 1, 2026, the maximum monthly In-Kind Support and Maintenance (ISM) deduction amount for shelter costs is $351.

C. Effective January 1, 2026, the payment floor standard for OAP is $189.

3.530.1 DEFINITIONS

“OAP” is a program for a client sixty (60) years of age or older.

“OAP-C” is a program for a client age sixty (60) or older who has been committed to the Colorado Mental Health Institute or to a Regional Center by order of the district or probate court.

3.531 DETERMINATION

A. The county department shall enter all client, resource, and income information B. The client shall have the right to decide how to spend his or her OAP grant payment.

C. The grant standard for OAP, as listed in Section 3.530.A, shall be adjusted to remain within available appropriations. Appeals shall not be allowed for grant standard adjustments necessary to stay within available appropriations.

D. In addition to the regular monthly OAP grant payments, supplemental payments necessary to comply with the Federal pass-along requirements may be provided.

These payments are supplements to regular grant payments and may be provided to eligible Adult Financial recipients in two (2) forms:

1. Maintenance Of Effort (MOE) Lump Sum Payments – these irregular lump sum payments cannot be anticipated, are not an entitlement, and do not affect grant standards. Appeals shall not be allowed for MOE payment adjustments. The Federal pass-along requirements are located in the Federal Regulations found at 20 C.F.R. § 416.2095-2099 (October 2025), which are hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available at no cost at 2. State Supplementary Payment – These monthly payments are included as 3.532 GRANT PAYMENT DETERMINATION A. OAP grant payments shall be calculated on an individual basis, with just one client per case.

B. When a client has been found eligible based upon eligibility rules as outlined in Sections 3.520.6 and 3.520.7, the amount of the client's authorized OAP grant payment shall be determined by deducting the client's total countable income from the OAP grant standard listed in Section 3.530.A. If the grant payment is less than the OAP payment floor standard outlined in section 3.530, a state supplementary payment will be issued to raise the grant payment to meet the payment floor standard.

1. If determined eligible on the first of the month, the client shall receive his 2. If determined eligible on any other day of the month, the client's first month remaining in the month; the client shall receive their authorized grant payments in subsequent months.

3. If a client is receiving services in another Adult Financial (AF) program in the month he or she turns sixty (60) years of age and is otherwise eligible for OAP, the client shall transition from the other AF program to OAP effective the first day of the client's birth month, and receive his or her authorized grant payment for the birthday month and subsequent months.

C. The OAP grant payment shall be made via Electronic Benefits Transfer, direct deposit, or warrant to the client, to a facility designated by the client, or to a legally designated person, such as a representative payee, fiduciary, or conservator.

For OAP-C clients, the financial officer of the facility or the client's guardian shall establish a reserve for the client in the amount of the current Personal Needs Allowance (PNA) grant standard for the client's personal needs.

D. The client shall be eligible only for a monthly PNA when program requirements are met and the client is a resident for at least thirty (30) consecutive days, in one of the following facilities:

1. In a general medical and surgical hospital;

2. In a nursing home, assisted living residence, or, intermediate care facility, approved setting; or 3. In a psychiatric facility when sixty-five (65) years of age or older.

E. The following persons are not eligible for a PNA or OAP grant payments:

1. Inmates in a penal institution; or, 2. Residents in an unlicensed private or uncertified public facility.

F. For every full calendar month that the client is a resident in a facility listed in

Section 3.532.D, the OAP PNA maximum shall be seventy-nine dollars ($79), effective October 1, 2016.

3.533 INCOME DISREGARDS

Disregards shall be applied before determining a client’s total countable income. If a client's total countable income equals or exceeds the OAP grant standard after the disregards are applied, he or she shall be denied or discontinued following the policies A. If the client has income, apply the following income disregards:

1. To determine countable earned income:

a. Deduct $65 from the gross earned income; and, b. Divide the remainder by two (2).

c. The result is the countable earned income.

2. To determine countable unearned income:

a. Determine the client's gross unearned income from all sources.

b. Subtract any amount received from SSI.

c. Deduct $20.00 from the remainder.

1) If the client is married, the $20.00 disregard shall be split equally between the client and the client’s spouse so that no more than a $20.00 disregard is applied for the married couple.

2) A client who receives SSI only, and does not receive any other unearned income, does not receive an unearned income disregard.

d. Add the full SSI income back to the remainder.

e. The remainder is countable unearned income.

f. If the client's gross unearned income is less than $20.00, the difference between the gross unearned income and the $20.00 deduction shall be applied to the earned income calculation, if applicable.

B. Subtract the countable earned and countable unearned income from the OAP grant standard to determine the grant payment amount. If the grant payment amount is less than the OAP payment floor standard as outlined in section 3.530, a state supplementary payment will be issued to raise the grant payment to meet the payment floor standard.

3.534 DEEMING INCOME

A. To determine the amount of income to deem to a client from a the client’s spouse who does not meet the criteria described below in ‘C’, calculate the countable earned income of the spouse as follows:

1. Deduct $65 from the client’s spouse's gross earned income; and, 2. Divide the remainder by two (2); and, 3. The result is the amount of earned income deemed to the client.

4. The deemed earned income shall be considered income to the client and shall be deducted, together with any other income, from the grant of the 5. Wages being garnished by the court are countable earned income.

B. To determine the amount of unearned income to deem to a client from the client’s spouse who does not meet the criteria as described below in ‘C’, calculate the countable unearned income of the spouse as follows:

1. Calculate the total amount of unearned income of the spouse;

2. Deduct the OAP grant standard from the total unearned income of the spouse;

3. Deduct an amount to meet the needs of each dependent child living in the household of the spouse equal to half the maximum SSI grant benefit standard, as defined in Section 3.510, less the dependent child's own income;

4. Deduct any medical care payments by the spouse for his or her dependents who are not covered by Medicare, Medicaid, or other health programs;

5. Deduct any amount of obligation of the spouse due to orders of judgment or for support by a court, unless there is a garnishment. Income garnished by the court is countable as unearned income.

6. The remainder is the amount of unearned income deemed to the client.

7. The deemed unearned income shall be considered income to the client and shall be deducted, together with any other income, from the grant of the client.

C. If a client’s spouse is receiving Adult Financial grant payments, SSI benefits, or Medicaid assistance and has income no greater than the OAP limit, his or her income shall not be considered as available to the client and shall not be deemed. If a client’s spouse is institutionalized and the client has retained the minimum monthly maintenance needs allowance (MMMNA), the MMMNA shall be deducted from the institutionalized spouse’s total income.

D. A sponsor's income can only be deemed to the non-citizen client he or she sponsor(s) to a non-citizen client is calculated as follows:

1. The total gross earned and unearned income of the sponsor are added 2. The following deductions are subtracted from the total gross income of the A. A deduction for the sponsor equal to the current SSI benefit standard, as defined in Section 3.510, for an individual for the month in which eligibility is being determined; plus, B. A deduction for the sponsor's spouse living in the same household with the sponsor, equal to one-half the current SSI benefit standard.

As defined in Section 3.510, for an individual; or a deduction for the sponsor's spouse, who is also a co-sponsor of the non-citizen, equal to the current SSI benefit standard for an individual; plus, C. A deduction equal to one-half the SSI benefit standard, as defined in Section 3.510, for an individual for each person who is a non-citizen client's spouse), as defined in Section 3.520.68.B.2.b.1.

3. The difference between the total income and the total deductions is 4. The non-citizen client's countable income is compared to the income standard of the Adult Financial program for which the non-citizen client is applying to determine eligibility and/or the grant payment amount.

5. If more than one non-citizen client has the same sponsor, all of the 3.540 AID TO THE NEEDY DISABLED STATE ONLY (AND-SO) PROGRAM The Aid to the Needy Disabled State Only (AND-SO) program provides interim assistance to clients age eighteen (18) through fifty-nine (59) years of age (unless diagnosed with blindness, then age zero (0) through 59 years of age); who are disabled or blind but have not been approved for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Individuals are required to meet the total disability requirements identified in this section, in addition to the non-financial and financial eligibility requirements in this section and sections 3.520.71 and 3.520.72. Individuals who are partially disabled or have a short-term disability are not eligible.

A. The total AND-SO grant standard is $248.00, effective April 1, 2022.

B. The grant standard for AND-SO shall be adjusted as needed to remain within available appropriations. Appeals shall not be allowed for grant standard adjustments necessary to stay within available appropriations.

3.540.1 DEFINITIONS

“Blind or blindness” means central visual acuity of 20/200 or less in the better eye with the use of a correcting lens. An eye which has a limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less.

“Employment which exists in the community” means there are jobs for which the client has competence located within an area where the client might reasonably be expected to commute (see definition of “reasonable commute”). It does not mean that there are actual job vacancies that the client could fill or that the client would be hired to fill a job vacancy.

“Improvement” related to the client's medical condition means that in comparison to the most recent medical certification, the physical or mental impairment(s) which prevented the client from engaging in SGA has decreased to the point that the client is able to engage in SGA or the client's residual functional capacity has increased to the point that the client is able to engage in SGA.

“Reasonable commute” means a commute no further than one hour one way.

“Residual functional capacity” means the client's maximum remaining ability to perform work of any type on a regular and continuing basis despite some disabling limitations.

“Substantial gainful activity (SGA)” means the performance of significant physical and/or mental activities in work for pay or profit, or in work of a type generally performed for pay or profit, regardless of the legality of the work. “Significant activities” are useful in the accomplishment of a job or the operation of a business, and have economic value.

Work may be substantial even if it is performed on a part-time basis, or even if the individual does less, is paid less, or has less responsibility than in previous work. Work activity is gainful if it is the kind of work usually done for pay, whether in cash or in kind, or for profit, whether or not a profit is realized. Activities involving self-care, household tasks, unpaid training, hobbies, therapy, school attendance, clubs, social programs, etc., are not generally considered to be SGA.

“Total disability” means a physical or mental impairment which is disabling and which, because of other factors such as age, training, experience, and social setting, substantially precludes the person having such disability from engaging in a useful occupation as a homemaker or as a wage earner in any employment which exists in the community for which he or she has competence, as defined in Section 26-2-103(14)(a), 3.541 DISABILITY REQUIREMENTS A. To qualify for AND-SO, the client must meet both the non-financial and financial eligibility requirements and have a total disability as defined in Section 3.540.1 and pursuant to Sections 26-2-103(14)(a) and 26-2-111(4)(a), C.R.S.

1. To meet the total disability requirement for AND-SO, the client shall be certified by a medical professional as defined by Section 3.541.1.

2. The client must have a physical or mental impairment that is disabling as identified by the SSA in the Listing of Impairments and consistent with Federal Regulations found at 20 C.F.R., Appendix 1 to Subpart P of Part 404 (February 18, 2025), which are hereby incorporated by reference.

This rule does not contain any later amendments or editions. These regulations are available at no cost at https://www.ecfr.gov/current/title- 20/chapter-III/part-404/subpart-P/appendix-

Appendix%201%20to%20Subpart%20P%20of%20Part%20404. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

3. The total disability must be expected to last six (6) months or longer.

B. To determine the client's disability the county department shall review and document medical data.

1. The county department shall review State prescribed medical certification form(s) and/or any Medicaid disability determination; and, 2. The county department shall weigh more heavily a disability determination completed through a Medicaid disability determination process than a medical certification form completed by a medical provider.

C. The county department shall review all documentation collected to determine if the client is eligible for AND-SO.

3.541.1 MEDICAL CERTIFICATION FORM

A. Medical certification shall be completed on the State Department's prescribed medical certification form.

1. The county department shall provide the form to the client or the medical provider at the time of application or interview and prior to the reexamination due date. The client shall arrange for the medical exam with an appropriate medical provider of his or her choosing.

a. It is the county department's responsibility to provide the medical form to the client or the client's provider of choice within ten (10) calendar days of application.

b. If the client fails to submit the required medical examination within thirty (30) calendar days following the interview or with their redetermination, the client has failed to comply with the requirements for eligibility and the client’s participation in the program will be denied or discontinued following the policies c. If the client requests a second opinion, the subsequent medical examination shall be at the client's expense.

d. If the county department requests a second opinion, the subsequent medical examination shall be at the county department's expense.

e. The county department shall review the medical certification form for completeness and to determine whether the information submitted is in conflict with other medical data, records, documentation, and information and/or observations received from the client, family, friends, professionals, community members, or the county department. The county department shall:

1) Ensure any incomplete forms are returned to the provider to be completed; and, 2) Consult and verify with the provider any questionable or contradictory information.

2. The medical certification shall be completed and signed by a medical provider as defined in Section 3.540.

a. The client shall be allowed to choose a medical provider licensed in a bordering state when the nearest Colorado provider is more than one hour from the client's home.

b. The medical certification must be dated no earlier than ninety (90) days before the application or recertification.

3. The medical certification form shall contain the disability limitations, including the length and scope of the disability, if any; and, 4. The medical re-examination date shall be based upon the date of the application or redetermination and the length of the disability, as documented by the medical provider, but shall not exceed twelve (12) months. However, if the client has been determined disabled by the State disability review contractor, the medical re-examination date shall be established by the review contractor.

B. The medical examination determining the client’s disability and completion of the medical certification form shall be completed by a medical provider that accepts Medicaid whenever possible when the client is receiving Medicaid. If the client’s primary medical provider does not accept Medicaid or the client is not receiving Medicaid, the county department shall authorize payment for examinations for AND-SO medical certification examinations.

1. Fees and costs shall be reimbursed to the county department using the 80% State share, 20% county share reimbursement methodology described in Section 26-1-122(3)(B), C.R.S.

2. The county department shall set the provider fee and shall make such payments in a timely manner.

3. Providers shall accept fees for services as negotiated as payment in full.

No client shall be assessed any additional or supplementary fee.

4. Providers may be excluded from completing medical certification examinations if there is adequate documentation that the provider:

a. Is not completing a thorough examination on which to base his or her decision; or, b. Falsified a medical certification form.

C. A determination of medical eligibility shall be completed by each medical reexamination date. The county department shall be allowed to request the client submit a medical re-examination at the time of financial redetermination or when the county has information that the client's medical condition may have changed.

1. Prior to the medical re-examination due date, the county department shall send a new medical certification form to the client.

2. If the client fails to submit the required medical re-examination by the redetermination due date, the county department shall terminate assistance following the policies outlined in Section 3.554.

3.541.2 DENIAL AND DISCONTINUATION RELATED TO DISABILITY

A. Following the policies outlined in Section 3.554, the county department shall deny or discontinue AND-SO assistance when:

1. There was an error in the prior disability determination. The county department shall gather more information on the discrepancies before taking a negative action on the case; or, 2. There has been improvement in the client's medical condition and the client is no longer totally disabled, as defined in Section 3.540.1.

Improvement may be demonstrated by:

a. Observations, symptoms, or other findings which demonstrate positive changes in the client's medical condition; or, b. Observations, symptoms, or other findings which demonstrate that the effect of the medical impairment(s) on the client has decreased.

c. New medical evidence which shows that while the client's underlying condition may not have changed, advances in medical therapy or technology have reduced or eliminated the adverse effect of the condition on the client; or, d. New or improved diagnostic techniques or other medical evaluations show that the client's previously determined medical condition is not as serious as previously indicated; or, e. There has been a change in prognosis; or, f. The client has compensated or adjusted to the medical condition which now enables the client to engage in SGA; or, g. The client's medical condition is correctable and the client refuses, without good cause, to obtain prescribed medical treatment to correct the condition. Good cause may include, but is not limited to:

1) Treatment is contrary to the established teachings of the client's religion, provided the client can establish he or she observes his or her religion; or, 2) Surgery has previously been performed with unsuccessful results and the same surgery is again being recommended for the same impairment; or, 3) The treatment because of its magnitude (e.g., open heart surgery or organ transplant that has less than a 50% chance of improving the client's condition) or unusual nature (e.g., experimental procedures) is very risky; or, 4) The cost of treatment is prohibitive or cannot be obtained; or, 3. There has been improvement in the client's residual functional capacity and the client is not totally disabled, as defined in Section 3.540.1.

Improvement may be demonstrated by:

a. Observations, symptoms, or other findings which demonstrate positive changes in the client's residual functional capacity; or, b. Observations, symptoms, or other findings which demonstrate that the effect of the social factors impacting residual functional capacity on the client has decreased; or, c. New evidence shows that while the client's underlying condition may not have changed, the client's vocational abilities and/or residual functional capacity has so improved that the client is able to engage in SGA; or, d. Vocational opportunities for which the client has competence have become available in the community; or, e. The client has compensated or adjusted to the social factors impacting residual functional capacity and the client is able to engage in SGA; or, f. Residual functional capacity is not a barrier to employment in some type of employment that exists in the community.

B. If the county department has documented evidence that a client is working and receiving income exceeding the AND-SO grant standard after applicable disregards as an employee, engaged in self-employment, or donating services or work hours without pay as defined in Section 3.520.784, the county department shall deny or discontinue the client from AND-SO grant payments following the policies outlined in Section 3.554.

3.541.3 DISABILITY DUE TO SUBSTANCE ABUSE

For the purpose of AND-SO, when the client's primary diagnosis is alcoholism or controlled substance addiction, the following criteria shall apply pursuant to Section 26- 2- 111(4)(E), C.R.S.:

A. The client shall only be eligible for twelve (12) cumulative months in a lifetime when substance abuse is identified on the medical certification form.

B. The client shall agree to treatment for addiction to be eligible for AND-SO. Upon consent, the county department shall refer the client to an assessment/treatment agency licensed by the State Department’s Office of Behavioral Health.

C. The client shall agree to a defined treatment program by the licensed agency.

D. If the client fails to comply with treatment, the following steps shall be followed:

1. The treatment center shall contact the county department within twentyfour (24) hours of the client's termination from treatment; and, 2. The county department shall discontinue the client's AND-SO assistance immediately upon termination from treatment effective the following month with timely notice provided.

E. The client shall submit to random testing by the licensed agency to ensure the client remains free of alcohol or controlled substance(s).

F. Any time a client tests positive for alcohol or controlled substance(s), the client shall be warned by the treatment center in writing. A copy of the written warnings shall be placed in the client's file and noted as either mailed or hand delivered. If a client tests positive for alcohol or controlled substance(s) twice in any threemonth period, the county department shall be notified and the client shall be terminated from AND-SO immediately effective the following month with timely notice provided.

G. The initial partial month is not counted toward the twelve-month maximum allowed. However, if a client is discontinued and subsequently reapplies and is approved, partial months after re-approval will count as a full month toward the twelve-month maximum allowed.

3.542 DETERMINATION OF ELIGIBILITY

A. The county department shall enter all client, resource, and income information B. Eligibility shall begin with the date of application or the date the client meets all eligibility requirements, whichever is later.

3.543 GRANT PAYMENT DETERMINATION

A. AND-SO grant payments shall be calculated on an individual basis with just one client per case.

B. When a client has been found eligible, the amount of the client's authorized AND- SO grant payment shall be determined by deducting the client's total countable income from the AND-SO grant standard.

1. If determined eligible on the first of the month, the client shall receive his 2. If determined eligible on any other day of the month, the client's first month remaining in the month; the client shall receive their full authorized grant payment in subsequent months.

C. The AND-SO grant payment shall be made via Electronic Benefits Transfer, direct deposit, or warrant to the client, to a facility, or to a legally designated person, such as a representative payee, fiduciary, or conservator.

D. The client shall be eligible only for a monthly PNA when program requirements are met and the client is a resident of a facility at least thirty (30) consecutive days, as follows:

1. In a general medical and surgical hospital;

2. In a nursing home, assisted living residence, or, intermediate care facility, approved setting.

E. The following persons are not eligible for a PNA or AND-SO grant payments:

1. Inmates in a penal institution; or, 2. Residents in an unlicensed private or uncertified public facility.

F. For every full calendar month that the client is a resident in an approved facility, the AND-SO Personal Needs Allowance maximum shall be seventy nine dollars ($79) effective October 1, 2016.

3.544 AND-SO INCOME DISREGARDS AND DEEMED INCOME

Disregards shall be applied before calculating a client’s total countable income. If a client's total countable income equals or exceeds the AND-SO grant standard after the disregards are applied, he or she shall be denied following the policies outlined in A. If the client has earned income, apply the following income disregards:

1. Deduct $65 from the gross earned income; and, 2. Divide the remainder by two (2).

3. The result is the countable earned income.

B. If the client has unearned income, apply the following income disregards:

1. Determine the client's gross unearned income from all sources.

2. Deduct $20.00. If the client is married, the $20.00 disregard shall be split between the client and the spouse so that no more than a $20.00 disregard is applied.

3. The result is countable unearned income.

C. Subtract the countable earned and countable unearned income from the AND- SO grant standard to determine the grant payment amount.

D. A portion of the earned income of the AND-SO client's spouse shall be deemed to the client, as follows:

1. Deduct sixty five dollars ($65) from the spouse's gross earned income;

2. Divide the remainder by two (2); and, 3. The result is the amount of earned income deemed to the client.

4. The deemed earned income shall be considered income to the client and shall be deducted, together with any other income, from the grant of the 5. Wages being garnished by the court are countable earned income.

E. A portion of the unearned income of the AND-SO client's spouse shall be deemed to the client, as follows:

1. Determine the spouse's unearned monthly gross income.

2. Deduct $20.00 unless the client also has unearned income. The $20.00 disregard shall be split between the client and the client’s spouse so that no more than a $20.00 disregard is applied.

3. The result is deemed to the client.

F. If a client’s spouse is receiving Adult Financial grant payments, SSI benefits, or Medicaid assistance and has income no greater than the SSI limit, their income shall not be considered as available to the client and shall not be deemed. If a client’s spouse is institutionalized and the client has retained the minimum monthly maintenance needs allowance (MMMNA), the MMMNA shall be deducted from the institutionalized spouse’s total income.

G. A sponsor's income can only be deemed to the non-citizen client he or she sponsor(s) to a non-citizen client is calculated as follows:

1. The total gross earned and unearned income of the sponsor are added 2. The following deductions are subtracted from the total income of the a. A deduction for the sponsor equal to the current SSI benefit standard for an individual, as defined in Section 3.510; plus b. A deduction for the sponsor's spouse living in the same household with the sponsor, equal to one-half the current SSI benefit standard for an individual, as defined in Section 3.510; or a deduction for the sponsor's spouse, who is also a co-sponsor of the non-citizen, equal to the current SSI benefit standard for an individual; plus c. A deduction equal to one-half the SSI benefit standard for an individual, as defined in Section 3.510, for each person who is a non-citizen client's spouse).

3. The difference between the total income and the total deductions is 4. The non-citizen client's countable income is compared to the income standard of the Adult Financial program for which the non-citizen client is applying to determine eligibility and/or the grant payment amount.

5. If more than one non-citizen client has the same sponsor, all of the H. The county department shall determine all countable earned and unearned income available from the client, the spouse, and the sponsor(s). The total shall be deducted from the AND-SO grant to determine the client's grant payment 3.545 INTERIM ASSISTANCE REIMBURSEMENT (IAR)

A. AND-SO payments made while an SSI claim is pending, in suspense, terminated, or in appeal shall be classified as interim assistance. At the time of application, the SSI payment procedure shall be explained to the client.

1. All AND-SO payments made to the client are recoverable upon approval for SSI benefits. If the first retroactive SSI payment is sent to the client, rather than the county department, he or she is required to repay any AND-SO grant payments from such lump sum for months he or she was determined eligible for SSI.

2. As a condition of eligibility for AND-SO the client shall be required to sign the IM-14, as defined in Section 3.510, at application and at least annually allowing recovery of the funds from the first retroactive SSI payment. This form must also be completed at every redetermination and whenever the client’s case is transferred to another county. The form must include the selection of one payment designation; client’s signature and date; a county representative’s signature and date, which shall not predate the client’s signature and date; and all requirements for the interim assistance agreement including the applicable county Social Security Grant Reimbursement (GR) Code as described in the SSA Interim Assistance Reimbursement State Handbook, Section 4 (December 5, 2024) which is hereby incorporated by reference. This rule does not contain any later amendments or editions. This handbook is available for no cost at https://www.ssa.gov/gso/eiar/eIAR_InternetHandbook.pdf. This handbook is also available for public inspection and copying at the Colorado Department of Human Services, Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, during regular a. The county shall notify the SSA within 30 calendar days of obtaining a valid IM-14, as defined in Section 3.510, if the notification exceeds 30 calendar days, the county department shall be required to obtain a new valid IM-14 from the client.

b. The county department shall be required to review the “IAR Transactions Rejected By SSA Report” in the statewide automated system, Cognos report platform, and shall take all necessary actions to resolve any discrepancies within thirty (30) calendar days of the original transmission date.

B. Within ten (10) working days of receipt of the reimbursement from SSA, the county department shall complete and send to the client the Apportionment Notice (IM-19), as defined in Section 3.510, to include the amount of the interim assistance payments made, by month, for all counties that provided AND-SO payments to the client. If the county department recovers excess IAR funds from the initial SSI retroactive payment, the county must reimburse the Social Security Administration utilizing the State prescribed form, within three (3) business days of the mailing of the IM-19.

C. The accounting of payments made shall be entered in the Federal SSA eIAR data system. The Federal SSA eIAR data system records the accounting of payments made. After processing this information, it issues payments to the county department and distributes the remainder, if any. Recoveries directly from a retroactive SSI payment can only be made from the first such payment.

D. When the SSI payment is received by the client, the county department shall consider the payment as income in the month received.

E. In the event that a client receives the initial retroactive SSI payment directly, the county department shall establish a recovery from the client.

1. The county department may agree to recover interim payments by periodic payments or through a lump sum recovery.

2. Any such recovery(ies) made shall be coded as IAR Recovery(ies).

3. Any amount recovered in the same month as the month in which the retroactive payment was received shall not be counted as income.

F. The county department shall not pay any portion of its share of the Federal SSI lump sum payment to the client or to any third party for legal, professional, or other fees incurred by the client in securing SSI benefits. All of the IAR payment shall be used to reimburse the AND-SO program for grant payments paid to the client as interim assistance in accordance with the agreement between the Colorado Department of Human Services and the Social Security Administration.

The client is not required to obtain legal or other third party representation in order to apply for and/or obtain SSI benefits, and the client is solely responsible for any fees incurred in this process.

G. If an SSI client's SSI payment is suspended or terminated, the client may apply for AND-SO and complete the IM-14, as defined in Section 3.510.

H. The county department that filed the original IM-14, as defined in Section 3.510, for an AND-SO client shall be the County of Record. The County of Record acting as an agent of the State shall:

1. Collect and apportion all AND-SO grant payments for all county departments that have provided AND-SO grant payments; and, 2. Account for all AND-SO payments to the Social Security Administration (SSA) timely; and, 3. Make an accounting in the statewide automated system for any reimbursement received. Non-system determined claims (NSDC) shall not be entered for IARs without State Department approval.

I. The county department shall maintain records of the IAR case for four (4) years from the end of the Federal fiscal year in which the IAR was processed.

J. The county department shall comply with other regulations that the State Department finds necessary to administer the interim assistance provisions.

3.546 AID TO THE NEEDY DISABLED-COLORADO SUPPLEMENT (AND-CS)

PROGRAM

The Aid to the Needy Disabled-Colorado Supplement (AND-CS) program provides a supplemental payment for clients age zero (0) to fifty-nine (59) who are receiving SSI due to a disability or blindness, but are not receiving the full SSI benefit standard, as defined in Section 3.510.

A. The total AND-CS grant standard is $994, effective January 1, 2026.

B. The grant standard for AND-CS shall be adjusted as needed to remain within available appropriations. Appeals shall not be allowed for grant standard adjustments necessary to stay within available appropriations.

C. In addition to the regular monthly AND-CS grant payments, supplemental payments necessary to comply with the Federal pass-along requirements may be provided. These payments are supplements to regular grant payments and may be provided to eligible Adult Financial recipients in two (2) forms:

1. MOE Lump Sum Payments – These irregular lump sum payments cannot be anticipated, are not an entitlement, and do not affect grant standards.

Appeals shall not be allowed for MOE payment adjustments. The Federal pass-along requirements are located in the Federal Regulations found at 20 C.F.R. § 416.2095-2099 (October 2025), which are hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available at no cost at 2. State Supplementary Payment – These monthly payments are included as D. Effective January 1, 2026, the maximum ISM amount for shelter costs is $351.

E. Effective January 1, 2026, the payment floor standard for AND-CS is $13.

3.547 DETERMINATION

A. To meet the disability eligibility requirement for AND-CS, the client must be approved for SSI due to a disability or blindness. The county department shall verify SSI eligibility through SVES or SDX and document in the statewide automated system case comments.

B. The county department shall enter all client, resource, and income information C. The client shall have the right to decide how to spend his or her AND-CS grant payment.

D. If a client is terminated from SSI, the client shall lose eligibility for the AND-CS program.

3.548 GRANT DETERMINATION

A. AND-CS grants shall be calculated on an individual basis with just one client per case.

B. When a client has been found eligible the amount of the client's authorized AND- CS grant payment shall be determined by deducting the client's total countable income from the AND-CS grant standard.

1. If determined eligible on the first of the month, the client shall receive his 2. If determined eligible on any other day of the month, the client's first month remaining in the month; the client shall receive their authorized grant payment in subsequent months.

C. The AND-CS grant payment shall be made via Electronic Benefits Transfer, direct deposit, or warrant to the client, to a facility, or to a legally designated person, such as a representative payee, fiduciary, or conservator.

D. The client shall only be eligible for a monthly Personal Needs Allowance (PNA) when program requirements are met and the client is a resident of a facility for at least thirty (30) consecutive days, as follows:

1. In a general medical and surgical hospital;

2. In a nursing home, assisted living residence, or, intermediate care facility, approved setting.

E. The following persons are not eligible for a PNA or AND-CS grant payments:

1. Inmates in a penal institution; or, 2. Residents in an unlicensed private or uncertified public facility.

F. The AND-CS Personal Needs Allowance maximum shall be seventy-nine dollars ($79) effective October 1, 2016. The AND-CS grant shall not be reduced until the month following the first full calendar month that the client is a resident in an approved facility.

G. If the Social Security Administration (SSA) is recovering any portion of the client's SSI payment due to an overpayment of benefits, AND-CS shall be calculated based on the gross SSI payment and not the received amount.

3.549 AND-CS INCOME DISREGARDS AND DEEMED INCOME

A. If the client has income, apply the following income disregards:

1. To determine countable earned income:

a. Deduct $65 from the monthly gross income; and, b. Divide the remainder by two (2).

c. The result is the countable earned income.

2. To determine countable unearned income:

a. Determine the client's unearned income from all sources.

b. Subtract any amount received from SSI.

c. Deduct $20 from the remainder.

1) If the client is married, the $20 disregard shall be split between the client and the spouse so that no more than a $20.00 disregard is applied for the married couple.

2) A client who receives SSI only, and does not receive any other unearned income, does not receive an unearned income disregard.

d. Add the full SSI income back to the remainder.

e. The result is the countable unearned income.

f. If the client's unearned income is less than $20.00, the difference between the gross unearned income and the $20.00 deduction shall be applied to the earned income calculation, if applicable.

B. Subtract the countable earned and countable unearned income from the AND-CS grant standard to determine the grant payment amount. If the grant payment is less than the AND-CS payment floor standard as outlined in section 3.546, a state supplementary payment will be issued to raise the grant payment to meet the payment floor standard.

C. A portion of the earned income of an AND-CS client's spouse shall be deemed to the client, as follows:

1. Determine the spouse's monthly gross income.

2. Deduct $65.00 from the monthly gross income; and, 3. Divide the remainder by two (2).

4. The result is the amount deemed to the client.

D. A portion of the unearned income for the AND-CS client's spouse shall be deemed to the client, as follows:

1. Determine the spouse's monthly gross unearned income.

2. Deduct any remaining unearned income disregard remaining from the client or $20.00, whichever is less. A couple shall be allowed a combined $20.00 disregard, which is split between the client and the spouse.

3. The result is countable unearned income and is deemed to the client.

E. When the AND-CS client is an unemancipated child under eighteen (18) years of age, the earned and unearned income of the child and the child's parents shall be subject to disregards and deeming, as outlined above. The parents' income shall be deemed using the same calculations as a spouse.

F. If a spouse or parent is receiving Adult Financial grant payments, SSI benefits, or Medicaid assistance and has income no greater than the SSI limit, their income shall not be considered as available to the AND-CS client and shall not be deemed. If a spouse is institutionalized and the client has retained the MMMNA, the MMMNA shall be deducted from the institutionalized spouse’s total income.

G. A sponsor's income can only be deemed towards the non-citizen client he or she sponsor(s) to a client is calculated as follows:

1. The total gross earned and unearned income of the sponsor are added 2. The following deductions are subtracted from the total income of the a. A deduction for the sponsor equal to the current SSI benefit standard, as defined in Section 3.510, for an individual for the month in which eligibility is being determined; plus b. A deduction for the sponsor's spouse living in the same household with the sponsor, equal to one-half the current SSI benefit standard, as defined in Section 3.510, for an individual; or a deduction for the sponsor's spouse, who is also a co-sponsor of the non-citizen client, equal to the current SSI benefit standard for an individual; plus c. A deduction equal to one-half the SSI benefit standard, as defined in Section 3.510, for an individual for each person who is a non-citizen client's spouse).

3. The difference between the total income and the total deductions is 4. Compare the non-citizen client's countable income to the income standard of the Adult Financial program for which the non-citizen client is applying to determine eligibility and/or the grant payment amount.

5. If more than one non-citizen client has the same sponsor, all of the H. The county department shall determine all countable earned and unearned income available from the client, the spouse/parents, and the sponsor(s). The total shall be deducted from the AND-CS grant standard to determine the client's grant payment amount. If the grant payment is less than the AND-CS payment floor standard as outlined in section 3.546, a state supplementary payment will be issued to raise the grant payment to meet the payment floor standard.

3.550 FINANCIAL REDETERMINATION

A. A redetermination of eligibility shall mean a case review/determination of necessary information and verifications to determine ongoing eligibility:

1. For OAP, every twelve (12) or twenty-four (24) months. The eligibility period for OAP shall be determined by the statewide automated system based on the following factors:

a. OAP cases shall be redetermined every twenty-four (24) months when:

1) There is no earned income; and, 2) The value of the client’s countable resources are at least two hundred ($200) under the client’s resource limit as defined in

section 3.520.72.A.

b. All other OAP cases shall be redetermined every twelve (12) months.

2. For AND-SO, every six (6) or twelve (12) months to align with the length of disability indicated on the medical certification form.

3. For AND-CS, every twelve (12) months.

B. Clients shall file their redetermination with the county department by the fifteenth (15th) of the month as specified in the redetermination packet.

1. A client's failure to file a redetermination timely may delay the determination of benefits and grant payments.

2. The county department must make an eligibility decision on complete, timely-received forms on or before the last day of the month in which the forms were due.

3. Complete forms received between the 16th and the last day of the month the redetermination is due must be approved or denied as soon as possible. The county department will have ten (10) days to act on such redeterminations, to include scheduling and conducting the interview when required and requesting any necessary verification. The county must make an eligibility decision on redetermination forms received between the 16th and last day of the month within thirty (30) days from receipt of such redetermination.

C. For Adult Financial programs, the county department shall schedule an interview with the client at every twenty-four (24) month redetermination, at a minimum, after application.

Effective February 01, 2026, for all ongoing cases, from the point of the next redetermination interview, an interview will be required at every twenty-four (24) month redetermination moving forward.

1. The client shall be offered an in-person interview.

2. If the client does not elect an in-person interview, the county shall schedule a phone interview.

3. The client shall be provided written notice at least four (4) days in advance of the scheduled interview. The client may provide a written or verbal waiver that written notice of the scheduled interview is not necessary when the county department is able to conduct the interview during redetermination processing. Written notice shall include:

a. The date and time for the interview;

b. Identification of any documentation that may be needed; and c. The opportunity to reschedule the appointment or make other arrangements in the event of good cause.

4. When the client does not keep the interview appointment and does not request an alternate time or arrangement, as described in Section 3.520.4.C, grant payments will be discontinued following the policies D. To redetermine eligibility a case review must be conducted and necessary verification must be received to determine ongoing eligibility.

1. If the client is approved and is receiving SSI benefits and has no other earned or unearned income, the income and resources received through the Federal State Data Exchange (SDX) or the Federal State Verification Eligibility System (SVES) interface shall be considered verified upon receipt.

a. The county department shall review non-financial eligibility and verify any changes; and, b. If the county department has obtained or received information related to income, resources, or non-financial eligibility requirements that is contrary to the SDX or SVES interfaces, the county department shall independently verify the information; and, c. The county department shall forward such contrary information to the local Social Security Administration office.

2. During the redetermination process and prior to eligibility determination, the county worker shall:

a. Conduct an interview when required;

b. Explain the purpose of the interview and the use of the information supplied by the client on the redetermination form and any additional required forms;

c. Inform the client in writing that Social Security Numbers will be used to request and exchange information with other agencies as

part of the eligibility process, including the Department of Labor and Employment (State wage and unemployment data), and the Social Security Administration;

d. Have the client complete the form(s) or provide assistance to the client in completing the form(s);

e. Explain the appeal rights to the client as outlined in Section 3.587;

f. Witness the signature of the client and sign as a person who helped complete the form(s), when applicable;

g. Review documents, verifications, and any other information supplied by the client with the client in order to obtain clarification if needed;

h. Request updated verifications for income, resources, and nonfinancial eligibility requirements which have changed. All countable resources must be verified using traditional verification documents and collateral contacts at every twenty-four (24) month redetermination. This may include, but is not limited to:

1) Newly declared, such as a new vehicle;

2) Previously declared, such as a change in marital status; and, 3) Changes from the previous redetermination, such as closure of a bank account.

i. County departments may use Colorado Works and the Supplemental Nutrition Assistance Program’s eligibility forms and processes when redetermining and verifying eligibility.

E. Any time while receiving Adult Financial program grant payments, if there is questionable information regarding the circumstances of a household or the county department receives information about changes in a household’s circumstances but cannot determine the effect of those changes on grant payments, the county worker can request a contact. The county department shall send a request for contact notice requesting the client attend an interview appointment. The interview should be in-person unless good cause applies which would allow for a phone interview in lieu of the in-person interview. If the client does not attend the interview appointment or request an alternate time or arrangement, as specified in Section 3.520.4.C, the case shall be discontinued.

The county department shall make a request for contact when:

1. It receives information that would contradict eligibility or that is questionable; or, 2. It suspects possible fraud; or, 3. It receives direction to do so from the State Department; or, 4. It is otherwise reasonable to do so under the prudent person principle.

F. Forms that the client is required to complete shall be mailed to the client at least thirty (30) calendar days prior to the first of the month in which the eligibility redetermination is due. This is considered the prior notice period. A review of the case record will indicate the forms required based on individual case circumstances. Mail-out redeterminations shall be conducted as follows:

1. A redetermination form shall be mailed to the client;

2. Form(s) shall be completed, signed by the client, and returned to the county department no later than redetermination due date; and, 3. When the client is unable to complete the form(s) due to physical, mental, or emotional disabilities, and has no one to help, the county department shall assist the client to complete the form(s), unless there is another available legal or other resource that is willing and able to assist the client.

4. When the client is unable to complete the redetermination packet in a timely manner due to good cause, the county department shall extend the due date up to thirty (30) calendar days. The assistance or referral action of the county department shall be recorded in the case record.

G. When the county department receives the completed redetermination packet, it shall:

1. Date stamp the redetermination form(s) and corresponding verification.

2. Thoroughly review the redetermination packet for completeness, accuracy, and consistency. All factors shall be evaluated as to their effect on eligibility and payment.

a. If the client failed to sign the redetermination packet, the redetermination packet shall be returned to the client for signature with instructions to return the signed packet before the end of the client's eligibility period. An unsigned redetermination packet shall be considered incomplete and shall not be processed by the county department.

b. If the redetermination packet is incomplete, the county department shall ask additional clarifying questions and request all necessary 3. Review the Redetermination packet for changes to:

a. Non-financial eligibility requirements, as outlined in Section 3.520.6;

b. Resources, as outlined in Section 3.520.72; and, c. Income, as outlined in Section 3.520.78.

4. Document verifications in the case file, utilizing the process described in

Section 3.520.4.D. The case file shall be used as a checklist in the redetermination process, and shall be used to keep track of matters requiring further action. When additional information is needed:

a. Due to incomplete form(s) or lack of verification, a notice shall be mailed to the client. The notice shall specify the items that are required for a redetermination to be completed in order to determine eligibility and/or payment;

b. Due to inaccurate or inconsistent data, the client may be contacted by telephone or be requested to make an office visit, to secure the proper information. Collateral contacts and interfaces shall be used to gather information whenever possible.

H. If the redetermination form is timely received but is incomplete, a correction notice shall be sent to the client advising the client that the redetermination form is incomplete and must be corrected by the last day of the month in which the forms were due to avoid termination and/or the county department shall work with the client to complete the form.

I. When the information provided on the redetermination form, or otherwise provided by the client, is the basis for reduction in the amount of assistance or in termination of assistance follow the policies outlined in Section 3.554.

3.551 LATE REDETERMINATIONS

When a client fails to return his or her redetermination packet by the last day of the month of the expiring eligibility period, the client's case shall be discontinued following the policies outlined in Section 3.554.

A. If the client returns the redetermination packet within thirty (30) calendar days after discontinuation, the following processing requirements shall be implemented:

1. If the client has good cause, the client's grant payments shall be reinstated. There shall be no break in the client's grant payments. The county department will have ten (10) days to act on such redeterminations, to include scheduling and conducting the interview when required and requesting any necessary verification. The county must make an eligibility decision on redetermination forms received within thirty (30) calendar days after discontinuation within thirty (30) days from receipt of such redetermination.

2. If the client does not have good cause, the county department shall use the redetermination packet as a new application. An interview is required and traditional verification methods must be used. The date of the new application shall be the date the county department received the redetermination packet. There shall be a break in the client's grant B. If the client returns the redetermination packet thirty-one (31) or more days after the discontinuation, the county department shall require the client to complete a new application. This will result in a break in the client's grant payments.

3.552 REPORTING CHANGES

A. When a client is certified for Adult Financial grant payments, a certification period is assigned. During the certification period, the client is required to report and provide verification of changes applicable to eligibility. Examples of changes include, but are not limited to, income, marital status, household composition, shelter costs, resources, and citizenship status. If a client does not report changes as required and as a result is overpaid grant payments, the client will be held liable for repaying any grant payments he or she was not eligible to receive.

B. Some changes may be reported directly to the county department through interfaces. Unless otherwise specified in Section 3.520.5, information that is received through interfaces is considered verified upon receipt and is not subject to additional verification by the client. The date of the change for this information shall be considered the date the information is reported to the county through an interface. The county department shall act on these changes within ten (10) calendar days of the date of the change, unless otherwise prescribed in Section 3.520.5.

C. Clients shall be required to report and provide verification of changes in circumstances by the 10th of the month following the month in which the change occurred. The county department has up to ten (10) calendar days to act on the information from the date the change is reported and verified, as outlined in

Section 3.553.

D. The client shall be allowed to report changes in person, by telephone, in writing, or electronically. Changes reported by the client by telephone, electronically, or in person shall be acted upon in the same manner as those reported in writing. If reporting by mail, clients will have met the reporting requirement provided the envelope is postmarked by the 10th of the month following the month in which the change occurred.

E. If additional verification is required to process the reported change, the client shall be notified of the verification needed and the deadline for submitting required verification to the county department, utilizing the process described in

Section 3.520.4.D. The notice shall inform the client that the change must be verified prior to action being taken by the county department if grant payments are to be increased.

F. When a change in client circumstances occurs and the county department has determined that a client has failed to cooperate in providing verification necessary to determine eligibility, the client's eligibility shall be terminated following written timely notice. Clients experiencing difficulty in obtaining necessary verification shall be assisted by the county department either in obtaining the documentary evidence or by making a collateral contact. The county department must ensure that the client was notified of the needed verification and at least eleven (11) calendar days was allowed to obtain the 3.553 ACTION ON CHANGES A. A change shall be considered to be reported as of the date the county department is notified of the change. A change shall be considered verified as of the date the county department receives verification of the change. If a change is reported and verified by the tenth (10th) of the month following the date of the change, the change shall be considered timely reported by the client.

B. The county department shall process the change within ten (10) calendar days from the date the change was verified, to be considered timely processed by the county department. Changes reported by clients shall be documented in the case record to indicate the change, the date the change was reported, and the date the change was verified. If the change causes a change to the client’s grant, a notice of action form shall be issued to inform the client of the change.

C. Changes shall be acted upon as follows:

1. Changes that result in an increase in grant payments shall take effect the month following the month the change was verified by the client. Due to the time required for processing by the county department, receipt of any increase in grant payments may be delayed beyond the month following the month of the change.

2. Changes that result in a decrease in grant payments or total ineligibility shall affect a case following the policies outlined in Section 3.554.

D. If grant payments are overpaid because a client fails to timely report and/or timely verify changes in circumstances or income as required, a claim shall be established and a notice of overpayment and a public assistance repayment agreement form referenced in Section 3.582.B.4. will be mailed. If the overpayment is discovered within the certification period, the client must be given written timely notice if grant payments are to be reduced.

E. For OAP, AND-CS, and HCA, if a client is overpaid and the system determined benefit is below the payment floor of the respective program, a claim will not be generated.

3.554 TIMELY AND ADEQUATE NOTICE

A. The county department and/or the Case Management Agency (CMA) shall notify a client of any change from his or her prior grant payment amount, the reason for the action, and the date the action becomes effective in writing.

B. Clients shall receive written timely notice, giving at least eleven (11) calendar days advance notice before any adverse action, such as a grant payment reduction, suspension, termination or denial, becomes effective during the certification period, except as specified in Section 3.554.C. The notice shall explain the reason for the proposed action and the date the action becomes effective.

1. When acting on a change in accordance with Section 3.553, if the eleven (11) calendar day timely notice period can be given within the month the written timely notice is sent, the change will become effective the first day of the following month.

2. If the 11 calendar day timely notice period concludes in the following month, the change shall become effective the first day of the month after which the timely notice period concluded.

3. If the timely notice period ends on a weekend or holiday and a request for a state level fair hearing and continuation of grant payments is received the first business day after the timely notice period, the request shall be considered timely received.

C. Adequate notice, not timely notice, is required in the following situations:

1. When facts indicate an overpayment because of probable fraud or an intentional program violation and such facts have been verified to the extent possible, prior notice shall be mailed at least five (5) calendar days before the proposed effective date.

2. The county department has determined that the State prescribed medical certification has expired.

3. The county department and/or CMA has determined that the client has stopped receiving Home Care Allowance (HCA) and is now receiving Home and Community Based Services (HCBS).

4. The client has died.

5. The client has provided a clear statement which states that he or she no longer wishes to receive assistance/services.

6. The client begins receiving SSI or SSDI. A claim to recover the AND-SO or Colorado Supplement grant payments that are issued in the same month that the SSI or SSDI benefits are received shall be created and the client shall be liable to repay the AND-SO or Colorado Supplement grant payments that were issued.

7. At application or redetermination, when a certification period has not yet been set.

D. If the change in circumstances requires a reduction or termination of grant payments, the following action will be required:

1. Send a written timely notice.

2. If a client requests a county conference, conduct the county conference as specified in Section 3.586. If a client is dissatisfied with the results of the county conference and requests a state level fair hearing before an Administrative Law Judge, such a request shall be in accordance with If a client does not request a county conference and only requests a state level fair hearing any time prior to the effective date of the timely notice, and the certification period has not expired, the client's grant payments shall be continued on the basis authorized immediately prior to the timely notice. Continued grant payments shall not be issued for a period beyond the end of the current certification period. Grant payments shall be continued until a final decision has been made by the Office of Appeals or until the certification period ends, whichever occurs first. The county department shall explain to the client that repayment will be required for the amount of any grant payments determined by the hearing officer to have been overpaid or the continued grant payments to which the client was not eligible to receive.

3. If the certification period expires before the hearing process is completed, the client may reapply for benefits.

4. If the client does not appeal the timely notice to decrease or terminate grant payments within the timely notice period, the changes shall be made in accordance with timeframes outlined in Section 3.553.C.

3.560 CASE TRANSFERS

A. If the client's eligibility has been discontinued and he or she reports a change of address after the discontinuation, the client shall be required to complete a new application for benefits in the new county department of residence. This will result in a break in the client's grant payments.

B. If the client notifies a county department of a change in address while the client's case is approved, the following steps shall be completed:

1. The case transfer shall be completed or additional verification shall be requested within three (3) working days. Verification will be acted on by the transferring county prior to transferring in accordance with timeliness requirements outlined in Section 3.553.

2. Prior to transferring an ongoing case to the new county department, the originating county department shall update the case to address any unresolved IEVS, discrepancies, claims, and any unworked case changes.

3. The new county department may choose to pull a case from the originating county department.

a. If the new county department chooses to pull the case, it is responsible for addressing any unresolved IEVS, notifying the originating county department that the case has been transferred, and requesting from the originating county department any unworked changes so the new county department can process the changes.

b. The originating county department shall be responsible for researching and documenting any discrepancies and claims.

C. If the client notifies the county department of a change of address during his or her redetermination certification period, the following apply:

1. The county department receiving the change of address notice shall:

a. Notify the client of the redetermination due date and the affected benefit month; and, b. Determine whether the client has received the redetermination packet.

1) If yes, the client shall be instructed to complete and return the redetermination packet to the new county department.

2) If no, the new county department shall mail a redetermination packet to the client's new address, ask the client to come to the office to complete a redetermination, or ask the client to complete the redetermination through the online application process.

2. If a client submits their redetermination packet to the originating county department prior to the end of the eligibility period and subsequently submits a new application in the client's new county department of residence before the redetermination is processed, the date of the redetermination shall be the date of application. The new county department may process the redetermination at the same time the new application is processed.

3. When the client's redetermination packet has been mailed and then the client reports a change in address, the following shall apply:

a. If the client reports the change of address and returns the redetermination packet to the originating county department, the originating county department shall process the redetermination and then transfer the case to the new county department.

b. If the client reports the change of address to the new county department prior to returning his or her redetermination packet to the originating county department, the originating county department shall instruct the client to return their redetermination to the new county department for processing.

c. If the client reports the change of address to the new county department after returning his or her redetermination packet to the original county department, the redetermination shall be processed by the original county department and then transferred to the new county department.

4. When the client's redetermination packet has not been mailed and the client reports the change in address during the recertification timeframe, the county department receiving the change of address shall:

a. Update the client's address in the statewide automated system to ensure the redetermination is mailed to the client's new address when it is generated by the statewide automated system;

b. Inform the client that his or her case shall be transferred to the new county department; and, c. Provide the client with the name and address of the new county department office; and, d. The originating county department shall transfer the case.

3.570 HOME CARE ALLOWANCE AND BURIAL

3.570.1 HOME CARE ALLOWANCE

3.570.11 PURPOSE OF PROGRAM

A. Home Care Allowance (HCA) is a special cash payment made to a client, five (5) years of age or older for the purpose of securing in-home, personal care 1. HCA is a non-entitlement program;

2. Clients must be evaluated for Home and Community Based Services through Health First Colorado (Medicaid) before the HCA program can be considered.

a. At application, if the client is functionally eligible for Home and Community Based Services (HCBS) through Health First Colorado (Medicaid), the client is not eligible for HCA.

b. At reassessment on or after 05/01/2022, clients must be evaluated for Home and Community Based Services through Health First Colorado (Medicaid) and if functionally eligible, the clients are no longer eligible for the HCA program. Clients who are determined eligible for HCBS through Health First Colorado at reassessment may remain on HCA for up to three (3) months while they transition to HCBS if the delay in transition is not within the client’s control.

c. HCA cannot be received while receiving Home and Community Based Services; and, 3. HCA is designed to serve clients with the lowest functional abilities and the greatest need for paid care.

B. Effective January 1, 2026, all tiers of HCA are eligible for the payment floor standard. The payment floor standard for HCA is $977.

C. The HCA grant is not taxable income to the client. The payment made to the care provider using the HCA grant received by the client is income to the care provider and subject to taxation under State and Federal laws.

D. The HCA grant standards shall be adjusted to stay within available appropriations. Appeals shall not be granted for these adjustments.

E. In addition to the regular monthly HCA grant payments, supplemental payments necessary to comply with the Federal pass-along requirements may be provided.

These payments are supplements to regular grant payments and may be provided to eligible Adult Financial recipients in two (2) forms:

1. MOE Lump Sum Payments – These irregular lump sum payments cannot be anticipated, are not an entitlement, and do not affect grant standards.

Appeals shall not be allowed for MOE payment adjustments. The Federal pass-along requirements are located in the Federal Regulations found at 20 C.F.R. § 416.2095-2099 (October 2025), which are hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available at no cost at 2. State Supplementary Payment – These monthly payments are included as 3.570.12 DEFINITIONS “Activities of daily living” (ADL) mean physical transfers, bladder care, bowel care, mobility, dressing, bathing, hygiene, and eating.

“Authorized representative” means an individual or organization designated by the client, or by the parent or guardian of the client, if appropriate, to assist in acquiring or utilizing Home Care Allowance (HCA). The extent of the authorized representative's involvement shall be determined upon designation.

“Care planning” means identifying client goals and choices for the care needed, services needed, appropriate service providers, and knowledge of the client and of community resources. The care plan shall be documented on the State Department prescribed care plan tool.

“Case management” means the assessment of a client's long-term care needs, development and implementation of a care plan, coordination and monitoring of the long-term care service delivery, evaluation of service effectiveness, and periodic reassessment of client needs. ”Case Management Agency” (CMA) means a public or private not-for-profit or for-profit organization contracted with the State of Colorado to provide case management services and activities, pursuant to Section 25.5-6-1702(2), C.R.S. (2025).

“Functional assessment” means the comprehensive evaluation of the client's ability to manage his or her activities of daily living and to determine the level of assistance the client requires to complete his or her activities of daily living.

“Home” means a non-facility residence. A home cannot include a homeless shelter or other temporary setting.

“Intake/screening/referral” means the initial contact with clients by the Case Management Agency (CMA) and shall include, but not be limited to, a preliminary screening of: the client's need for long term care services, the client's need for referral to other programs or services, eligibility for financial and program assistance, and the need for a comprehensive assessment.

“Medical leave” means the absence of the client from their home for more than twentyfour (24) hours due to admittance to a hospital or other facility, upon physician's order with the presumption on the part of the physician that the client will be returning to their home. Medical leave may be planned or unplanned.

“Non-medical leave” means the absence of the client from their home for more than twenty-four (24) hours for non-medical reasons that are not part of a client's care plan.

Non-medical leave may be planned or unplanned.

“Non-skilled care” means care provided by licensed and unlicensed non-medical personnel, including caregivers who assist or help the individual with daily tasks such as bathing, eating, cleaning the home, and preparing meals.

“Ongoing case management” means the evaluation of the effectiveness and appropriateness of services, on an ongoing basis, through contacts with the client, appropriate collateral contacts, and service providers.

“Reassessment” means a comprehensive re-evaluation by the case manager with the client and appropriate collaterals (such as family members, friends and/or caregivers) to determine the client's level of functioning, service needs, available resources, potential funding resources, and necessity for paid care. The reassessment of functional need shall be documented on the State Department prescribed assessment tool.

“Skilled personal care” means some exceptions to personal care for activities of daily living that, because of the severe or complex nature of the client's need, requires a person with specialized training and skill to complete the task. Skilled personal care is not a paid service of the Home Care Allowance (HCA) program. See Section 8.489.30 (10 C.C.R. 2505-10) of the HCPF rules for the definitions of personal care and the skilled exceptions to personal care.

3.570.13 ELIGIBILITY

A. Eligibility for HCA shall be based on both financial need and the client's functional needs. The client shall meet eligibility for both financial and functional requirements to be approved for an HCA payment.

B. To be financially eligible, the client shall:

1. Be approved for Supplemental Security Income (SSI) benefits; or, 2. Meet all eligibility criteria required for Aid to the Needy Disabled – State Only (AND-SO) program; or, 3. Have been receiving both Old Age Pension (OAP) grant payments and HCA as of December 31, 2013 and remain continuously eligible for both benefits.

C. To be functionally eligible, the client shall have an HCA eligible functional assessment score. The functional assessment score is calculated by determining the client's functional capacity score and need for paid care score, as follows:

1. Functional Capacity: determined by assessing the client's ability to complete all activities of daily living (ADLs) and applying a score to his or her ability to complete the ADLs using the functional impairment scale;

2. Need for Paid Care: determined by identifying the unmet need for paid care and applying a score to the unmet need using the need for paid care scale, as outlined in Section 3.570.14; and, 3. Combining the functional capacity score and the need for paid care score to determine whether the client meets the minimum scores for eligibility and, if eligible, the tier of grant payments to be approved, as follows:

Tier Capacity Score Need for Paid Care Score 1 21 or Higher 1 to 23 2 21 or Higher 24 to 37 3 21 or Higher 38 to 51 D. The CMA shall not approve the maximum authorized HCA amount for the tier if:

1. The authorization by the CMA shall be forwarded to the county department to determine financial eligibility.

2. The HCA provider is able to provide the authorized services for less than the maximum authorized amount; or, 3. The client is unwilling or unable to use the maximum authorized amount.

E. Each client who meets the minimum functional assessment scoring requirements for the HCA program shall be functionally eligible for an HCA grant.

1. The authorization by the CMA shall be forwarded to the county department to determine financial eligibility.

2. Clients shall not be approved for HCA if financially ineligible, even if the client is functionally eligible.

3. Clients shall not be approved for HCA if functionally ineligible, even if the client is financially eligible.

F. If financially and functionally eligible for HCA, the HCA grant payment shall begin on the first day of the month following the month in which the HCA is approved or the payment effective date from the State approved form completed by the CMA, whichever date is later. There shall be no retroactive HCA payments.

G. If a client is assessed and does not meet the functional assessment scoring requirements, the county department and CMA shall refer the client to other agencies or services available in the community, such as Area Agencies on Aging (AAA), Aging and Disability Resources for Colorado (ADRC), Centers for Independent Living, and/or other local community resources to help with any identified needs.

3.570.14 FUNCTIONAL ASSESSMENT SCORING

A. The need for skilled personal care shall not be included in the scoring of the need for paid care.

B. In order to be eligible for the Home Care Allowance program, each client shall score a minimum of twenty one (21) points when assessed for the ability to complete the ADL using the following functional impairment scale:

1. Independent: score zero (0) if the client is physically able to perform all essential components of the ADL, with or without an assistive device.

2. Low: score one (1) if the client requires occasional or intermittent supervision or stand-by assistance in a limited number of the components of the activity such as he or she is able to perform all essential components of the function, but impairment of function exists even with an assistive device.

a. Occasional or intermittent means the client does not need assistance daily, but may need assistance a few times a month or up to two (2) times per week.

b. Supervision means verbal prompting, cueing, and reminders to help the client if he or she needs assistance up to two (2) times per week.

c. Stand-by assistance means assistance or monitoring to help the client if he or she needs physical assistance up to two (2) times per week.

3. Moderate: score two (2) if the client is unable to perform the majority of the essential components of the function even with an assistive device, and the client requires hands-on and frequent assistance to accomplish the activity.

a. Frequent means the client needs assistance at least three (3) times per week and up to daily.

b. Hands-on assistance means the care provider must physically assist the client in completing the task.

4. Severe: score three (3) if the client is totally unable to perform the function and requires someone to perform the task, or the client requires constant supervision for the task.

C. The need for paid care score shall be based on the frequency of the client's unmet need for paid care and shall be modified by the following factors:

1. Need for paid care shall be scored as zero (0) when those services are provided through another program, agency, or individual.

2. For clients living with others, the need for paid care shall be scored only on the client's needs that are greater than and differentiated from typical household routine and the typical expectation of assistance by family members living in the home.

D. For children age five (5) through eighteen (18) years, functional capacity and need for paid care shall be scored according to age appropriate criteria. Children under the age of 5 shall not be scored and are not eligible to receive Home Care Allowance.

E. The need for paid care scale is as follows:

Score Frequency Definition Of Frequency 0 None Client's needs are met. No need for paid care. 1 Weekly Client needs paid care up to and including once a week. 2 Daily Client needs paid care more than once a week and up to once a day, seven days a week. 3 Twice Daily Client needs paid care two or more times per day at least five days per week.

F. The functional assessment shall be scored on the State Department prescribed form, which shall list each activity of daily living, the functional capacity score and the need for paid care score for each ADL.

3.570.15 ACTIVITIES OF DAILY LIVING

A. Activities of daily living (ADL) shall be scored using the functional capacity impairment scale and the need for paid care scale.

B. The activities of daily living are:

1. Critical ADL a. Transfers: the ability to move between surfaces, such as getting in and out of bed; transferring from a bed to a chair, wheelchair, or walker; moving from a chair or wheelchair to a walker or to a standing position; and the ability to use assistive devices, including prosthetics.

b. Bladder care: the extent to which the client has control of his OR her bladder functions and the ability of the client to accomplish the tasks of toileting, including catheterizing, getting on and off the toilet, changing incontinence products, and cleaning him/herself.

c. Bowel care: the extent to which the client has control of his OR her bowel functions and the ability of the client to accomplish the tasks of toileting, including getting on and off the toilet, changing incontinence products, and cleaning him/herself.

2. Basic ADL a. Mobility: the ability of the client to ambulate around the home and around essential places outside the home, with or without assistive devices.

b. Dressing: the ability of the client to accomplish all phases of the activities of dressing and undressing, including getting, putting on, fastening, and taking off all items of clothing, braces, and artificial limbs.

c. Bathing: the ability of the client to safely accomplish the task of washing body parts including getting into bathing waters, with or without assistive devices or whether the client requires stand by or hands-on assistance from another person.

d. Hygiene: the ability of the client to maintain personal hygiene other than bathing, including combing hair, brushing teeth, and clipping nails.

e. Eating: the ability to cut food into manageable size pieces, chew, and swallow food, with or without assistive devices.

3. Instrumental ADL a. Meals: the ability to safely prepare food to meet the basic nutritional requirements of the client, including cutting food, transferring food to cooking vessels and/or dishes, utilizing utensils, using a stove or microwave, and implementing special dietary needs. A child age 5 to 18 years shall not be scored for meals.

b. Housekeeping: the ability to maintain the interior of the client's residence for the purpose of health and safety, such as wiping surfaces, cleaning floors, making a bed, and cleaning dishes. A child age 5 to 18 years shall not be scored for housekeeping.

c. Laundry: the ability to gather and wash soiled clothing and linens; use washing machines and dryers; hang, fold, and put away clean clothing and linens. A child age 5 to 18 years shall not be scored for laundry.

d. Shopping: the ability to purchase goods that are necessary for health and safety. Activities include the ability to make needs known, to make a list, reach for the needed items at the store, ability to estimate or determine the cost of the item, and to move items into the home and put them away. A child age 5 to 18 years shall not be scored for shopping.

4. Supportive ADL a. Medicine: the ability to manage medications, including knowing the name of the medication, knowing the amount, frequency, and how to take the medicine, understanding the reason for taking it, and understanding possible side effects. A child age 5 to 14 years shall not be scored for medicine.

b. Appointment: the ability to schedule or make an appointment for essential activities, such as doctor visits, meetings with caseworkers, and transportation. A child age 5 to 18 years shall not be scored for appointments.

c. Money: the ability to manage money, such as balancing a check book, writing checks or paying a bill electronically, and ability to understand financial decisions. A child age 5 to 18 years shall not be scored for money.

d. Access: the ability to access resources or services in the community, such as locating the resource/service and completing the process necessary to receive the resource or service. A child age 5 to 18 years shall not be scored for access.

e. Telephone: the ability to use the telephone to communicate essential needs, such as answering the phone in a reasonable time, speaking clearly and loudly enough to be understood, dialing the phone, initiating a conversation, hearing the caller, and placing a call in an emergency. A child age 5 to 12 years shall not be scored for telephone.

3.570.16 CARE PLANNING AND CASE MANAGEMENT

A. Home Care Allowance may be used to purchase:

1. Non-skilled assistance with activities of daily living, as defined in Section 3.570.15; and;

2. Electronic monitoring, such as an emergency alert button; and, 3. One-time deep cleaning if a referral is initiated by Adult Protective Services and determined necessary by the CMA.

B. The CMA shall develop a care plan on the State Department prescribed form within ten (10) working days after program eligibility has been determined and prior to the arrangement for services.

1. The care plan shall be:

a. Signed by the client, CMA, and the service provider; and, b. Reviewed and updated at least once every twelve months; and, c. Reviewed sooner if there is a change in the client's needs; and, d. Provided to all parties.

2. Care planning shall include, but not be limited to, the following tasks:

a. Identifying and documenting care plan goals and client choices.

b. Identifying and documenting services, including type, duration and frequency.

c. Arranging for services through a service provider, family member, or other provider of the client's choosing.

1) Providers shall be at least eighteen (18) years of age or older and have the ability to provide appropriate services.

2) The CMA shall negotiate with the client and care provider to arrive at the total number of paid care hours to be provided monthly.

3) The HCA payments shall be made directly to the client or authorized representative who shall pay the provider the agreed upon, authorized amount monthly.

4) No portion of the authorized HCA amount shall be withheld by the client for personal use. The entire HCA authorized amount shall be spent for HCA allowable services.

d. Coordinating service delivery, negotiating with the service provider and the client regarding service provision, and formalizing the provider agreement.

e. Completing program requirements for the authorization of services.

f. Referring the client to community resources, as needed, and attempting to develop resources for the client if a resource is not available within the client's community.

g. Explaining the complaint procedures to the client, as listed on the care plan document.

h. Explaining the client's right to appeal any decision.

3. The CMA shall meet the client's needs, with consideration of the client's choices, using the most cost effective methods available.

a. When services are available to the client at no cost from family, friends, volunteers, or others, these services shall be utilized before the purchase of services, providing these services adequately meet the client's needs.

b. When public dollars must be used to purchase services, the CMA shall assist the client in comparing the cost of services.

c. The CMA shall ensure there is no duplication in services provided by any other public or privately funded services.

d. The CMA shall discuss with the client if other waivers and/or services are more appropriate or beneficial to the client and assess as needed.

C. The CMA shall provide ongoing case management, as follows:

1. Monitoring the quality of care provided to the client.

2. Contacting service providers concerning service coordination, effectiveness, and appropriateness.

3. Reviewing the client's assessment, care plan, and service agreements to include changes in client functioning, service effectiveness, appropriateness, and cost-effectiveness that may require a reassessment or a change in the care plan.

4. Making changes in care plans as appropriate to client needs and/or referring the client to community resources, if appropriate.

5. Providing conflict resolution and/or crisis intervention, as needed.

6. Identifying and contacting appropriate individuals, and resolving any problems or complaints raised by the client or others regarding service delivery.

7. Notifying the appropriate law enforcement and/or child/Adult Protective Services agency of suspected abuse, neglect or exploitation, as required by Sections 18-6.5 108, 19-3-304 and 26-3.1-102, C.R.S.

D. The CMA shall complete a review of the client's current assessment or reassessment and the care plan with the client six months following the assessment or reassessment.

1. The review shall be conducted by telephone, at the client's place of residence, at the place of service, or other appropriate setting as determined by the client's needs.

2. An in-person home visit shall be completed when significant changes in the client's condition are identified.

E. The CMA shall complete an in-person functional reassessment within twelve (12) months of the initial functional assessment and every twelve months thereafter. A reassessment shall be completed sooner if the client's condition changes.

F. Reassessment shall include the following tasks:

1. Reviewing the care plan, service agreement, and provider contract or agreement.

2. Evaluating service effectiveness, quality of care, and appropriateness of 3. Verifying continuing financial and program eligibility.

4. Annually, or more often if indicated, completing a new care plan and service agreement.

5. Referring the client to community resources, as needed; and 6. Discussing with the client if a HCPF waiver and/or service is more appropriate or beneficial and assess as needed.

G. The CMA shall update the information provided at the previous assessment or reassessment, utilizing the State Department prescribed form and the State prescribed system. When a new functional assessment is completed a copy shall be sent to the county department within ten (10) working days of the reassessment.

3.570.17 DENIALS, DISCONTINUATIONS, AND CASE TRANSFERS

A. The responsibility of the CMA is to determine the functional eligibility of the client.

The CMA shall deny or discontinue the client from the HCA program if he or she is determined functionally ineligible and provide timely or adequate notice as required by Section 3.554.

1. The client shall be informed of his or her appeal rights as outlined in 2. The client shall be provided appropriate referrals to other community resources within one (1) working day of discontinuation or denial.

3. If the discontinuation or denial is due to functional eligibility, the CMA shall notify the client that he or she must notify the providers on the care plan within one (1) working day of receiving notice from the county department.

4. If the discontinuation or denial is due to financial eligibility, the CMA shall notify the client that he or she must notify all providers on the care plan within one (1) working day of receiving notice from the county department.

5. The CMA shall notify the county department within five (5) working days of discontinuation.

6. The CMA shall prepare for and defend at the state level fair hearing any appeal related to functional denial or discontinuation. The CMA may request assistance and/or testimony from the county department.

B. The responsibility of the county department is to determine the financial eligibility of the client. The county department shall deny or discontinue the client from the HCA program if he or she is determined financially ineligible and provide timely or adequate notice as required by Section 3.554.

1. The client shall be informed of his or her appeal rights as outlined in 2. The client shall be provided appropriate referrals to other community resources within one (1) working day of discontinuation or denial.

3. The county department shall notify the CMA within five (5) working days of discontinuation.

4. The county department shall prepare for and defend at the state level fair hearing any appeal related to financial denial or discontinuation. The county department may request assistance and/or testimony from the CMA.

C. Following the notice procedures outlined in Section 3.554, denial and/or discontinuation from the HCA program shall occur for the following reasons:

1. Financial and Functional Eligibility: The CMA or county department shall deny or discontinue a client if the client is not financially eligible and/or is not functionally eligible for HCA.

2. Level of Care: The CMA shall deny or discontinue when the client:

a. Does not meet functional capacity score minimum requirements; or, b. Does not meet need for paid care score criteria.

3. Receipt of Services: The CMA or county department shall deny or discontinue when the client:

a. Has not received services for one month;

b. Has twice refused to schedule an appointment for an initial assessment, six (6)- month review, or reassessment within a thirty (30) consecutive day period;

c. Has failed to keep three (3) scheduled appointments within a thirty (30) consecutive day period;

d. Has refused to schedule an appointment for a required visit after the client's case has been transferred to a new CMA or county department;

e. Refuses to use the HCA payment to pay for services or uses the payment for services not identified in the service agreement;

f. Refuses to sign the intake form, care plan, or other documents and forms required to receive services.

4. Facility Status: The CMA or county department shall deny or discontinue when the client:

a. Is a resident of a nursing facility, hospital, or any other long-term care facility; or, b. Enters a hospital or other long-term care facility for treatment, hospitalization, or rehabilitation that continues for thirty (30) calendar days or more.

5. Service Limitations Related to Safety: The CMA or county department shall deny or discontinue when the client cannot be safely served given the type and/or amount of services available. Evidence of safety concerns include, but are not limited to:

a. The results of an Adult Protective Services assessment that substantiates ongoing risk.

b. A statement from the client's physician attesting to diminished cognitive capacity, debilitating mental health concerns, or ongoing risk.

c. Lack of available and/or appropriate service providers.

d. A functional assessment score indicating a level of need for services in excess of those available under the HCA program.

e. Other available information or evidence that will support the determination that the client's safety is at risk.

6. Service Limitations Related to Cost Effectiveness: The CMA or county department shall deny or discontinue when other more cost effective alternatives are available to meet the client's needs.

7. Living Arrangements: The CMA or county department shall deny or discontinue when the client is residing anywhere other than his OR her home.

a. The CMA may continue to authorize services while a resident is on medical or non-medical leave.

b. Combined leave shall not exceed a total of forty-two (42) days in a twelve (12) month period beginning with the date the client was approved for the HCA program.

8. Move Out of State: The CMA or county department shall deny or discontinue when the client has moved out of state.

a. Discontinuation shall be effective the day after the date of the move.

b. Clients who leave the State on a temporary basis with the intent to return to Colorado within thirty (30) calendar days shall not be discontinued. If the client fails to return to Colorado the client shall be discontinued on day thirty one (31).

9. Voluntary Withdrawal from the Program: The CMA or county shall deny or discontinue when the client requests withdrawal from the HCA program.

10. Death: The CMA or county shall discontinue the HCA program effective the day after the client's date of death. No notice of discontinuation shall be sent.

D. The CMA shall complete the following procedures to transfer an HCA client to a new county department:

1. The CMA shall notify the county department of the client's plans to relocate to another county and the date of transfer.

2. If the client's current service providers do not provide services in the area where the client is relocating, the CMA shall make arrangements, in consultation with the client, for new service providers.

E. The CMA shall complete the following procedures to transfer an HCA client to a new CMA SEP:

1. The transferring CMA shall contact the receiving CMA by telephone or email to give notification that the client is planning to transfer, to negotiate a transfer date, and to provide information.

2. The transferring CMA shall forward copies of the client's case records, including forms required for the HCA program, to the receiving CMA prior to the relocation, if possible, but in no case later than five (5) working days after the client's relocation.

3. The receiving CMA shall complete an in-person meeting with the client and an assessment and case summary update within ten (10) working days after notification of the client's relocation.

4. The receiving CMA shall review the care plan and the assessment tool, revise as necessary, and coordinate services and providers.

3.570.18 COUNTY DEPARTMENT AND CASE MANAGEMENT AGENCY (CMA)

REQUIREMENTS AND RESPONSIBILITIES

A. The county department shall:

1. Ensure all requirements of the county department are implemented, as appropriate for the HCA program, related to:

a. General requirements, as outlined in Section 3.520; and, b. Old Age Pension, as outlined in Section 3.530; and, c. Aid to the Needy Disabled State Only and Colorado Supplement, as outlined in Section 3.540 and 3.546; and, d. Financial redetermination, as outlined in Section 3.550.

2. Determine financial eligibility for HCA in the statewide automated system and update any changes in the case record.

3. Notify the CMA in writing:

a. Within five (5) working days of determining HCA eligibility.

b. Within five (5) working days after the eligibility worker determines that the client is no longer financially eligible for HCA.

c. Within one (1) working day when the client has filed a written appeal with the county department.

d. Within one (1) working day when the client has withdrawn the appeal or a final agency decision has been entered.

4. Respond to requests for information from the CMA within ten (10) working days.

B. The CMA shall:

1. Provide intake, screening, and referral activities, as follows:

a. Determine the appropriateness of a referral for a client assessment.

1) If appropriate, complete intake activities within two (2) working days of the referral.

2) Obtain the client's or client's authorized representative's signature on the intake form.

3) Complete the HCA functional assessment within thirty (30) calendar days of referral.

b. Provide the client information and referral to other agencies, as needed.

2. Identify potential payment source(s), including the availability of private funding:

a. Refer the client to the county department to complete an application; or, b. Refer the client to another community resource that can assist in completing the application; or, c. Verify the client's ability to private pay for services.

3. Complete a functional assessment when the county department provides written notification that the client has requested HCA and is receiving or has submitted an application for Old Age Pension (OAP), Aid to the Needy Disabled Colorado Supplement (AND-CS), Aid to the Needy Disabled State Only (AND-SO), or the client is receiving Supplemental Security Income (SSI).

a. If the client is being discharged from a hospital or nursing facility, the CMA shall complete the functional assessment regardless of whether an application date for State assistance or Medicaid has been provided by the county department.

b. The CMA shall complete the functional assessment within two (2) working days after notification when a client is being transferred from a hospital to the HCA program.

c. The CMA shall complete the functional assessment within five (5) working days after notification when a client is being transferred from a nursing facility to the HCA program.

d. The CMA shall complete the functional assessment within ten (10) working days after notification for all other clients. However, the CMA shall have a procedure for prioritizing urgent referrals.

4. Document all case information.

a. Documentation of contacts and case management activities shall be entered into the State prescribed system within five (5) working days of the contact or activity.

b. All information related to intake, assessment, and care planning shall be thoroughly documented within ten (10) working days of the intake, assessment or care planning using State Department prescribed forms and the State prescribed system.

c. Additional documentation that cannot be entered into the State prescribed system shall be maintained in the case file.

5. Notify clients of their program status using the State Department prescribed form at the time of initial eligibility, when there is a significant change in the client's payment or services, when an adverse action is taken, or at the time of discontinuation.

6. Notify the county department in writing:

a. Within five (5) working days of determining HCA functional eligibility.

b. Within five (5) working days after the CMA determines that the client is no longer functionally eligible for HCA.

c. Within one (1) working day when the client has filed a written appeal with the CMA.

d. Within one (1) working day when the client has withdrawn the appeal or a final agency decision has been entered.

7. Respond to requests for information from the county department within ten (10) working days.

8. Notify the client, at the time of his or her application and at the time of reassessment or discontinuation of the right to request a state level fair hearing before an Administrative Law Judge as outlined in Section 3.587, and to appeal adverse actions of the CMA or county department.

9. Inform the client's Adult Protective Services caseworker, if applicable, of the client's status. The case manager shall participate in mutual staffing of the client's case.

10. Immediately report to the Colorado Department of Public Health and Environment any congregate facility, with three (3) or more residents, that is not licensed.

11. Immediately report to the county department any information that indicates an overpayment, incorrect payment, or misuse of any HCA benefit, and shall cooperate with the county department in any subsequent recovery process.

12. Be subject to routine quality control, program monitoring, and contract management to minimally include:

a. Targeted review of the State prescribed system documentation;

b. Case file review;

c. Targeted program review conducted via phone, email, or survey;

d. Onsite program review;

e. A performance improvement plan to correct areas of identified noncompliance; and, f. Contract sanctions when the CMA fails to implement a performance improvement plan.

3.570.4 BURIAL ASSISTANCE PROGRAM

3.570.41 PURPOSE OF PROGRAM

Burial benefits are available to eligible clients to cover reasonable and necessary costs for burial services.

3.570.42 DEFINITIONS

“Burial benefit” means the State Department program to pay all or a portion of the cost of funeral, burial, or cremation services for certain deceased clients.

“Burial funds” means the funds authorized by the county department under the burial benefit.

“Burial plot” means the client's final resting place, whether a cemetery plot, vault, or crematorium niche.

“Burial services” means those services provided as part of funeral, burial, or cremation services, including:

A. Transportation of the body from the place of death to a funeral home or other storage facility, and/or from the funeral home to the funeral/memorial site, and/or to the burial plot;

B. Storage of the body prior to final disposition and/or storage of the cremated remains for no more than one hundred twenty (120) days, in those cases where the remains are not buried and are not claimed by the client's family or friends;

C. Embalming, where necessary for preservation of the body and/or preparation of the body for the casket or for cremation;

D. Purchase of a casket or of an urn or other receptacle for the cremated remains;

E. Purchase of a gravesite, vault, vault liner, or crematorium niche;

F. Purchase and placement of the grave marker and/or of perpetual care of the gravesite, vault, or crematorium niche;

G. Funeral or memorial service;

H. Cremation of the body;

I. Burial or internment of the body or cremated remains in a burial plot, vault, or crematorium niche;

J. Any other items that are incidental to burial services.

“Contributions” means any monetary payment or donation made directly to the service provider(s) by a non-responsible person to defray the expenses of a deceased public assistance or medical assistance recipient’s funeral, cremation, or burial, or any combination thereof.

“Legally responsible person(s)” means a person who is the decedent’s spouse or the decedent’s parent if the decedent is an unemancipated minor who is under the age of eighteen; and bears legal responsibility for the charges associated with the decedent’s funeral, cremation, or burial expenses.

“Nonresponsible person” means one of the following who makes a contribution to the charges for burial services:

A. A relative of the decedent who is not a legally responsible person; or, B. Any other person or party.

3.570.43 ELIGIBILITY AND DETERMINATION FOR BURIAL ASSISTANCE

A. A burial benefit shall be available to cover all or part of reasonable and necessary costs for burial services when:

1. A deceased client was receiving Old Age Pension (OAP), Aid to the Needy Disabled (AND-SO OR AND-CS), Home Care Allowance, and/or Colorado Medicaid assistance at the time of death; and, 2. The deceased client's estate is insufficient to pay all or part of the burial services; and, 3. The resources of the legally responsible person(s) for the support of the deceased client are insufficient, even with contributions from the client's estate, to enable the legally responsible person(s) to pay all or part of such expenses; and, 4. The total cost for all burial services does not total more than two thousand five hundred dollars ($2,500), except that the cost of a burial plot shall not be included in the $2,500 maximum cost limit when:

a. The client has a prepaid burial plot valued at two thousand dollars ($2,000) or less at the time of purchase; or, b. A burial plot was purchased by someone other than the deceased client and donated to the deceased client; and, B. The total burial benefit shall not exceed the current burial benefit rate.

1. Effective March 1, 2020, the burial benefit shall not exceed one thousand five hundred dollars ($1,500).

2. The reimbursement rate shall be adjusted by the State Department as needed to stay within the available appropriations. There shall be no appeal granted for this adjustment.

C. When assistance for funeral, burial, or cremation services is requested within thirty (30) days from the date of death on behalf of a deceased client as described in Section 3.570.43.A, by any interested party; an application requesting a burial benefit shall be completed and submitted to the county department for eligibility determination. Requests made after 30 days shall be evaluated by the county department and an extension may be given if good cause exists, not to exceed one (1) year from the date of death. Good cause shall exist for any application filed within one year of the date of death of the client, if the client’s date of death preceded the effective date of this rule. The client's family or friends, or the county department when there are no known family or friends, shall make arrangements for disposition of the client's body in a reasonable, dignified manner which approximates the wishes and the religious and cultural preferences of the client or family, to the extent possible within the burial benefit rules and burial grant payment funds.

1. The county department shall ensure that a choice of disposition by the client is made in writing. The choice of disposition may be made on the client's most recent application for benefits, in the client's will, or by any other document which the county department deems credible. If there are conflicting documents expressing the client’s choice of disposition, the county department shall utilize the most recent document containing the client’s choice. If the client has not expressed a choice of disposition, the client’s disposition shall be determined respectively by the client’s spouse, adult children, parents, or siblings.

2. The county department shall coordinate with the client's family or interested parties to explain the burial benefit rules, including:

a. Options in the event the client's or family's burial preferences cannot be met within the limitations of the burial rules or burial grant payment maximum; and, b. If the family's burial preference is in opposition to the client's preference, as noted on the client's most recent application for benefits or other documentation, the burial grant payment shall be used to meet the client's preference, unless all options for meeting that preference have been exhausted within the limitations of the burial grant payment; and, c. The legally responsible person's responsibility to pay the cost of burial services that exceed the approved burial grant payment; and, d. That voluntary contributions from family, friends, or other interested parties, may be used to cover some or all of the legally responsible person's costs that exceed the approved burial grant payment up to the maximum cost limit.

3. The county department shall use the following procedures when the deceased client's burial preferences are unknown and a family member cannot be located:

a. If a family member has not been located within twenty-four hours after the client dies, the county department shall have the body refrigerated or embalmed.

b. If a family member has not been located within seven (7) days, the county department shall make the determination to bury or cremate the body based on the best option available.

c. The county department shall complete and send written authorization to the appropriate funeral home or crematorium.

D. The county department shall reduce the burial grant payment by applying the following monies toward the full burial costs in the order listed:

1. First, subtract monies due from any insurance policy of the deceased client to a legally responsible person or any other person who makes a contribution to burial services and is named as beneficiary or a joint beneficiary; then if costs remain, 2. Subtract the value of the deceased client's estate as of the date of death that are available, including any cash or property of any kind which the deceased client owned or proportionate share of resources held in joint ownership at the time of death; then if costs remain, 3. Subtract monies from the legally responsible person(s) for the client, as follows:

a. Social Security lump sum death benefits payable to a legally responsible person shall be exempt.

b. If the legally responsible person(s) has resources below the SSI resource limit of $2,000 for an individual or $3,000 for a couple any resources would not be used to reduce the burial grant payment.

These limits are consistent with the provisions of Federal Regulations found at 20 CFR 416.1205 (2019), which are herein amendments or editions. These regulations are available for no cost at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Director of the Employment and Benefits Division, 1575 Sherman Street, Denver, Colorado, 80203, or at any State publications library during regular business hours.

1) If the legally responsible person is the widow(er), the individual resource limit shall apply.

2) The legally responsible person(s) may voluntarily contribute monies toward the cost of the burial services.

c. If the legally responsible person(s) has resources over the SSI limit, the amount of resources over the limit shall be used to reduce the burial grant payment; then if costs remain, 4. The county department shall issue a written authorization for the amount of the burial grant payment, up to the burial grant payment limit, as set forth in Section 3.570.43.B.1.

E. Once the application and choice of burial services is determined, the family or county department shall contact the appropriate provider(s) to obtain a written estimate of the provider's proposed charges for burial services. If more than one provider is involved, a separate written estimate from each provider shall be obtained.

F. Once the proposal(s) from the provider(s) is received, the county department shall determine if a burial grant payment is appropriate.

1. If the combined charges from the provider(s) exceed two thousand five hundred dollars ($2,500), no burial grant payment shall be paid.

2. The county department shall allow the provider(s) to resubmit a written estimate within ten (10) calendar days of notification that the charges exceeded the burial grant payment maximum.

G. All payments from a decedent's estate, payments from legally responsible persons, and contributions from any other person persons who make a contribution to burial services shall be paid directly to the provider(s) of services.

After the provision of all services, the providers shall bill the county department directly for reimbursement for appropriate costs that have not been covered by the resources from or contributions made by the decedent's estate, legally responsible persons, or any other person persons who make a contribution to burial services. The county department shall reimburse the appropriate providers directly, based upon the statement of agreement.

H. The county department of residence of the deceased client shall authorize the approved burial grant payment through the statewide automated system. The burial grant payment shall be paid directly to the provider(s). The burial application must be processed as soon as possible but no later than thirty (30) days from submission.

I. The county department shall have a statement of agreement between the providers, which ensures that the distribution of burial grant payment is proportional to burial services provided or as the providers otherwise determine.

The agreement shall be signed by all provider(s) and shall be approved and signed by the county department before the burial grant payment is authorized in the statewide automated system.

J. The county department will seek recovery of resources if:

1. The resource was reported to the funeral director after the deadline date, and the funeral director does not collect from them.

2. The resource becomes available only after the county department has paid for burial services. 3.570.5 SUPPORTIVE PAYMENTS (Effective 7/1/2022)

3.570.51 PURPOSE

A. The purpose of the disaster assistance payment is to provide disaster assistance to eligible clients to mitigate needs and/or expenses due to a county, Governor, or federally declared disaster. The payment shall not exceed two thousand dollars ($2,000) per client, per disaster.

B. The disaster assistance payment period begins when :

1. A county, and/or;

2. Governor, and/or;

3. Federal government declares a disaster.

C. The disaster assistance payment period ends when there is no longer:

1. A county, and/or;

2. Governor, and/or;

3. Federally declared disaster.

D. In cases where the effects of the disaster appear after the disaster declaration has been rescinded, the client may petition for disaster assistance which may be granted at the county director’s or director designee’s discretion.

3.570.52 ELIGIBILITY

In order to be eligible for disaster assistance, the client must:

A. Be approved for or receiving a grant payment during the time of the county, Governor, or federally declared disaster.

B. Have an emergent need related to the disaster that could include, but is not limited to: a threat to health or safety, lack of food, clothing, shelter, transportation, personal care or medical care, or other unmet expenses.

C. Request disaster assistance either verbally or in writing to the county department. Counties have the option to utilize a state prescribed form for a disaster assistance request.

D. Nothing precludes the county from making additional payments to the client for the disaster through a general assistance program or other resources. This payment shall also not preclude an individual from accessing additional resources that are unrelated to the disaster.

3.750.53 COUNTY DEPARTMENT RESPONSIBILITIES

When the county receives the disaster assistance request they shall:

A. Review the disaster assistance request and determine what the client may potentially be eligible for based on the request.

B. Only request verification related to the client’s request for disaster assistance if the county considers the request questionable.

C. Assess the client’s needs related to the disaster assistance request and make additional referrals to the client and inform them of other potential assistance that may be available.

D. Not request documentation to verify how the client has used their disaster assistance payment.

E. Make a determination of eligibility for disaster assistance the same day as the determination of eligibility for adult financial grant payment if the client is pending for adult financial assistance at the time of the request for disaster assistance.

F. Make a determination of disaster assistance eligibility within five business days if already active on adult financial assistance.

G. Notify the client of approval or denial of disaster assistance in writing through the statewide automated system.

3.580 PAYMENTS, OVERPAYMENTS, INTENTIONAL PROGRAM VIOLATIONS,

FRAUDULENT ACTS, RECOVERY, DISPUTE RESOLUTION, APPEAL, AND STATE

LEVEL FAIR HEARING

3.581 PAYMENTS

A. A client shall be placed on an issuance schedule so that he or she receives grant payments on or about the same date each month once a certification period is established. Due to the effective date of eligibility, the date on which a client receives his or her initial payment need not be the date that the client must receive any subsequent payments.

B. When the county department determines that a client was ineligible for all or a

part of a grant payment that the client has already received, the county department shall, subject to timely notice and recovery rules, establish a claim, and if valid, initiate a recovery.

C. If a client dies, payments to the client shall be treated as follows:

1. A client’s eligibility shall end on the date of his or her death.

2. If a client of any category of assistance dies before 12:00 a.m. on the first day of a month, no eligibility for a grant payment for the following month exists.

3. If a client of any category of assistance dies on or after 12:00 a.m. on the first day of a month, any payment to which the person was eligible shall be maintained for release to the client's personal representative as defined in

Section 15-10-201(39), C.R.S., for a maximum of three (3) months. The following rules apply when a personal representative requests to receive a deceased client’s last grant payment:

a. The individual claiming to be the personal representative of the deceased client must provide the court-issued letters described in

Section 15-12-103, C.R.S. to the county department in order to receive the deceased client’s last grant payment; or b. If the personal representative presents a court order ordering the county department to pay the deceased client’s last grant payment to a specific person or entity, the county department shall make the last grant payment payable to the person named in the order.

D. To calculate partial month payments:

1. Determine the client’s monthly grant payment amount for the program according to program rules at 3.520.78, 3.533, 3.544, and 3.549;

2. Determine the number of days for which the client is eligible for assistance and, based on the table in subsection 4 below, find the decimal figure corresponding to the number of days of eligibility;

3. Multiply the client’s monthly grant payment amount from subsection 1 by the decimal figure in the table in subsection 4 to determine the grant payment amount for the partial month;

4. To calculate the partial month payments, the following table shall be used:

Days Standard Days Standard Days Standard 1 .03288 11 .36164 21 .69041 2 .06575 12 .39452 22 .72329 3 .09863 13 .42739 23 .75617 4 .13151 14 .46027 24 .78904 5 .16439 15 .49315 25 .82192 6 .19726 16 .52603 26 .85480 7 .23014 17 .55890 27 .88768 8 .26302 18 .59178 28 .92054 9 .29590 19 .62466 29 .95342 10 .32876 20 .65754 30 .98630 E. All payments, including partial payments, shall have any cents dropped to the nearest dollar, except in cases where SSI income reduces the grant.

F. County departments shall not hold or delay the client’s grant payment beyond the regular issuance date except when:

1. A final agency decision has been made authorizing the action;

2. In cases where a corrected payment is to be issued, the corrected payment shall be issued by the effective date of the original warrant and the incorrect payment shall be cancelled;

3. When the county department receives reliable information that the client no longer resides at the last known address and attempts to locate the person through the post office, relatives, friends, etc., have been unsuccessful, the case shall be discontinued following the policies outlined in Section 3.554. If the client contacts the county department before grant payments are discontinued and provides the current address and all other eligibility criterion have been met, the client shall receive the grant payments they are eligible for; OR 4. Any grant payments issued to an Electronic Benefit Transfer (EBT) card and not accessed within TWO HUNDRED SEVENTY-FOUR (274) days of issuance, shall be expunged. The county shall reissue grant payments within NINETY (90) days of the expungement if requested by the client verbally, electronically, in person, or in writing. The county may reissue up to NINE (9) months of expunged grant payments.

G. The county department shall take prompt action to correct underpayments to clients of Adult Financial grant payments. There are two types of underpayments:

1) grant payment(s) received by or for a client that is less than the amount which the client should have received, but not a denial or termination, or 2) the failure of the county department to issue a grant payment to a client when such payment should have been issued (i.e., denials or termination of Adult Financial grant payments).

1. When the county department becomes aware of a potential underpayment, the county department shall:

a. Determine if an underpayment occurred; and, b. Record the facts and basis of its determination in the case record.

2. A county shall correct any underpayments by the month following the discovery of such underpayments.

3. Underpayments shall be used to pay any validated claims against the client unless the county department has determined this action will cause an undue hardship to the client as determined on a case-by-case basis.

Underpayments will be applied to claims using the following hierarchy:

a. Fraud or IPV claims first (undue hardship cannot be granted);

b. Client error claims second; and c. Administrative error claims last. Instances that may result in an administrative error claim include, but are not limited to, the 1) The county failed to take timely action on a change reported by the client.

2) The county incorrectly computed the client’s income, resources, or other information, or otherwise gave an incorrect grant payment.

3) Any other situation not caused by willful withholding of information on the part of the client and/or their authorized representative.

4. If an underpayment is discovered by the county department, the county department shall notify the client in writing, of its determination of the underpayment.

5. Prompt action shall be taken to correct underpayments that occurred within the past twelve (12) months from the discovery date by issuing a retroactive payment. Retroactive payments shall not be made unless the amount is one dollar ($1.00) or more.

H. The county department shall reissue a lost or stolen payment if the loss or theft is not questionable and the county determines that such loss was beyond the client's control.

A loss will be considered within the client’s control when:

1. The client has shared the EBT pin number or written the pin number on the EBT card itself, or 2. The client has given his or her card to another person for that person’s use.

I. A client is prohibited from using or allowing the use of his or her EBT card at automated teller machines (ATMs) and point of sale (POS) devices located in prohibited establishments as described in Section 3.520.4.C.4.f.

A client’s EBT transactions shall be monitored quarterly. Clients who use prohibited ATMs or POS devices shall be contacted by the county department.

Inappropriate usage shall result in:

1. A written warning that the use of the EBT card in prohibited establishments will result in the card being disabled. The county department shall provide education about appropriate use, access, and alternatives;

2. If continued misuse occurs (identified on the quarterly usage report after a warning has occurred), the cash grant payment portion of his or her EBT card shall be disabled for one month, requiring the county to notify the client of additional options for receipt of payment (direct deposit or county warrant) as well as notification of due process in accordance with State rules pursuant to Sections 3.520.1.H-I and 3.554.

3. If misuse continues, the county department shall deny or discontinue the grant payments and impose a one month ineligibility period. The county shall require the client to complete a new application after the one month ineligibility period if he or she wants to receive Adult Financial assistance.

The county department shall not accept a new application from the client until the one month ineligibility period expires. The county department shall follow the due process procedures pursuant to Sections 3.520.1.H-I and 3.554; and, 4. After the one month ineligibility period for continued misuse, if/when the client reapplies, any future EBT card usage at prohibited establishments shall be considered continued misuse. Such subsequent violations will result in the one month ineligibility period and reapplication process referred to in subsection 3, above.

3.582 OVERPAYMENTS

The county department shall establish a claim on an overpayment before the last day of the quarter following the quarter in which the overpayment was discovered.

A. An overpayment shall be adjusted if there is a record of any underpayment(s) for a prior period. The hierarchy of such adjustments shall be:

1. Fraud or IPV claims first, 2. Client error claims second; and, 3. Administrative error claims last.

B. Liability for an overpayment must be legally established. Methods for legally establishing an overpayment include but are not limited to:

1. An executed promissory note;

2. A court judgment;

3. A final agency action;

4. A signed public assistance repayment agreement form.

C. Failure to sign the public assistance repayment agreement form shall be handled as follows:

1. If the client against whom a collection action has been initiated is currently participating in any Adult Financial program and does not respond to the public assistance repayment agreement form within eleven (11) calendar days of the date the notice is mailed, grant payment reduction shall begin with the first month following the timely noticing period without further notice as described in Section 3.585.A.2.

2. If the client against whom a collection action has been initiated is not participating in the program when a collection action for a claim is initiated or if a collection action has been initiated for repayment of a claim and no response is made to the public assistance repayment agreement form within eleven (11) calendar days of the date the notice is mailed, the county department shall pursue all legal recovery methods as described in

Section 3.585 in order to recover the overpayment. Legal remedies include, but are not limited to, judgments, garnishments, claims on estates and the State income tax refund intercept process.

D. The amount of the overpayments involving income shall be calculated to allow for income disregards described in Sections 3.533, 3.544, and 3.549 based on the Adult Financial program from which the client received grant payments.

E. Computation of the overpayment for Adult Financial grant payments is based on the amount received that a client was originally eligible to receive. All earned and unearned income received by the client and any resources are taken into consideration in the computation.

In the instances where the overpayment is the direct result of actions tied to the determination of IPV and/or fraud, which resulted in receipt of grant payments in error, or grant payments received that the client was not eligible to receive, the overpaid grant payments shall be recovered from the client and/or a liable individual pursuant to the requirements of 3.583.

F. The calculation of overpayment shall begin in the month that the overpayment occurred.

1. Start with the amount issued to the client;

2. Determine the correct payment according to program rules at Sections 3.520.78, 3.533, 3.544, 3.549, and 3.581.D.

3. Compare the amount issued to the client to the correct payment amount.

a. If the amount issued to the client is greater than the correct payment amount, the difference is the overpayment amount.

b. If the amount issued to the client is less than the correct payment amount, the difference is the underpayment amount, as addressed in Section 3.581.G.

4. If the client is over the resource limit in any month, the client is totally ineligible for that month. Any payment received in such month(s) is an 5. If a client does not meet the non-financial eligibility requirements in any month, the client is totally ineligibile for the month. Any payment received in such month(s) is an overpayment.

G. When the county department has determined that a client has received an overpayment, the department shall:

1. Take action to research the overpayment and determine the amount of the 2. Determine if the overpayment is to be recovered as described in Section 3.585.

3. Document the facts and situation that produced the overpayment.

Document whether the overpayment is to be recovered. Retain all associated documentation and notices until the overpayment is repaid in full.

4. Determine whether there was willful withholding of information, fraud, or IPV as described in Sections 3.583 and 3.584.

5. Provide the client with timely or adequate notice as required by Section 3.554 of the amount due and the reason for the recovery including:

a. The liable individual(s) responsible for the repayment;

b. The amount of the claim;

c. The period the claim is for;

d. The reason for the overpayment including whether the overpayment is a result of fraud/IPV, client error, or administrative error;

e. The client’s rights and responsibilities;

f. The method of repayment;

g. How to obtain free legal assistance; and h. The applicable rules concerning the overpayment.

6. Send quarterly statements with the balance due.

3.583 ADULT FINANCIAL INTENTIONAL PROGRAM VIOLATIONS (IPV)

A. All clients must be provided with their rights in relation to IPV as follows:

1. The client has the right to an administrative disqualification hearing (ADH) before an administrative law judge (ALJ).

2. The county department may offer an ADH at the county. This does not preclude the client from requesting the ADH be held before an ALJ.

3. A client may waive the right to an ADH, either before an ALJ or with the county department by signing a waiver of ADH form. Clients have a right to look at all the evidence that would be used at an ADH before deciding whether to waive the right to an ADH.

4. If a client chooses to appear at the ADH he or she will be afforded the right to represent him or herself or to be represented by an attorney at his or her expense.

5. The client may choose to be represented by any other person he or she chooses pursuant to Section 26-2-127(1)(a)(IV), C.R.S..

6. A client and/or his or her representative, upon providing a signed release, may look at his or her case file, including all the evidence that will be used at the ADH. The client and/or his or her representative has the right to look at his or her case file before and during the ADH.

7. The county department shall provide a free copy of the evidence to be utilized during the ADH to the client at least fifteen (15) days prior to an ADH heard by the county. Upon request, the county department will provide a free copy of any other parts of the case file that the client determines is needed at the ADH.

8. A client may bring witnesses to speak on his or her behalf at the ADH.

9. The client and/or his or her representative has the right to question or deny any evidence or statements made against him or her at the ADH.

This includes the right to ask questions of persons testifying against him or her.

10. The client has the right to present any evidence that he or she feels is important to prove his or her case.

B. All clients for Adult Financial programs must be provided with a written notice of the penalties for an IPV on the Adult Financial application form. All Adult Financial clients shall be notified of the penalties for an IPV when reporting changes on the redetermination form.

C. A county department is required to refer the investigation to the appropriate investigatory agency for any client or representative payee whenever there is an allegation or reason to believe that individual has committed an IPV as described below.

When conducting an interview for IPV and/or fraud, the county department investigator or representative has the responsibility to ensure the following:

1. That an explanation was given to the individual regarding the reason the interview is taking place; and, 2. That the individual’s rights have been provided to him or her (Section 3.520.1.I); and, 3. That the individual’s rights and responsibilities including confidentiality of records and information, the right to non-discrimination provisions, the right to a county conference, and the right to a state level fair hearing have been provided to him or her; and, 4. That the rights and responsibilities presented in the “What I Should Know”

section of the application that the client acknowledged when he or she signed the application form have not been violated; and, 5. That the county and/or representative of the county shall not threaten the individual or engage in any other intimidation tactics toward the client.

D. If the county receives questionable information that is necessary for determining a client’s eligibility and the verification requested by the county department is not supplied by the client as required by the county department’s verification request timeframes, grant payments may be reduced and/or the case closed and grant payments terminated for a client’s failure to prove eligibility following the policies outlined in Section 3.554. These actions and notification shall not be used as an intimidation tactic or threat.

E. Following an investigation, action must be taken on cases where documented evidence exists to show a client has committed one or more acts of IPV. Action must be taken through:

1. Obtaining a “Waiver of Administrative Disqualification Hearing”; or, 2. An administrative disqualification hearing; or, 3. Referral for civil or criminal action in a county or district court; or, 4. Documenting in the case file the county department’s decision to take no action to pursue IPV using documented evidence to support the decision.

The county department shall establish a claim if appropriate.

F. In proceeding against such a client, the county department must coordinate any action with actions taken under the Food Assistance program where the factual issues are the same or related.

G. Overpayment actions shall be initiated within ten (10) calendar days of the investigation’s conclusion, unless otherwise specified in the case file. This is required in all cases even if ADH procedures or referral for prosecution is not initiated, except in instances where notification of overpayments may prejudice the ongoing criminal case or investigation. In these instances, the county department may make the determination to postpone notification of claims to the client if the overpayment is being referred to a court of appropriate jurisdiction.

The determination to postpone notification must be clearly documented in the case file.

H. The State Department will not condone any actions of the county department that could be determined to be a violation of State or Federal law. Any actions taken by a county department that is determined to be in violation of State or Federal law may be subject to corrective action per 9 C.C.R. 2501-1 Section 1.150 et seq.

I. These rules apply to all clients who commit an IPV who are recipients or representative payees of grant payments and/or services. The determination of IPV shall be based on clear and convincing evidence that demonstrates intent to commit IPV.

J. Supporting evidence warranting the pursuit of an IPV disqualification must be documented with a supervisory review. If the county department determines there is evidence to substantiate that a person has committed an IPV, the person has a right to an ADH. However, the county department shall allow that person the opportunity to waive the right to an ADH.

1. The State approved IPV forms shall be provided to the individual suspected of an IPV. These may be offered to the individual during the investigation or mailed once it has been suspected an IPV has occurred, but there is no plan to pursue criminal charges.

2. One of the State approved forms affords the individual the right to waive the ADH. If the individual chooses to waive his or her right to an ADH, the individual shall have fifteen (15) calendar days from the date the IPV forms are provided by the county to return the waiver. If the form is not returned, the county department shall pursue an ADH.

3. The completion of the waiver is voluntary and the county department may not require, nor by its actions appear to require, the completion of the waiver.

K. An IPV ADH must be requested whenever:

1. The facts of the case do not warrant civil or criminal prosecution;

2. Documentary evidence exists to show an individual has committed one or more acts of IPV; and 3. The individual has failed to sign and return the waiver of ADH form.

L. An ADH may be requested against an accused individual whose case is currently being referred for prosecution on a civil or criminal action in county or district court.

M. A county department may conduct an ADH or may use the Office of Administrative Courts (OAC) to conduct the ADH.

1. The individual may request verbally, in writing, electronically, or in person that the OAC conduct the ADH in lieu of a county ADH. Such an ADH must be requested ten (10) calendar days before the scheduled date of the county ADH.

2. The OAC or the county department must mail by certified mail, return receipt requested, a notice of the date of the ADH on the form prescribed by the State Department, to the individual alleged to have committed an IPV. The notice must be mailed at least thirty (30) calendar days prior to the ADH date, to the individual’s last known address. The notice form shall include a statement that the individual may waive the right to appear at an ADH.

3. The ALJ or ADH officer shall not enter a default judgment against the individual for failure to file a written answer to the notice of hearing or failure to appear at the ADH, but shall base the initial decision upon the evidence introduced at the ADH.

4. The ADH must be continued at the accused individual's request if good cause is shown. The request for continuance must be received by the presiding ALJ or ADH officer at least ten (10) calendar days prior to the ADH.

The ADH shall not be continued for more than a total of thirty (30) calendar days from the original ADH date. One additional continuance is permitted at the ADH officer or ALJ’s discretion. If the ADH officer or ALJ considers it necessary, a medical assessment may be ordered to substantiate or disprove a good cause statement of an accused individual. Such assessment shall be obtained at the agency’s expense and made part of the record.

N. Disqualification for IPV shall be as follows:

1. If the individual signs and returns the request for waiver of ADH within fifteen (15) calendar days from the date the waiver is sent, that person shall be provided with a notice of the period of disqualification.

2. The disqualification period shall begin no later than the first day of the following month from the date determined through the ADH process or, if the individual signed an ADH waiver, the date he or she signed the waiver.

a. Once the disqualification is imposed it shall continue without interruption. To consider a disqualification period served, the client shall have a break in grant payments totaling the time period of the disqualification. The disqualification period shall remain in effect unless and until the finding is reversed by the Office of Appeals or a court of appropriate jurisdiction or until the period of disqualification is served per Section c below.

b. The disqualification may be in addition to any other penalties which may be imposed by a court of law for the same offenses (i.e. criminal or civil sanctions).

c. The disqualification shall be in effect for twelve (12) months upon the first occasion of any such offense; twenty-four (24) months upon the second occasion of any such offense and permanently upon the third such offense. All disqualifications imposed shall run and be served consecutively.

3. The disqualification penalizes only the individual(s) found to have committed an IPV. If a client’s spouse and/or sponsor(s) have received an IPV on his or her own case(s), the spouse’s and/or sponsor(s)’ income and resources, when applicable, will be considered available to the client and used for determining eligibility.

4. An IPV disqualification in one county is valid and effective in all other Colorado counties. A county department shall consider a disqualification imposed by another county department when determining the appropriate disqualification penalty for the disqualified individual without an additional ADH or further right to appeal.

O. If, as a result of the ADH, the county ADH officer or ALJ finds the individual has committed an IPV, a written notice shall be provided to notify the individual of the decision. The county hearing decision notice shall be a State prescribed form, which includes a statement that a State ADH at the OAC may be requested.

1. In an ADH before an ALJ, the determination of IPV shall be an initial decision, which shall not be implemented while pending State Department review and a final agency decision. The initial decision shall advise the client that failure to file exceptions to findings of the initial decision will waive the right to seek judicial review of a final agency decision affirming the initial decision.

2. When an individual waives his or her right to an ADH, a written notice of the disqualification penalty shall be mailed to the individual. This notice shall be on a State prescribed notice form.

3. In the event that the ADH was heard by the county, the client may appeal the decision of the county ADH to the OAC. An appeal must be received by the county department or by the OAC within fifteen (15) calendar days of the date the county department mails the local ADH decision to the client. See Section 3.587 for rules regulating the appeal process.

4. A copy of the county ADH decision shall be forwarded to the State Department’s Division of Economic and Workforce Support for review at the same time the decision is mailed to the client.

3.584 FRAUDULENT ACT

A. When the county department or local service delivery agency determines that it has paid a client a grant payment as a result of a fraudulent act, the facts used in the determination shall be reviewed with the department’s legal counsel within the attorney general’s office and/or a representative from the district attorney’s office. If suspected fraud is substantiated by the available evidence, the case shall be referred to the district attorney. All referrals to the district attorney shall be made in writing and shall include the amount of assistance fraudulently received by the client.

B. If any deduction is being made from the client’s assistance payment it must be consistent with any court order resulting from a prosecution by the district attorney. If the individual being prosecuted is not an Adult Financial program client, another method of recovery shall be used to collect amounts due to the department.

1. Interest shall be charged from the month in which the overpayment was received until the date the overpayment is recovered. Interest shall be calculated at the legal rate.

2. The client may choose to repay the county department the entire amount of the overpayment at one time or establish a repayment plan. In either instance, the fraud charge should be discussed with the district attorney or appropriate investigative authority.

C. If the district attorney declines to prosecute, the amount of overpayment due, as established by the department, will continue to be recovered by deduction from subsequent grant payments or other method of recovery if the individual is not a client of Adult Financial grant payments.

3.585 RECOVERY

A. A county department must take action to research and determine if recovery should be initiated within ten (10) calendar days of discovering a client received an overpayment. The recovery of valid overpayments is required regardless of when the overpayment occurred except in situations as described in Section 3.585.H. Overpayments may be recovered from the client who was overpaid or who fraudulently received the assistance payment or another liable individual.

If a client is deceased, overpayments shall be recovered from the deceased client's estate.

B. The following rules do not apply in instances where the State or county department seeks recovery in a case that was transferred to the district attorney and prosecuted through the courts:

1. The client shall be notified of the recovery action to be taken, using the notice rules found at Section 3.554.C.;

2. When the overpayment is caused by an unintentional error, the client's willful withholding or an administrative error, such overpayment shall be deducted, after notice has been given pursuant to Section 3.554, from subsequent grant payments while the client is actively receiving Adult Financial grant payments.

a. The client may choose to repay the county department the entire amount of the overpayment at one time. The client shall work with the county department to determine how a lump sum repayment can be made.

b. When the recovery amount is not to be repaid in a single payment per subsection a above, and the case remains active, the county department shall establish a monthly recovery deduction from subsequent assistance payments. The monthly rate of recovery shall be ten dollars or ten percent of the assistance payment, whichever is higher.

The following procedure shall be used to arrive at the monthly recovery deduction amount:

1) If the error is a result of an agency error and the client does not meet criteria set forth in Section 3.585, compute ten percent (10%) of the Adult Financial grant payment amount.

If the resulting percentage amount is less than ten dollars ($10), the deduction from the grant payment amount shall be ten dollars ($10).

2) Deduct the percentage amount or ten dollars ($10), whichever is higher, from the grant payment. The result shall be rounded to the next lower whole dollar amount, if not already a whole dollar amount. This rounded amount is the final payment amount.

3) When the authorized payment amount is less than ten dollars ($10), the case is considered a “no payment” case and no deduction shall be made.

4) When the recovery is due to a fraudulent action on the part of the client and interest may be added thereto in accordance with Section 3.584.B.1., the interest amount shall not be included in the grant payment deduction unless the client agrees to such inclusion. If the client does not so agree, the interest amount shall be collected separately.

5) The amount of the grant payment deduction for recovery shall be recorded in the client's case file and collected via the statewide automated system.

c. The county department shall not establish a claim unless the amount of the claim is greater than $200, except in the following circumstances:

1) The overpayment is identified through a Federal or State level quality control review; or, 2) The claim is being pursued as and results in an IPV.

d. For OAP, AND-CS, and HCA, if a client is overpaid and the system determined benefit is below the payment floor of the respective program, a claim will not be generated.

3. When the overpayment is caused by the client’s willful withholding of information or an administrative error, and the Adult Financial case is no longer active, recovery of such overpayment shall be based upon the public assistance repayment agreement form or other methods of recovery.

a. The county shall establish a monthly repayment agreement with a former client. The repayment agreement shall not exceed twentyfive percent (25%) of available monthly income. Determination of the repayment amount must be clearly documented in the electronic case file.

b. The client may choose to repay the county department the entire amount of the overpayment at one time. The client shall work with the county department to determine how a lump sum repayment can be made.

c. The county department may write-off unpaid valid claims as follows:

1) Valid administrative error claims less than one hundred twenty-five dollars ($125.00) can be written off ninety (90) days after the termination of all public assistance.

2) Valid claims for client error, fraud, and IPV less than three hundred dollars ($300.00).

3) Any unpaid valid claim of $125 or more for an individual who was not convicted of an IPV or fraud specific to the overpayment, is no longer receiving public assistance, and the overpayment was established six (6) or more years ago, and the county department has determined that it is no longer cost effective to pursue collection.

d. If the client begins to receive Adult Financial grant payments again after the overpayment has been established and still has a claim balance, the deduction of grant payments shall occur as described in Section 3.585.B.2.

C. The client may issue the State a refund of any overpaid grant payments from his or her existing balance of Adult Financial grant payments on his or her Electronic Benefits Transfer (EBT) card by contacting the county department. This requires a written statement from the client.

D. Clients are not entitled to grant payments that were paid in error or mistakenly provided to the client based on a data entry error into the statewide automated system or an error resulting from the statewide automated system. The county shall create a claim and may retrieve the grant payments from the client’s EBT card within twenty-four (24) hours of the issuance without prior written authorization by the client. The client shall have no appeal rights in relation to this grant payment because he or she was not eligible for the initial receipt of the grant payment(s) in the first instance.

When grant payments issued in error are not retrieved from the client’s EBT card within twenty-four (24) hours, funds shall not be taken from the card using this method unless permission is granted from the client in writing using the State prescribed form. If permission is not granted, the county department shall pursue other methods of recovery as described in Section 3.585.

E. The client may request voluntary deductions be applied to the overpayment.

These are considered to be an amount in addition to the deduction from the grant payment as established through the recovery calculations in Section 3.585.B.

The client shall be provided written confirmation of the amount to be deducted and that he or she has the right to stop the voluntary deduction at any time by written request.

F. A claim may be filed against the estate of a client for overpayment. This includes cases where overpayments were made and not recovered. The county department's legal advisor must be consulted in determining the amount of assistance payments for which a claim is to be filed.

G. In accordance with Sections 26-2-133 and 39-21-108, C.R.S., the State and county departments may recover overpayments of public or medical assistance benefits through the offset (intercept) of a taxpayer's State income tax refund.

Tax refunds shall not be offset in instances where the taxpayer is making regular, ongoing payments as agreed to in the public assistance repayment agreement and/or based on arrangements between the taxpayer and the county(ies). Unless agreed to by the client, the county shall not offset tax refunds during the same month the client makes a payment on a claim if the payment agreement was established prior to the offset. Rent rebates are subject to the offset procedure.

The offset of the taxpayer State income tax refund and/or rent rebate may be used to recover overpayments that have been:

1. Determined by final agency action; or, 2. Ordered by a court as restitution; or, 3. Reduced to judgment.

H. Prior to certifying the taxpayer's name and other information to the Colorado Department of Revenue, the Colorado Department of Human Services shall notify the taxpayer, in writing at his or her last-known address, that the State intends to use the tax refund offset to recover the overpayment. In addition to the requirements of Section 26-2-133(2), C.R.S., the pre-offset notice shall include the name of the county department claiming the overpayment, the program that made the overpayment, and the current balance owed.

I. Effective August 1, 1991, the taxpayer is entitled to object to the offset by filing a request for a county conference or state level fair hearing within thirty (30) calendar days from the date that the State Department mails its pre-offset notice to the taxpayer. In all other respects, the procedures applicable to such hearings shall be those that are stated in Section 3.587. At the hearing on the offset, the county department or ALJ shall not consider whether an overpayment has occurred because overpayment has already been otherwise legally established, but may consider the following issues if raised by the taxpayer in his or her request for a hearing:

1. Whether the taxpayer was properly notified of the overpayment;

2. Whether the taxpayer is the person, who owes the overpayment;

3. Whether the amount of the overpayment has been paid or is incorrect;

4. Whether the debt created by the overpayment has been discharged through bankruptcy; or, 5. Whether other special circumstances exist including, but not limited to, the circumstances described in Section 3.585.H, (i.e., facts that show that the taxpayer was without fault in creating the overpayment and will incur financial hardship if the income tax refund is offset).

J. If an offset is established, an overpayment shall not be recovered using another method described in Section 3.585 in the month the offset occurs unless prior authorization is received from the individual making the recovery payments.

K. The county department is required to pursue collection of the overpayment from the client/responsible payee who managed and administered the Adult Financial funds. The county department shall pursue all available overpayment recovery options to collect the overpayment from the client/responsible payee first and then any other liable individuals legally responsible for overpayments, unless otherwise specified.

1. In instances where a trustee has used a client's trust income or property in a manner contrary to the terms of the trust:

a. Determine whether an overpayment of Adult Financial grant payments has occurred as a result of the client’s loss of income based on the trustee’s improper actions;

b. Consult with the county attorney or other legal resource to determine how to pursue action against a trust/trustee;

c. Advise the trustee of the overpayment circumstances; and d. If the trustee disagrees with such circumstances and overpayment, pursue the recovery establishment and collection through appropriate legal means; or e. Take appropriate steps to secure repayment with the cooperation of the trustee; or, f. Report such behavior or action by the trustee to the county Adult Protective Services to ensure the protection of the client’s rights in the trust.

2. In instances where a power of attorney has used his or her legal authority for purposes other than for the benefit of the client:

a. Determine whether an overpayment of Adult Financial grant payments has occurred as a result of the power of attorney’s improper actions;

b. Consult with the county attorney or other legal resource to determine how to pursue action against a power of attorney;

c. Advise the holder of the power of attorney of the overpayment circumstances; and, d. If the holder of the power of attorney disagrees with such circumstances and overpayment, pursue the recovery establishment and collection through appropriate legal means; or e. Take appropriate steps to secure repayment with the cooperation of the holder of the power of attorney; or f. Report such behavior or action by the trustee to the county Adult Protective Services to ensure the protection of the client’s rights and benefits.

L. In any case in which an overpayment has been made, there shall be no recovery from any person:

1. Who is without fault in the creation of the overpayment; and, 2. Who has reported any increase in income or other circumstances affecting the client's eligibility within the timely reporting requirements for the program; and, 3. If such recovery would deprive the person of income required for ordinary and necessary living expenses and would be against equity and good conscience. The fact that the client is receiving public assistance shall not be the only factor in making a determination that the person would be deprived of income required for ordinary and necessary living expenses and that equity and good conscience exist.

a. If a client has ten (10) percent or more of income remaining after necessary living expenses, he or she shall not be considered deprived of income.

b. If a client’s expenses exceed his or her income, additional questions must be asked to determine how he or she is meeting expenses to ascertain if other income (i.e. gift, in-kind) needs to be included in the income calculation.

M. When the overpayment recovery is not pursued, such fact, together with the reason, shall be documented in the statewide automated system. All information pertaining to the reason, establishment, and collection of claims shall be retained in the case record until the claim is written off or paid in full.

3.586 DISPUTE RESOLUTION

The dispute resolution process is available for disputes concerning county department actions related to eligibility, reduction of grant payment amounts, redetermination procedures, and other county actions that do not involve allegations of fraudulent acts or IPV on the part of the client. If there is a dispute regarding fraudulent actions or IPV, that dispute must be handled according to Sections 3.583 and 3.584 regarding IPVs and fraudulent acts.

In order to resolve disputes between county departments and/or the local service delivery agency and clients, county departments and local service delivery agencies shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple non-adversarial format for the informal resolution of disputes.

A. The county department or local service delivery agency, prior to taking action to deny, terminate, recover, initiate vendor payments or modify financial assistance provided under the Adult Financial program to a client, shall, at a minimum, provide the client an opportunity for a county conference.

1. The right of a client to a county conference is primarily to ensure that the proposed action is valid, to protect the client against an erroneous action concerning grant payments, and to ensure reasonable promptness of county action. The client may choose, however, to bypass the county conference and appeal directly to the State Office of Administrative Courts, pursuant to Section 3.587.

2. The client is entitled to:

a. Representation by an authorized representative retained at his or her own expense, such as legal counsel, relative, friend, or another spokesperson, or he or she may represent himself or herself;

b. Examine the contents of the case file and all documents and records used by the county department or agency in making its decision. Examination of the file is available at a reasonable time before the conference and during the conference. However, the file shall not include names of confidential informants, privileged communications between the county department and its attorney, or the nature and status of pending criminal prosecutions and any other information that is confidential or privileged; and c. Present new information or documentation to support reversal or modification of the proposed adverse action.

3. Failure of the client to request a county conference within ninety (90) calendar days from the date timely notice of the proposed action was mailed to the client without making a request for postponement within that same ninety (90) days, shall constitute abandonment of the right to a conference. The client does not lose the right to appeal directly to the OAC pursuant to Section 3.587.

4. Failure of the client to appear at the scheduled county conference without making a request for postponement prior to the scheduled date of the conference shall constitute abandonment of the right to a conference unless the client can show good cause for his or her failure to appear. The client does not lose the right to appeal directly to the OAC pursuant to B. The county conference shall be held before a person who was not directly involved in the initial determination of the action in question in the county department or agency where the proposed decision is pending. The county worker or contractor who initiated the action in dispute shall not conduct the county conference.

1. The person designated to conduct the conference shall be in a position which, based on knowledge, experience, and training, would enable him or her to determine if the proposed action is valid. This could include, but is not limited to, a supervisor, quality assurance personnel, or a manager with no previous knowledge of the case.

2. Two or more county departments/local service delivery agencies may schedule a joint county conference related to the same client. If two or more counties/local service delivery agencies schedule a joint county conference, the location of the conference need not be held in the county or agency taking the action, and the conference location shall be convenient to the client.

3. The county conference may be conducted either in person, by telephone, or video conference. A telephonic or video conference must be agreed to by the client.

4. The county/agency worker or other county or department employee or contractor shall attend the county conference and present the factual

basis for the disputed action.

5. The county conference shall be conducted on an informal basis. The county department/agency must provide specific reasons for the proposed action, and the applicable State Department's rules, or county policy. In the event the client does not speak English, an interpreter shall be provided by the county department/agency.

6. The county/agency shall have available at the conference all pertinent documents and records in the case file relevant to the specific action in dispute.

7. To the extent possible, the county conference shall be scheduled and conducted prior to grant payments being reduced or terminated.

8. The county department/local service agency shall provide notice to the client at least four (4) days prior to the scheduled time and location for the conference, or the time of the scheduled telephone or video conference.

Notice should be in writing. The client may provide a written or verbal waiver that written notice of the scheduled conference is not necessary when the county department is able to conduct the conference within four (4) days.

9. The county department may consolidate a client’s disputes regarding the Adult Financial program, the food assistance program, or any other public assistance program if the facts are similar and consolidation would facilitate resolution of all disputes.

10. The goal of the county conference is to reach an agreement between the client and the county department and/or the local service delivery agency.

C. At the conclusion of the conference, the person presiding shall summarize the discussion in writing. The summary shall include whether the issue was resolved and include the client’s appeal rights as described in Section 3.587.A. A copy of the written summary shall be provided to the client and/or his or her representative within eleven (11) calendar days. A copy of the summary will also be maintained in the client’s case file.

3.587 APPEAL AND STATE LEVEL FAIR HEARING

A. These rules apply to all state level fair hearings of county department actions concerning assistance payments and actions taken pursuant to State rules governing the Adult Financial program. An affected client who is dissatisfied with a county department or local service delivery agency action or the result of a county conference or failure to act concerning grant payments may appeal to the Office of Administrative Courts (OAC) for a state level fair hearing before an independent administrative law judge (ALJ). This will be a full evidentiary hearing of all relevant and pertinent facts to review the decision of the county department or local service delivery agency. The time limitations for submitting a request for an appeal are:

1. When the client elects to avail him or herself of a county conference, but is dissatisfied with that decision, the request must be submitted in writing and mailed or delivered as described in 3 below within the ninety (90) day period specified in 2, below;

2. When the client elects not to avail him or herself of a county conference but wishes to appeal directly to the state, a written request for an appeal must be mailed or delivered as described in 3 below no later than ninety (90) calendar days from the date timely notice of the proposed action was mailed to the person;

3. A request for an appeal must be mailed or delivered to the Office of Administrative Courts. If the request for appeal is sent to or made with the county department, the county shall forward such request to the OAC.

B. Requests for state level fair hearings may result from such reasons as:

1. The opportunity to make an application or reapplication has been denied;

2. An application for assistance or services has not been acted upon within the maximum time period for the category of assistance;

3. The application for assistance has been denied; the grant payment has been modified or discontinued; requested reconsideration or a grant payment amount deemed incorrect has been refused or delayed; grant payment has been delayed through the holding of payments; the county department is demanding repayment for any part of a grant payment to a client which the client does not believe is justified; or the client disagrees with the type or level of benefits or services provided.

C. The basic objectives and purposes of the appeal and state level fair hearing process are:

1. To safeguard the interests of the client;

2. To provide a practical means by which the client is afforded a protection against incorrect action on the part of the county department or local service delivery agency;

3. To bring to the attention of the State Department and county department or local service delivery agency information that may indicate need for clarification or revision of State and county policies and procedures;

4. To assure equitable treatment through the administrative process without resort to legal action in the district courts.

D. Any clear expression verbally or in writing by the client or his or her representative, that the client wants an opportunity to have a specific action of a county department or local service delivery agency reviewed by the State Department is considered an appeal and a request for a state level fair hearing.

The county department or local service delivery agency shall, when asked, aid the person in preparing a request for a hearing. If the request for a hearing is made verbally, the county department shall prepare a written request within ten (10) calendar days for the client or his or her representative's signature or have the client prepare such request, specifying the action he or she would like to appeal and the reason for appealing that action.

1. The client is entitled to:

a. Representation by any person he or she chooses pursuant to

Section 26-2-127(1)(a)(IV), C.R.S., legal counsel retained at the client’s own expense, or he or she may represent him or herself;

b. Examine the complete case file and any other documents, records, or pertinent material to be used by the county at the state level fair hearing, at a reasonable time before the date of hearing as well as during the hearing. However, the file shall not include the names of confidential informants, privileged communications between the county departments and its attorney, the nature and status of pending criminal prosecutions, and any other information that is confidential or privileged.

2. The client and staff of the county department are entitled to:

a. Present witnesses;

b. Establish all facts and circumstances pertinent to the decision being appealed;

c. Advance any arguments without undue interference;

d. Question or refute any testimony or evidence, including opportunity to confront and cross-examine adverse witnesses.

3.587.1 STATE LEVEL FAIR HEARING PROCEDURES

One or more persons from the Colorado Department Personnel & Administration, OAC, are appointed to serve as ALJ for the State Department.

A. The State ALJ shall, in preparation for the hearing, review the reasons for the decision under appeal and be prepared to interpret applicable departmental rules governing the Adult Financial program and the issue(s) under appeal.

B. When legal counsel does not represent the client and/or the department or local service delivery agency, the ALJ shall assist in bringing forth all relevant evidence and issues relating to the appeal.

C. Upon receipt by the OAC of an appeal request, OAC assigns a case number.

The OAC sets a hearing date at least ten (10) days from the date the appeal was requested, and sends a letter by first class or certified mail to the appellant and the county department or local service delivery agency notifying them of the date, time, and place of the hearing.

1. The letter advises the appellant that if these arrangements are not satisfactory, he or she must notify the OAC. An ALJ will decide if good cause exists, and whether the date, time, and/or place of the hearing will be changed.

2. An information sheet shall be enclosed with the letter that explains the hearing procedures to the appellant. The information sheet informs the appellant that:

a. He or she has the right to representation by an authorized representative retained at his or her own expense, such as legal counsel, a relative, a friend, or another spokesperson, or he or she may represent himself or herself;

b. The appellant or his or her representative has the right to examine all materials to be used at the hearing, before and during the hearing; and c. Failure to appear at the hearing as scheduled, without having secured a proper extension in advance, or without having shown good cause for failure to appear, shall constitute abandonment of the appeal and cause a dismissal thereof.

3. If OAC sets the hearing forty-five (45) days or more from the date of the notice of hearing, the county department/agency shall, within fifteen (15) days but no later than thirty (30) days prior to the hearing, prepare and mail a hearing packet to the appellant with a copy to OAC. If the hearing is set less than 45 days from the date of the notice of hearing, the county department/agency shall, within five (5) days but no later than ten (10) days prior to the hearing, prepare and mail the hearing packet. The hearing packet shall contain the following information:

a. The reasons for the decision of the county department or local service delivery agency and a specific explanation of each factor involved, such as the amount of excess resources or income, assignment or transfer of resources, or residence factors;

b. The specific State rules governing the Adult Financial program on which the decision is based with a numeric reference to each such

rule, including the appropriate Code of Colorado Regulations (C.C.R.) cites;

c. Notice that the county department or local service delivery agency will assist him or her by providing relevant documents from the case file for his or her claim, if he or she so desires, and that he or she has the opportunity to examine rules and other materials to be used at the hearing concerning the basis of the county decision.

4. Information that the appellant or his or her representative does not have an opportunity to see shall not be made available as a part of the hearing record or used in a decision on an appeal. No material made available for review by the ALJ may be withheld from review by the appellant or his or her representative.

5. In Adult Financial program appeals, the ALJ has twenty (20) calendar days from the hearing date to arrive at an initial decision. Once an initial decision is rendered, the OAC immediately sends the case and the initial decision to the State Department, Office of Appeals. The Office of Appeals serves the initial decision on the parties via first class mail and provides for an opportunity for the parties to file exceptions to the initial decision prior to the Office of Appeals issuing a final agency decision.

6. The initial decision shall not be implemented pending review by the Office of Appeals and entry of a final agency decision. All final agency decisions on these appeals shall be made within ninety (90) calendar days from the date the request for hearing is received.

D. When the client has had a county conference and wishes to appeal the county department or local service delivery agency 's action to the OAC, the following procedures shall be followed:

1. As part of the county conference the client is informed that if he or she wishes to appeal to the OAC for a hearing, the county department or local service delivery agency shall provide relevant documents from the case file for the client’s claim, if he or she so desires, and that he or she may have the opportunity to examine materials as described in the Section 3.587.1.C.2.;

2. The county department or local service delivery agency shall forward a copy of the county decision being appealed and a copy of the written notification of the decision given to the client to the OAC.

3. A copy of the OAC’s notice to the client setting a date for the hearing is forwarded to the county department or local service delivery agency. The county department or local service delivery agency shall provide the client with a hearing packet in accordance to Section 3.587.1.C.3.

4. If the client indicates to the county department that he or she desires to withdraw the appeal, the county department shall obtain a statement to that effect in writing and forward it to the OAC.

5. If a client has legal counsel or another authorized representative for the appeal, the county department or local service delivery agency will not discuss the merits of the appeal or the question of whether or not to proceed with it with the client unless the discussion is in the presence of, or with the permission of, such counsel or such other authorized representative.

6. If the county department or local service delivery agency learns that legal counsel will represent the client, the county department or local service delivery agency shall make every effort to ensure that it, too, is represented by an attorney at the hearing. The county department/agency may be represented by an attorney in any appeal that it considers such representation desirable.

7. If the appellant needs interpretation services, the county department shall arrange to have present at the hearing a certified interpreter who will be sworn to translate correctly.

8. The fact that an appellant and the county department or local service delivery agency have been notified that a hearing will be held does not prevent the county department/agency from reviewing the case and considering any new factors which might change the status of the case, or taking such action as may be indicated to reverse its decision or otherwise settle the issue. Any change that results in voiding the cause of appeal shall be immediately reported by the county department to the OAC.

9. Upon receipt of notice of a State hearing on an appeal, the county department or local service delivery agency shall arrange for a suitable hearing room appropriate to accommodate the number of persons, including witnesses, who are expected to be in attendance, taking into consideration such factors as privacy; absence of distracting noise; and the need for table, chairs, electrical outlets, adequate lighting and ventilation, and conference telephone facilities.

E. Telephonic conference hearings may be conducted as an alternative to in-person hearings unless otherwise requested by any of the parties. All applicable provisions of the in-person hearing procedures will apply, such as the right to be represented by counsel, the right to examine and cross-examine witnesses, the right to examine the contents of the case file, and the right to have the hearing conducted at a reasonable time and date.

1. The ALJ shall conduct the hearings in accordance with the State Administrative Procedure Act, Article 4 of Title 24, C.R.S., specifically,

Section 24-4-105.

2. The county department or local service delivery agency shall have the burden of proof, by a preponderance of the evidence, to establish the

basis of the decision being appealed. Every party to the proceeding shall have the right to present his or her case or defense by verbal and documentary evidence, to submit rebuttal evidence, and to conduct such cross-examination as may be required for a full and true disclosure of the facts. Subject to these rights and requirements, where a hearing is expedited and the interests of the parties will not be subsequently prejudiced thereby, the ALJ may receive all or part of the evidence in written form or by verbal stipulations.

F. The following provisions govern the procedure at State hearings before the ALJ:

1. The hearing is closed to the public. However, any person or persons whom the appellant wishes to appear for or with him or her may be present, and, if requested by the appellant on the record, such hearing may be public;

2. The purpose of the hearing is to determine the pertinent facts in order to arrive at a fair and equitable decision in accordance with the rules of the State Department. In arriving at a decision, only the evidence and testimony introduced at the hearing is considered by the ALJ. However, in circumstances when it is shown at the hearing that medical or other evidence could not, for good cause, be obtained in time for the hearing, the ALJ may permit the introduction of such evidence after the hearing.

The opposing party must also be furnished with a copy of this new evidence and must have the opportunity to controvert or otherwise respond to it. Delays in rendering the initial decision will be attributed to the party requesting that the ALJ hear additional evidence after the hearing;

3. Although the hearing is conducted on an informal basis and an effort is made to place all the parties at ease, it is essential that the evidence be presented in an orderly manner so as to result in an adequate record;

4. When an ALJ makes a decision regarding the merits of the case, or the dismissal of the appeal, that decision is called an initial decision, see

Section 3.587.2 addressing initial decisions;

5. A complete and exact record of the hearing shall be made by electronic or other means. When requested by the party, the OAC shall cause the proceedings to be transcribed at the expense of the requesting party;

6. The ALJ shall not enter a default against any party for failure to file a written answer in response to the notice of hearing, but shall base the initial decision upon the evidence introduced at the hearing. However, an appellant may be granted a postponement of the hearing if the county department or local service delivery agency has failed to provide the hearing packet required by Section 3.587.1.D.3, and the appellant has therefore been unable to prepare for the hearing.

7. When the ALJ dismisses an appeal for reasons other than failure to appear, the decision of the ALJ shall be an initial decision which shall not be implemented until after the Office of Appeals completes its review and enters a final agency decision.

8. When OAC has notified the appellant of the time, date, and place of the OAC hearing and the appellant fails to appear at the hearing, without giving notice to the ALJ of acceptable good cause for his or her inability to appear at the hearing, then the appeal shall be considered abandoned.

The ALJ shall enter an order of dismissal and the OAC shall serve it upon the parties. The dismissal order shall not be implemented pending review by the Office of Appeals and entry of a final agency decision.

However, the appellant, shall have ten (10) calendar days from the date the order of dismissal was mailed to draft and send a letter to the ALJ explaining the reason for his or her failure to appear. If the ALJ then finds that there was good cause for the appellant not appearing, the ALJ shall vacate the order dismissing the appeal and reschedule the hearing date.

If the appellant submits a letter seeking to show good cause and the ALJ finds that the stated facts do not constitute good cause, the ALJ shall enter an initial decision confirming the dismissal.

If the appellant does not submit a letter seeking to show good cause within the ten (10) day period, the order of dismissal shall be filed with the Office of Appeals of the State Department. The Office of Appeals shall confirm the dismissal of the appeal by a final agency decision, which shall be served upon the parties.

After the final agency decision is served on the parties, the county department or local service delivery agency shall carry out the necessary actions within ten (10) calendar days of the final agency decision becoming effective. The actions may be: to provide assistance in the correct amount; to terminate assistance; to recover assistance incorrectly paid; and/or other appropriate actions in accordance with the rules and final agency decision.

9. The appellant may file exceptions to any ALJ initial decision pursuant to

Section 3.587.2.C.

3.587.2 DECISION AND NOTIFICATION

A. Following the conclusion of the state level fair hearing, the ALJ shall promptly prepare and issue an initial decision and file it with the State Department, Office of Appeals.

The Office of Appeals of the State Department is the designee of the State Department’s Executive Director for reviewing the initial decision of the ALJ. The Office of Appeals enters a final agency decision on behalf of the executive director affirming, modifying, or reversing the initial decision.

1. The initial decision shall make an initial determination whether the county, local service delivery agency, or State Department or its agent acted in accordance with, and/or properly interpreted, the rules of the State Department governing the Adult Financial program.

2. The ALJ has no jurisdiction or authority to determine issues of constitutionality or legality of departmental rules.

3. The initial decision shall advise the client who brought the appeal that failure to file exceptions to findings of the initial decision will waive the right to seek judicial review of a final agency decision that affirms those findings.

4. The Office of Appeals shall promptly serve the initial decision upon each party by first class mail, and shall transmit a copy of the decision either electronically or in writing to the division of the State Department that administers the program(s) pertinent to the appeal.

5. The initial decision shall not be implemented pending review by the Office of Appeals and entry of a final agency decision.

B. Upon receiving the initial decision, the Office of Appeals may issue an order of remand based on an issue that warrants an immediate remand before the initial decision is even mailed to the parties.

Additionally, the Office of Appeals may issue an order of remand after its substantive review of an initial decision, and prior to issuing a final agency decision, based on the need for further clarification, findings, conclusions of law, and/or further proceedings. An order of remand is not a final agency decision that is subject to judicial review.

C. Any party seeking a final agency decision which reverses, modifies, or remands the initial decision of the administrative law judge shall file exceptions to the decision with the Office of Appeals, within fifteen (15) days (plus three days for mailing) from the date the initial decision is mailed to the parties. If that date falls on a weekend or State holiday, the due date shall be moved to the next business day. Exceptions must state specific grounds for reversal, modification or remand of the initial decision.

1. If the party asserts that the ALJ’s findings of fact are not supported by the weight of the evidence, the party shall, simultaneously with, or prior to, the filing of exceptions, request that the OAC create a transcript of all or a portion of the hearing and file it with the Office of Appeals. No transcript is required if the review is limited to a pure question of law. Similarly, if the exceptions assert only that the ALJ improperly interpreted or applied State rules or statutes, the party filing exceptions is not required to provide a transcript or recording to the Office of Appeals.

If applicable, the exceptions shall state that a transcript has been requested. Within five (5) days of the request for a transcript, the party requesting it shall advance the cost therefore to the transcriber designated by the OAC, unless the transcriber waives prior payment.

2. A party who is indigent and unable to pay the cost of a transcript may file a written request, which need not be sworn, with the Office of Appeals for permission to submit a copy of the hearing audio recording instead of the transcript. If submission of a recording is permitted, the party filing exceptions must promptly request a copy of the recording from the OAC and deliver it to the Office of Appeals. Payment in advance shall be required for the preparation of a copy of the recording.

3. The Office of Appeals shall serve a copy of the exceptions on each party by first class mail. Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties in which to file a written response to such exceptions. The Office of Appeals shall not permit verbal argument.

4. The Office of Appeals shall not consider evidence that was not part of the record before the ALJ. However, the case may be remanded to the ALJ for rehearing if a party establishes in its exceptions that material evidence has been discovered that the party could not with reasonable diligence have produced at the hearing.

5. While review of the initial decision is pending before the Office of Appeals, the record on review, including any transcript or recording of testimony filed with the Office of Appeals, shall be available for examination by any party at the Office of Appeals during regular business hours.

6. The State Department’s division responsible for administering the program relevant to the appeal may file exceptions to the initial decision, or respond to exceptions filed by a party, even though the division has not previously appeared as a party to the appeal. The division's exceptions or responses must be filed in compliance with the requirements of this

section. Exceptions filed by a division that did not appear as a party at the hearing shall be treated as requesting review of the initial decision upon the State Department's own motion.

7. In the absence of exceptions filed by any party or by a division of the State Department, the Office of Appeals shall review the initial decision, and may review the hearing file of the ALJ and/or the recorded testimony of witnesses, before entering a final agency decision. Review by the Office of Appeals shall determine whether the decision properly interprets and applies the rules of the State Department and/or relevant statutes, and whether the findings of fact and conclusions of law support the decision. If a party or division of the State Department objects to the final agency decision entered upon review by the Office of Appeals, the party or division may seek reconsideration of the final agency decision pursuant to subsection D below.

8. The Office of Appeals shall mail copies of the final agency decision to all parties by first class mail.

9. For purposes of requesting judicial review, the effective date of the final agency decision shall be the third day after the date the decision is mailed to the parties, even if the third day falls on Saturday, Sunday, or a legal holiday. The parties shall be advised of this in the final agency decision.

10. The State or county department or local service delivery agency shall initiate action to comply with the final agency decision within three (3) working days after the effective date. The department shall comply with the decision even if reconsideration is requested; unless the effective date of the final agency decision is postponed by order of the Office of Appeals or a reviewing court.

D. No motion for reconsideration shall be granted unless it is filed in writing with the Office of Appeals within fifteen (15) days of the date that the final agency decision is mailed to the parties. The motion must state specific grounds for reconsideration of the final agency decision.

The Office of Appeals shall mail a copy of the motion for reconsideration to each party of record and transmit electronically or in writing to the appropriate division of the State Department.

A motion for reconsideration of a final agency decision may be granted by the Office of Appeals for the following reasons:

1. A showing of good cause for failure to file exceptions to the initial decision within the fifteen (15) day period allowed by Section 3.587.2.b; or, 2. A showing that the final agency decision is based upon a clear or plain error of fact or law. An error of law means failure by the Office of Appeals to follow a rule, statute, or court decision, which controls the outcome of the appeal.

E. When a final agency decision concludes that an action of the county, local service delivery agency, or State Department was not in accordance with the rules of the State Department, or when the county/agency or State Department determines that its action was not supported by the State Department’s rules after the client makes a request for a hearing, the adjustment or corrective payment is made retroactively to the date of the incorrect action.

F. The client is to be fully informed by the final agency decision of his or her further right to apply for judicial review of the final agency decision. Judicial review can be started by filing an action for review in the appropriate State district court. Any such action must be filed in accordance with Section 24-4-106, C.R.S. and with the Colorado Rules of Civil Procedure within thirty-five (35) days after the final agency decision becomes effective.

G. The State Department will establish and maintain a method for informing, in summary and depersonalized form, all county departments and other interested persons concerning the issues raised and decisions made on appeals.

Editor's Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1.

Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Rules 3.500-3.500.63 repealed eff. 09/15/2012.

Entire rule eff. 03/02/2014.

Rules 3.530-3.530 A emer. rules eff. 05/02/2014.

Rule 3.581 emer. rule eff. 06/06/2014.

Rules 3.520.4-3.520.4 D.6 emer. rules eff. 07/11/2014.

Rule 3.530 eff. 08/01/2014.

Rules 3.540-3.540 A emer. rules eff. 08/06/2014.

Rules 3.520.4-3.520.4 D.6, 3.540-3.540 A, 3.581 eff. 10/01/2014.

Rules 3.530, 3.540, 3.581 emer. rules eff. 01/01/2015.

Rules 3.532, 3.543, 3.583 emer. rules eff. 01/22/2015.

Rules 3.530, 3.540, 3.581 eff. 03/20/2015.

Rules 3.532, 3.543, 3.583 eff. 04/01/2015.

Rules 3.510, 3.520.71, 3.542 eff. 06/01/2015.

Rule 3.520.4 emer. rule eff. 06/05/2015.

Rule 3.520.4 eff. 09/01/2015.

Rules 3.520.4-3.520.4 D eff. 01/01/2016.

Rules 3.532 F.2, 3.532 H, 3.543 I, 3.570.11 B, 3.570.21 B, 3.583 D.4.a, 3.583 D.5.a eff. 10/01/2016.

Rules 3.530, 3.540, 3.581 emer. rules eff. 11/04/2016.

Rules 3.530, 3.540, 3.581 eff. 03/02/2017.

Rules 3.530, 3.540, 3.581 emer. rules eff. 12/01/2017.

Rules 3.530, 3.540, 3.581 eff. 04/01/2018.

Rules 3.540 A, 3.570.11 B, 3.570.21 B eff. 09/01/2018.

Rules 3.520.71, 3.540.1, 3.541, 3.541.1, 3.542 A eff. 11/01/2018.

Rules 3.530, 3.540, 3.581 emer. rules eff. 11/02/2018.

Rules 3.530, 3.540, 3.581 eff. 02/01/2019.

Rules 3.530, 3.540, 3.581 emer. rules eff. 01/01/2020.

Entire rule eff. 03/01/2020.

Rule 3.540.2 eff. 07/01/2020.

Rules 3.510, 3.583 I, 3.583 N.2 eff. 01/01/2021. Rules 3.530, 3.546 emer. rules eff. 01/01/2021.

Rules 3.530, 3.546 eff. 03/02/2021.

Rules 3.510, 3.520.72 F, 3.581 F eff. 08/01/2021.

Rules 3.510, 3.520.68 A emer. rules eff. 12/03/2021.

Rules 3.510, 3.530, 3.546 A, D emer. rules eff. 01/01/2022.

Rules 3.510, 3.520.68 A, 3.530, 3.546 A, D eff. 03/02/2022.

Rules 3.510, 3.520.4 C.4.f.2), 3.520.785 B.25, 3.520.786 N, P, 3.540 A, 3.570.11 A.2, 3.570.5-3.570.53 eff. 04/01/2022.

Rules 3.520.5 E, 3.520.61 C, 3.520.66, 3.520.67 E emer. rules eff. 07/01/2022.

Rules 3.520.5 E, 3.520.61 C, 3.520.66, 3.520.67 E eff. 08/30/2022.

Rules 3.510, 3.520.5 D, 3.520.61 C-D, 3.520.65-3.520.68, 3.520.69 D, 3.520.71 D emer. rules eff. 12/10/2022.

Rules 3.510, 3.530, 3.546 A,D emer. rules eff. 01/01/2023.

Rule 3.510, 3.520.5 D, 3.520.61 C-D, 3.520.65 A, 3.520.65 B.3, 3.520.66, 3.520.67, 3.520.68, 3.520.69 D.5, 3.520.71 D, 3.530, 3.546 A,D eff. 03/02/2023.

Rule 3.520.69 emer. rule eff. 08/07/2023.

Rule 3.520.69 eff. 10/30/2023.

Rules 3.510, 3.530, 3.546 A,D emer. rules eff. 01/01/2024.

Rules 3.510, 3.530, 3.546 A,D eff. 03/30/2024.

Rules 3.530 A,B, 3.546 A,D emer. rules eff. 01/01/2025.

Rules 3.530 A,B, 3.546 A,D eff. 03/02/2025.

Rules 3.510, 3.530, 3.531 D, 3.532 A-B, 3.533 B, 3.546, 3.549 B, 3.549 H, 3.553 E, 3.570.11 B-E.2, 3.585 B.2.D emer. rules eff. 01/01/2026.

Rules 3.510, 3.520.1, 3.520.5, 3.520.66, 3.520.67, 3.520.71, 3.520.72, 3.520.73, 3.520.741, 3.520.742, 3.520.77, 3.520.781, 3.520.785, 3.520.786, 3.520.79, 3.540, 3.541, 3.541.1, 3.541.2, 3.5453.550, 3.551, 3.553, 3.554, 3.570.12, 3.570.13, 3.570.16, 3.570.17, 3.570.18, 3.570.53, 3.583, 3.587.1, eff. 02/01/2026.

Rules 3.510, 3.530, 3.531 D, 3.532 A-B, 3.533 B, 3.546 A, 3.546 C, 3.546 D-E, 3.549 B, 3.549 H, 3.553 E, 3.570.11, 3.585 B.2.d eff. 03/02/2026.

Annotations

Rule 3.520.4.D.6. (adopted 08/08/2014) was not extended by Senate Bill 15-100 and therefore expired 05/15/2015.

##### **9 CCR 2503-6** Colorado Works Program {#sec-9-ccr-2503-6 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-6}

DEPARTMENT OF HUMAN SERVICES

COLORADO WORKS PROGRAM

9 CCR 2503-6 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.600 COLORADO WORKS PROGRAM [Rev. eff. 3/1/2022] 3.600.1 Performance Contract County departments shall enter into a performance contract with the State Department, which may be called a memorandum of understanding (MOU), regarding the delivery of Colorado Works programming.

This contract will outline performance measures that the county department is required to meet. 3.600.2 County Policies County departments shall submit the following county policies to the State Department for review and approval. The State Department is responsible for reviewing and approving county policies, assuring that all counties are complying with all federal and State statutes and regulations. After approval by the State Department, the county department shall have their State approved policies signed by their county board of commissioners or the board’s designee and provide a signed copy back to the State Department. The State Department will communicate, in advance, when a change to the list of required policies is made.

Counties that do not provide signed county policies within the timeframe required by the State Department will operate under these broad State rules and default to the State defined policies.

The following policies are required:

A. Diversion B. County Approved Settings C. Workforce Requirements and Employment Outcomes D. Disaster Assistance E. Domestic Violence F. Assistance and Supportive Payments G. Substance Abuse (only required if practiced)

County departments should regularly review their Colorado Works policies to ensure alignment with current county practice. 3.600.3 Contracting 3.600.31 Private Contracting The Board of County Commissioners may contract all or part of the Colorado Works program operation to private or public providers. They may also choose to contract out the provision of goods or services to Colorado Works (CW) eligible persons/families.

A. Prior to initiating a contract with a provider, the county shall:

1. Verify that the provider has not been debarred or suspended or otherwise found to be ineligible for participation in federal assistance programs by consulting the ineligible parties list at http://www.epls.gov.

2. Determine if the provider is acting as a sub-recipient and is therefore subject to OMB Circular A-133 (2003) and expanded auditing and oversight requirements. No later editions or amendments are incorporated. This circular is available at no cost from the U.S. Government Publishing Office at 732 North Capitol St., N.W., Washington, D.C. 20002, or at https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/circulars/a133/a133.pdf.

These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver, B. All contracts shall:

1. Specify the Temporary Assistance for Needy Families (TANF) purpose(s) that is served and/or supported, as outlined in the Code of Federal Regulations at 45 CFR 260.20 (2021). No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Health and Human Services at 200 Independence Ave., S.W., Washington D.C. 20201, or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver, 2. Approximate, with reasonable certainty, the number of CW eligible persons to be served and include the method used to calculate this number. This number and the calculation used must be documented and made available upon request by the State Department for audit purposes.

3. Outline the provider's eligibility verification process to ensure that goods and services are provided to CW eligible persons/families.

4. Explain how the costs for the goods/services are calculated.

5. Prohibit supplantation.

6. Include a regular accounting of activities and costs at least twice a year.

7. Clarify that all expenditures for goods, services, or start-up funds be documented with a purchasing document.

8. Ensure that the agency has the ability to clearly identify CW eligible individuals from others in situations where an agency receives funding from multiple sources.

9. Outline specific and measurable performance goals for the contract.

10. Require, if the county chooses to, that a client apply for CW, sign a written agreement, or complete an Individualized Plan.

11. Ensure that a HIPPA agreement is signed and on-file in instances where the provider will obtain protected health information. All other contracts must ensure reasonable expectations for the provider to keep client information confidential and secure.

12. Complete an audit in instances where the county is contracting $750,000 or more in CW funds during the fiscal year, in compliance with OMB Circular A-133, as incorporated by reference in section 3.600.31.a.2.

C. Some contracts may be classified as a community resource investment contract pursuant to

Section 26-2-707.5(1), C.R.S. These contracts do not require clients to complete an application, a written agreement, or Individualized Plan, though the county may continue to require such documentation per their own individual contracting procedures.

Community resource investment contracts shall meet all contract requirements as outlined above in section 3.600.31 and shall:

1. Include the purpose of the contract and investment in the community.

2. Specify the income eligibility standards that are used.

3. Outline the county’s dispute resolution process if it differs from that outlined in section 3.609.6. 3.600.32 County Contract with Religious Organizations Counties may contract with religious organizations for the payment of cash assistance or provision of services. If the individual objects to being served by the religious organization chosen as a contractor, the county must provide alternative means for the individual or family to receive benefits, assistance, or services. Contract agencies providing services to individuals must have the ability to provide services that are equitable and make all services available offered to every client. 3.600.4 State Flexibility for Pilot Programs Nothing in these rules prohibits the State Department from piloting programs to serve the TANF population within the bounds of federal regulations for the program. Pilot programs may be offered at the State level or in partnership with one or more county departments. Pilot programs may be designed to serve a subset of clients based on broad-based eligibility factors and may have different eligibility criteria than listed in this rule volume. 3.600.5 Program Review and Oversight County department supervisory personnel and/or quality assurance staff shall review eligibility determinations (certifications, denials, and/or pending cases) monthly. Supervisory personnel and/or quality assurance staff shall:

A. Review a minimum number of cases, including specific programs and/or actions, per month as outlined annually by the State Department based on the county department’s Colorado Works caseload size. The State Department will notify the county of the minimum number of cases to be reviewed.

The county may elect to:

1. Create a plan to pull a random sample that includes at least the minimum number of Colorado Works cases set forth by the State Department and submit that plan to the State for approval.

2. Use the State prescribed random sample.

B. Determine the correctness of eligibility determinations;

C. Ensure correction of any errors within ten (10) business days or the time frame specified within the approved review plan;

D. Maintain a record of the cases reviewed for audit purposes, including audit results and any required actions taken by the county. County departments must keep case file reviews for a minimum of three (3) years; and;

E. Report these results and actions to the State on a monthly basis via the state prescribed process. 3.601 Program Definitions “Adequate” (related to notice) means a written notice sent to the client which details any determination of eligibility, as well as a change or discontinuation of grant payments and the reason for that change.

“Administrative Disqualification Hearing” (ADH) means a disqualification hearing against an individual accused of wrongfully obtaining or attempting to obtain assistance.

“Administrative error claim” means a client was overpaid and a claim validated based on an error on the

part of the county department of human services.

“Administrative Law Judge” (ALJ) means an Administrative Law Judge appointed pursuant to Section 24- 30-1003, C.R.S.

“Adverse action” means a county action to reduce grant payments or to deny an application. A reduction may be the result of a sanction, a demonstrable evidence closure, or ineligibility based on income or household changes.

“Applicant” means any individual or family who individually or through an authorized representative or someone acting responsibly for him or her has applied for benefits under the programs of public assistance administered or supervised by the State Department pursuant to Title 26, Article 2, C.R.S., as defined at Section 26-2-103(1), C.R.S.

“Application” means an initial or redetermination request on State approved forms (paper or electronic) for a grant payment and/or services.

“Approval” means assistance is authorized by the county department.

“Assessed need” means any identified need of a client or family receiving Colorado Works grant payments beyond ordinary, routine living expenses that is designed to deal with a specific crisis situation or episode of need, is not intended to meet recurrent or ongoing needs, and will not extend beyond four (4) months without a new assessment.

“Assistance unit” means individuals who live together and who are receiving grant payments as one household.

“Authorized representative” means someone acting reasonably for the client with the authority to make decisions on behalf of the client and who has taken responsibility for the case, including but not limited to, signing documents and speaking with county departments. The authorization must be in writing and signed by the client.

“Basic cash assistance” means a recurrent cash payment intending to meet ongoing needs.

“Budgetary unit” means those people whose income is considered in the determination of eligibility and grant payment calculation because they are considered financially responsible for members of an assistance unit. Members of the budgetary unit can be in the assistance unit or outside of the assistance unit.

“Caretaker” means a person who exercises the responsibility for a child.

“Certification period” means the time period for which a CW client is approved to receive grant payments before a redetermination is required.

“Claim” means an overpayment of a grant payment, diversion, or supportive payment that needs to be researched and validated by the county department.

“Clear and convincing” evidence is stronger than “a preponderance of evidence” and is unmistakable and free from serious or substantial doubt.

“Client” means a current or past applicant or a current or past recipient of a Colorado Works grant payment.

“Client error claim” means a client was overpaid and a claim was validated based on unintentional or willful withholding of information on the part of the client.

“Collateral contact” means a person outside the client’s household (excluding sponsor(s) and landlord who also live in the home) who has first-hand knowledge of the client’s circumstance and provides a verbal or written confirmation thereof. This confirmation may be made either in person, in writing, electronically submitted, or by telephone. Acceptable collateral contacts include but are not limited to: employers, landlords, social/migrant service agencies, and medical providers who can be expected to provide accurate third-party verification. The name/title of the collateral contact as well as the information obtained must be documented in the statewide automated system.

“Colorado Works” is the Temporary Assistance for Needy Families (TANF) program in Colorado.

“Countable income” means income considered available to the individual after the application of valid exemptions, disregards, and deductions.

“County department” means the county department of human/social services.

“County policy(ies)” means the written county policies governing the Colorado Works program as approved by the State Department and county board of commissioners or their designee.

“County worker” means an employee or designated representative of the county department.

“County approved setting” means a living arrangement evaluated and deemed appropriate by the county department according to county policy.

“Demonstrable evidence” means evidence that a Colorado Works client has refused to comply with the workforce program.

“Denial” means that a Colorado Works application was denied because the client was not eligible for a grant payment upon application.

“Dependent child(ren)” means a person who resides with a parent or non-parent caretaker and who is:

A. Under eighteen (18) years of age; or, B. Between the ages of eighteen (18) and nineteen (19) and a full-time student in a secondary school or in the equivalent level of vocational or technical training (including seeking to obtain high school equivalency) and expected to complete the program before age nineteen (19).

“Discontinuation” means that a client who is currently receiving a grant payment is no longer eligible and his or her grant payment will be stopped.

“Disqualified person” means a person who would be a member of the assistance unit but is ineligible due to program prohibitions.

“Diversion” means a short-term cash payment (not to extend beyond four (4) months) intended to meet an episode of need.

“Domestic violence” (also known as family violence) means a pattern of coercive control one individual inflicts upon another in the context of familial, household, or intimate partner (current or former) relationships including marriage and dating. Violence may be inflicted through a variety of means including, but not limited to:

A. Physical acts threatening or resulting in physical injury to the individual, including hitting, punching, slapping or biting;

B. Intimidation resulting in fear of imminent bodily harm through the use of gestures, displays of weapons, or destruction of property, including pets;

C. Threats of or attempts at physical or sexual abuse or other means of coercion and control, including harm to or threats to harm children, other family members, or pets;

D. Sexual abuse or threats to inflict nonconsensual sexual acts, including sexual activity with a minor;

E. Mental, emotional, or psychological abuse including degradation, constant put-downs, or humiliation that results in a reduced ability to engage in daily activities;

F. Isolation from friends, family, or any type of emotional support system;

G. Neglect or deprivation of medical care;

H. Stalking;

I. Economic abuse or control of finances through withholding money or sabotaging attempts to attain economic self-sufficiency; and/or, J. Child molestation, incest.

“Domestic violence survivor” means any person who has experienced or is experiencing domestic violence as defined above.

“Earned income” means payment in cash or in-kind received by an individual for services performed as an employee or as a result of being engaged in self-employment.

“Effective date of eligibility” means the first date a client is eligible for the public assistance program.

“Eligibility requirements” means criteria used to determine individuals eligible or ineligible to receive grant payments and/or services.

“Eligible client” means a client whose countable income is below the grant standard and who meets all non-financial eligibility criteria.

“Emancipated juvenile” means the same as in Section 19-1-103(45), C.R.S.

“Exceptional disengagement” means a pattern of documented non-compliance with the Individualized Plan over a span of time without reporting good cause. The pattern must clearly demonstrate repetitive disengagement from the program over a span of not more than two (2) months, such as three (3) consecutive times in one (1) month or four (4) times in two (2) months. Exceptional disengagement does not exist when a client has demonstrated an unmet need for transportation or childcare or when domestic violence or a disability impact a client. Exceptional disengagement is reported to the State Department via a State prescribed review process.

“Excluded person” means a person who is not included in the assistance unit or budgetary unit.

“Exempt income” means any income that is not countable income for the purpose of eligibility.

"Federal Poverty Guidelines" also called Federal Poverty Level (FPL) means the income level for a household as set forth in the Federal Register 86 FR 7732, 7732-7734, as of February 1, 2021. This rule does not contain any later amendments or editions. These guidelines are available for no cost at https://www.federalregister.gov/. These guidelines are also available for public inspection and copying at the Colorado Department of Human Services, Director of the Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, or at any state publications library during regular business hours.

“Fleeing felon” means a person fleeing to avoid prosecution or custody or confinement after conviction for a felony.

“Fraud” means the same as in Section 26-1-127(1), C.R.S.

“Family violence option (FVO) trained worker” means a county worker or contract staff who has participated in the State prescribed FVO training.

“Good cause” means circumstances beyond the control of the client. Good cause includes, but is not limited to, medical emergencies or hospitalization; a client who has a disability or other medical condition(s) requiring additional time and/or assistance; a delayed appointment with the Social Security Administration beyond the client's control; a client who is experiencing domestic violence, a child-only case, and a client who is the head of a single-parent household who has a child under one (1) year of age, or other good cause determined reasonable by the county department using the prudent person principle, including the reasons outlined in 3.608.3. Related to the appeal process, the following circumstances do not constitute good cause: an excessive workload of a party or his or her representative or attorney; when a party obtains legal representation in an untimely manner; a party or his or her representative or attorney’s failure to either receive or timely receive, a timely mailed initial decision, or other timely mailed correspondence from the Office of Administrative Courts, the Office of Appeals, or the county department; when a party or his or her representative or attorney has failed to advise the Office of Administrative Courts, the county department, or the Office of Appeals of a change of address or failed to provide a correct address; or any other circumstance which was foreseeable or preventable.

“Grant payment” means the Colorado Works program payment that can either be basic cash assistance or diversion. Grant payments may also be referred to as the benefit.

“Grant standard” means the maximum Colorado Works grant payment that can be provided to a client based on the household composition, not including diversion or assessed need.

“Guardian” means the same as in Section 26-2-703(10.2), C.R.S.

“Immediate family member” means spouses, child(ren), parents, siblings, and the spouses of those persons.

“Income” means any financial gain by means of money payment or in-kind payment. Payments made directly to a vendor are not income.

“Income reporting standard” means the amount of income which requires an assistance unit to report an increase in earnings during a certification period.

“In-kind” means something of value received for the benefit of a client or sponsor(s) of a client and is considered either earned or unearned income. Examples of this are food or shelter that the client received for free or at fair market value or less.

“Intent” and/or “intentionally” means the same as in Section 18-1-501(5), C.R.S.

“Intentional program violation” (IPV) occurs when an individual makes a false or misleading statement or fails to disclose by misrepresentation or concealment of facts, or acts in a way that is intended to mislead or conceal any eligibility factor on any application or other written and/or electronic communication for the

purpose of establishing or maintaining eligibility to:

A. Receive a grant payment for which the client is not eligible; or, B. Increase a grant payment for which the client is not eligible; or, C. Prevent a denial, reduction or termination of a grant payment.

“Investigation’s Conclusion” means the investigation into an IPV has concluded and the amount of overpayment has been determined.

“Irregular” (related to income) means income which an individual cannot reasonably expect to receive on a monthly basis.

“Liable individual” means a person financially responsible for an overpayment including the client, sponsor(s) of a client, a payee, parents of dependent children, and/or other persons determined to be financially liable by a court.

“Medical services” means services that are allowable or reimbursable under Title XIX of the Social Security Act.

“Minor” means a person who is under the age of eighteen (18).

“Noncustodial parent” means an individual who, at the time he or she requests and receives program services:

A. Is a parent of a minor child; and, B. Is a resident of Colorado; and, C. Does not live in the same household as the minor child.

"Overpayment” means a payment was made in excess of the amount a client was eligible for.

“Parent” means an adoptive or natural/biological parent, including an expectant parent.

“Periodic payments” means payments that are irregular or a one-time payment.

“Potential income” means a benefit or payment to which the client or sponsor(s) of a client may be entitled and could secure, such as spousal support, annuities, pensions, retirement or disability benefits, veterans compensation and pensions, workers' compensation, Social Security retirement or disability benefits, Supplemental Security Income (SSI) benefits, and unemployment compensation.

“Produce” means to provide for inspection either: 1) an original or 2) a true and complete copy of the original document. A document may be produced either in person, electronically, or by mail.

“Program prohibitions” means any of the following that prevents a required member of the assistance unit from participating in the Colorado Works program.

A. The individual has misrepresented his or her residence to receive TANF benefits or services simultaneously in two or more states;

B. The individual is a fugitive or fleeing felon;

C. The individual is a non-citizen who does not meet the definition of an eligible qualified non-citizen;

D. The individual has been convicted of welfare fraud under the laws of this State as described in

Section 26-1-127, C.R.S., any other state, or the federal government. The individual convicted of fraud shall not be permitted to receive grant payments but may receive services as deemed necessary; or, E. The individual lacks or failed to provide a Social Security Number (SSN) or proof of application for a SSN.

“Prudent person principle” means that, based on experience and knowledge of the program, the county department exercises a degree of discretion, care, judiciousness, and circumspection, as would a reasonable person, in a given case.

“Qualified non-citizen” is the same as “qualified alien” in 8 U.S.C. 1641(b) and the language, including all notes, in 8 U.S.C. § 1101 and may also be referred to as a legal immigrant.

“Questionable” means the information provided is unclear, conflicting information has been provided, or the county has reason to believe facts presented are contrary to the information provided by the client.

“Received” (for the purpose of income) means the date on which the income is actually received or legally becomes available for use, whichever occurs first, whether reported timely by the client or not.

“Received” (as it applies to receipt of verification, documentary evidence, and reported changes in circumstances) means the date the verification, documentary evidence, and reported changes were received by the county department.

“Recovery” means the collection of a valid claim to repay grant payments to which a client was not entitled.

“Redetermination” means a case review/determination of necessary information and verifications to determine ongoing eligibility and may also be called renewal.

“Responsibility/exercising responsibility” means the accountability for and obligation to make decisions on behalf of a child(ren).

“Sanction” means a reduction in Colorado Works grant payments for an established period of time as a result of not participating in the Workforce Development program.

“Scheduled appointment” or “scheduled interview” means an appointment or interview set using a State prescribed or State approved appointment notice provided to the client.

“Self-employment” means work that is performed at the client's discretion either informally, as an independent contractor or as the owner of a business and not for an employer. Self-employment does not include S-Corps or Limited Liability Companies (LLC).

“Signature” means handwritten signatures, electronic signature techniques, recorded telephonic signatures, or documented gestured signatures. A valid handwritten signature includes a designation of an x. For Individualized Plans and conditions agreements, a verbal agreement is an acceptable signature and must be substantiated with an electronic, recorded telephonic, or written agreement of the terms.

“Sponsor” means any person(s) who executed an affidavit of support (USCIS form I-864 or I-864a (March 6, 2018)) or another form deemed legally binding by the Department of Homeland Security on behalf of a non-citizen as a condition of the non-citizen's date of entry or admission into the United States as a permanent resident. These forms are herein incorporated by reference. This rule does not contain any later amendments or editions. These forms are available at no cost from https://www.uscis.gov/forms.

These forms are also available for public inspection and copying at the Colorado Department of Human Services, Director of the Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203, or at any state publications library during regular business hours.

“State Department” or “the Department” means the Colorado Department of Human Services.

“Statewide automated system” means the electronic platform used to calculate public assistance program benefits and grant payments.

“Supplantation” means the replacement of county funds serving Colorado Works clients with block grant funds and the use of those county fund savings for purposes other than the Colorado Works program.

“Supportive payment” means a payment and/or service in addition to basic cash assistance or diversion that is based on an assessed need.

“Termination” means that the client who is currently receiving Colorado Works program grant payments is no longer eligible and his or her grant payments will be stopped.

“Timely notice” means the county shall generate a notice to the client at least eleven (11) calendar days prior to the initiation of any adverse action. This shall be sent to his or her last address known to the “Unearned income” means any income received by a client or sponsor(s) of a client that is not earned through employment or self-employment.

“Unintentional” or “without intent” means an act, or something done or performed that was not voluntary or intended.

“Verification” or “verify” means confirming statements, application information, and other case information by obtaining written, audio, or other evidence or information that proves such fact or statement to be true.

“Verified upon receipt” means information that is provided directly from the primary source and is not questionable and no additional verification is required.

“Willful” means the same as in in Section 18-1-501(6), C.R.S.

“Willful withholding of information” includes:

A. Willful misstatement including understatement, overstatement, or omission, whether verbal or written, made by a client in response to verbal or written questions from the county department; and/or, B. Willful failure by a client to report changes in income or other circumstances which may affect the amount of grant payment.

“Withdraw” or “withdrawal” means an application is not processed because the client who submitted the application withdraws his or her request for assistance prior to eligibility determination, or requests his or her grant payment be discontinued.

“Workforce Development (WD)” means the program provided to clients determined to be work eligible as described in section 3.607. 3.602 Applications for Colorado Works 3.602.1 Applications A. An individual shall have the opportunity to apply for Colorado Works assistance without delay.

When an individual is unable to make an application in person at the county department, the county department, upon request of the applicant, shall mail the State Department’s prescribed public assistance application form or assist the individual in applying for assistance utilizing other forms of the State Department’s prescribed application.

1. County departments shall not require any pre-eligibility screening process designed to deter individuals from applying for Colorado Works benefits, services, and/or payment. All applications shall be accepted by the county department and entered into the statewide automated system to determine the applicants’ eligibility for the program.

2. County departments shall accept applications for Colorado Works during normal business hours. They shall not be restricted to a certain day or time of day. County departments shall not refer applicants to community resource providers in place of allowing them to apply for Colorado Works benefits or otherwise limiting opportunities to apply for Colorado Works. In addition, county departments shall accept applications at all Human/Social Services departments for public assistance locations. The application date shall be the date that the application is received in the public assistance office.

3. If the applicant wishes to terminate the process before the application is completed, it shall be treated as an “inquiry” and the application will not be acted upon for a determination of eligibility. An inquiry is a request of information about eligibility requirements for public assistance. If the applicant wishes to terminate the process after the application is submitted, it shall be treated as a “withdrawal/denial.”

4. An applicant may choose to withdraw his or her application anytime during the application process or after a grant payment is determined. A decision by the applicant to withdraw shall be treated as a denial by the county department. The applicant shall be notified of the action of the county department on the State-approved Notice of Action form.

5. County departments shall simplify the requirements relating to determination and verification of eligibility criteria, such as accepting the simplist form of eligibility verification possible. County departments may use other public assistance program’s eligibility forms and processes when redetermining and verifying eligibility.

B. Administrative Review All Colorado Works clients whose benefits have been denied, reduced or terminated shall receive timely and adequate notice of the denial or change in benefits in accordance with section 3.609.1.

In addition, the client shall have the right to appeal a county department’s action in accordance with State rules pursuant to Section 3.609.7. A Colorado Works client receiving basic cash assistance shall have benefits continued if an appeal is filed timely in accordance with rules at

Section 3.609.1.E.2.

C. General information concerning public assistance programs shall be provided to all persons seeking information. This shall be provided in writing by the county department. In addition, verbal notice shall be provided to all persons seeking information when requested. Available information shall include:

1. Information about the Colorado Works Program;

2. Conditions of eligibility;

3. Scope of benefits;

4. Time limits;

5. Related services available;

6. Domestic violence waivers; and, 7. Rights and responsibilities of clients.

D. The county department shall ensure that no information concerning a client is released without authorization except as outlined in E.2.i below. In circumstances when a client needs assistance with the application process, information shall not be released by the county department to the assisting individual(s) unless the individual is accompanied by the client, or is the client’s authorized representative, or a written authorization to release information is obtained from the client. Upon request, the county department shall provide assistance in completing the application form.

When a client is a person with disabilities and is unable to complete the forms the spouse, other relative, friend, or authorized representative may complete the forms. When no such person is available to assist in these situations, the county department must assist the client in the completion of the necessary forms. The county department also may refer the client to a legal or other resource. The county shall provide reasonable accommodations under the Americans with Disabilities Act for disabled clients. The county department shall make referral to the Social Security Administration (SSA) office for all aged, disabled, or blind clients that may be eligible to receive SSA benefits. However, this shall not negate the county department’s responsibility to obtain and process the application. In the event that a client needs assistance in submitting and completing an application, the individual providing this assistance is not considered to be the authorized representative unless the required prescribed or approved State form has been signed indicating such authority for the individual to be the authorized representative on the case.

Applications for clients in special situations shall be handled as follows:

1. Clients who cannot write their names shall make a mark, and such mark shall be witnessed by the signature of at least one witness. The printed name and address of such witness shall follow the signature. County workers may act as witnesses if not related to the client.

2. A client receiving medical treatment in a medical facility shall submit an application to the county department in which the facility is located. When a county department receives an application for a client whose place of residence is in another county, the application shall be forwarded to that county department for processing. When a client has no determinable county of residence, the county department in which the facility is located shall process the application.

3. An application for a client in a public institution shall be processed by the county department where the client has established residence or the county in which the court is located which issued a confinement order. When the application process is completed, the case shall become the responsibility of the county department in which the institution is located.

4. All clients’ rights shall be preserved. The signed release of information form/authorization to release information form may be used only for the entities/agencies for which it is intended. No subset of that agency or legal entity attached to that agency shall be included in the authorization to release information unless specified by the client.

E. Receiving Applications for Colorado Works Benefits 1. When receiving applications for benefits, county workers shall:

a. Record the date the signed application was received by the county department.

b. Review applications for completeness and determine eligibility for assistance;

c. Schedule an interview with the client if the interview is not taking place immediately.

1) The client shall be offered an in-person interview at redetermination. if the client does not elect an in-person interview, the county shall schedule and conduct a phone interview.

2) The client shall be provided written notice of the interview at least four (4) calendar days of the scheduled interview. The client may provide a written or verbal waiver that written notice of the scheduled interview is not necessary when the county department is able to conduct the interview during application processing. Notice shall include:

a) The date and time for the interview;

b) Identification of any documentation that may be needed;

c) The opportunity to reschedule the appointment or make other arrangements in the event of good cause.

3) When the client does not keep the interview appointment and does not request an alternate time or arrangement, as described in this section, grant payments will be denied.

d. Make a home visit when required by county policy to determine a county approved setting for a minor client; and, e. Refer the client to other services when appropriate. Applications that have been approved for refugees shall be referred to the Colorado Refugee Services Program for other ongoing case management and services offered through Colorado Works.

2. The application process shall consist of all activity from the date the application is received from the client until a determination concerning eligibility is made. Language translation via interpreter shall be provided by the county department of residence as needed. The major steps in the application process shall include:

a. The application shall be date stamped by the county department to secure the application date for the client;

b. An explanation shall be provided to the client of the various benefit options;

c. An explanation shall be provided to the client of the eligibility factors;

d. An explanation shall be provided to the client of the client’s responsibility to accurately and fully complete the application, provide documents to substantiate or verify eligibility factors, and that the client may use friends, relatives, or other persons to assist in the completion of the application;

e. An assurance shall be provided to the client of the county worker's availability to assist in the completion of the application and to secure needed documentation which the client is unable to otherwise secure;

f. An explanation shall be provided to the client of the process to determine eligibility;

g. An explanation shall be provided to the applicant of the client’s rights and responsibilities including confidentiality of records and information, the right to non-discrimination provisions, the right to a county dispute resolution process, the right to a State-level appeal, the right to apply for another category of assistance and that a determination of the client’s eligibility for such other assistance will be made;

h. An explanation shall be provided to the client that the client may withdraw from the application process at any time.

i. The agency shall inform all clients in writing at the time of application that the agency will use all Social Security Numbers (SSN) of required household members to obtain information available through state identified sources. One interface includes, but is not limited to, the Income and Eligibility Verification System (IEVS) used to obtain information of income, eligibility, and the correct amount of assistance payments. Information gathered through State identified sources may be shared with other assistance programs, other states, the Social Security Administration, the Department of Labor and Employment, and the Child Support Services Program as permitted by Section 26-1-114, C.R.S.; and, j. An explanation shall be provided to the client of all Colorado Works program benefits and requirements applicable to the family members in the household.

The county department shall, when appropriate, provide the information verbally and in written form.

k. An explanation provided regarding the process of utilizing the Electronic Benefit Transfer (EBT) card. This explanation shall include:

1) Identification of the following establishments as described in Section 26- 2-104(2), C.R.S.in which clients shall not be allowed to access cash benefits through the Electronic Benefits Transfer services from automated teller machines and point of sale (POS) devices:

a) Licensed gaming establishments as defined in Section 44-30- 103(18), C.R.S.;

b) In-state simulcast facilities as defined in 44-32-102(11), C.R.S.;

c) Tracks for racing as defined in Section 44-32-102(24), C.R.S.;

d) Commercial bingo facilities as defined in Section 24-21-602(11);

e) Stores or establishments in which the principal business is the sale of firearms;

f) Retail establishment licensed to sell malt, vinous, or spirituous liquors except for liquor-licensed drug stores as defined in

Section 44-3-410, C.R.S.;

g) Establishments licensed to sell medical marijuana or medical marijuana-infused products, or retail marijuana or retail marijuana products; and, h) Establishments that provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment.

2) An explanation that the cash portion issued on the EBT card may be suspended with identified misuse of the EBT card at the above prohibited locations.

3. An application has been made when the county department receives the signed public assistance application forms meeting the criteria identified in Section 3.602.1.F. An application is different from an inquiry.

4. An application must be accepted by any county department; however, it is the responsibility of the county of residence to determine eligibility. The county department that received the application incorrectly shall forward the application to the county of residence promptly.

5. An application may be submitted by the client or by an individual acting on the client’s behalf when the client is unable to submit an application.

6. To be accepted, applications for Colorado Works can only be made by a caretaker with whom a dependent child(ren) is living.

F. Minimum Application Requirements 1. The county department shall require a written application, signed under penalty of perjury, using the State Department's prescribed public assistance form.

2. The application form shall be used as the primary source of information. To be considered complete, the application shall contain, at a minimum, the name of the client, signature of the client or authorized representative, and an address for the client which can include general delivery or a county office. If an address is not provided, another means of contact such as phone number or email address must be utilized to obtain an address.

3. The date of application shall be the first working day the county department receives a signed application form, which indicates the client’s desire to receive public assistance.

The application must be date stamped with the date the county department receives the signed application to secure the application date.

G. Information Sharing There are public assistance programs that are to be jointly administered by county departments.

This requires sharing of information to the extent permitted by Section 26-1-114, C.R.S.

Communications from one division to the other shall be formalized so that they serve a purpose, and there is a record of that purpose.

H. Confidentiality Information regarding families shall remain confidential and available only for the purposes authorized by federal or State law as described in Section 3.609.73, Protections to the Individual.

I. Processing Standard The county department shall process applications as expeditiously as possible but no later than forty-five (45) calendar days following the application date as described in Section 3.602.1.F.3.

1. The county department shall consider an application for Colorado Works to be an application for all programs of public assistance, except for child welfare services, for which the client has requested assistance. County departments shall make clients aware of other services and assistance under other public assistance programs that they may be eligible.

2. The determination should be followed by a written notification of eligibility status to the client. Clients who refuse to cooperate in completing the application processes shall be denied based upon timely noticing in accordance to Section 3.609.1. In cases where verification is incomplete, the county department shall provide the client with a statement of required verification on the State prescribed notice form and offer to assist the client in obtaining the required verification. The county department shall allow the client eleven (11) calendar days to provide the missing verifications, unless the client can provide good cause or the verification falls under the programs verification at an individual level described in Section 3.604.3 . If good cause is provided, the client shall have until the twentieth (20th) calendar day following the date of application to provide the necessary verification. The State prescribed notice form shall reflect specific months of eligibility and ineligibility.

3. Following a determination of ineligibility, applications remain valid for a period of thirty (30) calendar days.

a. If the client has good cause and notifies the county department that he/she is requesting benefits within thirty (30) calendar days of the denial, the county department shall reschedule the interview if not already completed, and the current application date shall be used.

b. If the client does not have good cause and notifies the county department that he/she is requesting benefits, and the request is made within thirty (30) calendar days of the current application, that application can be used, but the date of application shall be the most recent date the client requested benefits.

c. If the continued application results in a denial for any reason and the client makes a subsequent request for Colorado Works without good cause, a new application shall be required.

d. If the client requests benefits more than thirty (30) days from the date of the denial, they must submit a new application.

4. County departments shall require no more than one interview for a Colorado Works client. When an interview is conducted, the county worker shall review the application for completeness and secure, if necessary, signed copies of the Authorization for Release of Information form, and any other forms or documentation necessary to determine eligibility.

J. Information Concerning Immunizations At the time of application, the county department shall provide information concerning immunizations to all clients seeking benefits through the Colorado Works program. The information shall include parent education of vaccines, information concerning where to access vaccines in the local community, and the exemptions listed in Section 25-4-903, C.R.S. The Department of Public Health and Environment or the County or District Public Health Agency shall provide the immunization information to the county department for this purpose.

K. Reporting Case Actions 1. “Denied,” is the action that the county shall take when the client fails to meet the eligibility requirements of the category of assistance desired. A denial also may be on the basis of such factors as, but not limited to:

a. The client refuses to furnish information necessary to determine eligibility;

b. The client is unwilling to have the county department contact a collateral source to secure information, and the client refuses to sign the State-approved Authorization for Release of Information form;

c. The client does not supply information or otherwise fails to cooperate with the county department within ten (10) calendar days of the request for information unless good cause is granted and after having received notification of the reason for delay;

d. The client moves to an unknown address before determination of eligibility has been completed;

e. A third-party refuses to provide documentation of essential verifications and the client is unwilling to cooperate in obtaining such information personally.

1) Authorization of the release of such information alone does not constitute cooperation if the county department requests further assistance from the client. Documentation of lack of cooperation must be entered by the county in the case record.

2) However, if the client is willing to cooperate but unable to obtain the information, no denial or delayed determination of eligibility shall occur.

The county shall assist the client in gaining the information required to make a determination of eligibility.

2. A decision by the client to “withdraw,” shall be treated as a denial by the county department. 3.602.2 Right and Opportunity to Register to Vote A client for public assistance shall be provided the opportunity to register to vote. The county department shall provide public assistance clients the prescribed voter registration application at application and redetermination for public benefits. 3.603 Case File Maintenance 3.603.1 Purpose and Use of Case File Records A. Preparation of Case Record Preparation of the case record shall begin at the point of initial application with the client and case maintenance shall continue as long as the case is open for assistance.

B. Purpose The major purposes of a case record shall be:

1. To assist the county worker in reaching a valid decision concerning eligibility or case action, and the amount of payment and type of assistance;

2. To ensure assistance is based on factual information and verifications received;

3. To provide for continuity of assistance when a worker is absent, when a case is reopened, and when a case is transferred from one county worker/department to another;

4. To ensure valid administration of the county department in keeping with its function and purposes;

5. To serve as a valuable basis for research, for interpretation of the work of the county department, and as a basis for development and evaluation of policy and procedure.

C. Case Numbering A case number shall be assigned to the client at the time of application for assistance.

D. The county department shall document all case actions in case comments. This information shall include actions taken by the county department, the basis of such actions, and the result or outcome of the action taken on the case, and must also include:

1. All case decisions related to the prudent person principle;

2. All decisions related to the disposition of claims;

3. Any interactions with the client;

4. Actions related to a county conference and/or state level fair hearing;

5. Cause of untimely processing of the application or redetermination;

6. Other information that would be critical to document county department actions and/or would be necessary to justify case decisions during a case review, audit, appeal, or lawsuit; and, 7. Information pertaining to eligibility, verifications, collateral contacts, program participation, and associated expenditures.

E. Documentation The county department shall document all income and non-financial eligibility information into the statewide automated system.

1. The county department shall not omit case information from the statewide automated system based on the assumption that the information is unnecessary for eligibility determination.

2. All case information used to determine eligibility and changes in basic biographical information shall be updated at the time of redetermination.

F. Arrangement of Case Record and Content of the Case Record All case files, including electronic files, shall contain all documents necessary to determine the eligibility and participation in program requirements. All case files, including electronic files, at a minimum shall be:

1. Labeled clearly, and, 2. Easily accessible for state reviews and/or audit purposes.

G. Storing County Records The county department shall be responsible for the provision of a safe place for storage of case records and other confidential material to prevent disclosure by accident or as a result of curiosity of persons other than those involved in the administration of the programs. Data of any form shall be retained for the current year, plus three previous years unless:

1. There is a written statutory requirement, rule, or regulation available from a county (i.e., a broader county policy), State or federal agency requiring a longer retention period; or, 2. There has been a claim, audit, negotiation, litigation or other action started before the expiration of the three-year period. If any such action has been started, the county must maintain the case record for the duration of the action. If a county department shares building space with other county offices, locked files to store case material shall be used.

Facility and other maintenance personnel shall be instructed concerning the confidential nature of information.

H. Removal of Case Records Case records are the property of the State Department and shall be restricted to use by the State Department and county department. 3.604 Eligibility Criteria for Colorado Works Payments and Services 3.604.1 Eligibility Criteria To receive a Colorado Works grant payment, a client must:

A. Be a resident of Colorado.

1. There shall be no durational residency requirement and a client who establishes intent to remain in Colorado shall be considered a resident.

2. Residence shall be retained until abandoned.

3. Persons receiving TANF benefits from another state shall not be eligible for Colorado Works grant payments during any month a payment was made by the other state.

B. Be lawfully present in the United States as:

1. A citizen of the United States (including persons born in the United States, Puerto Rico, Guam, Virgin Islands (U.S.), American Samoa, or Swain's Island; persons who have become citizens through the naturalization process; persons born to U/S. citizens outside the United States with appropriate documentation); or, 2. A qualified legal non-citizen who entered the United States prior to August 22, 1996; or, 3. A qualified legal non-citizen who entered the United States on or after August 22, 1996, who has been in a qualified non-citizen status for a period of five years, unless they meet one of the exceptions to the five-year bar consistent with 8 U.S.C. 1613(b).

C. Be a member of an assistance unit who meets income eligibility requirements and has provided required verifications or be a noncustodial parent (noncustodial parents may receive services, but not basic cash assistance).

D. Not be admitted to an institution as a patient for tuberculosis or mental disease, unless the person is a child and receiving “under 21” psychiatric care under Medicaid benefits.

E. Not be in the custody of or confined in a county, state, or federal correction facility or institution as an inmate, which is one who is confined or serving time imposed by a court, except as a patient in a public medical institution. Those considered to not be an inmate also include, but are not limited to, those on a work release or court monitoring system.

F. Not be a temporary resident or non-citizen in one of the following situations:

1. Non-citizens with no status verification from the United States Citizenship and Immigration Service (USCIS);

2. Non-citizens granted a specific voluntary departure date;

3. Non-citizens applying for a status; or, 4. Citizens of foreign nations residing temporarily in the United States on the basis of visas issued to permit employment, education, or a visit. 3.604.2 Household Composition A. A Colorado Works household consists of clients who are part of the assistance unit and/or budgetary unit.

1. The assistance unit consists of individuals who live together and who must apply for and receive Colorado Works grant payments as a single household.

Members of the same assistance unit who meet the requirements of the Colorado Works program shall receive basic cash assistance or shall be considered when determining diversion grant amounts.

Persons not required to be in one assistance unit, but residing in the same household, shall have the option of applying for Colorado Works as separate units. Each assistance unit shall be budgeted using the appropriate need standard for the unit.

2. The budgetary unit consists of individuals who are part of the assistance unit as well as individuals who are outside of the assistance unit but considered financially responsible for members of the assistance unit.

3. Clients must provide any information or verification needed to determine who must be in the assistance unit and budgetary unit.

B. Two parent household cases will be paid with county maintenance of effort (MOE) funds. All other single parent and child only cases will be paid with county TANF block grant funds.

C. Members of the Assistance Unit 1. The following individuals must be included in the assistance unit when living in the home:

a. Dependent child(ren) who live in the home of a caretaker.

b. Parents of dependent child(ren) who live in the home unless the child is a minor parent who is requesting assistance for their own child or responsibility is established with another caretaker through court order, child welfare, or adoption.

c. Siblings of dependent child(ren) who live in the home and are legally in the care of the requesting caretaker.

d. Half siblings of the dependent child(ren) who live in the home that do not receive child support payments.

e. The spouse of a pregnant parent.

2. The following individuals are optional members of the assistance unit. These individuals are included in the assistance unit when living in the home and requesting assistance:

a. The spouse of a parent who is not themselves a parent of dependent child(ren) who live in the home.

b. A non-parent caretaker.

c. The spouse of a non-parent caretaker.

d. Half siblings of the dependent child(ren) who live in the home and are receiving child support. The parent or non-parent caretaker of the half sibling receiving child support shall decide whether to include such half sibling receiving child support in the assistance unit.

e. Siblings of the dependent child(ren) who live in the home but are not in the legal custody of the requesting caretaker due to an established court order, child welfare involvement or an adoption.

f. A parent who lives in the home of another caretaker and no longer has legal custody of the dependent child(ren) who live in the home.

g. Parent(s) of a minor parent who is requesting assistance for their own child.

3. The following individuals are excluded from the assistance unit.

a. Individuals receiving SSI payments.

b. Individuals who receive other Title IV benefits such as foster care, adoption subsidy or Title IV kinship payments.

D. Members of the Budgetary Unit 1. The following individuals must be included in the budgetary unit:

a. Any individual who is part of the assistance unit (to include optional members of the assistance unit who requested assistance) regardless of whether or not the individual is eligible to receive assistance.

b. The spouse of a parent or non-parent caretaker who requested assistance, regardless of whether or not the spouse has requested assistance for themselves.

c. The unborn child of a pregnant parent.

d. The non-recipient parent(s) of a minor parent.

e. The sponsor of a non-citizen who is part of the assistance unit (whether or not the non-citizen is themselves eligible to receive Colorado Works grant payments).

2. The following individuals are excluded from the budgetary unit:

a. An optional member of the assistance unit who chooses not to receive assistance for himself or herself.

b. Individuals who are excluded from the assistance unit as identified in Section 3.604.2.C.3.

E. A dependent child is considered to be living in the home of a caretaker as long as the caretaker exercises the responsibility for the care of the child even if the following occurs:

1. The child or the caretaker is temporarily absent from the home to receive medical treatment;

2. The child is under the jurisdiction of the court;

3. Legal custody is held by an agency that does not have physical custody of the child;

4. The child is in regular attendance at a school away from home.

F. School-aged, dependent children must be in school, home school, pursuing a GED, or attending online courses to obtain a high school diploma or GED. A dependent child is still considered to be a student in regular attendance during official school or training program vacation periods, absences due to illness, convalescence or family emergencies. County departments must work with families to enroll children not enrolled in and attending school.

G. Assistance units may remain eligible and payment for the child shall continue for Colorado Works when children are absent from the home for a period greater than forty-five (45) consecutive calendar days for the following reasons:

1. Child(ren) receiving medical care or education that requires him or her to live away from the home; or, 2. Child(ren) visiting a noncustodial parent, as specified in a parenting plan entered by the court or a parenting plan signed by both parties, the visit not exceeding six (6) months unless otherwise specified; or, 3. Child(ren) residing in voluntary foster care placement for a period not expected to exceed three (3) months. Should the foster care plan change within three months and the placement become court-ordered, the child is not longer considered to be living in the home as of the time the foster care plan is changed.

H. When more than one caretaker exercises responsibility for a child, the following hierarchy shall be followed. A caretaker:

1. Is a parent; or, 2. Is a relative by blood, marriage, or adoption who is within the fifth degree of kinship to the dependent child (not to be separated due to death or divorce); or is appointed by the court to be the legal guardian or legal custodian of the dependent child; or, 3. If those identified in a-b above are not available, is a person who exercises responsibility for a dependent child within the person’s home and provides verification of such responsibility such as a court order, school or medical records listing the individual as the child’s contact, collateral contact with child welfare, or another document acceptable to the county department. the prudent person principle may be used to determine that a non-parent caretaker other than a guardian, legal custodian, or a relative exercises responsibility for a child. The individual who exercises responsibility and is highest in the above hierarchy list shall be deemed the caretaker for the assistance unit.

I. A parent or non-parent caretaker is considered to be living in the home and may continue as a member of the assistance unit/ family needs unit if the individual is temporarily away from home if one of the following occurs:

1. Is on active duty in the uniformed service of the United States.

2. Is temporarily absent from the home to receive medical treatment.

3. Is temporarily absent from the home for less than forty-five (45) calendar days and has established an intent to return.

J. Indian Tribe Eligibility Members of an Indian Tribe not eligible for assistance under a Tribal Family Assistance Plan are eligible for Colorado Works.

K. Assistance for Eligible Refugees Refugees are qualified non-citizens exempt from the five-year bar. Those refugees eligible for assistance through TANF/Colorado Works shall submit an application to their county of residence. Those applications that have been approved shall be referred to the Colorado Refugee Services Program (CRSP) for other ongoing case management and services offered through the TANF/Colorado Works program.

1. The CRSP is responsible for performing the eligibility assessment as required by section 3.607.3 for all refugees referred to them by county departments and will apply uniform guidelines that apply to all county departments regarding the assessment of refugees.

2. Based on the assessment of the refugee, CRSP will make recommendations to the county departments and will apply uniform guidelines that apply to all county departments regarding the assessment of refugees. These recommendations shall include, at a minimum:

a. Whether the refugee is determined to be ready to work.

b. The type(s) of activities that will be most beneficial to the refugee; and, c. The amount and duration of supportive services and other assistance payments necessary to achieve self-sufficiency for the refugee.

3. The county department shall consider the recommendations of CRSP and the recommended supportive payments within the county policy.

L. Individuals Ineligible for Colorado Works Program The following individuals shall not be eligible under Colorado Works:

1. Fugitives or fleeing felons;

2. Assistance units with an adult participating in a strike;

3. Qualified legal non-citizens or those who are not federally exempt, who entered the United States on or after August 22, 1996, are ineligible for cash assistance for five (5) years from the date of entry into the United States.

M. Penalties for Disqualified or Ineligible Persons Persons who are required members of the assistance unit, but who are disqualified from receiving or are ineligible to receive Colorado Works basic cash assistance or diversion due to program prohibitions or violations, shall be removed from the assistance unit for the purposes of determining the assistance unit size. Disqualified individuals income must be considered when determining eligibility without applying income disregards.

The following disqualified or ineligible individuals shall have such month counted as a month of participation in the calculation of their overall sixty-month (60) lifetime maximum as referenced in

section 3.606.6 when a grant payment is received for others in the assistance unit.

1. Individuals convicted by a court or whose disqualification was obtained through an intentional program violation (IPV) waiver for misrepresenting their residence in order to obtain assistance in two states at the same time shall have their Colorado Works assistance denied for ten (10) years.

2. Individuals who have committed fraud as determined by a court or determination of an IPV by administrative hearing shall result in the disqualified caretaker being removed from the grant for a twelve (12) month period for the first offense, twenty-four (24) months for the second offense, and lifetime for the third offense. An IPV from another state shall be used to determine eligibility for an individual. The level of the IPV established by the Administrative Law Judge from the other state shall be used to determine the level of the IPV for Colorado Works. The timeframes established herein shall be used; the timeframe established from the other state shall no longer be valid.

3. Individuals who are fleeing felons for the time that that person meets the definition of fleeing felon as described in 3.601.

4. Individuals who have failed to apply for a Social Security Number unless a federally allowable reason, as listed in 20 CFR § 422.107 (2023), exists for not attempting to obtain a social security number. No later editions or amendments are incorporated.

These regulations are available at no cost from the U.S. social security administration, 1500 Champa Street, Suite 200, Denver, CO 80202, or at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Economic Security, 1575 Sherman Street, Denver, CO 80203, during regular business hours. Once that person has taken action to apply for a Social Security Number, they may become eligible.

6. Individuals who are non-citizens and do not meet the definition of a qualified non-citizen, those who fail to prove citizenship or fail to provide proof that they are otherwise possess a qualified non-citizen status and/or proof of lawful presence.

N. Minor Parent Applicants/Participants A minor who is also a parent may apply for Colorado Works.

1. When a minor parent is not emancipated and has a marital status of single, grant payments may not be approved unless the minor parent resides with another adult caretaker or the minor parent resides in another setting which the county has determined is an appropriate setting.

a. Counties shall assist minor parents who are otherwise eligible and are not living in a county approved setting according to the county’s policy to find an appropriate living arrangement.

b. Counties shall assist assistance units which include an unmarried minor parent(s) who has a child at least twelve (12) weeks of age, who has not completed his or her high school education or GED, and who is not participating in educational activities or an approved training program, in participating in such programs within sixty (60) calendar days from the date the initial assessment is completed for those sixteen (16) or older or within sixty (60) calendar days from the date the eligibility interview takes place for those under the age of sixteen (16). Participation means enrollment, attendance, or an action otherwise specified by the county department. Failure to participate without good cause will result in the termination or discontinuation of Colorado Works basic cash 2. When a minor parent does not live in the home of another caretaker:

a. The minor parent may not receive benefits until deemed to be in a county approved setting by the county department unless the minor is emancipated, has a marital status other than single, or resides with an adult relative.

b. A minor parent who is emancipated or has a marital status other than single is not considered to be living in the home of a caretaker even if they are living in the home of their parent.

c. A minor who is a parent and does not live in the home of a caretaker will receive assistance as an adult if approved.

3. Minor Parents and Caretakers a. If the minor parent lives with an unrelated non-parent caretaker who chooses not to be a member of the assistance unit, the minor must be in a county approved setting.

b. If the minor parent lives with an unrelated non-parent caretaker who chooses to be a member of the assistance unit, the county department may choose if it is necessary to approve the setting before grant payments are provided per county policy.

c. If the minor parent lives with his or her parent, the county department does not need to approve a setting even if the minor’s parent chooses not to be a member of the assistance unit.

d. A minor parent who is the dependent child of a caretaker will receive assistance as a child if approved even if the caretaker is not included in the assistance unit.

O. Out of the Home 1. For Colorado Works purposes, a client who is out of State temporarily shall be provided assistance on the same basis as one who is in the state as long as the individual has established intent to return. The client’s temporarily out of the State status shall not exceed ninety (90) consecutive days.

2. A client who is a resident of an institution is not considered to be in the home. A client shall be considered a resident in an institution when the recipient's stay is at least thirty (30) consecutive days. Institutions include general medical and surgical hospitals, nursing homes, assisted living residences, and mental institutions. Residents of an institution who continue to have the responsibility of a dependent child may receive Colorado Works if the dependent child also resides in the institution or continues to be cared for in the home, unless individual needs are provided for through other state. 3.604.3 Program Verifications A. The county department shall not require any documentary evidence (verification) and/or written statements for eligibility determination until the county department receives a signed and dated application. The client has the primary responsibility for providing documentary evidence for required verification and the responsibility to resolve questionable information. The county worker shall assist the client in obtaining the necessary documentation if the client is cooperating with county workers. The client may supply documentary evidence in person, through mail, by facsimile, through an electronic device, or through an authorized representative. The county worker shall accept all pertinent documentary evidence provided by the client and shall be primarily concerned with how adequately the verification proves the statements on the application and/or program participation, if applicable. If written verification cannot be obtained, county workers shall substitute an acceptable “collateral contact” if available, as defined in section 3.601 program definitions and E-F of this section.

If the client is missing any verification, the county department shall request additional and/or required verifications from the client. the request shall include:

1. A specific list of verifications necessary to determine eligibility;

2. The due date for when the verifications must be returned, which shall be eleven (11) calendar days from the date the verification was requested in writing; and, 3. Notification that if the client fails to return the verifications by the due date, the county department shall process the application without those verifications, which may lead to a denial of grant payments.

If proper verification is not received and a collateral contact is unavailable, the client will be noticed (in writing or verbally) with information that the county worker will assist with obtaining verification, provided that he or she is cooperating with the county department.

Verification is an eligibility requirement. Failure to provide requested verification may result in the case and/or client being denied, closed, terminated, or discontinued. The verification process shall begin the date the application is date stamped by the county and shall continue throughout the life of the case, including program participation and applicable verifications for ongoing redeterminations of eligibility.

B. Required Primary Verifications 1. All information received through the Income and Eligibility Verification (IEVS) System shall be reviewed and verified. Assistance shall not be denied, delayed, or discontinued pending receipt of information requested through IEVS, if other evidence establishes the client's eligibility for assistance.

2. All participating clients shall provide to the county the following information:

a. Verification of lawful presence in the United States; section 3.604.3.I.

b. Verification of citizenship or qualified non-citizenship status; section 3.604.I-J.

c. A Social Security Number (SSN) for each client applying for benefits or proof that an application for a SSN has been made. Proof of application is only valid for up to eight (8) months without good cause. The agency shall explain to the client that refusal or failure without good cause to provide a SSN or a receipt of a SSN application will result in ineligibility for the client for whom an SSN or receipt is not obtained. Only the client for whom the SSN or receipt is not provided will be ineligible, and not the entire assistance unit.

1) For clients that made application for a SSN at initial eligibility determination, verification of the SSN must be received prior to the next recertification.

2) For clients added to the assistance unit within sixty (60) days of the certification period expiring, verification of the SSN must be received by the following recertification.

3) The county department shall verify the SSNs provided by the assistance unit with the Social Security Administration (SSA) in accordance with procedures established by the state department for the State On Line Query (SOLQ) system.

4) The county department shall accept as verified a Social Security Number that has been verified by any program agency participating in SOLQ system.

d. Verification of a caretaker’s responsibility for the child(ren) must be provided, unless the caretaker is the child(ren)’s parent. Verification may include, but is not limited to, verbal or written confirmation from the child’s parent, a court order, school or medical records listing the individual as the child’s contact, or collateral contact with child welfare. The prudent person principle may be used to determine that a non-parent caretaker other than a guardian, legal custodian, or a relative exercises responsibility for a child.

e. Verification of income of any member of the assistance unit or other household member whose income is used to determine eligibility and payment.

f. Verification of Colorado residency.

3. Counties may require further verification of any information that is received that is determined to be questionable or inconsistent. Such a determination must be documented in the applicant's case file.

4. An applicant may request an extension of time beyond the forty-five (45) day maximum to process an application for Colorado Works benefits in order to obtain necessary verification. The extension may be provided at county discretion. The worker must document the reason for the extension in the statewide automated system and/or case 5. All immigrants shall have non-citizen status verified through the Systematic Alien Verification for Entitlements (SAVE) system. Assistance shall not be delayed or discontinued pending this verification.

C. Secondary Verifications When applicable, secondary verifications for eligibility and program participation, may include, but are not limited to:

1. Verification of relationship of a dependent child to other household members;

2. Verification of good cause, to include good cause for a delay in providing verifications for assistance, good cause for not cooperating with child support services, and good cause for not participating in work activities;

3. Verification of child support, to include information of the noncustodial parent and/or child support income/expenses as specified in section 3.606;

4. Verification of school attendance for all school-aged children included in the assistance unit, including home school, GED, and online attendance;

5. Verification of work participation;

6. Verification establishing allowable absences of an adult or child in the assistance unit if leaving the state/home and requesting to continue benefits; and/or, 7. Verification of pregnancy, when no children are in the assistance unit.

D. Sources of Verification Counties may use collateral contacts, interfaces, prudent person principle, documentary evidence, and in some cases, client statement as sources of verification.

E. Use of a Collateral Contact, Review, and Follow-up Applications shall be reviewed and any necessary follow-up activities such as collateral contacts, verifications, etc., shall be initiated within five (5) calendar days of when the county department obtains information containing the collateral contacts information from the client. Priority shall be given to those applications where critical and emergent need is apparent.

F. Requirements for Collateral Contact to Make a Determination of Eligibility 1. The client shall be given the opportunity to provide documentation necessary to determine eligibility. When necessary, the county department shall assist the client to secure documentation. If documentation that is necessary to determine eligibility is not received, a notice shall be sent to the client to advise him or her of the proposed action to deny or discontinue the case. The notice to the client shall also include a specific description of the documentation necessary to determine eligibility.

In general, the county department shall rely on the client to provide the documentation necessary to determine eligibility.

2. A collateral contact is an oral or written confirmation of a household's circumstances by a person outside of the household. The signature on the application shall be considered consent for the use of collateral contacts. The county department may rely on members of the household to provide the name of any collateral contact. If the individual provides an unacceptable collateral contact who cannot be expected to provide accurate verification, the county department shall:

a. Request the name of another collateral contact; or, b. Ask for alternative forms of verification; or, c. Substitute a home visit to establish a county approved setting when applicable.

3. Confidentiality shall be maintained when talking with collateral contacts. The county department shall disclose only the information that is absolutely necessary to obtain information being sought. If the client fails to provide a collateral contact or provides a contact that is unacceptable to the eligibility worker, the county worker may select a collateral contact that can provide information that is needed. Except for contacts to verify information provided through IEVS, the collateral contact selected by the county worker shall not be contacted without first obtaining the prior written or verbal approval of an adult household member or the authorized representative. Collateral contacts for IEVS do not require household designation or prior contact approval. The notice of proposed action shall advise the household that they have the option to consent to the collateral contact, to provide acceptable verification in another form, or to withdraw the application.

If the household refuses to choose one of the above options, the application shall be denied.

The case file shall be documented to support action taken by the county department. The county department shall not determine the household to be ineligible when a person outside the household refuses to provide information required for the client to resolve a request for verification (i.e. a former employer will not provide verification of employment termination and does not respond to attempts for a collateral contact by the county department). In such scenarios, the prudent person principle must be used to determine eligibility without the unavailable verification.

Household members who are disqualified or in an ineligible status are not considered individuals outside the household.

4. In cases in which the information from another source contradicts statements made by the household, the household shall be afforded a reasonable opportunity to resolve the discrepancy prior to an eligibility determination.

G. The rules contained herein are intended to be sufficiently flexible to allow the eligibility worker to exercise reasonable judgment to determine when a request for verification is unnecessary because the facts of the case are clear. In making a certification decision, the eligibility worker should ask whether his or her judgment is reasonable, based on experience and knowledge of the program.

The prudent person principle may not be used to waive the requirement to verify lawful presence for clients over the age of eighteen (18).

The prudent person principle may not be used to verify that a SSN application has been submitted for a newborn unless the pregnancy was previously verified or the newborn was born in a colorado hospital.

The prudent person principle may be used to determine that a non-parent caretaker other than a guardian, legal custodian, or a relative exercises responsibility for a child and/or when determining good cause for non-cooperation with the workforce development program activities or child support services.

All case decisions related to the prudent person principle must be documented in case comments.

H. Interfaces are acceptable verification sources for Colorado Works.

1. Income and Eligibility Verification System (IEVS)

IEVS provides for the exchange of information for Colorado Works with the SSA and the Colorado Department of Labor and Employment (DOLE). The county department shall act on all information received through IEVS. The county department shall, at a minimum, prior to approval of benefits, verify potential earnings and unemployment benefits through DOLE for all applicants, except institutionalized applicants. Benefits shall not be delayed pending receipt of verification from a collateral contact (e.g., employers). In cases where the county department has information that an institutionalized or group home recipient is working, wage and unemployment insurance benefits matches are required at application. All other matches will be initiated through IEVS upon approval of benefits.

Through IEVS, recipient SSNs will be matched with source agency records on a regular

basis to identify potential earned and unearned income, resources and assets, including:

a. The following data shall be considered verified when entered into the statewide automated system:

1) SSA (Beneficiary and Earnings Data Exchange/Bendex, State Data Exchange/SDX) Social Security benefits, SSI, pensions, selfemployment earnings, federal employee earnings; and, 2) Unemployment Insurance Benefits (UIB).

b. DOLE wage data shall not be considered verified upon receipt. Additional verification must be obtained to verify wage information.

c. At initial application and at redetermination, a client of Colorado Works shall be notified through a written statement provided on or with the application form that the information available through IEVS: will be requested and used for eligibility determinations; shall be verified through sources, such as collateral contacts with the client, when discrepancies are found by the county department; and may affect the assistance unit’s eligibility and level of payment.

1) All verification types obtained by a collateral contact to validate or invalidate the IEVS discrepancy shall be documented; and, 2) Case documentation shall be available in the case file or statewide automated system documenting the action taken on the case within fortyfive (45) calendar days of initial receipt. Case documentation must include the purpose of the review, the action taken on the case, and how the determination was made that supported the action taken by the d. The county department shall review and process IEVS within forty-five (45) days.

No more than twenty (20) percent of the IEVS reviewed may remain unprocessed beyond forty-five (45) days when:

1) The reason that the action cannot be completed within forty-five (45) days is the non-receipt of requested third-party verification; and, 2) Action is completed promptly, when third-party verification is received or at the next time eligibility is redetermined, whichever is earlier. If action is completed when eligibility is redetermined and third-party verification has not been received, the county department shall make its decision based on information provided by the recipient and any other information in its possession.

2. Public Assistance Reporting Information System (PARIS)

The county department shall query PARIS at initial application and at redetermination to determine whether the client is receiving benefits in another state, veterans’ benefits, or military wages or allotments.

3. Systematic Alien Verification for Entitlements (SAVE)

The county department shall query SAVE at initial application and at redetermination to:

a. Determine whether a qualified non-citizen has a sponsor(s);

b. Verify the non-citizen registration number provided by the client and, if the number and name submitted do not match, take prompt action to terminate assistance to the client; and c. Determine if there has been a change in the non-citizen’s status.

4. Colorado Department of Revenue, Division of Motor Vehicles (DMV)

The Colorado DMV may be used by the county department to verify lawful presence and identity.

I. Verification of Citizenship and Lawful Presence 1. Verification of citizenship in the United States Citizenship may be verified by a birth certificate, possession of a U.S. passport, a Certificate of U.S. Citizenship (USCIS form N-560 or NH-561), a Certificate of Naturalization (USCIS form N-550 or N-570), a Certificate of Birth Abroad of a Citizen of The United States (Department of State Forms FS-545 or DS-1350), or identification cards for U.S. citizens (USCIS-I-179 or USCIS-I-197). Documents that are acceptable as verification of citizenship can be found in the Department of Revenue rules at 1 CCR 204-30, Rule 5, Appendix A and B (Mar. 2, 2021), no later editions or amendment are incorporated. These regulations are available at no cost form the Colorado Department of Revenue, 1881 Pierce St., Lakewood, CO 80214 or at https://www.sos.state.co.us/ccr.

These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Economic Security, 1575 Sherman St., Denver, 2. Verification of questionable citizenship information The following guidelines shall be used in considering questionable statement(s) of citizenship from a client:

a. The claim of citizenship is inconsistent with statements made by the client, or with other information on the application, or on previous applications.

b. The claim of citizenship is inconsistent with information received from another source.

c. The claim of citizenship is inconsistent with the documentation provided by the client.

Application of the above criteria by the eligibility worker must not result in discrimination based on race, religion, ethnic background or national origin, and groups such as migrant farm workers or Native Americans shall not be targeted for special verification. The eligibility worker shall not rely on a surname, accent, or appearance that seems foreign to find a claim to citizenship questionable. Nor shall the eligibility worker rely on a lack of English speaking, reading, or writing ability as grounds to question a claim to citizenship.

3. The client whose citizenship is in question shall be ineligible to participate until proof of citizenship is obtained. If a non-citizen is unable to provide any USCIS document at all, there is no responsibility to offer to contact USCIS on the non-citizen's behalf.

Responsibility exists only when the non-citizen has a USCIS document that does not clearly indicate eligible or ineligible non-citizen status. The county department shall contact the State Department, not the USCIS, to obtain information about the noncitizen's correct status. The method used to document verification of citizenship and the result of that verification shall be contained in the case file.

4. All persons eighteen years of age or older must establish lawful presence in the United States prior to receiving Colorado Works with the exception of those exempt in the list provided in this section. The requirements of this section do not apply to clients under the age of eighteen (18).

a. In order to verify his or her lawful presence in the United States, a client must:

1) Produce and provide to the county department:

a) A valid Colorado driver’s license or a Colorado identification card issued pursuant to article 2 of title 42, C.R.S.; or, b) A United States military card or military dependent’s identification card; or, c) A United States coast guard merchant mariner card; or, d) A Native American tribal document; or, e) Any other document authorized by rules adopted by the Department of Revenue (1 CCR 2204-30, Rule 5, Appendix A, as incorporated by reference in section 3.604.3.I.1 of these rules).

b. The requirements of this section do not apply to the following clients, programs and services:

1) For any purpose for which lawful presence in the United States is not required by law, ordinance, or rule;

2) For obtaining health care items and services that are necessary for the treatment of an emergency medical condition of the person involved and are not related to an organ transplant procedure;

3) For short-term, non-cash, in-kind emergency disaster relief;

4) For programs, services, or assistance such as soup kitchens, crisis counseling and intervention, and short-term shelter specified by federal law or regulation that:

a) Deliver in-kind services at the community level, including services through public or private non-profit agencies;

b) Do not condition the provision of assistance provided on the individual recipient’s income or resources; and, c) Are necessary for the protection of life or safety;

5) Pregnant women;

6) For individuals over the age of eighteen years of age and under the age of nineteen years who continue to be eligible for medical assistance programs after their eighteenth birthday.

5. A non-citizen considered a legal immigrant will normally possess one of the following forms provided by the citizenship and immigration services (USCIS) as verification:

a. I-94 arrival/departure record.

b. I-551 resident alien card (I-551).

c. Forms I-688b or I-766 employment authorization document.

d. A letter from USCIS indicating a person's status.

e. Letter from the U.S. Department of Health and Human Services (HHS) certifying a person's status as a victim of a severe form of trafficking.

f. Iraqi and Afghan individuals who have been admitted as Special Immigrants (SI).

g. Any of the documents permitted by the Colorado Department of Revenue rules for evidence of lawful presence (1 CCR 204-30, appendix B, as incorporated by reference in section 3.604.3.I.1 of these rules).

6. Legal immigrants applying for public assistance must present documentation from USCIS showing the applicant's status. All documents must be verified through SAVE to determine the validity of the document. Benefits shall not be delayed, denied or discontinued awaiting the SAVE verification.

J. Verification required from non-citizens 1. As a condition of eligibility for financial assistance, when a sponsored non-citizen is included in the assistance unit or budgetary unit, the client must provide income information about the non-citizen's sponsor(s).

K. When a client is unable to provide verification for citizenship, qualified non-citizenship status, lawful presence, identity, and/or their social security number, the county department shall grant thirty (30) calendar days to the client to provide the verification. If the verification is provided in the allotted time, the same application may be used to determine eligibility and benefits provided.

Verification shall be provided for each individual requesting/receiving payments at the time of application and redetermination. In addition, supportive services, special needs payments and assistance in obtaining verifications shall be provided.

Individuals unable to provide this verification will not receive payment for themselves and their income will be used to determine eligibility for the household. 3.604.4 Colorado Works and Child Support Services A. As a condition of continued eligibility, clients for Colorado Works are statutorily required to assign all rights to child support on their own behalf or on behalf of any other member of the assistance unit for whom the application is made. A client's failure to sign and date the application form to avoid assignment of support rights precludes eligibility for the assistance unit. Failure to cooperate with Child Support Services at application and/or while receiving basic cash assistance, without good cause, will result in the termination or discontinuation of the Colorado Works basic cash assistance.

This assignment is effective for child support due and owed during the period of time the person is receiving public assistance. The assignment takes effect upon a determination of eligibility for Colorado Works cash assistance. The assignment remains in effect with respect to the amount of any unpaid support obligation accrued and owed prior to the termination of Colorado Works cash assistance to the client. The application form shall contain acknowledgement of these provisions and shall be signed and dated by the client.

1. Clients may request that their case not be referred to child support services based upon good cause. Claims found to be valid are:

a. Potential physical or emotional harm to a child(ren).

b. Potential physical or emotional harm to a parent or caretaker.

c. Pregnancy or birth of a child related to incest or forcible rape.

d. Legal adoption before court or a parent receiving pre-adoption services.

e. Other reasons documented by the county department.

f. Reasons considered to be in the best interest of the child.

g. Other court order.

2. Every client shall be given notice and the opportunity to claim that his or her case should not be referred to Child Support Services based upon good cause.

3. Determination of such good cause must be in writing and documented in the case file by the county director or designee of the county director.

4. Each case not referred based upon good cause shall be reviewed by the county director or designee at least yearly.

B. Basic cash assistance shall be considered part of the Unreimbursed Public Assistance (UPA) as defined in the Child Support Services Rule Manual at 9 CCR 2504-1 section 6.002.

C. If a family is ineligible for Colorado Works basic cash assistance due to child support income and the income received from child support is either not received or is less than the family need standard, the family may request to be reinstated for assistance in that month. The income from the current month will be used to determine eligibility and payment prospectively. 3.604.5 Family Violence Option (FVO) Waiver The federal government allows state Temporary Assistance for Needy Family (TANF) programs to participate in the option to waive certain program requirements for individuals who have been identified as survivors of family (domestic) violence.

A. Waiver provisions 1. The FVO waiver allows a county to exempt Colorado Works clients from the following standard program elements if it is determined that participation in these elements would unfairly endanger or penalize an individual or their child(ren) as a result of their experience of family violence:

a. Work activities b. TANF time clock. Assistance received while the FVO waiver is in effect does not prevent the TANF time clock from advancing, but is an allowable reason to extend assistance beyond the sixtieth (60th) month.

c. Child support services 2. The county department shall involve the client when choosing to invoke a FVO waiver.

The individual at their discretion may accept or refuse any waiver offered.

B. Requirements for FVO waivers:

When a county department and client invoke the FVO waiver the following are required:

1. Implement county written policies which at a minimum address:

a. Domestic violence and FVO;

b. How counties intend to provide information about the FVO waiver, related benefits, domestic violence services, and options provided by Colorado Works and others to all clients on an ongoing basis.

This information should be provided in accordance with section 3.602.1 and at a minimum shall include (1) procedures for voluntarily and confidentially selfidentifying as a survivor of domestic violence and how self-disclosed information will be used and (2) benefits of and procedures for applying for waivers from any program requirements and extension of time limits;

c. The process for screening and assessing domestic violence continually.

2. Training and case actions for county staff.

a. The core FVO/domestic violence training shall be mandatory for all staff who play a role in determining, modifying, or granting FVO waivers, including intake, assessment, case management, or Workforce Development staff. This training must be completed prior to contact with Colorado Works clients. CDHS strongly recommends that all county staff, including experienced staff, supervisors, and/or managers, attend the core FVO training at least once every five (5) years, and attend ongoing and specific training offered or recommended by Colorado Works and local agencies that address domestic violence issues.

b. County staff who have participated in the core FVO training shall be the only staff who shall provide information about and screen for domestic violence, assess for domestic violence waiver eligibility, make waiver determinations, review waivers and extensions, consider sanctions, and/or develop and modify an Individualized Plan of a client who has a waiver.

3. Follow certain processes with regard to all Colorado Works clients including:

a. Screen Colorado Works clients by identifying those who are or have been survivors of domestic violence by using the State Department domestic violence screening form.

b. Assess Colorado Works clients who are identified as a survivor of domestic violence by:

1. The nature and extent to which the individual may engage in work activities;

2. The resources and services needed to assist the individual in obtaining safety and self-sufficiency; and, 3. A plan to increase the client’s safety and self-sufficiency.

c. Domestic violence exemptions (or waivers) of certain Colorado Works requirements may be granted for good cause based on circumstances that warrant non-participation in program work requirements described in this section, non-cooperation with Child Support Services as defined in section 3.604.4,A.1, or a program extension. Good cause may also be determined through the use of the prudent person principle as specified in section 3.604.3.G. And defined in

section 3.601.

1. Good cause for granting an FVO waiver of work activities and/or the sixty (60)-month time limit extension is defined as anything that would potentially endanger or unfairly penalize a client or the client’s family if he/she participated in work activity requirements or grant payments were discontinued.

2. Good cause for granting a waiver of the Child Support Services cooperation requirement is defined as anything in section 3.604.4.A.1, including circumstances that are not in the best interest of the child, e.g., potentially endangering or unfairly penalizing the client or child if the individual cooperated with Child Support Services.

4. Provide certain resources to all Colorado Works clients and survivors of domestic violence. Counties are to make immediate referrals to appropriate services, including: domestic violence services, legal services, health care, emergency shelter, child protection, and law enforcement. Such referrals are to be documented in the client’s case C. FVO provisions 1. Screening clients includes:

a. All clients are to be screened continually for domestic violence by trained workers.

b. At any point in Colorado works program participation, a client may be identified or may self-identify as a survivor of domestic violence.

c. Workers are to use sensitivity and discretion in selecting the appropriate setting for domestic violence screening. The screening and any information related to the client’s domestic violence shall remain confidential in accordance with section 3.609.73.

2. Waiver provisions, case documentation, and the Individualized Plan (IP)

a. The county shall use only FVO-trained workers to work with survivors of domestic violence throughout the application, screening, waiver/IP development, and case management processes, and when implementing, modifying, and monitoring sanctions for a domestic violence survivor.

b. Workers shall use the prudent person principle in determining what FVO waiver(s) will most benefit the individual. The IP shall be developed with a priority on safety and self-sufficiency for the individual and the individual’s child(ren).

c. Waivers shall be based on need, and may be granted as long as need is demonstrated. This can be accomplished at application or throughout the life of the case.

d. Waivers shall be documented in the statewide automated system describing and taking into account:

1) The past, present, and ongoing impact of domestic violence on the individual and the family;

2) The individual’s available resources;

3) The maximized safety of the individual and the individual’s family while leading to self-sufficiency;

4) Identification of specific program/work activities requirements being required and/or waived;

5) Prioritization of work, excepting those cases where work would lead to greater risk of family violence; re-assessment should occur every six (6) months, at minimum.

3. Appeal of a waiver denial a. If a waiver is denied, and the client wishes to dispute this decision, he or she may appeal through the State Division of Economic and Workforce Support. The Division will review and make decisions on the appeal. If the State Division of Economic and Workforce Support denies the client’s appeal, he or she has the right to appeal further through the judicial review process in section 24-4-106, C.R.S.

The appellant shall be granted all requested waivers and continue to receive benefits through the appeal process.

b. Any individual may reapply for a waiver at any time. 3.605 Income 3.605.1 Income A. For Colorado Works grant payments, all countable gross income that members of the assistance unit and budgetary unit have received or expect to receive shall be used to determine eligibility.

1. Consideration of income - for purpose of determining need, all countable gross income received in the month prior to, if available, and in the month of application shall be used to determine eligibility of members of the assistance unit.

2. Availability of income - income shall be countable when actually available, when the client has a legal interest in a sum, and has the legal ability to make such sum available for support and maintenance. Income, in general, is the receipt by a client of a gain or benefit in cash or in-kind during a calendar month. Received means the date on which the income becomes legally available.

3. Securing potential income - a client must make every reasonable effort to secure potential income.

a. The time required to make income available shall not be used as a basis for delaying the processing of an application.

b. When the client is taking appropriate action to secure potential income, the assistance unit shall continue without adjustment until the income is available.

c. If the client refuses to make a reasonable effort to secure potential income, such income must be considered as if available. Timely and adequate notice must be given to the assistance unit regarding a proposed action to deny, reduce, or terminate assistance, based on the availability of the income.

d. If, upon the receipt of the prior notice, the client acts to secure the potential income, the proposed action to deny, reduce, or terminate assistance shall be withdrawn and assistance must be approved and/or continued without adjustment until the income is, in fact, available.

4. Income of a non-participant stepparent and a non-participant parent of an unmarried minor parent a. A stepparent’s countable income is considered available to stepchildren included in the assistance unit as dependent children. The countable income of a nonparticipant parent(s) of an unmarried minor parent who is living in the same home as the minor parent, shall also be deemed to the assistance unit.

The countable income equals gross earned income minus the employment disregard of $90, minus the maintenance or child support paid to others outside the assistance unit, minus the amounts actually paid by the individual to other individuals not living in the home and who could be claimed by the individual for federal income tax purposes, plus any unearned income received by the stepparent or non-participant parent. The needs of the stepparent or parent of the minor parent, and the needs of individuals living in the home for whom the stepparent or parent are responsible shall be deducted from the result to determine the amount attributed to the assistance unit.

b. Income of parents living in the same home as the unmarried minor parent shall be attributed to the assistance unit of the minor parent.

5. Sponsored non-citizens a. It shall be presumed that an affidavit of support demonstrates the sponsor's ability to make income available to a non-citizen whom he or she sponsors at a minimum of one hundred twenty-five percent (125%) of the Federal Poverty Level. Therefore, the net income of a non-citizen’s sponsor and the sponsor's spouse shall be deemed to the assistance unit.

b. Sponsor net income equals gross earned income minus twenty percent (20%) or $175, whichever is less, minus support paid to dependents not living in the sponsor's home, plus any unearned income. The remaining income shall be considered available as unearned income to the non-citizen for the purpose of establishing eligibility and payment for Colorado Works.

The client may rebut the county department's determination that the income of the sponsor is available. If such a determination is made, the sponsor’s income will not be deemed to the assistance unit.

c. The income of the sponsor will not be deemed to the assistance unit if any of the following are true:

1) The non-citizen is a qualified non-citizen who is not a legal permanent resident (i.e. refugees, asylees, parolees and Cuban and Haitian entrants).

2) The non-citizen adjusted their status to legal permanent resident from refugee or asylee status.

3) The non-citizen’s sponsor signed the sponsorship agreement prior to December 19, 1997.

4) The non-citizen is a victim of battery or extreme cruelty.

5) The total income of the non-citizen and non-citizen’s spouse, together with the total income of the sponsor and the sponsor’s spouse (who is also a sponsor) is less than one hundred twenty-five percent (125%) of the Federal Poverty Guidelines for the household size of both the noncitizen and the sponsor.

6) The non-citizen earned or can be credited with forty (40) qualifying quarters of coverage as defined under Title II of the Social Security Act.

7) The non-citizen was sponsored on an affidavit of support other than the I-864. Or the non-citizen entered in a nonfamily or employment classification that did not require the sponsor to sign form I-864.

d. If it is determined that the legal immigrant received financial assistance benefits that were the responsibility of the sponsor, the State Department or county department may recover such funds from the sponsor or the legal immigrant via the following:

1) Income assignments;

2) State income tax refund offset;

3) State lottery winnings offset; and, 4) Administrative lien and attachment.

Enforcement of duties under affidavit of support shall be the responsibility of the sponsored immigrant.

6. Net income of persons who are required to be included in the assistance unit, but who are disqualified due to failure to meet citizenship, non-citizen status, lawful presence or Social Security Number requirements, or are ineligible as defined in section 3.604.2.C, shall be deemed to the assistance unit. Net income equals gross earned income minus employment disregards and employment incentives plus any unearned income.

B. Countable Income All countable income, including earned and unearned income received, or unearned income an assistance unit expects to receive in the application month and any month following shall be used to determine eligibility for the assistance unit. 3.605.2 Earned Income A. Earned In-kind Income Earned in-kind income shall be income resulting from the performance of services by the client for which he or she is compensated in shelter or other items in lieu of wages.

B. Consideration of Earned Income “Earned Income” is still considered when:

1. Money payments obligated to the employee are diverted to a third-party for the employee’s household or other expenses;

2. Wages are being garnished by a court order.

With the exception of contract employment, wages that are paid to an employee for a period for which services were rendered are considered available when paid rather than when earned, except that wages held at the request of the employee are considered income in the month they would otherwise have been paid.

C. Income from Short-Term Employment Income received from short-term employment such as temporary employment (ninety days or less) and subsidized employment shall not be considered to determine eligibility as long as the client has not been terminated or has terminated the employment due to a fault of their own. This employment may be documented in the Individualized Plan.

D. Countable Earned Income 1. Consideration of Earned Income Against the Program Income Standard Unless otherwise specified, any earned income is countable and the applicable earned income must be considered against the applicable needs standard.

2. Determining Earned Income The amount of wages, salaries, or commissions available to the client after the applicable disregards is considered the net earned income.

3. Wages for Providing Home Care Allowance Services When a client is the care provider to another client for whom a Home Care Allowance (HCA) payment is made, the HCA payment is considered earned income to the client who is the care provider.

4. Earned Income of a Dependent Child not in School All earned income of dependent children who are not students or making satisfactory progress in an equivalent activity shall be considered in determining eligibility for Colorado Works.

E. Self-Employment Income 1. A client who is self-employed shall have the following applied to their income:

a. To determine the net profit of a self-employed client, deduct the cost of doing business from the gross income.

1) These expenses include, but are not limited to, the rent of business premises (if working out of the home, the cost of the room used when doing business shall be used to determine the amount of the expense), wholesale cost of merchandise, utilities, interest, taxes, labor, and upkeep of necessary equipment.

2) Depreciation of equipment shall not be considered as a business expense.

3) The cost of and payments on the principal of loans for capital assets or durable goods shall not be considered as a business expense.

4) Personal expenses such as personal income tax payments, lunches, and transportation to and from work are not business expenses, and are included in the applicable earned income disregards computation.

b. Appropriate allowances for the cost of doing business for clients who are licensed, certified, or approved day care providers are:

1) For the first child for whom day care is provided, deduct $55, and 2) For each additional child deduct $22. If the client can document a cost of doing business that is greater than the amounts above, the procedure described in (a), above, shall be used.

c. The result net profit amount, secured after the appropriate deductions described above, shall be treated as described in section 3.605.2.D, concerning earned income.

d. An allowable form of verification for self-employment is a client’s ledger of income and expenses.

2. Income Received From Self-Employment All self-employment income that is received regularly shall be considered income in the month it is received.

3. Irregular Receipt of Self-Employment Income If receipt of self-employment income is irregular or varies significantly from month to month, it shall be averaged over a twelve-month period.

4. Other Types of Self-Employment Income Some different types of self-employment income and how they are considered include, but are not limited to, the following:

a. Self-employment income earned by the owner of a farm – shall be considered in the month it is received.

b. Rental income – shall be considered as self-employment income only if the client actively manages the property for an average of twenty (20) hours per week or more.

c. Board (to provide a person with regular meals only) payments shall be considered earned income in the month received to the extent that the board payment exceeds the maximum Food Assistance allotment for a one-person household per boarder and other documented expenses directly related to the provision of board.

d. Room (to provide a person with lodging only) payments shall be considered earned income in the month received to the extent that the room payment exceeds other documented expenses directly related to the provision of room.

e. Room and board payments shall be considered earned income in the month received to the extent that the payment for room and board exceeds the Food Assistance allotment for a one-person household per room and boarder and other documented expenses directly related to the provision of room and board.

F. In-Kind Countable Earned Income 1. Donated in-kind earned income is countable when it:

a. Is regular and for a specific time period;

b. Is a necessary service; and, c. If not performed by the client, someone would have to be hired to perform the service.

2. If donated services meet these requirements, the value of these services is determined by:

a. The going rate in the community; or b. From two employers of like services.

3. The client shall be informed that the continuation of donation of services will result in an income deduction from the assistance grant after all applicable earned income disregards have been applied.

G. In-Kind Income In Exchange For Employment In-kind income received in exchange for employment is employment income and shall have the appropriate earned income disregards applied to the total value of the income. The amount considered as earned income when a client is paid in-kind is the value of the item supplied. The current market value of the item is used if the value of the item is not provided. 3.605.3 Countable Unearned Income Unless otherwise specified, any unearned income is countable and together with all other countable income of the client it must be considered against the applicable assistance program need and/or grant standards specified in the regulations covering the different programs.

A. Countable Unearned Income Countable unearned income includes, but is not limited to the following, as well as other payments from any source, which can be construed to be a gain or benefit to the client and which are not earned income:

1. Veteran’s Compensation and pension.

2. Income from rental property is considered as unearned income where the client is not actively managing the property on an average of at least twenty (20) hours a week.

Rental income is countable to the extent it exceeds allowable expenses. Allowable expenses are maintenance, taxes, management fees, interest on mortgage, and utilities paid. This shall not include the purchase of the rental property and payments on the principal of loans for rental property.

3. Current spousal maintenance (also referred to as alimony).

4. U.S. Department of Veterans Affairs (VA) educational assistance (G.I. Bill) payments or any other benefits which are conditional upon school attendance are income to the extent that they exceed expenses necessary for school attendance.

5. Proceeds of a life insurance policy to the extent that they exceed the amount expended by the beneficiary for the purpose of the insured recipient's last illness and burial which are not covered by other benefits.

6. Proceeds of a health insurance policy or personal injury lawsuit to the extent that they exceed the amount to be expended or required to be expended for medical care.

7. Strike benefits.

8. Income from jointly owned property - in a percentage at least equal to the percentage of ownership or, if receiving more than percentage of ownership, the actual amount received.

9. Lease bonuses (oil or mineral) received by the lessor as an inducement to lease land for exploration are income in the month received.

10. Oil or mineral royalties received by the lessor are income in the month received.

11. Stepparent and non-citizens' sponsors' attributable income for Colorado Works cases.

12. Amounts withheld from unearned income because of a garnishment are countable as unearned income.

13. Loans or inheritances.

14. Gifts or prizes.

15. Dividends and interest received on savings bonds, leases, etc.

16. Annuities, pensions, or retirements payments.

17. Disability or survivor's benefits.

18. Worker's Compensation payments.

19. Unemployment Compensation.

20. Social Security benefits.

B. Periodic Payments The following types of periodic payments are countable unearned income:

1. Annuities - payments calculated on an annual basis which are in the nature of returns on prior payments or services; they may be received from any source;

2. Pension or retirement payments - payments to a client following retirement from employment, such payments made by a former employer or from any insurance or other public or private fund;

3. Disability or survivor's benefits - payment to a client who has suffered injury or impairment, or to such client’s dependents or survivors; such payments may be made by an employer or from any insurance or other public or private fund;

4. Worker's Compensation payments - payments awarded under federal and state law to an injured employee or to such employee's dependents; amounts included in such awards for medical, legal, or related expenses incurred by a client in connection with such claim are deducted in determining the amount of countable unearned income;

5. Veteran compensation and pension - payments based on service in the armed forces; such payments may be made by the VA, another country, a state or local government, or other organization. Any portion of a VA pension that is paid to a veteran for support of a dependent shall be considered countable unearned income to the dependent rather than the veteran.

6. Unemployment Compensation - payments in the nature of insurance for which one qualifies by reason of having been employed and which are financed by contributions made to a fund during periods of employment;

7. Railroad retirement payments - payments, such as sick pay, annuities, pensions, and unemployment insurance benefits, which are paid by the Railroad Retirement Board (RRB) to a client who is or was a railroad worker, or to such worker's dependents or survivors;

8. Social Security benefits - old age (or retirement), survivors, dependent, and disability insurance payments (OASDI or RSDI) made by the Social Security Administration; also included are special payments at age seventy-two (72) (Prouty Benefits and Black Lung benefits);

9. Supplementary Medical Insurance Benefits (SMIB)- Social Security “Medicare” supplementary medical insurance benefit is a voluntary program, therefore the full Social Security award amount is counted as income to determine Colorado Works eligibility and to determine the amount of financial assistance to the client. The lump sum SMIB refund received by the “buy-in” recipient is exempt income as the client has previously been charged with that income.

10. Military Allotment- A military allotment received on behalf of a client for those individuals included in the budget unit shall be considered as income in the month received. The military allotment received by the non-recipient spouse, parent, or stepparent on behalf of individuals not in the assistance unit shall be considered as income in the month received to the extent that such income exceeds the need standard concerning those persons not in the budget unit. 3.605.4 Exempt Unearned Income A. For the purpose of determining eligibility for Colorado Works, the following shall be exempt from consideration as income:

1. Income Tax refunds.

a. The Earned Income Tax Credit (EITC) shall also be exempt for the month in which the EITC payment is received and for the following month.

b. County departments shall provide assistance to help clients apply for and receive the federal and State EITC.

2. Third-Party Payments- The value of any third-party payment for medical care or social services paid on behalf of a client.

3. Emergency Assistance- Emergency Assistance received on a one-time basis in cash or in kind from other agencies and organizations.

4. Energy Assistance- Home energy assistance granted to a client by a private non-profit organization or home energy supplier, whether in kind, by voucher, or vendor payment.

5. Personal Care and Home Care- Personal care or home care allowances paid to a recipient or non-recipient spouse, parent, stepparent, or child, from a federal, state, or local government program for in-home supportive services (attendant, chore, housekeeping) shall be exempt as income in determining the amount of attributable nonrecipient spouse, non-recipient parent, or non-recipient stepparent income. However, it shall be classified as employment income in determining the attendant's own eligibility for 6. VA Aid and Attendance- VA Aid and Attendance may be paid to qualified veterans in addition to their regular VA benefit. VA Aid and Attendance is exempt income to the applicant or recipient to determine eligibility for public assistance in the applicant's or recipient's own home, if the VA Aid and Attendance is used for medical supplies and medical or attendant care not covered by Medicare or Medicaid, or other health insurance programs. The remainder is deducted from the assistance grant. (Amounts for attendant care are treated in the same manner as specified in the preceding paragraph.)

7. General Assistance- General Assistance granted to a client by the county department prior to or as a supplement to categorical assistance.

8. Crime Victims Compensation Act.

B. General Income Exemptions – Exemptions from Consideration as Income For the purpose of determining eligibility for Colorado Works, the following shall be exempt from consideration as income:

1. A bona fide loan. Bona fide loans are loans, either private or commercial, which have a repayment agreement.

2. Benefits received under the Older Americans Act, Nutrition Program for the Elderly.

3. The value of supplemental food assistance received under the special food services program for children provided for in the National School Lunch Act and under the Child Nutrition Act, including benefits received from the special supplemental food program for Women, Infants and Children (WIC).

4. Home produce utilized for personal consumption.

5. Payments received under Title II of the Uniform Reconciliation Act and Real Property Acquisition Policies Act; relocation payments to a displaced homeowner toward the purchase of a replacement dwelling are considered exempt for up to six (6) months.

6. Experimental Housing Allowance Program (EHAP) payments made by HUD under

Section 23 of the U.S. Housing Act.

7. Payments from Indian judgment funds and tribal funds held in trust by the Secretary of the Interior and/or distributed per capita; and the initial purchase made with such funds.

8. Distributions from a native corporation formed pursuant to the Alaska Native Claims Settlement Act (ANCSA) which are in the form of: cash payments up to an amount not to exceed $2,000 per individual per calendar year; stock; a partnership interest; or an interest in a settlement trust. Cash payments, up to $2,000, received by a client in one calendar year is excluded as income.

9. Assistance from other agencies or organizations that are provided for items not included in the need standard or do not duplicate a component of the need standard in total.

10. Major disaster and emergency assistance provided to clients, and comparable disaster assistance provided to states, local governments, and disaster assistance organizations.

11. A child receiving foster care or kinship care funds under Title IV of the Social Security Act shall be excluded from the assistance unit and his or her income shall be exempt from consideration for Colorado Works eligibility and payment.

12. Payments to volunteers serving as foster grandparents, senior health aids, or senior companions, and to persons serving in the Service Corps of Retired Executives (SCORE) and Active Corps of Executives (ACE) and any other program under Title I (AmeriCorps VISTA) when the value of all such payments adjusted to reflect the number of hours such volunteers are serving is not equivalent to or greater than the minimum wage, and Title II and Title III of the Domestic Volunteer Services Act.

13. Training allowances or training scholarships granted by Workforce Innovation and Opportunity (WIOA)or other programs to enable any individual to participate in a training program is exempt.

14. Payments received from the Youth Incentive Entitlement Pilot Projects (YIEPP), the Youth Community Conservation and Improvement Projects (YCCIP), and the Youth Employment and Training Programs (YETP) under the Youth Employment and Demonstration Project Act (YEDPA).

15. Social Security benefit payments and the accrued amount thereof paid to a client when an individual plan for self-care and/or self-support has been developed under the following conditions:

a. Supplemental Security Income (SSI) permits such disregard under such developed plan for self-care-support goal, and b. Assurance exists that the funds involved will not be for purposes other than those intended.

16. Income received through the Workforce Innovation and Opportunity Act, including supportive services through that program.

17. Money received from the Radiation Exposure Compensation Trust Fund, P.L. No. 101- 426 as amended by P.L. No. 101-510.

18. Reimbursement of out-of-pocket expenses.

19. Payments received by clients because of their status as victims of Nazi persecution pursuant to P.L. No. 103-286.

20. Individual Development Accounts (IDAs).

21. Distributions from retirement savings accounts.

22. Distributions from health care savings accounts.

23. Income paid to children of Vietnam veterans who were born with spina bifida pursuant to P. L. No. 104-204.

24. Income of A client who is attending school (student in a secondary education or undergraduate degree program) shall be considered as follows:

a. Income received from a college work-study program grant shall be exempt.

b. All earned income, including earned income from WIOA, that is received by a dependent child who is a full-time student or a part-time student who is not a fulltime employee shall be disregarded.

25. Educational savings accounts.

26. Educational grants, loans, stipends, and/or scholarships.

27. A client receiving SSI payments shall be excluded from the assistance unit and his or her income shall be exempt from consideration for Colorado works eligibility and payment.

28. Refugee resettlement funds and reception and placement money.

29. Interim Cash Payment received through the Colorado Refugee Services Program.

30. Life or disability insurance policies that may have a cash value taken.

31. The benefits provided from the Low-Income Energy Assistance Program (LEAP).

32. A child receiving subsidized adoption funds shall be excluded from the assistance unit and his or her income shall be exempt from consideration for Colorado Works eligibility and payment.

33. Income that is exempt shall also be exempt if received as a lump sum or excluded if designated or legally obligated for legal fees related to obtaining the lump sum payment, medical bills, funeral and burial expenses, or income taxes.

34. Income tax credits when identified as exempt by the state or federal government.

35. Wages earned through subsidized employment programs including employment, apprenticeships, on-the-job training, and transitional jobs. 3.605.5 Child Support Income A. At initial application, current child support payments received by the assistance unit shall be considered income and counted against the need standard to determine eligibility.

B. Once found eligible, child support income is excluded in the basic cash assistance grant calculation.

C. For purposes of redetermination (RRR):

1. Inconsistent child support payments are not countable. Child support payments are considered consistent when received in all six (6) of the six (6) previous months.

2. Once consistency of payments has been established, current child support is averaged over the previous six (6) months. If that averaged amount is $500 or less for the household, the child support income is disregarded for both eligibility and grant calculation. If that amount is over $500 for the household, it is counted, in combination with other income, against the need standard to determine continued eligibility.

3. If found eligible, the child support income is disregarded for basic cash assistance grant calculation.

D. Child support arrears are exempt income and are not used for eligibility or grant calculation. 3.606 Colorado Works Certification and Benefit Calculation 3.606.1 Basic Cash Assistance A. Payment of Basic Cash Assistance (BCA) Grants Counties or groups of county departments shall not reduce the BCA grant, restrict eligibility, or impose sanctions that are inconsistent with state and federal laws or the rules of this Section 3.606.1.

B. Unreimbursed Public Assistance The BCA grant shall be considered part of the Unreimbursed Public Assistance (UPA) as defined in the Child Support Services rule manual at 9 CCR 2504-1 Section 6.002.

C. Recipient's Right to Decide In accordance with the principle of the unrestricted money payment, a client shall have the right to decide how any payment received shall be spent.

D. Vendor Payments for client Protection The county may pay the basic cash assistance grant to vendors on behalf of the client with the client's voluntary agreement. In all other situations the payment shall be made to the client.

E. Considering Income for Eligibility and Payment Applications received will be certified for six (6) consecutive months beginning the first month the assistance unit is found eligible for basic cash assistance. The certification period consists of the calendar months beginning with the first day of the budget month (day/month the application is received and the assistance unit is found eligible) and ending with the last day of the sixth (6th) month (unless found ineligible) in which financial assistance is provided and that is intended to cover the ongoing basic needs of the assistance unit.

For eligibility and payment, income shall be considered in the month of application and throughout the certification period. This is also true for redetermination and establishing a new certification period going forward. The following calculation shall be used: countable earned income minus applicable earned income disregards, plus countable unearned income.

F. Determining Eligibility for Basic Cash Assistance Grant Based on the Need Standard The State department shall annually review and as necessary update the need standard to reflect the current economic situations in the state.

The basic cash assistance grant shall be determined based upon income using the following need standard. If the client has zero income the following cash payment shall be received based upon those included in the assistance unit:

COLORADO WORKS STANDARDS OF ASSISTANCE CHART

Number of Children Each Additional Child No Caretaker Need Standard 0 Standard 0 One Caretaker Need Standard 253 Standard 374 Two Caretakers Need Standard Standard 527 G. Pregnancy Allowance Pregnant parents are eligible for the basic cash assistance grant plus a ten-dollar ($10.00) pregnancy allowance. The client is eligible for the pregnancy allowance through the month in which the pregnancy ends.

H. Gross Income To be eligible for Colorado Works basic cash assistance, the countable gross earned and unearned income together shall not exceed the need standard for the household size after disregards have been applied in accordance with section 3.606.2.

I. Calculation of the Basic Cash Assistance Grant for an Eligible Assistance Unit To calculate the basic cash assistance amount for an eligible assistance unit:

1. Deduct the earned income disregard(s) from the gross earned income, received or expected to be received by members of the assistance unit, in the month of application;

2. Add to the result from step 1, above, the unearned income received or expected to be received by members of the assistance unit;

3. Deduct the total from step 2, above, from the grant amount for the household size.

J. Reporting of Earned Income When the assistance unit reports earned income:

1. Apply the appropriate earned income disregards to the gross earned income of each employed member of the budgetary unit as described in Section 3.606.2; and, 2. Add the unearned income received by each member of the budgetary unit; and, 3. Compare the total to the need standard for the household size.

4. If the net countable income equals or exceeds the need standard, the assistance unit is not eligible for Colorado Works basic cash assistance.

K. Calculation of an Eligible Assistance Unit To calculate the basic cash assistance grant amount for an eligible assistance unit:

1. Deduct the net countable income from the grant amount for the assistance unit; and, 2. Drop the cents, and the remainder is the authorized grant. 3.606.2 Earned Income Disregards For all cases with eligible members that have earned income (not including disqualified individuals), payment and eligibility will be determined using the income disregards as described below. All payments shall be calculated by using applicable disregards.

A. Earned Income Disregards Calculations The following earned income disregards shall be applied to gross wages for clients:

1. At application, the gross earned income minus the ninety dollar ($90.00) earned income disregard, plus any countable unearned income received or expected to be received by members of the assistance unit, shall not exceed the need standard for the household size and shall be applied. If income does not exceed the need standard for the household size, a one hundred percent (100%) disregard shall be applied to earned income for the first certification period to determine the payment amount. after the first certification period, a sixty seven percent (67%) disregard shall be applied to determine the payment amount.

2. For an assistance unit currently receiving basic cash assistance:

a. A new source of earned income shall receive a one hundred percent (100%) earned income disregard for the first certification period that the income impacts according to section 3.606.3.

b. A current source of earned income shall receive the sixty seven (67%) disregard. 3.606.3 Changes and Reporting Requirements Colorado Works clients shall report information concerning income, household composition, and residency. The income reporting standard for an assistance unit is provided on the change report form and in noticing. Information on such changes may be reported to the county of residence by use of a change report form, the client’s redetermination packet, and/or by making the county aware of the change. Changes shall be reported by the tenth (10th) of the month following the month the change occurred. The county must act on all changes reported within ten (10) calendar days of the report by entering the change into the statewide automated system. By acting on changes, the county department shall determine eligibility.

A. Negative and positive changes during the certification period 1. If the assistance unit will receive an increase in grant payments as indicated by the total net change of all changes in the month, the increase will affect the case the month following the date the change is reported and verified.

2. If the assistance unit will receive a decrease in grant payments, the grant payment amount will remain the same until redetermination when a new payment amount will be set for the upcoming certification period or the case discontinues.

The only decreases that occur during the certification period are identified in section 3.606.3.C below. These changes take effect after timely noticing is applied.

B. Limited reporting standard A recipient with an established certification period must report certain changes in household circumstances by the tenth (10th) day of the month following the month in which the change occurred. The client will be notified in writing of the changes they are required to report. The county worker must act on reported changes within ten (10) calendar days from the date the change is reported by entering the change into the statewide automated system. The following changes must be reported during the certification period:

1. When the income of the assistance unit exceeds the income reporting standard for that assistance unit.

a. The reporting standard for earned income is a reflection of the amount of earned income the household could receive and still be eligible for Colorado Works after applicable disregards are applied (calculated by dividing the need standard for the household by .33).

b. The reporting standard for unearned income is the need standard for the household, as identified in 3.606.1.F.

2. When the assistance unit receives earned or unearned income from a new source.

3. When a change to the number of people living in the home occurs.

4. When the assistance unit no longer resides at the address previously reported to the C. Ongoing eligibility and the effect of negative and positive changes to the certification period The certification period does not guarantee ongoing eligibility. To remain eligible, the primary eligibility criteria must still be met, including remaining below the need standard. All changes are compared against the assistance unit size and grant amount.

1. A negative change may result in the reduction of payment or case closure before the end of the certification period. When a negative change occurs, the reduction of payment or closure shall take place after the appropriate noticing timeframe as identified in 3.609.1.

A negative change shall include, but is not limited to:

a. An increase in income in which the budgetary unit’s total countable income is over the need standard after applicable income disregards are applied.

b. Income is received from a new source which results in the exclusion of a member of the assistance unit.

c. A member leaves the household.

1) If the member leaving the home is the only dependent child on the case.

2) If a pregnancy ends.

3) When a government agency provides information that a dependent child is no longer in the household and the child’s new household is in need of services from another program (such as child support) with a different caretaker or parent.

4) When a member leaves the home and applies for assistance and/or someone is requesting assistance for that member during the original assistance unit’s certification period:

a) A new assistance unit may apply for the member as he/she leaves the original assistance unit but the member shall not receive a portion of the new assistance unit’s basic cash assistance grant until benefits have been terminated for that member in the original assistance unit.

b) The individual is considered to be a part of the original assistance and budgetary units during the noticing period. After the noticing period, the grant amount for the original assistance unit will be recalculated using the new household size and benefits will continue as long as eligibility continues for that assistance unit until the certification period ends.

5) When a member requests assistance to stop for him or herself, or a caretaker who remains a part of the original assistance unit requests that they stop receiving benefits for another member who has left the home. when a member of the assistance unit or budgetary unit leaves the home, the individual’s income shall be excluded beginning the first day of the month following the month the individual reported they left the home and the basic cash assistance grant adjusted accordingly.

d. An eighteen-year-old who is the only dependent child graduates from high school or stops attending school.

e. Death of a client.

f. Imposing sanctions.

g. Imposing actual intentional program violation (IPV) penalties.

2. A positive change results in a payment increase and shall be effective the month following the month the change is reported and verified. Payments shall be adjusted accordingly and provided to the recipient timely. A positive change shall include, but is not limited to:

a. Termination of or decrease in income.

b. Adding a member to the assistance unit.

1) The initial application for Colorado Works is sufficient to cover all members who join the assistance unit after initial application. Verification is still needed to establish eligibility for the member joining the assistance unit.

2) A new member(s) who is added to an existing assistance unit shall be added effective the first day of the following month that the assistance unit reported the change and provided any necessary verifications.

a) If the new member has income, it will be considered income to the assistance unit in the month that the new member joined the household. The income shall be used to determine eligibility and payment according to the negative and positive change rules in

section 3.606.34.a.

b) If the new member is a newborn, the newborn shall be added effective the first day of the month of birth and documentation shall consist of the birth date and a Social Security Number (SSN) or an SSN application. No other documentation is required to add a baby to the assistance unit after the birth is reported unless there is questionable information regarding the relationship to a parent(s), citizenship, or qualified noncitizenship status.

c) Adding a pregnancy.

d. Providing individual level verification.

e. A member who was previously ineligible becomes eligible.

3. Positive and negative changes may occur at the same time. All changes will be taken into consideration and the net result of the change will be compared to the client’s base eligibility determination. The comparison will be used to determine if there is a negative change, positive change, or complete ineligibility to the assistance unit’s basic cash assistance grant.

D. At any time while receiving basic cash assistance, if there is questionable information regarding the circumstances of a household, the county worker can request verification of the questionable information. If the client fails to submit verification of the questionable information, grant payments may be discontinued. 3.606.4 Redetermination of Eligibility A. Filing a redetermination (RRR) to continue benefits Colorado Works clients shall file their RRR with the county by the 15th of the month as specified in the RRR packet. A client’s failure to file a RRR timely may delay the determination of benefits.

All RRR forms must be entered into the statewide automated system within two (2) business days. Complete forms received timely must be acted upon by the county department by the last day of the month in which the forms were due. Complete forms received between the 16th and the last day of the month the RRR is due must be approved as soon as possible. The county department will have ten (10) days to act on such redeterminations, to include scheduling and conducting the interview and requesting any necessary verification. The county must make an eligibility decision on redetermination forms received between the 16th and the last day of the month within thirty (30) days from receipt of such RRR.

An interview for Colorado Works basic cash assistance cases shall take place annually and necessary verifications must be requested and obtained at each RRR to determine whether the client continues to be eligible for Colorado Works.

B. Redetermination procedures- mail out Forms that the client is required to complete shall be mailed to the client at least thirty (30) calendar days prior to the first of the month in which eligibility redetermination is due. This is considered the prior notice period. The following procedures relate to mail-out redetermination:

1. An RRR packet shall be mailed to the client which identifies the RRR due date and the date when Colorado Works grant payments will stop if the RRR packet is not returned;

2. The RRR packet shall be completed, signed by the client, and returned to the county department no later than the 15th of the month in which the client’s existing certification ends; and, 3. When the client is unable to complete the RRR packet due to physical, mental, or emotional disabilities, and has no one to help, the county department shall either assist the client or refer the client to a legal or other resource.

4. When initial arrangements or a change in arrangements are being made, an extension of up to thirty (30) days may be allowed. The assistance and/or referral action of the county department shall be recorded in the case record.

C. Complete RRR packet A complete RRR packet has all questions applicable to Colorado Works and/or specific to the household’s circumstances completed by the client and is signed by the client or authorized representative.

D. Redetermination process The redetermination process shall consist of all activity from the date the RRR is received from the client until a determination concerning eligibility is made.

During the redetermination process, the county worker shall:

1. Date the RRR packet to record the date of receipt by the county department.

2. Enter the RRR into the statewide automated system within two (2) business days.

3. Schedule and conduct an interview when required. The client shall be provided with written notice of a scheduled interview in accordance with section 3.602.1.E.1.c. When the client does not keep the appointment and does not request an alternate time or arrangement, as described in section 3.602.1.E.1.c, grant payments will be terminated at the end of the current certification period.

4. Explain the purpose of the interview and the use of the information supplied by the client on the RRR form and any additional required forms.

5. Inform all clients in writing at the eligibility redetermination that Social Security Numbers for all clients will be used to request and exchange information with other agencies as

part of the eligibility process, including the Department of Labor and Employment (State Wage And Unemployment Data), Social Security Administration, and Internal Revenue Service (unearned income). IEVS information may also be exchanged with other state or federal agencies administering public assistance programs, including the Department of Labor and Employment, Child Support Services, and the Social Security Administration.

6. Have the client complete the forms or complete the form on behalf of the client.

7. Explain the appeal rights to the client.

8. Witness the signature of the client and sign as a person who helped complete the forms, when applicable.

9. Review documents, verifications, and any other information supplied by the client with the client in order to obtain clarification if needed. Information requested shall include:

a. Income.

b. Other eligibility factors to be verified unless satisfactory documentation is in the case record.

E. Redetermination not returned When the RRR packet is not returned by the 15th of the RRR due month, discontinuation of benefits shall occur at the end of the RRR due month. This action to discontinue shall not be taken, however, if the completed and signed forms are returned between the 16th and the end of the RRR due month as defined in section 3.606.4.A. If no response is received by the end of the RRR due month, the case shall be discontinued upon the effective date of the notice sent to the client with the RRR packet.

F. Incomplete redetermination packets If the RRR packet is received by the first filing deadline, but it is incomplete, a correction notice shall be sent to the client advising the client that the RRR packet is incomplete and must be corrected by the correction deadline to avoid termination and/or the county department shall work with the client to complete the packet.

G. Termination of benefits and adequate notice When the information provided in the RRR packet, or otherwise provided by the client, is the

basis for reduction in the amount of assistance or in termination of assistance, such actions shall be taken after adequate notice, as defined in section 3.601 and described in 3.609.1,C and D, is given.

H. Termination of benefits and adequate notice redetermination requirements A redetermination of eligibility shall be complete for Colorado Works when:

1. All necessary forms concerning the redetermination are completed and have been reviewed;

2. Requested verification is obtained and recorded in the case file;

3. All factors are evaluated and decisions on continued eligibility and amount of money payment have been reached; and 4. Notice of change in payment, if applicable, is completed and mailed to the client. A stateapproved notice of proposed action form shall be used for positive actions and for negative or adverse actions.

I. Reopening and reinstatements Cases may be reopened prior to the effective date of closure with good cause and may be reinstated if closed within thirty (30) calendar days or less.

1. Reinstatement in lieu of an application- when a request is made for the category of assistance from which the client was discontinued within thirty (30) calendar days following the effective date of discontinuation, the following procedures shall be followed:

a. A RRR packet or current application shall be in the case file or completed and signed by the client;

b. Income shall be verified;

c. Other eligibility factors shall be verified unless satisfactory documentation is in the case record;

d. Eligibility determination shall be completed and appropriate actions shall be taken.

2. Reopening in lieu of an application- when a client requests assistance prior to the effective date of the client’s discontinuation from assistance, the following procedures shall be followed:

a. A RRR packet or current application form shall be in the case file or completed and signed by the client;

b. Income shall be verified;

c. Other eligibility factors shall be verified unless satisfactory documentation is in the case record;

d. Eligibility determination shall be completed and appropriate actions shall be taken;

e. If reopened, child support services and other appropriate units shall be so advised. 3.606.5 Clients Moving to a New County of Residence A. Colorado Works clients transferring from one county to another shall remain eligible for the basic cash assistance and shall continue to be eligible. For work required individuals, the client remains eligible until assessed by the new county, in accordance with the timeframes outlined in 3.608.1.A. The benefits shall continue without interruption.

B. Clients who are transferring to another county are required to continue to report changes and the transferring county shall continue to process the client's changes during the period in which the transfer to another county is in process.

1. Clients shall continue to report changes by the tenth (10th) of the month following the month in which the change occurred and complete redeterminations as required by the paying county; and, 2. The paying county shall continue its activities; and, 3. The paying county shall resolve all issues concerning the client’s continuing eligibility or termination before the transfer is completed; and, 4. The paying county shall assure that the case is updated in a timely way to enable acceptance by the county of residence. 3.606.6 Time Limits and Extensions A. Time Limits Each month for which a basic cash assistance grant is received shall be counted toward the time limits of adult members who are part of the assistance unit regardless of whether or not the adult is eligible to receive assistance. Any assistance unit containing an adult may receive Federal TANF grant payments for up to sixty (60) cumulative months.

B. Time Limits and Sanction Periods Months in which a partial Colorado Works payment was made due to a sanction shall be counted toward the time limit.

C. Extensions An assistance unit containing an individual who has received Federal TANF assistance in Colorado or another state as an adult for sixty (60) or more cumulative months shall not be eligible for Colorado Works assistance in Colorado unless the household demonstrates good cause as defined in section 3.601 and outlined in 3.608.3. The county department must reference criteria in the state prescribed extension determination form to approve or deny an extension request for a client who is requesting to receive TANF beyond sixty (60) months. Assistance units that contain disqualified members shall not be eligible for consideration of an extension.

1. The State Department shall send a notification to clients who are approaching the sixty (60) month time limit on Federal TANF assistance. The county department shall make all reasonable efforts to contact these clients by phone or in person to explain the extension process and to accept a request for an extension.

2. All clients shall have the opportunity to request an extension. Requests for an extension of Colorado Works shall be made in the county of residence and may be made electronically, in person, by phone, or in writing. County departments must enter the client’s request, and the good cause reason for the extension request, into CBMS within ten (10) calendar days.

3. The county department shall have (30) calendar days after the receipt of a request for an extension to make a decision whether to grant or deny the extension in accordance with the criteria in the state prescribed form. The county shall send a notice to the client concerning the decision by the thirtieth (30th)) calendar day of receiving the request.

4. If the request for an extension is denied, the notice shall include the reason for the denial and the right to appeal the decision per Section 3.609.6. A client who has been granted an extension may request an additional extension prior to the end of the current extension period. If a timely request is not made, the county department may grant an extension if the client is able to demonstrate good cause. Good cause shall be determined by the county department and cannot be appealed.

5. An extension may be granted for up to six (6) months. A client who has been granted an extension may request additional extensions, but the request must be made prior to the end of the current extension period.

6. Nothing in these rules shall be construed to prohibit a former client from requesting a hardship or domestic violence extension, after the lapse of the sixty (60) month lifetime limit, when new hardship or domestic violence factors occur, to the extent permissible under State and federal law.

7. The client receiving an extension shall meet with the county worker on a regular basis to address specific needs and to identify assistance in an Individualized Plan.

D. Hardship A household may be considered to be experiencing a hardship if one or more of the following prevents the adult member(s) of the assistance unit from securing or maintaining employment:

1. Disability of the caretaker, his or her spouse, the dependent child(ren) or immediate relative for whom the caretaker is the primary caregiver, pursuant to the definition of “persons with disabilities” at Section 3.604.3; or, 2. Involvement in the judicial system because a member of the assistance unit has an existing case; or, 3. Family instability which may include a caretaker with the proven inability to maintain stable employment or inability of the caretaker to care for the children in his or her own home or in the home of a relative; or, 4. Inadequate or unavailable:

a. Child care, b. Housing, c. Transportation, d. Employment opportunities, or, e. Other hardship reasons listed on the state prescribed extension determination form.

E. Hardship Due to Domestic Violence Domestic violence extension may be granted when domestic violence problems, as defined at

Section 3.604.5 prevent the adult member(s) from participating in work activities or securing employment.

F. Exemptions From the 60-Month Time Limit Any month of receipt of assistance by an adult while living in Indian Country, or a Native Alaskan village where at least fifty percent (50%) of the adults were not employed, shall not be counted toward the sixty (60) cumulative months of Federal TANF assistance. Indian Country is defined in 18 U.S.C. Section 1151.

G. Twenty Percent (20%) Allocation of Extensions Up to twenty percent (20%) of the Statewide caseload receiving Colorado Works may be granted an extension beyond the sixty (60) month time limit due to hardship or domestic violence. At any point that records indicate that the State will exceed the twenty percent (20%) maximum on the number of Colorado Works extensions granted to assistance units, the State shall determine if this is due to the provision of federally recognized good cause domestic violence waivers. If the records support this determination, as allowed by federal law, the State shall provide information to the federal government to demonstrate that the reason for exceeding the twenty percent (20%) maximum was due to granting federally recognized good cause domestic violence waivers. The State Department has the sole responsibility of monitoring this federal limit. County departments are not restricted to a certain number of extensions unless the Statewide limit is reached. 3.606.7 Funeral, Burial, and Cremation Expenses A. Death Reimbursement 1. A death reimbursement benefit shall in some circumstances be available to assist in paying for the funeral, burial, and cremation expenses of a deceased client. Death reimbursement benefits paid for the disposition of a deceased client under these rules are not entitlements. Benefit levels for such dispositions shall be adjusted by the State Department in order to contain expenditures within the available legislative appropriation.

2. The total amount of death reimbursement benefit paid by the county department pursuant to this section shall not exceed one thousand five hundred dollars ($1,500). To be eligible for a state contribution, the total combined reasonable charges (including those paid by the deceased client’s estate, family, State Department funds, or any other source) for services, property, and supplies shall not exceed two thousand five hundred dollars ($2,500).

3. A birth certificate and death certificate shall not be required for a burial in the circumstances of a stillborn child or a pregnancy ended by miscarriage. Documentation from a medical provider and/or a collateral contact shall take the place of the birth and death certificate.

B. When State Funds may be Contributed A death reimbursement benefit covering reasonable funeral expenses or reasonable cremation or burial expenses or any combination thereof shall be paid by the State Department for a deceased client, subject to state appropriations, as follows:

1. The expenses are incurred for the disposition of a deceased client who received Colorado Works while alive; and, 2. The deceased client’s estate is insufficient to pay all or part of such expenses (a deceased client’s estate is defined as property of any kind that the deceased client owned at the time of death); and, 3. The county department shall issue a written authorization and itemization of the services, property, and supplies for which the State Department funds shall be contributed. The total charge and amount of State Department funds authorized for each item shall be included in this authorization; and, 4. The total combined reasonable charges (including those paid by the deceased client’s estate, family, State Department funds, or any other source) for services, property, and supplies which have been authorized by the county department shall not exceed two thousand five hundred dollars ($2,500).

C. Disposition by Funeral, Burial, and Cremation In those cases where disposition of a deceased client is by funeral/memorial service and burial or cremation, the county department may authorize that State Department funds shall be contributed toward the expenses for the following:

1. Transportation of the deceased client’s body from the place of death to a funeral home or other storage facility;

2. Storage of the body during the time prior to final disposition;

3. Embalming, where necessary for preservation of the body;

4. Funeral or memorial service;

5. Purchase of casket;

6. Preparation of body for placement in casket;

7. Transportation of body and casket to site of funeral/memorial service and/or cemetery;

8. Purchase of gravesite;

9. Purchase of vault (liner), when required by the cemetery;

10. Opening and closing of grave;

11. Purchase and placement of grave marker;

12. Perpetual care of gravesite by owner of cemetery;

13. Cremation of body;

14. Purchase of an urn or other receptacle for the cremated remains of the decedent;

15. Burial of the cremated remains of the decedent, including purchase of gravesite, vault (liner) if required by the cemetery, opening and closing of grave, purchase and placement of grave marker, and perpetual care of gravesite;

16. Storage of the cremated remains for no more than one hundred twenty (120) days, in those cases where they are not buried and are not claimed by the decedent's family or friend; and/or, 17. Any other items that are incidental to the funeral/memorial service and burial/cremation.

D. Arranging for Details of Disposition Even though State Department funds may be contributed toward the expenses for the items listed in the preceding sections, some of those items will not be requested, necessary, or affordable in some situations (e.g., in the case of a direct burial with or without graveside service, or immediate cremation with no burial). In the course of contacting relatives of the deceased client in order to arrange for disposition, the county department and any provider which is involved (e.g., a funeral home or cemetery) should consult with the family members about the applicable regulatory provisions, the resources of the decedent's estate and family/friends, and the relative costs of the various types of disposition.

In those cases where the client or family has requested that the disposition include items which cannot be provided within the limitations of these regulatory provisions, and where the family is unable or unwilling to make separate financial arrangements without a State Department contribution, the county department shall make arrangements for disposition of the client’s body in a reasonable, dignified manner which approximates the wishes and the religious and cultural preferences of the client or family.

E. Limitation of Total Charges for Disposition Regardless of the manner of disposition, State Department funds shall not be contributed if the total charges (including those paid by the deceased client’s estate, family, state funds, or any other source) for services, property, and supplies related to the disposition exceed two thousand five hundred dollars ($2,500).

F. Procedures to be Followed by County Departments The county department in which the deceased client’s case is active shall be responsible for determining whether and in what amounts State Department funds may be contributed for the disposition of the deceased client’s body.

1. When assistance for funeral, burial, or cremation services is requested on behalf of a deceased client, the county department shall obtain a completed application for funeral/burial/cremation assistance as prescribed by the State Department. This form is used to make a determination of eligibility for State Department funds for such services.

The county department shall ensure that a choice of disposition by the client or a family member is made in writing. The choice of disposition may be made in the client’s will, on the application for funeral/burial/cremation assistance, or by any other document that the county department deems to be credible. When a choice of disposition between burial and cremation was made by the client in writing, and the client is determined to be eligible for burial assistance, the choice shall be honored by the county department within the limits of costs and reimbursement available.

If a choice of disposition was not previously made by the client, the county department shall request a family member (spouse, adult children, parents, or siblings) to make the choice. The application form provides a section to be used by the family to make a written choice of disposition. Once the choice of disposition is determined, the appropriate providers shall be contacted to obtain signed proposals of items and charges for disposition. The Provider's Proposed Charges for Funeral/Burial/Cremation of Deceased Recipient of Assistance form shall be used for this purpose. If more than one provider is involved, a separate form for each provider MUST be used.

Once the application and proposals from providers are received, the county department will be able to determine if a State Department funded death reimbursement is appropriate.

If the combined charges from the providers exceed two thousand five hundred dollars ($2,500), no death reimbursement shall be paid from State Department funds.

Providers may seek contributions from non-responsible persons only to the extent that monies are available from such parties.

2. In determining the extent of the State Department funded contribution, if any, toward the expenses of disposition, the county department shall proceed in accordance with the following steps:

a. If the client did not make a written choice between burial and cremation, the county department shall determine whether the client’S family has any preference. The county department shall encourage such relatives, in making a choice of disposition, to consider the relatives' ability to contribute to the costs of the available options.

b. After determining the method of disposition for the deceased client, the county department shall next determine whether any funds for disposition are available from the deceased client’s estate using the guidelines in section 26-2-129(6), or from those individuals legally responsible, as defined in section 26-2-129(2)(E), C.R.S., for the deceased client’s support. The county department shall also inquire about the availability of such funds from persons who appear to be interested in the manner of the deceased client’s disposition, even if such persons are not legally responsible for the deceased client’s support.

c. The county department shall require the legally responsible person to financially participate towards the charges for funeral, burial, or cremation unless their resources are less than the Supplemental Security Income (SSI) resource limit which is $2,000 for an individual and $3,000 for a couple as described in C.R.S. 26-2-129(5). The amount of resources over the SSI limit shall be used to reduce the State Department funded Death Reimbursement payment. Money voluntarily contributed by the responsible party towards the burial, funeral, or cremation costs by the responsible party is also used to reduce the Death Reimbursement Benefit.

d. The value of a prepaid burial plot of two thousand dollars ($2,000) or less when purchased is exempt and not counted toward the total funeral, cemetery, or burial expenses. If the final resting place was purchased by someone other than the decedent and donated to the deceased client, it shall not be counted as personal resource of the deceased client or legally responsible person.

e. Social Security lump sum death benefits payable to a legally responsible person shall not be used in reducing the maximum Death Reimbursement Benefit.

f. Funds disbursed from any insurance policy of the deceased client to a legally responsible person or non-responsible person who is named as beneficiary or a joint beneficiary of the deceased client’s policy, are counted as available and shall be used to reduce the maximum Death Reimbursement. Providers may seek contributions from non-responsible persons to the extent that monies are available from such parties.

g. Contributions made by non-responsible parties shall not reduce the Death Reimbursement Benefit. These funds are used to offset the maximum combined charges to the providers. The county department shall make every reasonable effort to minimize the contribution of State Department funds for a deceased client’s disposition. The State Department may limit the maximum State Department contribution to a figure lower than one thousand five hundred dollars ($1,500) in order to contain total State Department expenditures within the available legislative appropriation. The State prescribed form shall be used to inform the county department accounting office of itemized total charges and the total State Department contribution.

3. The county department shall use the following procedures in cases where the county department becomes aware of a deceased client, and a family member cannot be located:

a. If a family member has not been located within twenty-four hours after the client dies, the county department shall have the deceased client’s body refrigerated or embalmed.

b. If a family member has not been located within seven days, the county department shall make the determination to bury or cremate the deceased client based on the best option available.

c. The county department shall complete and send the State required form, Authorization of Cremation, to the appropriate funeral home/crematorium to authorize the cremation.

d. The county department may authorize payment for funeral, burial, and cremation expenses up to one year after the death of the client. Those persons who made arrangements for the disposition of the deceased recipient's body must provide all necessary information to enable the county department to determine whether and to what extent a contribution of State Department funds is appropriate.

G. Provider Agreement The county department shall have a statement of agreement between the providers that sets forth the charges and the amounts of any disbursement of funds by the county department. The agreement shall assure that the distributions of death reimbursement benefits are equitable. All vendor(s) who are providing the services must sign the agreement. The form must be approved and signed by the county department before death reimbursement is provided. Payment shall be made pursuant to the agreement. 3.606.8 Diversion, Other Assistance, and Family Needs Payments A. A Colorado Works client may receive a diversion payment to address a specific crisis situation or episode of need. Such payments are not designed to meet clients’ basic ongoing needs. A diversion payment may address needs over a period of no more than four (4) months. In addition to a diversion payment, a client who is eligible for diversion may receive supportive payments based on a defined need.

A Colorado Works client may receive a diversion payment (diversion grant) under the following terms and conditions:

1. The client does not need long-term cash assistance or basic cash assistance as determined by the assessment.

2. The client demonstrates a need for a specific item or type of assistance, including but not limited to, cash, housing, or transportation. Such assistance may be provided in the form of cash payment, vendor payments, or in-kind services.

3. The client enters into a written or verbal agreement with the county department. The agreement shall be documented in the statewide automated system and shall:

a. Document the reason why the client does not need basic cash assistance; and, b. Define the expectations and the terms of the diversion payment; and, c. Specify the need(s) for and the specific type(s) of non-recurring cash payment.

4. The client shall agree not to receive any further Colorado Works assistance in the county where he or she received the diversion payment or any other county for a period of time to be established by the county that issued the diversion payment. This Period of Ineligibility (POI) shall start in the month that the payment is provided and shall not be longer than the equivalent maximum grant payment for the household size over the same period of time.

5. If the client is unable to sustain the agreement because of circumstances beyond his or her control, he or she may apply for and the county may grant basic cash assistance or another diversion payment prior to the end of the POI. The county department can end the POI before it expires if good cause exists and is granted by the county department.

6. A diversion payment is a needs-based, cash or cash-equivalent payment made to a client who is eligible for basic cash assistance, or, at county option, and based on the county’s policy, a higher income limit not to exceed the maximum criteria established in the State plan for non-recurrent short-term benefits. All diversion clients who receive a one-time cash payment are not required to assign child support rights, and receipt of such payment does not count toward their Federal TANF assistance time limit.

7. Two Payments of Assistance in the Same Month A client shall not receive a diversion grant for any month in which he/she receives basic cash assistance.

B. Supportive payments and referrals 1. Counties shall provide referrals for all families and assess non-work eligible families for supportive payments at each eligibility interview, at minimum. Work eligible clients must be assessed for supportive payments according to 3.608.1, at minimum. To receive supportive payments while receiving Colorado Works grant payments, clients must have an assessed need as defined in section 3.601. Supportive payments can also be issued as incentives for gaining or maintaining employment, participation in the workforce development program, or other achievements.

2. County departments shall take action on all supportive payment requests within ten (10) calendar days from the date of request by the client. All requests for and decisions to approve or deny supportive payments must be documented in the statewide automated system. Clients shall receive notice of supportive payment decisions as defined in section 3.609.7.

3. Supportive payments may include anything but the following:

a. Medical services, except for family planning;

b. Title IV of the Social Security Act funding that supports children in foster care;

c. Supports to children under 18 who are not in the home;

d. Any juvenile justice purposes; and e. Capital assets over $5,000.

C. Family Preservation Eligibility To receive Family Preservation Services as provided in the Social Services rule manual, 12 CCR 2509-4 Section 7.304.21 under “Title IV-A Emergency Assistance,” a family's income and resources must meet all of the following guidelines:

1. The family income must be under $75,000 yearly; and, 2. The child must meet out-of-home placement criteria; and, 3. The child lived with a specified relative within the last six months.

D. Other assistance Counties may provide assistance to clients meeting the following broad based Colorado Works eligibility criteria:

1. At least one dependent child or pregnancy in the home;

2. Lawfully present; and 3. Household income under $75,000 yearly.

E. County Department's Right to Decide The county department may provide, by means of its own funds, items which are needed by a client and which are not included in the standards of assistance. Such provisions for “unmet need” shall not be deducted as income in the budgeting process. 3.607 Initial Workforce Development (WD) 3.607.1 Work Eligible A. The following are work eligible clients, unless excluded by subsection B below:

1. An adult, minor child head-of-household, or spouse of a minor child head-of-household receiving assistance.

2. A parent who is not receiving assistance that is living with their child who is receiving B. The following are not mandatory for the Workforce Development program:

1. A minor parent who is not a head-of-household or who is not a spouse of a head-of household.

2. A non-citizen who is ineligible to receive assistance due to his or her immigration status based on criteria established in 3.604.1.

3. Anyone receiving supplemental security income.

C. The following work eligible clients are mandatory for the workforce development program. however, good cause or hardship may impact the client’s program participation.

1. Work eligible clients who are included in subsection a but report hardship or good cause based on criteria in 3.601.

2. For clients with hardship or good cause, county departments must engage the client in activities that address hardship or good cause. 3.607.2 Workforce Development Screening All work eligible clients will have a Workforce Development Screening completed within thirty (30) calendar days from the date of application as defined in section 26-2-708, C.R.S. Benefits shall not be delayed or postponed for any Workforce Development requirement.

The Workforce Development Screening shall consist of an evaluation of basic skills, past employment, and employability for a client who is 18 years of age or older, or who is 16 years of age or older, but is not yet 18 years old and is not attending high school or a high school equivalency program and has not completed high school or obtained a certificate of high school equivalency. 3.607.3 Workforce Development Assessment Once referred to Workforce Development, all work eligible clients must have the State prescribed Workforce Development Assessment completed at their initial Workforce Development appointment.

A. The Workforce Development Assessment must be completed prior to and shall be utilized to inform the development of the first and subsequent Individualized Plans (see section 3.608.1.A).

B. The Workforce Development Assessment shall be documented in case comments in the statewide automated system.

C. The Workforce Development Assessment shall also be utilized to determine the issuance of supportive payments. 3.607.4 Condition Agreement All counties shall use the State prescribed Condition Agreement that clearly outlines the expectations of the county and the client. The county worker shall review the Condition Agreement with the client within thirty (30) calendar days from the date of the Workforce Development Screening as defined in section 26- 2-708, C.R.S.

The client shall sign the Condition Agreement, using a valid form of signature, one time per application. 3.607.5 Individualized Plan The Individualized Plan shall be developed collaboratively between the county worker and the client, addressing the family’s needs, goals, and supports. The Individualized Plan shall be comprehensive including matters relating to securing and maintaining training, education, or work. No abbreviations or acronyms shall be used. The Individualized Plan shall identify goals and determine manageable action steps for satisfying the objectives.

The first Individualized Plan shall be developed at the same time the county worker and client review the Condition Agreement (within thirty (30) calendar days from the date of the Workforce Development Screening).

The county worker shall ensure the client understands the terms of the Individualized Plan, including reasons the client might not need to engage in work activities and good cause as outlined in the reengagement section 3.608.3. The client shall indicate by a valid form of signature as defined in 3.601 and date that they agree with the Individualized Plan. If the client does not agree with the Individualized Plan, the client may follow the steps outlined in section 3.609.7 regarding due process.

If a client does not participate in the Workforce Development program prior to signing the first Individualized Plan, this shall be considered Demonstrable Evidence, as defined in 3.601, and will result in the closure of the grant payment. Once an Individualized Plan is signed, clients that do not participate in the Workforce Development program are subject to re-engagement according to 3.608.3. 3.608 Ongoing Workforce Development 3.608.1 Ongoing Case Management The Workforce Development worker will have contact with the client at least once every ninety (90) days.

This contact may include an update to the Individualized Plan if needed and shall include an assessment for supportive payments as outlined in section 3.606.8.

A. Ongoing Workforce Development Assessment The State prescribed Workforce Development Assessment shall be completed at least once every six (6) months and must be documented in case comments in the Statewide Automated System. in addition, the State prescribed Workforce Development Assessment must be completed by the new county of record within thirty (30) days of a county transfer.

B. Individualized Plan Modification Either a client or a county department may request a modification of the Individualized Plan. Any modification made will result in a new Individualized Plan that must have a valid form of signature as defined in 3.601 and date by the client. If the client does not agree with the modification, they may request due process as defined in section 3.609.7. In addition, an updated Individualized Plan must be completed by the new county of record within thirty (30) days of a county transfer. 3.608.2 Work Activities A. Engaged in Work Activities Work eligible clients are required to engage in the Workforce Development program, once determined eligible for Colorado Works. All activities in the Individualized Plan shall relate to the outcome of both initial and ongoing assessments. The statewide automated system shall accurately reflect all activities that a client is participating in, regardless if that activity is included in the Individualized Plan.

B. Allowable Work Activities Work activities are defined in greater detail in Colorado’s federally approved Work Verification Plan (2020); no later amendments or editions are incorporated. The Work Verification Plan can be found at https://drive.google.com/open?id=0b9eaxw7_92zsvnnhexz4u3hzdue. Copies are also available for public inspection and copying by contacting the Colorado Department of Human Services, Director of the Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203 or at any State publications library during regular business hours.

The State of Colorado will seek public comment on any changes to the Work Verification Plan by posting such changes for comment on the publicly accessible Colorado Department of Human Services website, at least thirty (30) days prior to implementing the change.

County defined work activities are listed in county policy which can be reviewed at the county department or copies are also available for public inspection and copying by contacting the Colorado Department of Human Services, Director of the Division of Economic and Workforce Support, 1575 Sherman Street, Denver, Colorado, 80203 during normal business hours.

Allowable work activities include:

1. Employment, such as full-time or part-time employment, subsidized employment, on the job training, and temporary employment.

2. Education, such as pursuing a degree, high school equivalency, job skills training, english as a second language courses, or pursuing a certificate.

3. Volunteer work, such as community service, work experience programs, and unpaid internships.

4. Search for work, such as applying for jobs, interviewing, attending job fairs, and attending hiring events.

5. Job readiness activities, such as interpreting labor market information, identifying references, building job search skills, building cultural competencies, substance abuse and mental health treatment, mitigating the effects of domestic violence, and rehabilitation activities.

C. Work Activity Outlined in the Individualized Plan For purposes of participating in the work activities requirements of this section, a Colorado Works client shall be considered to be engaged in work program requirements if they are participating in the work activities listed in section 3.608.2.B or in the Work Verification Plan incorporated in

section 3.608.2.B, or in any other work activities designed to lead to self-sufficiency as determined by the county department and as outlined in their Individualized Plan.

D. Clients in paid work experience shall be entitled to the same wages and benefits, including but not limited to, sick leave, holiday and vacation pay, as are offered to employees who are not clients and who have similar training or experience performing the same or similar work at a specific workplace. Clients in unpaid work experience are entitled to all rules under the Fair Labor Standards Act as indicated in the Work Verification Plan. 3.608.3 Re-engagement and Good Cause Counties should make every reasonable effort to ensure Individualized Plans are appropriate, achievable, and the most likely strategy to support a client’s long-term economic well-being goals.

Good cause for not engaging in Workforce Development can be reported at any time during the current application period and verification is not required to be provided by the client. The county worker shall use the Prudent Person Principle to determine good cause which may be reported by the client in person, virtually, telephonically, or electronically. County workers must enter good cause in the State Benefit Management System within five (5) calendar days.

A. There may be instances where a client is unable to comply, such as:

1. Missing a scheduled meeting; or 2. Not participating with the Individualized Plan.

In these instances, the county shall send a request to the client to report good cause and provide the client with eleven (11) calendar days to report good cause.

B. In general, the Prudent Person Principle is used to determine good cause. At a minimum, good cause for the client may include, but is not limited to:

1. Breakdown in child care arrangements 2. A lack of available and appropriate child care pursuant to a county department's written policy. Colorado Works clients who are caring for a child should be granted good cause if:

a. There is not appropriate child care within a reasonable distance from the client's home or work site.

b. There is no available or suitable child care.

c. There is not appropriate and affordable child care arrangements within the rate structure defined in the approved county child care rate plan.

3. Remotely located without transportation 4. Breakdown in transportation arrangements with no feasible alternative 5. School obligations that frequently necessitate a parent’s or caretaker’s attendance 6. Loss of housing or a housing crisis that might result in homelessness or eviction 7. Medical emergencies, including mental health, substance abuse, or crisis, involving anyone in the household 8. Physical or mental disability or illness of the client or an individual in the client’s care 9. Legal proceedings for the client or other immediate family members 10. Employment issues when layoffs occur, wages are below applicable federal and state minimum wage standards, working conditions present a risk to health or safety, or workers’ compensation protection does not exist 11. Client’s incarceration 12. Jury duty 13. Death of an immediate family member or authorized representative 14. Other situations as determined by the county C. If a client reports good cause criteria for not participating in the Workforce Development program, a sanction or closure will not be imposed. Once good cause is determined, the re-engagement process ends. County departments must follow the state prescribed process for re-engagement to include good cause, re-engagement, sanctioning, and closing a case.

D. At the time of the good cause request, a re-engagement appointment shall be sent through the Statewide Automated System and the client shall be provided written notice of the appointment at least four (4) calendar days, but no more than eleven (11) calendar days in advance. The client may provide a written or verbal waiver that written notice of the scheduled appointment is not necessary when the county department is able to conduct the appointment during communication with the client.

Notice shall include:

1. The date and time for the appointment 2. The opportunity to reschedule the appointment or make other arrangements in the event of good cause E. If the county department makes contact with the client and good cause is provided, the reengagement process stops. The Workforce Development worker shall enter a case comment including the date and type of contact into the Statewide Automated System.

F. Clients may reschedule their re-engagement appointment prior to the re-engagement appointment. The rescheduled appointment cannot exceed fifteen (15) calendar days from the original re-engagement appointment.

G. Timeframes for rescheduling the re-engagement appointment include:

1. The Workforce Development worker shall schedule the new re-engagement appointment within four (4) calendar days of the client’s request to reschedule.

2. The client shall be provided written notice of the rescheduled appointment at least four (4) calendar days, but no more than fifteen (15) calendar days in advance. The client may provide a written or verbal waiver that written notice of the scheduled appointment is not necessary when the county department is able to conduct the appointment during communication with the client.

H. If the client attends the re-engagement appointment but does not provide good cause, a sanction will not be imposed, except as outlined below. Once the client attends the re-engagement appointment, the re-engagement process ends. The county or client may request modification of the Individualized Plan as outlined in section 3.608.1.B.

When a county determines that there has been exceptional dis-engagement by the client, as evidenced by repetitive or cumulative attendance at re-engagement appointments without reporting good cause, a sanction, as defined in section 3.608.4 may be applied to the grant payment based on state department review.

I. If the client misses the re-engagement appointment, there are no attempts to reschedule prior to the scheduled appointment, and the client does not provide good cause, a sanction, as defined in

section 3.608.4 will be applied to the grant payment. The following process shall occur:

1. The unsuccessful outcome of the re-engagement attempts shall be documented in the statewide automated system within five (5) working days of the determination by the county worker.

2. A notice of grant payment reduction based on the sanction will be sent according to

section 3.609.7.

3. If good cause is provided after the unsuccessful outcome of the re-engagement attempts is entered into the Statewide Automated System, the sanction shall be reversed. 3.608.4 Sanction A. Sanctions from other counties All sanctions shall be served when a client moves from one county to another. The new county may become aware of good cause for previous non-participation and may reverse the sanction if appropriate.

B. Sanctions issued in other states will not be recognized in the State of Colorado.

C. Effect of a sanction on the Colorado Works grant payment The Colorado Works grant payment for the entire household shall be reduced due to a sanction imposed against a member of the assistance unit as follows:

1. First, Second, and Third level sanctions The reduction for the first level sanction shall be one dollar ($1.00), second and third instance of sanction shall be twenty five percent (25%) of an assistance unit’s grant payment.The sanction shall be in effect for one month for each level sanction. A first, second, or third instance of sanction shall progress to the next level of sanction if the client does not re-engage in the Workforce Development program as defined in subsection G. Below by the end of the month that the sanction is being served.

2. Fourth level sanction The reduction for a fourth instance of sanction is 100% and shall result in case closure of the Colorado Works grant payment. The closure shall be in effect for one month. A new application for Colorado Works grant payments is required according to section 3.602.1.

D. Serving a sanction All sanctions imposed by a county must be served by the client. If a client has had a break in grant payment for one month or more, the sanction shall be considered served. If a client reapplies for benefits anytime within the calendar month that they are serving a sanction, the client must serve the sanction by having a reduction in benefits according to the first, second, or third level sanctions, or by having a case closed for a fourth level sanction.

E. Sanctioning a client that has been sanctioned previously Once a sanction is served, all subsequent occurrences shall be in accordance with the level following the sanction previously served as outlined in 3.608.4.C. and D.

F. Sanctioning more than one client in an assistance unit Each Colorado Works case can experience no more than one sanction level in a month. If multiple clients in the same assistance unit have sanctions, the sanctions will be served simultaneously and at the higher sanction level when multiple levels exist.

G. Re-engagement following a sanction When a client who is serving a sanction contacts the county worker and indicates an interest in participating in the Workforce Development program, an Individualized Plan will be developed.

Once the Individualized Plan is signed, the sanction will not progress to the next sanction level unless a new instance of non-compliance occurs. The county worker will enter the reengagement date into the Statewide Automated System and resume ongoing case management.

When a client is serving a sanction based on exceptional dis-engagement defined in section 3.601 and outlined in 3.608.3.H, the client is considered re-engaged based on their attendance at the most recent re-engagement appointment. 3.608.5 Appeal of a Sanction A Colorado Works client has the right to appeal the county department’s action to sanction. The client can utilize the local level dispute resolution process and/or a state level hearing process per section 3.609.9.

The appeal period for proposed sanctions for Colorado Works begins with the mailing of a notice of sanction that lists the proposed action and the client's appeal rights.

A notice of proposed action shall not be issued by the county department for proposed Colorado Works sanctions until the re-engagement process has been completed. 3.609 Colorado Works Notice, Payments, Overpayment, Intentional Program Violations and Fraud, Dispute Resolution, Appeal and State Level Fair Hearing 3.609.1 Notice A. Each client of Colorado Works shall receive prior written notice of any agency action affecting his or her eligibility for or receipt of grant payments.

1. The client shall be notified in writing of county department approval of:

a. An application for Colorado Works.

b. Any change in the amount of grant payment.

c. The right to a county conference and/or state level fair hearing if the client is dissatisfied with the effective date of eligibility, or the amount or type of assistance authorized.

2. A client shall be given notice of any action by the county department, or any person or agency acting on its behalf, which adversely affects the client’s eligibility for, or right to grant payments authorized under the Colorado Works program. Failure to give notice of an adverse action shall be grounds for setting aside the action on appeal. The notice must meet the following standards:

a. The notice must be in writing; and, b. It must describe clearly and in plain language the action to be taken and the reason(s) for the action; and, c. It must refer by number to the section(s) of the state department's rules that require or permit the action being taken, or cite the specific changes in federal or state law requiring the action; and, d. It must state the effective date of the proposed action; and, e. It must explain the client’s right to request a county conference and/or state level fair hearing, the time period for requesting a conference or hearing, and the steps which must be taken to obtain a conference or hearing; and, f. It must explain the client's right to continued grant payments and the obligation to repay if it is determined that the client was not eligible to receive them; and, g. It must inform the client of his or her right to be represented or assisted by legal counsel, a relative, a friend, or a spokesperson of his or her choosing; and, h. To the extent practicable, notice shall be in his or her primary language. If he or she is illiterate, the action shall also be explained verbally.

B. The county department shall notify a client of any change from his or her prior grant payment amount, the reason for the action, and the date the action becomes effective in writing.

C. Clients shall receive written timely notice, giving at least eleven (11) calendar days advance notice before any adverse action taken during the certification period, becomes effective, except as specified in section 3.609.7.C. The notice shall explain the reason for the proposed action and the date the action becomes effective.

1. When acting on a change, if the eleven (11) calendar day timely notice period can be given within the month the written timely notice is sent, the change will become effective the first day of the following month.

2. If the 11 calendar day timely notice period concludes in the following month, the change shall become effective the first day of the month after which the timely notice period concluded.

3. If the timely notice period ends on a weekend or holiday and a request for a state level fair hearing and continuation of grant payments is received the first business day after the timely notice period, the request shall be considered timely received.

4. Colorado Works grant payments must be discontinued or reduced after thirty-one (31) calendar days in the following situations:

a. The client’s income exceeds the grant standard, after application of disregards.

b. All eligible dependent children in the assistance unit no longer meet the definition of living in the home.

c. A dependent child(ren) in the assistance unit no longer meet the definition of living in the home and Colorado Works is requested for the child(ren) by another caretaker.

d. An adult member of the assistance unit leaves the home and requests assistance in a new assistance unit.

e. All members of the assistance unit leave the state of Colorado to reside in another state or country.

f. An eighteen-year-old who is the only dependent child graduates from high school or stops attending school.

The thirty-one (31) day count begins on the first day of the month following the month in which the change occurred. Colorado Works benefits will be discontinued on the first day of the month following the month in which the thirty-first (31st) day falls.

An individual may be removed from the assistance unit according to D below, and prior to thirty-one (31) calendar days, when the change described in this section occurs simultaneously with a change in which adequate notice, not timely notice, is required.

D. Adequate notice, not timely notice, is required in the following situations:

1. When facts indicate an overpayment because of probable fraud or an intentional program violation and such facts have been verified to the extent possible, prior notice shall be mailed at least five (5) calendar days before the proposed effective date.

2. The client has died.

3. An adult member of the assistance unit formally requests for benefits to stop for themselves in their original assistance unit, or a caretaker who remains a part of the original assistance unit requests that they stop receiving benefits for another member who has left the home.

4. When an adult member of the assistance unit who is not the head of household requests for benefits to stop for themselves and their child(ren) when that adult makes a declaration that they have left the home due to domestic violence.

5. The client begins receiving Title-IV of the Social Security Act funds from another source such as foster care/ Title-IV kinship/adoption subsidies.

6. The client begins receiving benefits under another public assistance program which may not be received concurrently with a Colorado Works grant, such as Supplemental Security Income or Adult Financial programs.

7. At application or redetermination, when a certification period has not yet been set.

8. An adult member of the assistance unit has already received sixty months of assistance and a hardship extension has not been granted.

E. If the client’s change in circumstances requires a reduction or termination of grant payments, the following action will be required:

1. Send a written timely or adequate notice, according to subsections C. and D., above.

2. If a client requests a county conference, conduct the county conference as specified in

section 3.609.6. If a client is dissatisfied with the results of the county conference and requests a state level fair hearing before an Administrative Law Judge, such a request shall be in accordance with section 3.609.7. If a client does not request a county conference and only requests a state level fair hearing any time prior to the effective date of the timely notice, and the certification period has not expired, the client's grant payments shall be continued on the basis authorized immediately prior to the timely notice. Continued grant payments shall not be issued for a period beyond the end of the current certification period. Grant payments shall be continued until a final decision has been made by the Office Of Appeals or until the certification period ends, whichever occurs first. The county department shall explain to the client that repayment will be required for the amount of any grant payments determined by the hearing officer to have been overpaid or the continued grant payments to which the client was not eligible to receive.

3. If the certification period expires before the hearing process is completed, the client may reapply for benefits.

4. If the client does not appeal the timely notice to decrease or terminate grant payments within the timely notice period, the changes shall be made in accordance with timeframes outlined in section 3.609.1. 3.609.2 Payments A. A client shall be placed on an issuance schedule so that he or she receives grant payments on or about the same date each month once a certification period is established. Due to the effective date of eligibility, the date on which a client receives his or her initial payment need not be the date that the client must receive any subsequent payments.

1. Initial payment The initial payment to eligible clients shall include assistance beginning with the date of application. Should the assistance unit be ineligible on the date of application, but become eligible prior to the time that a determination of eligibility is made, the initial payment shall include assistance beginning with the date on which the assistance unit became eligible.

To calculate partial month payments:

a. Determine the grant amount based on the size and composition of the assistance unit;

b. Deduct the total net countable income – this is the authorized grant amount for the entire month;

c. Determine the number of days for which payment is made and based on the table in subsection E. Below, find the decimal figure corresponding to the number of days of eligibility;

d. Multiply the authorized grant amount for the entire month by such decimal figure to determine the authorized grant amount for the partial month;

e. Subtract from authorized grant amount for the partial month any appropriate deductions, unless the authorized grant for the partial month is less than $10, in which case no payment is made. However, if the deductions from the authorized grant amount for the partial month results in an amount less than $10, such lesser amount shall be paid except when the amount is less than $1.00.

To calculate the partial month payments, the following table shall be used:

Days Standard Days Standard Days Standard 1 .03288 11 .36164 21 .69041 2 .06575 12 .39452 22 .72329 3 .09863 13 .42739 23 .75617 4 .13151 14 .46027 24 .78904 5 .16439 15 .49315 25 .82192 6 .19726 16 .52603 26 .85480 7 .23014 17 .55890 27 .88768 8 .26302 18 .59178 28 .92054 9 .29590 19 .62466 29 .95342 10 .32876 20 .65754 30 .9863 2. Payment determination For the certification period, eligibility and payment shall be determined prospectively.

B. When the county department determines that a client was ineligible for all or a part of a payment that the client has already received, the county department shall, subject to notice as described in 3.609.1 and these recovery rules, establish a claim, and if valid, initiate recovery.

C. If a client dies, payments to the client shall be treated as follows:

1. A client’s eligibility shall end on the date of his or her death.

2. If a client dies before 12:00 a.m. on the first day of a month, no eligibility for a grant payment for the following month exists.

3. If a client dies on or after 12:00 a.m. on the first day of a month, any payment to which the person was eligible shall be maintained for release to the client’s personal representative as defined in section 15-10-201(39), C.R.S., for a maximum of three (3) months. The following rules apply when a personal representative requests to receive a deceased client’s last grant payment:

a. The individual claiming to be the personal representative of the deceased client must provide the court-issued letters described in section 15-12-103, C.R.S. to the county department in order to receive the deceased client’s last grant payment; or b. If the personal representative with court-issued letters presents a court order ordering the county department to pay the deceased client’s last grant payment to a specific person or entity, the county department shall make the last grant payment payable to the person named in the order.

D. All payments, including partial payments, shall have any cents dropped to the nearest dollar.

E. The client has the right to decide how to use his or her grant payment. The county department shall not:

1. Impose any restriction, either direct or implied, on a client’s use of his or her grant payment including, but not limited to, requesting a client to provide receipts or proof of how the money has been spent; or 2. Require the client to account for the use of the grant payment, except for the Electronic Benefits Transfer (EBT) card point of sale limitations listed in 26-2-104(2), C.R.S.; or, 3. Give assistance to creditors in the collection of the client’s debts.

F. County departments shall not hold or delay the client’s grant payment beyond the regular issuance date except when:

1. A final agency decision has been made authorizing the action;

2. In cases where a corrected payment is to be issued, the corrected payment shall be issued by the effective date of the original warrant and the incorrect payment shall be cancelled.

3. When the county department receives reliable information that the client no longer resides at the last known address and attempts to locate the person through the post office, relatives, friends, etc., have been unsuccessful, the client’s grant payment shall be discontinued. Discontinuing the grant payment is an adverse action and notice shall be given following the policies outlined in section 3.609.1.C. If the client contacts the county department before grant payments are discontinued and provides the client’s current address and all other eligibility criterion have been met, the client shall receive the grant payments they are eligible for;

4. Any grant payments issued to an Electronic Benefits Transfer (EBT) card and not accessed within two hundred seventy-four (274) days of issuance shall be expunged.

The county shall reissue grant payments within 90 days of the expungement if requested by the client verbally, electronically, in person, or in writing. The county may reissue up to twelve (12) months of expunged grant payments.

G. The county department shall take prompt action to correct underpayments to clients of Colorado Works grant payments. There are two types of underpayments: 1) grant payment(s) received by or for a client that is less than the amount which the client should have received but not a denial or termination, or 2) the failure of the county department to issue a grant payment to an eligible client when such payment should have been issued (i.e., denials or termination of Colorado Works grant payments).

1. When a county department becomes aware of a potential underpayment, the county department shall:

a. Determine if an underpayment occurred; and, b. Record the facts and basis of its determination in the case record.

2. A county shall correct any underpayments by the month following the discovery of such underpayments.

3. Underpayments shall be used to pay any validated claims against the client unless the county department has determined this action will cause an undue hardship to the client as determined on a case-by-case basis. Underpayments will be applied to claims using the following hierarchy:

a. Fraud or intentional program violation (IPV) claims first (undue hardship cannot be granted);

b. Client error claims second; and c. Administrative error claims last. Instances that may result in an administrative error claim include, but are not limited to, the following:

1) The county failed to take timely action on a change reported by the client.

2) The county incorrectly computed the client’s income or other information, or otherwise gave an incorrect grant payment.

3) Any other situation not caused by willful withholding of information on the

part of the client and/or their authorized representative.

4) If an underpayment is discovered by the county department, the county department shall inform the client in writing of its determination of the underpayment.

5) Prompt action shall be taken to correct underpayments that occurred within the past twelve (12) months from the discovery date by issuing a retroactive payment. Retroactive payments shall not be made unless the amount is one dollar ($1.00) or more.

H. The county department shall reissue a lost or stolen payment if the loss or theft is not questionable and the county determines that such loss was beyond the client's control.

A loss will be considered within the client’s control when:

1. The client has shared the EBT pin number or written the pin number on the EBT card itself, or 2. The client has given his or her card to another person for that person’s use.

J. A client is prohibited from using or allowing the use of his or her EBT card at automated teller machines (ATMs) and point of sale (POS) devices located in establishments as described in

section 3.602.1.E.2.k.

A client’s transactions shall be monitored quarterly. Clients who use prohibited ATMs or POS devices (misuse) shall be contacted by the county department. Misuse shall result in:

1. A written warning that the use of the EBT card in prohibited establishments will result in the card being disabled. The county department shall provide education about appropriate use, access, and alternatives;

2. If continued misuse occurs (identified on the usage report after a warning has occurred), the cash portion of his or her EBT card shall be disabled for one month, requiring the county to inform the client of additional options for receipt of payment (direct deposit or county warrant) as well as notification of the dispute resolution process in accordance with state rules pursuant to section 3.609.6;

3. If misuse continues, the county department shall deny or discontinue the cash benefit for one month. The county shall require the client to complete a new application after the one-month time period if the client requests assistance. The county department shall not accept a new application from the client until the one-month denial or discontinuance expires. The county department shall follow the dispute resolution process pursuant to

section 3.609.6; and, 4. After the one-month case closure for continued misuse, if/when the client reapplies, any future EBT card usage at prohibited establishments shall be considered continued misuse. Such subsequent violations will result in the one-month denial/discontinuance and reapplication process referred to in subsection 3, above. 3.609.3 Overpayments The county department shall establish a claim on an overpayment before the last day of the quarter following the quarter in which the overpayment was discovered.

A. An overpayment claim shall be adjusted if there is a record of any underpayment(s) for a prior period. Any underpayment must be applied to the overpayments in the following hierarchy:

1. Fraud or IPV claims first, 2. Client error claims second; and, 3. Administrative error claims last.

B. Liability for an overpayment must be legally established. Methods for legally establishing an overpayment include but are not limited to:

1. An executed promissory note;

2. A court judgment;

3. A final agency action; or 4. A signed public assistance repayment agreement form.

The state department’s public assistance repayment agreement form shall be provided to the client once an overpayment claim is established.

C. Failure to sign the public assistance repayment agreement form shall be handled as follows:

1. If the client against whom a recovery has been initiated is currently participating in the Colorado Works program and does not respond to the public assistance repayment agreement form within eleven (11) calendar days of the date the notice containing the public assistance repayment form is mailed, grant payment reduction shall begin with the first month following the timely noticing period without further notice.

2. If the client against whom a recovery has been initiated is not participating in the program when a recovery for a claim is initiated or if a recovery has been initiated for repayment of a claim and no response is made to the public assistance repayment agreement form within eleven (11) calendar days of the date the notice is mailed, the county department shall pursue all legal recovery methods in order to recover the overpayment. Legal remedies include, but are not limited to, judgments, garnishments, claims on estates and the state income tax refund intercept process.

D. The amount of the overpayments involving income shall be calculated to allow for income disregards described in section 3.606.2.

E. All earned and unearned income received by the client are taken into consideration in the computation.

In the instances where the overpayment is the direct result of actions tied to the determination of IPV and/or fraud, which resulted in receipt of grant payments in error, or grant payments received that the client was not eligible to receive, the overpaid grant payments shall be recovered from the client and/or a liable individual.

F. The calculation of overpayment shall begin in the month that the overpayment occurred.

1. Start with the amount issued to the client;

2. Determine the correct payment;

3. Compare the amount issued to the client to the correct payment amount.

a. If the amount issued to the client is greater than the correct payment amount, the difference is the overpayment amount.

b. If the amount issued to the client is less than the correct payment amount, the difference is the underpayment amount; follow the procedures for underpayment in section 3.609.2.G.

4. If a client does not meet the non-financial eligibility requirements in any month, the client is totally ineligible for the month. Any payment received in such month(s) is an overpayment.

G. When the county department has determined that a client has received an overpayment, the department shall:

1. Take action to research the overpayment and determine the amount of the overpayment.

2. Determine if the overpayment is to be recovered.

3. Document the facts and situation that produced the overpayment. Document whether the overpayment is to be recovered. Retain all associated documentation and notices until the overpayment is repaid in full.

4. Determine whether there was willful withholding of information, fraud, or IPV.

5. Provide the client with timely or adequate notice as required by section 3.609.1 of the amount due and the reason for the recovery including:

a. The liable individual(s) responsible for the repayment;

b. The amount of the claim;

c. The period the claim is for;

d. The reason for the overpayment including whether the overpayment is a result of fraud/IPV, client error, or administrative error;

e. The client’s rights and responsibilities;

f. The method of repayment;

g. How to obtain free legal assistance;

h. The applicable rules concerning the overpayment; and i. Provide the public assistance repayment form.

6. Send quarterly statements with the balance due. 3.609.4 Recovery A. The recovery of valid overpayments is required regardless of when the overpayment occurred.

Overpayments may be recovered from the client who was overpaid or who fraudulently received the assistance payment or another liable individual.

If a client is deceased, overpayments shall be recovered from the deceased client's estate.

B. The following rules for recovery do not apply in instances where the state or county department seeks recovery in a case that was transferred to the district attorney and prosecuted through the courts:

1. The client shall be notified of the recovery action to be taken, using the notice rules found at section 3.609.1.

2. When the overpayment is caused by an unintentional error, the client's willful withholding or an administrative error, such overpayment shall be deducted, after notice has been given, from subsequent grant payments while the client is actively receiving Colorado Works grant payments.

a. The client may choose to repay the county department the entire amount of the overpayment at one time. The client shall work with the county department to determine how a lump sum repayment can be made.

b. When the recovery amount is not to be repaid in a single payment per subsection a above, and the case remains active, the county department shall establish a monthly recovery deduction from subsequent grant payments. The monthly rate of recovery shall be ten dollars or ten percent of the assistance payment, whichever is higher.

The following procedure shall be used to arrive at the monthly recovery deduction amount:

1) If the error is a result of an agency error and the client does not meet criteria set forth in section 3.609.4.L, compute ten percent (10%) of the Colorado Works grant payment amount. If the resulting percentage amount is less than ten dollars ($10), the deduction from the grant payment amount shall be ten dollars ($10).

2) Deduct the percentage amount or ten dollars ($10), whichever is higher, from the grant payment. The result shall be rounded to the next lower whole dollar amount, if not already a whole dollar amount. This rounded amount is the final payment amount.

3) When the authorized payment amount is less than ten dollars ($10), the case is considered a “no payment” case and no deduction shall be made.

4) When the recovery is due to a fraudulent action on the part of the client and interest may be added thereto, the interest amount shall not be included in the grant payment deduction unless the client agrees to such inclusion. If the client does not so agree, the interest amount shall be collected separately.

5) The amount of the grant payment deduction for recovery shall be recorded in the client's case file and collected via the statewide automated system.

c. The county department shall not establish a claim unless the amount of the claim is greater than $200, except in the following circumstances:

1) The overpayment is identified through a federal or state level quality control review; or, 2) The claim is being pursued as and results in an IPV.

3. When the overpayment is caused by an unintentional error, the client’s willful withholding of information or an administrative error, and the Colorado Works case is no longer active, recovery of such overpayment shall be based upon the public assistance repayment agreement form or other methods of recovery.

a. The county shall establish a monthly repayment agreement with a former client.

The repayment agreement shall not exceed twenty-five percent (25%) of available monthly income. Determination of the repayment amount must be clearly documented in the electronic case file.

b. The client may choose to repay the county department the entire amount of the overpayment at one time. The client shall work with the county department to determine how a lump sum repayment can be made.

c. The county department may write-off unpaid valid claims as follows:

1) Valid administrative error claims less than one hundred twenty-five dollars ($125.00) can be written off ninety (90) days after the termination of Colorado Works.

2) Valid claims for client error, fraud, and IPV less than three hundred dollars ($300.00).

3) Any unpaid valid claim of one hundred twenty-five dollars ($125.00) or more for an individual who was not convicted of an IPV or fraud specific to the overpayment, is no longer receiving public assistance from Colorado Works, Adult Financial, or SNAP, and the overpayment was established six (6) or more years ago, and the county department has determined that it is no longer cost effective to pursue collection.

4) Once written off, a claim is not subject to recovery.

d. If the client begins to receive Colorado Works grant payments again after the overpayment has been established and still has a claim balance, the deduction of grant payments shall occur as described in section 3.609.5.

C. The client may issue the state a refund of any overpayments from his or her existing balance of Colorado Works grant payments on his or her electronic benefits transfer (EBT) card by contacting the county department. This requires a written statement from the client.

D. Clients are not entitled to payments that were paid in error or mistakenly provided to the client based on a data entry error into the statewide automated system or an error resulting from the statewide automated system. The county shall create a claim and may retrieve the payments from the client’s EBT card within twenty-four (24) hours of the issuance without prior written authorization by the client. The client shall have no appeal rights in relation to this payment because he or she was not eligible for the initial receipt of the payment(s) in the first instance.

When payments issued in error are not retrieved from the client’s EBT card within twenty-four (24) hours, funds shall not be taken from the card using this method unless permission is granted from the client in writing using the state prescribed form. If permission is not granted, the county department shall pursue other methods of recovery.

E. The client may request voluntary deductions be applied to the overpayment. These are considered to be an amount in addition to the deduction from the grant payment as established through the recovery calculations. The client shall be provided written confirmation of the amount to be deducted and that he or she has the right to stop the voluntary deduction at any time by written request.

F. A claim may be filed against the estate of a client for overpayment. This includes cases where overpayments were made and not recovered. The county department's legal advisor must be consulted in determining the amount of assistance payments for which a claim is to be filed.

G. In accordance with sections 26-2-133 and 39-21-108, C.R.S., the State and county departments may recover overpayments of public or medical assistance benefits through the offset (intercept) of a taxpayer's state income tax refund. Tax refunds shall not be offset in instances where the taxpayer is making regular, ongoing payments as agreed to in the public assistance repayment agreement and/or based on arrangements between the taxpayer and the county(ies). Unless agreed to by the client, the county shall not offset tax refunds during the same month the client makes a payment on a claim if the payment agreement was established prior to the offset. Rent rebates are subject to the offset procedure.

The offset of the taxpayer state income tax refund and/or rent rebate may be used to recover overpayments that have been:

1. Determined by final agency action; or, 2. Ordered by a court as restitution; or, 3. Reduced to judgment.

H. Prior to certifying the taxpayer's name and other information to the Colorado Department of Revenue, the Colorado Department of Human Services shall notify the taxpayer, in writing at his or her last-known address, that the State intends to use the tax refund offset to recover the overpayment. In addition to the requirements of section 26-2-133(2), C.R.S., the pre-offset notice shall include the name of the county department claiming the overpayment, the program that made the overpayment, and the current balance owed.

I. Effective August 1, 1991, the taxpayer is entitled to object to the offset by filing a request for a county conference or state level fair hearing within thirty (30) calendar days from the date that the state department mails its pre-offset notice to the taxpayer. In all other respects, the procedures applicable to such hearings shall be those that are stated in section 3.609.7. At the hearing on the offset, the county department or ALJ shall not consider whether an overpayment has occurred because overpayment has already been otherwise legally established, but may consider the following issues if raised by the taxpayer in his or her request for a hearing:

1. Whether the taxpayer was properly notified of the overpayment;

2. Whether the taxpayer is the person who owes the overpayment;

3. Whether the amount of the overpayment has been paid or is incorrect;

4. Whether the debt created by the overpayment has been discharged through bankruptcy; or, 5. Whether other special circumstances exist, (i.e., facts that show that the taxpayer was without fault in creating the overpayment and will incur financial hardship if the income tax refund is offset).

J. If a tax refund offset is established, an overpayment shall not be recovered using another method in the month the offset occurs unless prior authorization is received from the individual making the recovery payments.

K. The county department is required to pursue collection of the overpayment from the client/responsible payee who managed and administered the Colorado Works funds. The county department shall pursue all available overpayment recovery options to collect the overpayment from the client/responsible payee first and then any other liable individuals legally responsible for overpayments, unless otherwise specified.

1. In instances where a trustee has used a client's trust income or property in a manner contrary to the terms of the trust, the county department shall:

a. Determine whether an overpayment has occurred as a result of the client’s loss of income based on the trustee’s improper actions;

b. Consult with the county attorney or other legal resource to determine how to pursue action against a trust/trustee;

c. Advise the trustee of the overpayment circumstances; and d. If the trustee disagrees with such circumstances and overpayment, pursue the recovery establishment and collection through appropriate legal means; or e. Take appropriate steps to secure repayment with the cooperation of the trustee; or, f. Report such behavior or action by the trustee to the county protective services to ensure the protection of the client’s rights in the trust.

2. In instances where a power of attorney has used his or her legal authority for purposes other than for the benefit of the client, the county department shall:

a. Determine whether an overpayment has occurred as a result of the power of attorney’s improper actions;

b. Consult with the county attorney or other legal resource to determine how to pursue action against a power of attorney;

c. Advise the holder of the power of attorney of the overpayment circumstances; and, d. If the holder of the power of attorney disagrees with such circumstances and overpayment, pursue the recovery establishment and collection through appropriate legal means; or e. Take appropriate steps to secure repayment with the cooperation of the holder of the power of attorney; or f. Report such behavior or action by the trustee to the county protective services to ensure the protection of the client’s rights and benefits.

L. In any case in which an overpayment has been made, there shall be no recovery from any person:

1. Who is without fault in the creation of the overpayment; and, 2. Who has reported any increase in income or other circumstances affecting the client's eligibility within the timely reporting requirements for the program; and, 3. Who would be deprived of income required for ordinary and necessary living expenses such that it would be against equity and good conscience to seek recovery. The fact that the client is receiving public assistance shall not be the only factor in making a determination that the person would be deprived of income required for ordinary and necessary living expenses and that equity and good conscience exist.

a. If a client has ten (10) percent or more of income remaining after necessary living expenses, he or she shall not be considered deprived of income.

b. If a client’s expenses exceed his or her income, additional questions must be asked to determine how he or she is meeting expenses to ascertain if other income (i.e. gift, in-kind) needs to be included in the income calculation.

M. When the overpayment recovery is not pursued, such fact, together with the reason, shall be documented in the statewide automated system. All information pertaining to the reason, establishment, and collection of claims shall be retained in the case record until the claim is written off or paid in full. 3.609.5 Intentional Program Violation (IPV) and Fraud A. All clients must be provided with their rights in relation to IPV as follows:

1. The client has the right to an administrative disqualification hearing (ADH) before an administrative law judge (ALJ).

2. The county department may offer an ADH at the county. This does not preclude the client from requesting the initial ADH or a second ADH be held before an ALJ under subsections M and O.

3. A client may waive the right to an ADH, either before an ALJ or with the county department, by signing a waiver of ADH form. Clients have a right to look at all the evidence that would be used at an ADH before deciding whether to waive the right to an ADH.

4. If a client chooses to appear at the ADH he or she has the right to represent him or herself or to be represented by an attorney at his or her expense.

5. The client may choose to be represented by any other person he or she chooses pursuant to section 26-2-127(1)(a)(IV), C.R.S.

6. A client and/or his or her representative, upon providing a signed release, may look at his or her case file, including all the evidence that will be used at the ADH. The client and/or his or her representative has the right to look at his or her case file before and during the ADH.

7. The county department shall provide a free copy of the evidence to be utilized during the ADH to the client at least fifteen (15) days prior to an ADH heard by the county. Upon request, the county department will provide a free copy of any other parts of the case file that the client determines is needed at the ADH.

8. A client may bring witnesses to speak on his or her behalf at the ADH.

9. The client and or his or her representative has the right to question or deny any evidence or statements made against him or her at the ADH. This includes the right to ask questions of persons testifying against him or her.

10. The client has the right to present any evidence that he or she feels is important to prove his or her case.

B. All Colorado Works clients must be provided with a written notice of the penalties for an IPV on the application form. All Colorado Works clients shall be notified of the penalties for an IPV when reporting changes on the redetermination form.

C. A county department is required to refer the investigation to the appropriate investigatory agency for any client or representative payee whenever there is an allegation or reason to believe that individual has committed an IPV as described below.

When conducting an interview for IPV and/or fraud, the county department investigator or representative has the responsibility to ensure the following:

1. That an explanation was given to the individual regarding the reason the interview is taking place; and, 2. That the individual’s rights have been provided to him or her (section 3.609.6.A); and, 3. That the individual’s rights and responsibilities including confidentiality of records and information, the right to non-discrimination provisions, the right to a county conference, and the right to a state level fair hearing have been provided to him or her; and, 4. That the rights and responsibilities presented in the “what I should know” section of the application that the client acknowledged when he or she signed the application form have not been violated; and, 5. That the county and/or representative of the county shall not threaten the individual or engage in any other intimidation tactics toward the client.

D. If the county receives questionable information that is necessary for determining a client’s eligibility and the verification requested by the county department is not supplied by the client as required by the county department’s verification request timeframes (section 3.604.3), grant payments may be reduced and/or the case closed and grant payments terminated for a client’s failure to prove eligibility following the notice policies outlined in section 3.609.1. These actions and notification shall not be used as an intimidation tactic or threat.

E. Following an investigation, the county must take action on cases where documented evidence exists to show a client has committed one or more acts of IPV. The county must take action through:

1. Obtaining a “waiver of administrative disqualification hearing”; or, 2. Proceeding with an ADH, either at the county department or in front of an ALJ, or both as described in subsections M. and O. below; or, 3. Referring the case for civil or criminal action in a county or district court; or, 4. Documenting in the case file the county department’s decision to take no action to pursue IPV using documented evidence to support the decision.

5. Establishing a claim based on the IPV, if appropriate.

F. In proceeding against a client who is alleged to have committed an IPV, the county department must coordinate any action with actions taken under the food assistance program where the factual issues are the same or related.

G. Overpayment actions shall be initiated in the statewide automated system within ten (10) calendar days of the investigation’s conclusion, unless otherwise specified in the case file. This is required in all cases even if ADH procedures or referral for prosecution is not initiated, except in instances where notification of overpayments may prejudice the ongoing criminal case or investigation. In these instances, the county department may make the determination to postpone notification of claims to the client if the overpayment is being referred to a court of appropriate jurisdiction. The determination to postpone notification must be clearly documented in the case H. The state department will not condone any actions of the county department that could be determined to be a violation of state or federal law. Any actions taken by a county department that is determined to be in violation of state or federal law may be subject to corrective action per 9 C.C.R. 2501-1 section 1.150.

I. These rules apply to all clients who commit an IPV who are recipients or representative payees of grant payments and/or services. The determination of IPV shall be based on clear and convincing evidence that demonstrates intent to commit IPV.

J. Supporting evidence warranting the pursuit of an IPV disqualification must be documented and reviewed by a supervisor. If the county department determines there is evidence to substantiate that a person has committed an IPV, the person has a right to an ADH. However, the county department shall allow that person the opportunity to waive the right to an ADH.

1. The State approved IPV forms shall be provided to the individual suspected of an IPV.

These may be offered to the individual during the investigation or mailed once it has been suspected an IPV has occurred, but there is no plan to pursue criminal charges.

2. One of the state approved forms affords the individual the right to waive the ADH. If the individual chooses to waive his or her right to an ADH, the individual shall have fifteen (15) calendar days from the date the IPV forms are hand-delivered or mailed by the county to return the waiver. If the form is not returned, the county department shall pursue an ADH.

3. The completion of the waiver is voluntary and the county department may not require, nor by its actions appear to require, the completion of the waiver.

K. An IPV ADH must be requested whenever:

1. The facts of the case do not warrant civil or criminal prosecution;

2. Documentary evidence exists to show an individual has committed one or more acts of IPV; and 3. The individual has failed to sign and return the waiver of ADH form.

L. An ADH may be requested against an accused individual whose case is currently being referred for prosecution on a civil or criminal action in county or district court.

M. A county department may conduct an ADH or may use the Office of Administrative Courts (OAC) to conduct the ADH.

1. The individual may request verbally, in writing, electronically, or in person that the OAC conduct the ADH in lieu of a county ADH. Such an ADH must be requested ten (10) calendar days before the scheduled date of the county ADH.

2. The OAC or the county department must mail by certified mail, return receipt requested, a notice of the date of the ADH on the form prescribed by the state department, to the individual alleged to have committed an IPV. The notice must be mailed at least thirty (30) calendar days prior to the ADH date, to the individual’s last known address. The notice form shall include a statement that the individual may waive the right to appear at an ADH.

3. The ALJ or ADH officer shall not enter a default judgment against the individual for failure to file a written answer to the notice of hearing or failure to appear at the ADH, but shall base the initial decision upon the evidence introduced at the ADH.

4. The ADH must be continued at the accused individual's request if good cause is shown.

The request for continuance must be received by the presiding ALJ or ADH officer at least ten (10) calendar days prior to the ADH.

The ADH shall not be continued for more than a total of thirty (30) calendar days from the original ADH date. One additional continuance is permitted at the ADH officer or ALJ's discretion. If the ADH officer or ALJ considers it necessary, a medical assessment may be ordered to substantiate or disprove a good cause statement of an accused individual.

Such assessment shall be obtained at the agency’s expense and made part of the record.

5. In the event that the ADH was heard by the county, the client may request an ADH to be heard by the OAC within fifteen (15) calendar days of the date the county department mails the local ADH decision to the client.

N. Disqualification for IPV shall be as follows:

1. If the individual signs and returns the request for waiver of ADH within fifteen (15) calendar days from the date the waiver is sent, that person shall be provided with a notice of the period of disqualification.

2. The disqualification period shall begin no later than the first day of the following month from the date determined through the ADH process or, if the individual signed an ADH waiver, the date he or she signed the waiver.

a. Once the disqualification is imposed it shall continue without interruption. To consider a disqualification period served, the client shall have a break in grant payments totaling the time period of the disqualification. The disqualification period shall remain in effect unless and until the finding is reversed by the Office of Appeals or a court of appropriate jurisdiction or until the period of disqualification is served per section c below.

b. The disqualification may be in addition to any other penalties which may be imposed by a court of law for the same offenses (i.e. criminal or civil sanctions).

c. The disqualification shall be in effect for twelve (12) months upon the first occasion of any such offense; twenty-four (24) months upon the second occasion of any such offense and permanently upon the third such offense, pursuant to

section 26-2-128(1), C.R.S. all disqualifications imposed shall run and be served consecutively.

3. The disqualification penalizes only the individual(s) found to have committed an IPV. If a client’s spouse and/or sponsor(s) have received an IPV on his or her own case(s), the spouse’s and/or sponsor(s)’ income and resources, when applicable, will be considered available to the client and used for determining eligibility.

4. An IPV disqualification in one county is valid and effective in all other Colorado counties.

A county department shall consider a disqualification imposed by another county department when determining the appropriate disqualification penalty for the disqualified individual without an additional ADH or further right to appeal.

O. If, as a result of the ADH, the county ADH officer or ALJ finds the individual has committed an IPV, a written notice shall be provided to notify the individual of the decision. The county hearing decision notice shall be a state prescribed form, which includes a statement that a state ADH at the OAC may be requested.

1. In the event that the ADH was heard by the county, the client may appeal the decision of the county ADH to the OAC. An appeal must be received by the county department or by the OAC within fifteen (15) calendar days of the date the county department mails the local ADH decision to the client. See section 3.609.7 for rules regulating the appeal process.

2. A copy of the county ADH decision shall be forwarded to the State Department Division of Economic and Workforce Support for review at the same time the decision is mailed to the client. If the client does not appeal the county ADH decision to the OAC, it becomes an initial decision and if no response is sent by the Division of Economic and Workforce Support to the county department, the county’s decision becomes a final decision. If the Division of Economic and Workforce Support disagrees with the county department decision, they may: remand the decision to the county department or require the county to send the ADH request to OAC for determination of IPV, as described in M.5 above.

3. In an ADH before an ALJ, the determination of IPV shall be an initial decision, which shall not be implemented while pending state department review and a final agency decision.

The initial decision shall advise the client that failure to file exceptions to findings of the initial decision will waive the right to seek judicial review of a final agency decision under

section 24-4-106, C.R.S. affirming the initial decision.

4. When an individual waives his or her right to an ADH, a written notice of the disqualification penalty shall be mailed to the individual. This notice shall be on a state prescribed notice form.

P. When the county department determines that it has paid a client a grant payment as a result of fraud, the facts used in the determination shall be reviewed with the department’s legal counsel within the attorney general’s office and/or a representative from the district attorney’s office. If suspected fraud is substantiated by the available evidence, the case shall be referred to the district attorney. All referrals to the district attorney shall be made in writing and shall include the amount of assistance fraudulently received by the client.

Q. If any deduction is being made from the client’s assistance payment it must be consistent with any court order resulting from a prosecution by the district attorney. If the individual being prosecuted is not a Colorado Works program client, another method of recovery shall be used to collect amounts due to the department.

1. Interest shall be charged from the month in which the overpayment was received until the date the overpayment is recovered. Interest shall be calculated at the legal rate.

2. The client may choose to repay the county department the entire amount of the overpayment at one time or establish a repayment plan. In either instance, the fraud charge should be discussed with the district attorney or appropriate investigative

authority.

R. If the district attorney declines to prosecute, the amount of overpayment due, as established by the department, will continue to be recovered by deduction from subsequent grant payments or other method of recovery if the individual is not a current client of Colorado Works grant payments. 3.609.6 Dispute Resolution The dispute resolution process is available for disputes concerning county department actions related to eligibility, reduction of grant payment amounts, redetermination procedures, and other county actions that do not involve allegations of fraud or IPV on the part of the client. If there is a dispute regarding fraud or IPV, that dispute must be handled according to sections 3.609.1 and 3.609.5 regarding IPVs and fraud. In order to resolve disputes between county departments and clients, county departments shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple, non-adversarial format for the informal resolution of disputes.

A. The county department, prior to taking action to deny, terminate, recover, initiate vendor payments, or modify financial assistance provided under the Colorado Works program to a client, shall, at a minimum, provide the client an opportunity for a county conference.

1. The right of a client to a county conference is primarily to ensure that the proposed action is valid, to protect the client against an erroneous action concerning grant payments, and to ensure reasonable promptness of county action. The client may choose, however, to bypass the county conference and appeal directly to the state office of administrative courts, pursuant to section 3.609.7.

2. The client is entitled to:

a. Representation by an authorized representative retained at his or her own expense, such as legal counsel, relative, friend, or another spokesperson, or he or she may represent himself or herself;

b. Examine the contents of the case file and all documents and records used by the county department or agency in making its decision. Examination of the file is available at a reasonable time before the conference and during the conference.

However, the file shall not include names of confidential informants, privileged communications between the county department and its attorney, or the nature and status of pending criminal prosecutions and any other information that is confidential or privileged under state or federal law; and c. Present new information or documentation to support reversal or modification of the proposed adverse action.

3. Failure of the client to request a county conference within ninety (90) calendar days from the date timely notice of the proposed action was mailed, absent the client requesting a postponement within that same ninety (90) days, shall constitute abandonment of the right to a conference. The client does not lose the right to appeal directly to the OAC pursuant to section 3.609.7.

4. Failure of the client to appear at the scheduled county conference without making a request for postponement prior to the scheduled date of the conference shall constitute abandonment of the right to a conference unless the client can show good cause for his or her failure to appear. The client does not lose the right to appeal directly to the OAC pursuant to section 3.609.7.

B. The county conference shall be held before a person who was not directly involved in the initial determination of the action in question. The county worker or contractor who initiated the action in dispute shall not conduct the county conference.

1. The person designated to conduct the conference shall be in a position which, based on knowledge, experience, and training, would enable him or her to determine if the proposed action is valid. This could include, but is not limited to, a supervisor, quality assurance personnel, or a manager with no previous knowledge of the case.

2. Two or more county departments may schedule a joint county conference related to the same client. If two or more counties schedule a joint county conference, the location of the conference need not be held in the county taking the action, and the conference location shall be convenient to the client.

3. The county conference may be conducted either in person, by telephone, or by video conference. A telephonic or video conference must be agreed to by the client.

4. The county/agency worker or other county or department employee or contractor shall attend the county conference and present the factual basis for the disputed action.

5. The county conference shall be conducted on an informal basis. The county department/agency must provide specific reasons for the proposed action, and the applicable state department's rules or county policy. In the event the client does not speak English or other language services are needed, an interpreter shall be provided by the county department/agency.

6. The county/agency shall have available at the conference all pertinent documents and records in the case file relevant to the specific action in dispute.

7. To the extent possible, the county conference shall be scheduled and conducted prior to grant payments being reduced or terminated.

8. The county department shall provide notice to the client at least four (4) days prior to the scheduled time and location for the conference, or the time of the scheduled telephone or video conference. Notice should be in writing. The client may provide a written or verbal waiver that written notice of the scheduled conference is not necessary when the county department is able to conduct the conference within four (4) days.

9. The county department may consolidate a client’s disputes regarding the Colorado Works program, the food assistance program, or any other public assistance program if the facts are similar and consolidation would facilitate resolution of all disputes.

10. The goal of the county conference is to reach an agreement between the client and the C. At the conclusion of the conference, the person presiding shall summarize the discussion in writing. The summary shall include whether the issue was resolved and include the client’s appeal rights as described in section 3.609.7. A copy of the written summary shall be provided to the client and/or his or her representative within eleven (11) calendar days. A copy of the summary will also be maintained in the client’s case file. 3.609.7 Appeal and State Level Fair Hearing A. These rules apply to all state-level fair hearings of county department actions concerning assistance payments and actions taken pursuant to state rules or official county policies governing the Colorado Works program. An affected client who is dissatisfied with a county department action or the result of a county conference or failure to act concerning grant payments may appeal to the Office of Administrative Courts (OAC) for a fair hearing before an independent Administrative Law Judge (ALJ). This will be a full evidentiary hearing of all relevant and pertinent facts to review the decision of the county department. The time limitations for submitting a request for an appeal are:

1. When the client elects to avail himself of a county conference, but is dissatisfied with that decision, the request must be submitted in writing and mailed or hand-delivered as described in subsection 3 below, within the ninety (90) day period specified in 2, below;

2. When the client elects not to avail himself of a county dispute resolution conference but wishes to appeal directly to the state, a written request for an appeal must be mailed or hand-delivered as described in 3 below no later than ninety (90) calendar days from the date the notice of the proposed action was mailed to the client;

3. A request for an appeal must be mailed or hand-delivered to the office of administrative courts. If the request is sent to or mailed to the county department, the county shall forward such request to the OAC.

B. Requests for state hearings may result from such reasons as:

1. The opportunity to make application or reapplication has been denied;

2. An application for assistance or services has not been acted upon within the maximum time period for the category of assistance;

3. The application for assistance has been denied, the grant payment has been modified or discontinued, vendor payments have been initiated, requested reconsideration or a grant payment amount deemed incorrect has been refused or delayed, payment has been delayed through the holding of payments, the county department is demanding repayment for any part of a grant payment which the client does not believe is justified, or the client disagrees with the type or level of benefits or services provided.

C. The basic objectives and purposes of the appeal and state hearing process are:

1. To safeguard the interests of the client;

2. To provide a practical means by which the client is afforded a protection against incorrect action on the part of the county department;

3. To bring to the attention of the state department and county department information that may indicate need for clarification or revision of state and county policies and procedures;

4. To assure equitable treatment through the administrative process without resort to legal action in the courts.

D. Any clear expression verbally or in writing by the client or his or her representative, that the client wants an opportunity to have a specific action of a county department reviewed by the state department is considered a request for a state level fair hearing. The county department shall, when asked, aid the person in preparation of a request for a hearing. If the request for a hearing is made verbally, the county department shall prepare a written request within ten (10) calendar days for the client or his or her representative’s signature or have the client prepare such request, specifying the action he or she would like to appeal and the reason for appealing that action.

1. The client is entitled to:

a. Representation by any person he or she chooses pursuant to section 26-2- 127(1)(a)(iv), C.R.S., legal counsel retained at the client’s own expense, or he or she may represent him or herself;

b. Examine the complete case file and any other documents, records, or pertinent material to be used by the county at the state level fair hearing, including the hearing packet as described in section 3.609.711.D.3, before the date of hearing as well as during the hearing. However, the file shall not include the names of confidential informants, privileged communications between the county departments and its attorney, the nature and status of pending criminal prosecutions, and any other information that is confidential or privileged under state or federal law.

2. The client and staff of the county department are entitled to:

a. Present witnesses;

b. Establish all facts and circumstances pertinent to the decision being appealed;

c. Advance any arguments without undue interference;

d. Question or refute any testimony or evidence, including opportunity to confront and cross-examine adverse witnesses. 3.609.71 Hearing Procedures 3.609.711 State Level Fair Hearing Procedures The procedures in this section apply to all hearings in front of the OAC. One or more persons from the Colorado Department of Personnel and Administration, Office of Administrative Courts (OAC), are appointed to serve as ALJs for the state department.

All hearings described in this section shall be conducted in accordance with section 24-4-105, C.R.S.

A. The State Administrative Law Judge shall, in preparation for the hearing, review the reasons for the decision under appeal and be prepared to interpret applicable Departmental rules and/or official written county policies governing the Colorado Works program and pertaining to the issue under appeal.

B. The county department shall forward copies of its applicable Colorado Works policies and any subsequent amendments, including effective dates, to the OAC. Clients appealing a county action shall be provided reasonable opportunity to examine the county's policies.

C. When legal counsel does not represent the client and/or the department, the ALJ shall assist in bringing forth all relevant evidence and issues relating to the appeal.

D. Upon receipt by the OAC of an appeal request, OAC assigns a case number. The OAC sets a hearing date at least ten (10) days from the date the appeal was requested, and sends a letter by first class or certified mail, or by email through the electronic filing system to the appellant and the county department notifying them of the date, time, and place of the hearing.

1. The appellant is told that if these arrangements are not satisfactory, he or she must notify the OAC. An ALJ will decide if good cause exists, and whether the date, time, and/or place of the hearing will be changed.

2. An information sheet shall be enclosed to explain the hearing procedures to the appellant. The information sheet informs the appellant that: he or she has the right to representation retained at his or her own expense, such as legal counsel, a relative, a friend, or another spokesperson, or he or she may represent himself or herself under

section 26-2-127(1)(a)(iv), C.R.S.; the appellant or his or her representative has the right to examine all materials to be used at the hearing, before and during the hearing.

3. For all hearings except IPV ADH hearings, the information sheet shall also include a notice that failure to appear at the hearing as scheduled, without having secured a proper extension in advance, or without having shown good cause for failure to appear, shall constitute abandonment of the appeal and cause a dismissal thereof. Pursuant to section 3.609.5.M.2-3., failure to appear does not result in a dismissal of an ADH hearing.

4. If OAC sets the hearing forty-five (45) days or more from the date of the notice of hearing, the county department/agency shall, within fifteen (15) days but no later than thirty (30) days prior to the hearing, prepare and mail a hearing packet to the appellant with a copy to OAC. If the hearing is set less than 45 days from the date of the notice of hearing, the county department/agency shall, within five (5) days but no later than ten (10) days prior to the hearing, prepare and mail the hearing packet. The hearing packet shall contain the following information:

a. The reasons for the decision of the county department and a specific explanation of each factor involved, such as the amount of excess income or residence factors;

b. The specific state rules governing the Colorado Works program or county policy on which the decision is based with a numeric reference to each such rule, including the appropriate Code of Colorado Regulations (C.C.R.) cites;

c. Notice that the county department will assist him or her by providing relevant documents from the case file for his or her claim, if he or she so desires, and that he or she has the opportunity to examine rules and other materials to be used at the hearing concerning the basis of the county decision.

5. Information that the appellant or his or her representative does not have an opportunity to see shall not be made available as a part of the hearing record or used in a decision on an appeal. No material made available for review by the ALJ may be withheld from review by the appellant or his or her representative.

6. In Colorado Works program appeals, the ALJ has twenty (20) calendar days from the hearing date to arrive at an initial decision. Once an initial decision is rendered, the OAC immediately sends the case and the initial decision to the State Department, Office of Appeals. The Office of Appeals serves the initial decision on the parties via first class mail and provides for an opportunity for the parties to file exceptions to the initial decision prior to the Office of Appeals issuing a final agency decision.

7. The initial decision shall not be implemented pending review by the Office of Appeals and entry of a final agency decision. All final agency decisions on these appeals shall be made within ninety (90) calendar days from the date the request for hearing is received.

E. When the client has had a county conference and wishes to appeal the county department's action to the OAC, the following procedures shall be followed:

1. As part of the local conference the client is informed that if he or she wishes to appeal to the OAC for a hearing, the county department shall provide relevant documents from the case file for the client’s claim, if he or she so desires, and that he or she may have the opportunity to examine materials as described in the section 3.609.

2. The county department shall forward a copy of the decision being appealed and a copy of the written notification given to the client to the OAC.

3. A copy of the OAC’s notice to the client setting a date for the hearing is forwarded to the county department. The county department shall provide the client with a hearing packet in accordance with section 3.609.711.D.3.

4. If the client indicates to the county department that he or she desires to withdraw the appeal, the county shall attempt to obtain a statement to that effect in writing and forward it to the OAC.

5. If a client has legal counsel or another authorized representative for the appeal, the county department will not discuss the merits of the appeal or the question of whether or not to proceed with it with the client unless the discussion is in the presence of, or with the permission of, such counsel or such other authorized representative.

6. If the county department learns that legal counsel will represent the client, the county department shall make every effort to ensure that it, too, is represented by an attorney at the hearing. The county department may be represented by an attorney in any appeal that it considers such representation desirable.

7. If the appellant needs interpretation services, the county department shall arrange to have present at the hearing a certified interpreter who will be sworn to translate correctly.

8. The fact that an appellant and the county department have been notified that a hearing will be held does not prevent the county department from reviewing the case and considering any new factors which might change the status of the case, or taking such action as may be indicated to reverse its decision or otherwise settle the issue. Any change, which results in a voiding of the cause of appeal, shall be immediately reported to the OAC.

9. Upon receipt of notice of a state hearing on an appeal, the county department shall arrange for a suitable hearing room appropriate to accommodate the number of persons, including witnesses, who are expected to be in attendance, taking into consideration such factors as privacy; absence of distracting noise; and the need for table, chairs, electrical outlets, adequate lighting and ventilation, and conference telephone facilities.

F. Telephonic hearings may be conducted as an alternative to in-person hearings unless otherwise requested by any of the parties. All applicable provisions of the in-person hearing procedures will apply, such as the right to be represented by counsel, the right to examine and cross-examine witnesses, the right to examine the contents of the case file, and the right to have the hearing conducted at a reasonable time and date.

G. The county department shall have the burden of proof, by a preponderance of the evidence, to establish the basis of the ruling being appealed. Every party to the proceeding shall have the right to present his or her case or defense by verbal and documentary evidence, to submit rebuttal evidence, and to conduct such cross-examination as may be required for a full and true disclosure of the facts. Subject to these rights and requirements, where a hearing is expedited and the interests of the parties will not be subsequently prejudiced thereby, the ALJ may receive all or part of the evidence in written form or by verbal stipulations.

H. The following provisions govern the procedure at state hearings before the ALJ:

1. The hearing is closed to the public however, any person or persons whom the appellant wishes to appear for or with him or her may be present, and, if requested by the appellant and in the record, such hearing may be public;

2. The purpose of the hearing is to determine the pertinent facts in order to arrive at a fair and equitable decision in accordance with the rules of the state department. In arriving at a decision, only the evidence and testimony introduced at the hearing is considered by the ALJ. However, in circumstances when it is shown at the hearing that medical or other evidence could not, for good cause, be obtained in time for the hearing, the ALJ may permit the introduction of such evidence after the hearing. The opposing party must also be furnished with a copy of this new evidence and must have the opportunity to controvert or otherwise respond to it. Delays in rendering the initial decision will be attributed to the party requesting that the ALJ hear additional evidence after the hearing;

3. Although the hearing is conducted on an informal basis and an effort is made to place all the parties at ease, it is essential that the evidence be presented in an orderly manner so as to result in an adequate record;

4. When an ALJ makes a decision regarding the merits of the case, or the dismissal of the appeal, that decision is called an initial decision.

5. A complete and exact record of the proceedings shall be made by electronic or other means. When requested by the party, the OAC shall cause the proceedings to be transcribed.

6. When the ALJ dismisses an appeal for reasons other than failure to appear, the decision of the ALJ shall be an initial decision, which shall not be implemented until the Office of Appeals completes its review and enters a final decision.

7. The ALJ shall not enter a default against any party for failure to file a written answer in response to the notice of hearing, but shall base the initial decision upon the evidence introduced at the hearing. However, an appellant may be granted a postponement of the hearing if the county department has failed to provide the hearing packet required by

section 3.609.711, and the appellant has therefore been unable to prepare for the hearing.

8. When OAC has notified the appellant of the time, date, and place of the OAC hearing and the appellant fails to appear at the hearing, without giving notice to the ALJ of acceptable good cause for his or her inability to appear at the hearing, then the appeal shall be considered abandoned. The ALJ shall enter an order of dismissal and the OAC shall serve it upon the parties. The dismissal order shall not be implemented pending review by the Office of Appeals and entry of an agency decision.

However, the appellant shall have ten (10) calendar days from the date the order of dismissal was mailed to draft and send a letter to the ALJ explaining the reason for his or her failure to appear. If the ALJ then finds that there was good cause for the appellant not appearing, the ALJ shall vacate the order dismissing the appeal and reschedule the hearing date.

If the appellant does not submit a letter seeking to show good cause within the ten (10) day period, the order of dismissal shall be filed with the Office of Appeals of the state department. The Office of Appeals shall review the dismissal of the appeal and give the appellant time to file exceptions before issuing a final agency decision in accordance with the procedures in section 3.609.72.

After the final agency decision is served on the parties, the county department shall carry out the necessary actions within ten (10) calendar days of the final agency decision becoming effective. The actions may be: to provide assistance or services in the correct amount, to terminate assistance or services, to recover assistance incorrectly paid, and/or other appropriate actions in accordance with the rules. Pursuant to section 24-4- 106(5), C.R.S., the effective date of the final agency decision may be postponed if the appellant makes a request for postponement due to irreparable injury to the state department or the court reviewing the final agency action on judicial review. 3.609.72 Decision and Notification A. Following the conclusion of the state level fair hearing, the ALJ shall promptly prepare and issue an initial decision and file it with the State Department, Office of Appeals.

The Office of Appeals of The State Department is the designee of the State Department’s executive director for reviewing the initial decision of the ALJ. The Office of Appeals enters a final agency decision on behalf of the executive director affirming, modifying, or reversing the initial decision.

1. The initial decision shall make an initial determination whether the county or state department or its agent acted in accordance with, and/or properly interpreted, the rules of the state department and/or the county policies governing the Colorado Works program.

2. The ALJ has no jurisdiction or authority to determine issues of constitutionality or legality of Colorado Statute, departmental rules, or county policy(ies) governing the Colorado Works program.

3. The initial decision shall advise the client who brought the appeal that failure to file exceptions to the initial decision will waive the right to seek judicial review under section 24-4-106, C.R.S. of a final agency decision that affirms the initial decision.

4. The Office of Appeals shall promptly serve the initial decision upon each party by first class mail, and shall transmit a copy of the decision either electronically or by mail to the division of the state department that administers the program(s) pertinent to the appeal.

5. The initial decision shall not be implemented pending review by the Office of Appeals and entry of an agency decision.

B. Upon receiving the initial decision, the Office of Appeals may issue an order of remand based on an issue that warrants an immediate remand before the initial decision is even mailed to the parties.

Additionally, the Office of Appeals may issue an order of remand after its substantive review of an initial decision, and prior to issuing a final agency decision, based on the need for further clarification, findings, conclusions of law, and/or further proceedings. An order of remand is not a final agency decision that is subject to judicial review under section 24-4-106, C.R.S.

C. Any party seeking final agency decision which reverses, modifies, or remands the initial decision of the ALJ shall file exceptions to the decision with the Office of Appeals, within fifteen (15) days (plus three days for mailing) from the date the initial decision is mailed to the parties. If that date falls on a weekend or State holiday, the due date shall be moved to the next business day.

Exceptions must state specific grounds for reversal, modification or remand of the initial decision.

1. If the party asserts that the ALJ’s findings of fact are not supported by the weight of the evidence, the party shall, simultaneously with, or prior to, the filing of exceptions request the OAC create a transcript of all or a portion of the hearing and file it with the Office of Appeals. No transcript is required if the review is limited to a pure question of law.

Similarly, if the exceptions assert only that the ALJ improperly interpreted or applied State rules or statutes, the party filing exceptions is not required to provide a transcript or recording to the Office of Appeals.

If applicable, the exceptions shall state that a transcript has been requested. Within five (5) days of the request for transcript, the party requesting it shall advance the cost therefore to the transcriber designated by the OAC unless the transcriber waives prior payment.

2. A party who is indigent and unable to pay the cost of a transcript may file a written request, which need not be sworn, with the Office of Appeals for permission to submit a copy of the hearing recording instead of the transcript. If submission of a recording is permitted, the party filing exceptions must promptly request a copy of the recording from the OAC and deliver it to the Office of Appeals. Payment in advance shall be required for the preparation of a copy of the recording.

3. The Office of Appeals shall serve a copy of the exceptions on each party by first class mail. Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties in which to file a written response to such exceptions. The Office of Appeals shall not permit oral argument.

4. The Office of Appeals shall not consider evidence that was not part of the record before the ALJ. However, the case may be remanded to the ALJ for rehearing if a party establishes in its exceptions that material evidence has been discovered which the party could not with reasonable diligence have produced at the hearing.

5. While review of the initial decision is pending before the Office of Appeals, the record on review, including any transcript or recording of testimony filed with the Office of Appeals, shall be available for examination by any party at the Office of Appeals during regular business hours.

6. The state department’s division(s) responsible for administering the program(s) relevant to the appeal may file exceptions to the initial decision, or respond to exceptions filed by a party, even though the division has not previously appeared as a party to the appeal.

The division's exceptions or responses must be filed in compliance with the requirements of this section exceptions filed by a division that did not appear as a party at the hearing shall be treated as requesting review of the initial decision upon the state department's own motion.

7. In the absence of exceptions filed by any party or by a division of the state department, the Office of Appeals shall review the initial decision, and may review the hearing file of the ALJ and/or the recorded testimony of witnesses, before entering a final agency decision. Review by the Office of Appeals shall determine whether the decision properly interprets and applies the rules of the state department and/or relevant statutes, and whether the findings of fact and conclusions of law support the decision. If a party or division of the state department objects to the final agency decision entered upon review by the Office of Appeals, the party or division may seek reconsideration of the final agency decision pursuant to subsection c, below.

8. The Office of Appeals shall mail copies of the final agency decision to all parties by first class mail.

9. For purposes of requesting judicial review under section 24-4-106, C.R.S., the effective date of the final agency decision shall be the third day after the date the decision is mailed to the parties, even if the third day falls on Saturday, Sunday, or a legal holiday.

The parties shall be advised of this in the final agency decision.

10. The State or county department shall initiate action to comply with the final agency decision within three (3) business days after the effective date. The department shall comply with the decision even if reconsideration is requested, unless the effective date of the agency decision is postponed by order of the Office of Appeals or a reviewing court pursuant to section 24-4-106(5), C.R.S.

D. No motion for reconsideration shall be granted unless it is filed in writing with the Office of Appeals within fifteen (15) days of the date that the final agency decision is mailed to the parties.

The motion must state specific grounds for reconsideration of the final agency decision.

The Office of Appeals shall mail a copy of the motion for reconsideration to each party of record and transmit electronically or in writing to the appropriate division of the state department.

A motion for reconsideration of a final agency decision may be granted by the Office of Appeals for the following reasons:

1. A showing of good cause for failure to file exceptions to the initial decision within the fifteen (15) day period allowed by section 3.609.7; or, 2. A showing that the agency decision is based upon a clear or plain error of fact or law. An error of law means failure by the Office of Appeals to follow a rule, statute, or court decision, which controls the outcome of the appeal.

E. When a final agency decision concludes that an action of the county or state department was not in accordance with rules of the department, or when the county or state department determines that its action was not supported by the state department’s rules after the client makes a request for a hearing, the adjustment or corrective payment is made retroactively to the date of the incorrect action.

F. The client is to be fully informed by the final agency decision of his or her further right to apply for judicial review of the agency decision. Judicial review can be started by filing an action for review in the appropriate state district court. Any such action must be filed in accordance with section 24- 4-106, C.R.S. and with the Colorado Rules of Civil Procedure within thirty-five (35) days after the final agency decision becomes effective.

G. The state department will establish and maintain a method for informing, in summary and depersonalized form, all county departments and other interested persons concerning the issues raised and decisions made on appeals. 3.609.73 Protections to the Individual A. Confidentiality All information obtained by the county department concerning a client of Colorado Works is confidential information.

1. The county department shall inform county officials and other persons who have dealings with the department as to the confidential nature of information, which may come into their possession through transaction of department business.

When a county worker consults a bank, current/former employer of a client, another social agency, etc., to obtain information or eligibility verification information, the identification of the county worker as an employee of the county department will, in itself, disclose that an application for assistance has been made by a client. In this type of contact, as well as other community contacts, the department shall strive to maintain confidentiality whenever possible.

2. Ensuring privacy while interviewing and the continuous confidentiality of information are essential. This involves both office facilities and county worker discretion. Office procedures and facilities should be such that information is not inadvertently revealed to persons not concerned with the affairs of a particular client. The county worker must also use discretion in mentioning department business outside the office.

3. The county or state department may share information across systems so that a client is efficiently served by programs using other systems to determine eligibility/maintain information to the extent allowable under section 26-1-114, C.R.S.

B. Confidentiality must be treated as follows:

1. Aggregated information not identified with any client, such as caseload statistics and analysis, is not confidential and may be released for any purpose.

2. Information secured by the county department for the purpose of determining eligibility and need is confidential.

3. Unless disclosure is specifically permitted by the state department, the following types of information are the exclusive property of, and are restricted to use by, the state and county departments:

a. Names and addresses of Colorado Works clients, and/or the grant payment amount;

b. Information contained in applications, reports of medical examinations, correspondence, and other information concerning any person from whom, or about whom, information is obtained by the county department;

c. Records of state or county departmental evaluations of the above information.

d. All information obtained through the Income and Eligibility Verification System (IEVS).

4. No one outside the state or county department shall have access to records of the department except for the following individuals: those executing the Income and Eligibility Verification System (IEVS); child support services officials; the SSA; and federal and State auditors and private auditors for the county these individuals shall have access only for purposes necessary for the administration of the program.

a. Client records may be used as exhibits for administrative, civil and/or criminal proceedings when the proceedings relate directly to the receipt of Colorado Works Programs.

b. Additional individuals shall have access to the client’s records as long as the client is notified and his or her prior permission for release of information is obtained, unless the information is to be used to verify income or eligibility under administration of the IEVS.

c. If the information is needed to provide benefits to a client in an emergency situation, and the client is physically or mentally incapacitated to the extent that he or she cannot sign the release form, and time does not permit obtaining the client’s consent prior to release of information, the county department must notify the client within eleven (11) calendar days after supplying the information. If the applicant or client does not have a telephone or cannot be personally contacted within eleven (11) days, the county department must send written notification containing the required information. The verbal or written notification shall include the name and address of the agency that requested the information, the reason the information was requested and a summary of the information released.

d. The release of records is strictly conditioned upon the information being used solely for the purpose authorized and the person requesting the information must certify the use to be made of the information and that it will not be disclosed or used for any other purpose.

5. The district attorney or county human services board member, shall have access to the records of the department, excluding IEVS information, if the following identified consent or notice conditions are met.

a. A district attorney upon presentation of a written request accompanied by evidence that fraud is the reason for the request b. A county human services board member, as described in section 26-1-116, C.R.S. if the board member has an obligation to perform Colorado Works duties per county business processes or county policies approved by the state department as described in section 3.600.2.

When a county board member or a district attorney who has met the above conditions needs information about a client that is not in the possession of the county department, the requestor, with the aid of the county department, may contact the state department to inquire as to the appropriate methods of securing it.

6. County departments shall not release information regarding clients to law enforcement agencies unless a valid search warrant is received by the county or state department, except as provided in section 3.609.73.B.4.

7. Upon request to the state department by the Colorado Bureau of Investigation, with the responsibility for location and apprehension of a person with an outstanding felony arrest warrant, the addresses of a fleeing felon who is a client of Colorado Works programs shall be released pursuant to section 26-1-114(3)(a)(iii) C.R.S.

8. The client shall have an opportunity to examine such pertinent records concerning him or her as constitutes a basis for adverse action and in the case of a county conference or a state level fair hearing. Other requests for information by the client shall be honored only when the client makes the request in person and his or her identity is verified or the request is in the form of a written and signed statement.

The client may designate an individual, firm, or agency to represent him or her at conferences and hearings. The client must put the designation of such representative in writing. The representative shall have access to all pertinent records.

9. The client may give a formal written release for disclosure of information to other agencies, such as hospitals or advocate agencies. If the client is not present, or the opportunity to agree or object to the use or disclosure cannot practicably be provided because of the client’s incapacity or an emergency circumstance, the department may, in the exercise of professional judgment, determine whether the disclosure is in the best interests of the client and, if so, disclose only the minimum confidential information necessary that is directly relevant to the client’s care.

10. Information provided to agencies and/ or individuals must be limited to the specific information required to determine eligibility, conduct ongoing case management, or otherwise necessary for the administration of the Colorado Works program. Information obtained through IEVS will be stored and processed so that no unauthorized personnel can acquire or retrieve the information. County departments are responsible for limiting IEVS data to only those individuals requiring access to determine eligibility or otherwise administer the programs.

All persons with access to information obtained pursuant to the income and eligibility verification requirements will be advised of the circumstances under which access is permitted, how data will be utilized, confidentiality of data, and the sanctions imposed for illegal use or disclosure of the information. 3.609.74 Protection Against Discrimination County departments are to administer Colorado Works in such a manner that no client will, on the basis of race, color, religion, creed, national origin, ancestry, sex/gender (including transgender status), pregnancy, age, sexual orientation, gender identity, political affiliation, or physical or mental disability, or any other protected groups as described in the state department’s anti-discrimination policy, be excluded from participation, be denied any aid, care, or services, or other benefits of, or be otherwise subjected to discrimination in his or her interactions with the Colorado Works program.

A. The references to “aid” includes all forms of assistance, including direct and vendor payments, work programs and information and referral services.

B. The county department shall not, directly or through contractual or other arrangements, on the grounds of race, color, religion, creed, national origin, ancestry, sex/gender (including transgender status), pregnancy, age, sexual orientation, gender identity, political affiliation, or physical or mental disability, or any other protected status: :

1. Provide any aid to an individual which is different, or is provided in a different manner, from that provided to others;

2. Subject a client to segregation barriers or separate treatment in any manner related to access to or receipt of assistance, care services, or other benefits;

3. Restrict a client in any way in the enjoyment or any advantage or privilege enjoyed by others receiving aid, care, services, or other benefits provided under assistance programs;

4. Treat a client differently from others in determining whether he or she satisfies any eligibility or other requirements or conditions which must be met in order to receive aid, care, services, or other benefits provided under the Colorado Works program;

5. Deny a client an opportunity to participate in assistance programs through the provision of services or otherwise, or afford him or her an opportunity to do so which is different from that afforded others under programs of assistance.

6. Deny a client the opportunity to participate as a member of a planning or advisory body that is an integral part of the program.

C. No distinction is permitted in relation to the use of physical facilities, intake and application procedures, caseload assignments, determination of eligibility, and the amount and type of benefits extended by the county department to clients.

D. The county department shall ensure that other non-federal agencies, persons, contractors and other entities with which it contracts business are in compliance with the above prohibition of discrimination requirements on a continuing basis. The county department staff is responsible for being alert to any discriminatory activity of other agencies and for notifying the state department concerning the situation.

E. The State department, through its various contacts with agencies, persons, and referral sources, will be continuously alert to discriminatory activity and will take appropriate action to assure compliance with these prohibitions against discrimination the county department, on notification by the state department, will also terminate payments to the offender or association with any agency, person, or resource being used which has been found by the state department or the Colorado Civil Rights Division to continue discriminatory activity against clients.

F. A client who believes he or she is being discriminated against may file a complaint with the county department, the state department, the Colorado Civil Rights Division or directly with the federal government. When a complaint is filed with the county department, the county director is responsible for an immediate investigation of the matter and taking necessary corrective action to eliminate any discriminatory activities found. If such activities are not found, the client is given a written explanation of the outcome. If the client is not satisfied, he or she is requested to direct his or her complaint, in writing, to the state department, client services section, which will be responsible for further investigation and other necessary action. The client services section can be reached by email at cdhs_clientservices@state.co.us.] 3.609.75 Additional Programs and Services 3.609.751 Optional Noncustodial Parent Programs A county may provide services under the Colorado Works program to a noncustodial parent (as defined in

section 3.601), in accordance with the county’s policy. A noncustodial parent shall not be eligible to receive basic cash assistance under the program.

A. Such services provided to a noncustodial parent shall be intended to promote the sustainable employment of the noncustodial parent and enable such parent to pay child support.

B. Provision of such services shall not negatively impact the custodial parent’s eligibility for benefits or services.

C. Any services offered to a noncustodial parent shall be based on the county’s review of:

1. The noncustodial parent’s request for services; and, 2. The county’s assessment of the noncustodial parent’s needs.

D. All services offered to a noncustodial parent shall be outlined in an Individualized Plan entered into by the county and the noncustodial parent.

E. Services may include, but are not limited to, parenting skills, mediation, workforce development, job training activities, and job search. _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Rules 3.600-3.609 eff. 09/15/2012. Rules 3.610-3.638 repealed eff. 09/15/2012.

Rules 3.600.1, 3.604.1, 3.605.3, 3.606.6, 3.608.4, 3.609.95 eff. 04/01/2013.

Rules 3.602.1.E, 3.602.1.I, 3.604.2, 3.605.3.D, 3.605.3.E.1, 3.605.3.E.2, 3.606.1-3.606.3, 3.606.4.A, 3.606.4.B, 3.606.4.F-G, 3.606.4.L, 3.608.4.H.1-3.608.4.H.4, 3.608.4.I-3.608.4.J, 3.609.1.A.1- 3.609.1.A.2 eff. 07/01/2013.

Rule 3.606.4.B eff. 08/07/2013.

Rules 3.602.1-3.602.1.E emer. rule eff. 07/11/2014.

Rules 3.602.1-3.602.1.E eff. 10/01/2014.

Rule 3.602.1 emer. rule eff. 06/05/2015.

Rules 3.600.31, 3.601, 3.602.1, 3.604.1, 3.604.2, 3.605.2, 3.606.6, 3.606.8, 3.607.2, 3.608.1, 3.608.3, 3.608.4, 3.609.961-3.609.962 eff. 07/01/2015.

Rule 3.602.1 emer. rule eff. 06/05/2015.

Rule 3.602.1 eff. 09/01/2015.

Rules 3.602.1-3.602.1.E, 3.609.3-3.609.3.J eff. 01/01/2016.

Rules 3.605.2.F, 3.605.3.A.1, 3.605.3.D.24.a eff. 11/01/2016.

Rules 3.602.1.E.2.i, 3.604.1.C.2, 3.604.1.G, 3.604.1.N.5.d.18), 3.604.2 O, 3.604.2.V.2.a.3), 3.604.2.V.3.c, 3.605.3 A, 3.605.3.E, 3.606.1 A, 3.606.2 A, B, 3.606.4 B, L, 3.606.8.D, 3.609.4.F, 3.609.4.G.1.c, 3.609.94.D.1 eff. 04/01/2017.

Rules 3.601, 3.604.2 eff. 10/01/2017.

Rule 3.605.3.D eff. 01/01/2018.

Rule 3.606.2 F eff. 09/01/2018.

Rules 3.609.5 E, 3.609.92 B eff. 01/30/2020.

Rules 3.607.1 B, 3.608.1 B, 3.608.2 A-C, 3.608.3 eff. 08/01/2020.

Rules 3.609.4 E, 3.609.4 G.2.b eff. 01/01/2021.

Rules 3.601, 3.604.1 N.7.f, 3.604.1 N.11, 3.604.2 L.2.c emer. rules eff. 12/03/2021.

Entire rule eff. 03/01/2022. Rules 3.601, 3.604.1 B.3, 3.604.3 I.5.f emer. rules eff. 03/01/2022.

Rules 3.601, 3.604.1 B.3, 3.604.3 I.5.f eff. 03/02/2022.

Rule 3.606.1 F emer. rule eff. 06/03/2022.

Rule 3.606.1 F eff. 08/30/2022.

Rules 3.600.2, 3.601, 3.602.1 A.5, 3.602.1 B, 3.602.1 I.3.C-D, 3.604.2 C.3.b, 3.604.2 K, 3.604.2 K.3, 3.604.2 L, 3.604.2 M.4, 3.604.3 C.7, 3.604.3 G, 3.606.1 F-G, 3.606.2 A, 3.606.3 C.1.c.3), 3.606.3 C.2.b.2), 3.606.6 C, 3.606.6 D.4, 3.606.8 A, 3.607.1 B, 3.607.1 C, 3.607.5, 3.608.3 C, 3.608.4 C.1, 3.609.4 B.3.c, 3.609.6 B eff. 06/01/2023.

Rule 3.604.3 J.2 repealed emer. rule eff. 08/07/2023.

Rule 3.604.3 J.2 repealed eff. 10/30/2023.

Rule 3.606.1 F eff. 07/01/2024.

Rules 3.601, 3.604.3 I.4, 3.609.2 B, 3.609.4 C,D,K eff. 11/01/2024.

Rules 3.604.5 C.3.a, 3.606.1 F, 3.608.2 B, 3.609.5 O eff. 07/01/2025.

Annotations

Rule 3.602.1 E. 2.k. (adopted 08/08/2014) was not extended by Senate Bill 15-100 and therefore expired 05/15/2015.

##### **9 CCR 2503-7** Low-Income Energy Assistance Programs (leap) {#sec-9-ccr-2503-7 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-7}

DEPARTMENT OF HUMAN SERVICES

Income Maintenance (Volume 3)

LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP)

9 CCR 2503-7 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.750 LOW-INCOME ENERGY ASSISTANCE PROGRAMS 3.750.1 AUTHORITY 3.750.11 Low-Income Home Energy Assistance Act [Rev. eff. 12/1/14]

Programs authorized under the Low-Income Home Energy Assistance Act include a Heating Fuel Assistance Program and a Crisis Intervention Program. 3.750.12 Intent of the Heating Fuel Assistance Program [Rev. eff. 12/1/14]

The Heating Fuel Assistance Program is intended to help meet winter home heating costs of households composed of low-income families and individuals. 3.750.13 Intent of the Crisis Intervention Program [Rev. eff. 12/1/14]

The Crisis Intervention Program (CIP) is intended to assist with the repair or replacement of the nonworking primary heating system of approved Heating Fuel Assistance Program applicants. 3.750.14 (None) [Rev. eff. 2/1/12] 3.750.15 Funding [Rev. eff. 9/1/11]

This program is federally and privately funded and is subject to availability of funds. If funds are increased, decreased or become unavailable, the services provided herein shall be increased, decreased or terminated accordingly.

3.751 GENERAL PROVISIONS 3.751.1 DEFINITIONS [Rev. eff. 12/1/14]

“Adverse Action” means any action that causes a households benefits to be reduced or terminated.

“Appellant”: an applicant or recipient who has requested a state level fair hearing pursuant to section 3.751.43 of these rules.

“Applicant”: The person who completes and signs the basic LEAP application form.

“Approved Vendor” means a vendor that has signed a state specified agreement as it is prescribed in

Section 3.758.46.

“Bulk Fuel”: Bulk fuel is an energy source for home heating which may be purchased in quantity from a fuel supplier and stored by the household to be used as needed. Normally, bulk fuel includes wood, propane, kerosene, coal and fuel oil.

“Collateral Contact” means a verbal or written confirmation of a household’s circumstances by a person outside the household who has first-hand knowledge of the information. The name/title of the collateral contact, as well as the information provided, must be documented in the report of contact (ROC).

“Completed Application”: A basic LEAP application shall be considered to be a completed application when:

“Completed Application”: A basic LEAP application shall be considered to be a completed application when:

A. The applicant has provided an adequate response to all application questions which are necessary to determine eligibility and payment level;

B. The applicant has provided all required verification. A Social Security Number (SSN) for each household member or proof of application for a SSN must be provided. A SSN is required to determine eligibility. If no SSN is provided for a household member, that member will not be included in the household, but the member's income will be counted;

C. The application is signed “Date of Application”: For purposes of the Low-Income Energy Assistance Programs, the date of application shall be the date an application form that contains a legible name and address is received by the county department.

“Disabled or Handicapped”: For purposes of the Low-Income Energy Assistance Programs, the term disabled or handicapped means persons who receive vocational rehabilitation assistance; Social Security disability, SSI, AB, AND, veterans disability payments, or who provide a physician's statement which indicates incapacity to engage in substantial gainful employment. This definition may be different for other public assistance programs.

“Discrepancy”: For the purposes of these rules, discrepancy means a lack of similarity between the application and a corresponding data field in the LEAP system. All discrepancies require a record of contact note to be entered into the LEAP system.

“Elderly”: For the purposes of these rules, the term elderly means aged 60 or over.

“Eligibility Period”: There shall be one eligibility period for the Basic Low-Income Energy Assistance Programs from November 1st through April 30th. If April 30 th for a particular calendar year falls on a holiday or weekend, then the eligibility period shall be extended until midnight the next business day. This program is contingent upon the continued availability of funds in accordance with Sections 3.750.15 and 3.758.48.

“Emergency Applicant”: This is a household which has had heat service discontinued or is threatened with discontinuance or is out of fuel or will run out of fuel within fourteen calendar days or the client is responsible for heating costs that are included in rent and has received an eviction notice to vacate the premises within thirty (30) calendar days.

“Estimated Home Heating Costs (EHHC)”: The amount of the heating costs incurred during the previous heating season for the applicant's address at the time of application to be used as an estimate, or projection, of the anticipated heating costs for the current heating season (November 1st through April 30th). Such estimated heating costs shall not include payment arrearages, investigative charges, reconnection fees, or other such charges not related to residential fuel prices and consumption levels. An EHHC can only be obtained from approved vendors, for all other vendors use flat rates.

“Federal Poverty Level”: The term poverty level as used in these rules describes federal guidelines updated annually by the U.S. Department of Health and Human Services. The guidelines, printed in the Federal Register, establish minimum subsistence income levels by household size.

“Heat Related Arrearage”: Any past due amounts for the primary heating fuel and/or supportive fuel.

“Home Heating Costs”: Charges related directly to the primary heating fuel used in a residential dwelling.

“Household”: The term “household” shall mean any individual or group of individuals who are living together as one economic unit for whom primary heating fuel is customarily purchased in common or who make undesignated payments for heat in the form of rent.

“Household Income Contribution (HIC)” the household income contribution is the percentage subtracted from the EHHC based on the federal poverty level of the applicant.

“Income Verification Period”: The income verification period is from the date of application to the same date of the prior month (approximately thirty (30) calendar days from the date of application) when used to verify income except for self-employment income and earned ongoing income, in accordance with

Section 3.752.22, B.

“Lawful Permanent Residents” are non-citizens who are lawfully authorized to live permanently within the United States.

“Life Threatening Crisis” means a household whose members’ health and/or well-being would likely be endangered if energy assistance or repair or replacement of the primary heating system is not provided.

“Non-Bulk Fuel”: Non-bulk or metered fuel is an energy source for home heating which is provided by a utility company and is regulated and metered by the utility company. Normally, non-bulk fuel includes natural gas and electricity.

“Non-Traditional Dwelling”: A non-traditional dwelling means a structure that provides housing that is not affixed to a permanent physical address or is enumerated as such in this rule (see Section 3.752.25), including, but not limited to, cars, vans, buses, tents and lean-tos.

“Overpayment”: of heating fuel assistance program benefits shall mean a household has received benefits in excess of the amount due that household based on eligibility and payment determination in accordance with these rules.

“Point in Time”: Point in time indicates that eligibility is determined by accounting for the circumstances of the household on the date of the application, regardless of any changes thereafter.

“Primary Heating Fuel”: The primary heating fuel is the main type of fuel used to provide heat within the dwelling. When heat (such as natural gas and/or electric) is included in the rent, this may be reflected as “utilities” included in rent.

“Primary Heating Source”: The primary heating system that provides heat to the dwelling such as a furnace, wood burning stove or boiler. Temporary or portable heating sources are not considered a primary heating source and, therefore, are not eligible for LEAP assistance.

“Program Year”: means from November 1st through April 30th for the Heating Fuel Assistance Program. If April 30th for a particular calendar year falls on a holiday or weekend, then the eligibility periods shall be extended until midnight the next business day. This program is contingent upon the continued availability of funds in accordance with Sections 3.750.15 and 3.758.48.

“Propane Bottles are small propane containers that hold less than one hundred (100) gallons.

“Prudent Person Principle”: means that, based on experience and knowledge of the program, the county department/contractor exercises a degree of discretion, care, judiciousness, and circumspection, as would a reasonable person, in a given case.

“Public Assistance Income”: For purposes of verifying income under the Low-Income Energy Assistance Programs, the term public assistance income shall mean income received from the following types of Department of Human Services programs:

A. Colorado Works;

B. OAP (Old Age Pension, both the SSI-supplement and State-only groups);

C. AND (Aid to the Needy Disabled, both the SSI-supplement and State-only groups);

D. AB (Aid to the Blind, both the SSI-supplement and State-only groups);

E. NCRA (Non-Categorical Refugee Assistance);

F. SSDI (Social Security Disability Insurance) for clients on another state program, such as a Medicaid waiver or buy in program.

“Questionable”. Means inconsistent or contradictory information, statements, documents or case documentation that require verification from the household to determine eligibility.

“Reapplication” means a household who has been denied for the current program year and is reapplying for a LEAP benefit. The application is to be treated as a new application whose point in time is reset to the date of the new application.

“Recipient”: a LEAP applicant who has received a LEAP benefit.

“Report of Contact (ROC)” means the electronic chronological history of the case which contains both system generated entries and manual entries.

“Subsidized Housing”: Subsidized housing means housing in which a tenant receives an ongoing governmental or other subsidy (e.g., assistance provided by a church) and the amount of rent paid is based on the amount of the tenant's income.

“Supportive Fuel”: Supportive fuel is an energy source needed to operate the primary heating system in a residential setting. For example, electricity is a supportive fuel required to operate a natural gas furnace.

Supportive fuels are not eligible for LEAP assistance.

“Tiny Home”: A residential structure up to 500 square feet in size.

“Traditional Dwelling”: Traditional dwelling means a structure that provides a housing or residential environment that is affixed to a permanent physical address.

“Vendor”: A vendor is an individual, a group of individuals, or a company who is regularly in the business of selling fuel (bulk or non-bulk) to customers for residential home heating purposes. 3.751.2 HOUSEHOLDS [Eff. 12/1/14]

A. Any individual considered as part of an approved household cannot subsequently be considered as part of another household during the same eligibility period.

B. Each person living at a dwelling must be counted as either a member of the applicant's household or a member of a separate household.

C. The maximum number of household members shall be fifteen (15). The maximum number of separate households shall be nine (9).

D. The following cannot be classified as separate households:

1. Husband and wife living together;

2. Children under eighteen (18) years of age and living in the same dwelling as the parent or guardian, unless emancipated;

3. Individuals that enter into civil unions.

E. A parent with his or her children may be listed as a separate household when residing in the same dwelling with his or her ex-spouse in cases of legal separation or divorce. 3.751.21 Permanent Separation [Eff. 12/1/14]

A married couple is considered to be permanently separated when:

A. They are divorced or legally separated; or, B. Both physical and financial ties have been dissolved and a relationship as spouses no longer exists. 3.751.22 Presumption of Marriage [Eff. 12/1/14]

Unless there has been a divorce or legal separation, the presumption is made that the couple is still married. Such presumption must be refuted by persons, other than the spouses, who can establish that they are in a position to know and assert that a complete and permanent separation does, in fact, exist.

A legal separation or divorce can be verified by court documents. Attestation of separation by persons other than the spouses can be in writing or collateral contact.

3.751.3 NON DISCRIMINATION POLICIES/RIGHT AND OPPORTUNITY TO APPLY 3.751.31 Non-Discrimination [Rev. eff. 12/1/14]

Non-discrimination policies as outlined in this rule manual shall apply to all households applying for the Heating Fuel Assistance Program. 3.751.32 Opportunity to Apply [Rev. eff. 11/1/84]

All persons shall be provided an opportunity to file an application form on the date of initial contact with the county department during the application period. 3.751.33 Interpreters [Rev. eff. 9/1/11]

An interpreter shall be available to assist persons known to the Department to be non-English speaking in completing application forms and to provide information between the applicant and the county department. 3.751.34 Authorized Representative [Rev. eff. 11/1/13]

A formal, legal authorized representative may apply on behalf of an applicant household when the applicant household is unable to apply on its own behalf. Proper legal documentation of guardianship and/or durable power of attorney must be presented. 3.751.35 Authorized Signature by Mark [Rev. eff. 12/1/14]

Applicants who are partially or totally illiterate and who cannot write their names shall make a mark, and such mark shall be witnessed by the signature of at least one witness. The address of such witness shall follow the signature. County/Contractor workers may act as witnesses if not related to the applicant.

3.751.4 NOTICE AND HEARINGS 3.751.41 Timely and Adequate Notice [Rev. eff. 12/1/14]

Each applicant for or recipient of heating fuel assistance or crisis intervention must receive notice of any agency action affecting his/her eligibility for or receipt of benefits or service. 3.751.42 Denials [Rev. eff. 12/1/14]

Notices of denial shall advise the applicant of the reason for the denial; the regulation citation relied on by the county department, and appeal rights and procedures. For advance payments of the Heating Fuel Assistance Program, notices of denial shall advise the applicants of their right to a forthwith hearing. See 3.756.15 notification of approval or denial. 3.751.43 Request for a State Level Fair Hearing [Rev. eff. 12/1/14]

An applicant or recipient may request a state level fair hearing for:

A. An application for assistance which has not been acted upon within the maximum time period for the category of assistance;

B. An application for assistance which has been denied;

C. An application for assistance which has been partially denied.

An applicant or recipient who requests a state hearing has the right to:

A. A state level fair hearing before an administrative law judge, if the issue is appealable, and if the written request for a state level fair hearing is mailed or delivered to the office of administrative courts no later than ninety (90) calendar days from the date the notice of action was mailed by the county or contractor to the applicant or recipient; and B. Judicial review of the final agency decision in the appropriate state district court, after exhausting the administrative appeal rights granted under these rules.

Any clear expression, orally or in writing, by the applicant or someone legally authorized to act for him or her, that he or she wants an opportunity to have a specific action of a county department or contractor reviewed by the state department is considered an appeal and a request for a hearing. The county department or contractor shall, when asked, aid the applicant in preparation of a request for a hearing. If the request for a hearing is made orally, the county department or contractor shall immediately prepare a written request for the applicant’s signature or have the applicant prepare such a request, specifying the action on which the request is based and the reason for appealing that action.

The applicant or recipient is entitled to be represented at the state level fair hearing by an authorized representative, such as legal counsel, a relative, a friend, or other spokesperson, or they may represent themselves.

With the exception of the names of confidential informants, privileged communications between the county or contractor and its attorney, and the nature and status of pending criminal prosecutions, and any other information this confidential or privileged, the applicant or recipient is entitled to examine the completed case file and any other documents, records, or pertinent material that will be used by the county or contractor at the state level fair hearing at a reasonable time before the date of the hearing, but no later than 30 days prior to the date set for the hearing.

The county shall forward copies of its policies and any subsequent amendments, including effective dates, to the state department and to the Colorado department of human services office of appeals (hereinafter “office of appeals”). Applicants appealing a county or contractor action shall be provided reasonable opportunity to examine the county or contractor’s policies.

County departments/contractor shall notify the state leap office in writing within seven (7) days upon receipt of a request for a state level fair hearing by an applicant on heating fuel assistance program. 3.751.44 Authority and Duties of State Administrative Law Judge One or more persons from the state department of general support services/personnel, office of administrative courts, are appointed to serve as administrative law judges for the state department of human services.

The state administrative law judge shall, prior to the hearing, review the reasons for the decision under appeal and be prepared to interpret applicable departmental rules and/or official written county policies governing the low-income energy assistance program and pertaining to the issue under appeal.

If either party chooses not to be represented by legal counsel, the administrative law judge shall assist in bringing forth all relevant evidence and issues relating to the appeal. 3.751.45 State Responsibilities Every appeal requesting a state level fair hearing will be assigned a case number when such appeal is received by the office of administrative courts. A hearing date will be set at least ten (10) days in advance of the fair hearing and a letter by first class or certified mail will be sent to the appellant and the county department or contractor notifying them of the date, time, and place of the hearing. The appellant will be notified in writing that if good cause exists consideration will be given to changing the date; time or location provided they request the change to the office of administrative courts prior to the scheduled fair hearing. An information sheet shall be enclosed in the notification letter to explain the hearing procedures to the appellant. The appellant will be informed that they or their representative may examine all materials to be used at the hearing, before and during the hearing. The appellant also will be informed that failure to appear at the hearing as scheduled, without having shown good cause for failure to appear, shall constitute abandonment of the appeal and cause a dismissal thereof. Information which the appellant or their representative does not have an opportunity to see shall not be made a part of the hearing record or used in a decision on an appeal. No material made available for review by the administrative law judge may be withheld from review by the appellant or their representative.

In assistance payment appeals, the administrative law judge has 20 days from the hearing date to arrive at an initial decision. The initial decision shall not be implemented until after the office of appeals completes its review and enters a final agency decision. All final agency decisions on these appeals shall be made within 90 days from the date of the request for hearing is received.

In all other appeals, the administrative law judge shall arrive at an initial decision within a reasonable timeframe. The administrative law judges’ initial decision shall not be implemented until after the office of appeals completes its review and enters a final agency decision. All final agency decisions on these appeals shall also be made within a reasonable amount of time.

Once the initial decision has been made, it shall immediately be delivered to the office of appeals for determination of the final agency decision. 3.751.46 County and Contractor Responsibilities Upon receipt of the request for appeal by the county or contractor, the county or contractor shall mail a letter to the appellant, with a copy to the office of administrative courts and the state leap office, no later than five (5) days prior to the hearing, giving the following information:

A. The reasons for the decision of the county or contractor and a specific explanation of each factor involved in the reaching the decision, such as, but not limited to, the amount of excess income, residence factors, and household factors;

B. Citation(s) to the specific state rules and county or contractor policies governing the decision; and C. Notice that the county or contractor will assist the appellant in organizing the facts supporting their claim if the appellant so desires, and that the appellant has the opportunity to examine the state rules, county or contractor policies, and other materials to be used at the hearing concerning the basis of the county or contractor decision.

If the county or contractor fails to mail the letter with all required information to the appellant no later than five days prior to the hearing, the appellant may be granted a postponement of the hearing to allow the appellant to prepare for the hearing.

If the appellant will be represented at the hearing by legal counsel or another designated representative, the county or contractor will not discuss with the appellant the merits of the appeal or the question of whether to proceed with the appeal, unless any such conversation takes place in the presence of or with the permission of the legal counsel or designated representative.

If necessary, the county or contractor will arrange to have present at the hearing a qualified interpreter who will be sworn to translate correctly.

The fact that an appellant and the county or contractor have been notified that a hearing will be held does not prevent the county or contractor from reviewing the case or considering any new factors which might change the status of the case, and taking action to reverse its decision or otherwise settle the issue. Any change which results in a voiding of the basis for the appeal will be immediately reported by the appellant to the office of administrative courts by telephone and in writing.

Upon receipt of notice of a state hearing on an appeal, the county department/contractor shall arrange for a suitable hearing room appropriate to accommodate the number of persons who are expected to be in attendance, including witnesses, taking into consideration such factors as privacy; absence of distracting noise; need for tables, chairs, electrical outlets, adequate lighting, and ventilation; and telephone conferencing abilities. 3.751.47 Conduct and Procedures of State Level Fair Hearings 3.751.471 Conduct of State Level Fair Hearings The administrative law judge shall conduct state level fair hearings in accordance with the Colorado administrative procedure act (C.R.S. §§ 24-4-101 through 24-4-108).

The county or contractor shall have the burden of proof, by a preponderance of the evidence, to establish the basis of the decision being appealed. Every party to the proceeding shall have the right to present their case or defense by oral and documentary evidence, to submit rebuttal evidence, and to conduct such cross-examination as may be required for a full and true disclosure of the facts. Subject to these rights and requirements, where a hearing will be expedited and the interests of the parties will not be subsequently prejudiced thereby, the administrative law judge may receive all or part of the evidence in written form or by oral stipulations.

Hearings may be conducted by telephone conference as an alternative to face-to-face hearings, unless any party requests a face-to-face hearing. All applicable provisions of the face-to-face hearings procedures will apply. 3.751.472 Procedures of State Hearings State level fair hearings are confidential; however, any person or persons whom the appellant wishes to appear for them may be present, and, if requested by the appellant and in the record, such hearing may be made open to the public.

The purpose of the state level fair hearing is to determine the pertinent facts in order to arrive at a fair and equitable decision in accordance with the rules of the state department. In arriving at a decision, only the evidence and testimony introduced at the hearing will be considered, except that in circumstances when it is shown at the hearing that evidence could not, for good cause, be obtained in time for the hearing, the administrative law judge may permit the introduction of medical or other evidence after the hearing, provided that the opposing party is also furnished a copy and is afforded the opportunity to controvert or otherwise respond to such evidence.

Although the hearing may be conducted on an informal basis and efforts may be made to place all parties at ease, the evidence must be presented in an orderly manner in order to create an adequate record.

A complete and exact record of the proceedings shall be made by electronic or other means. When required, the office of administrative courts shall cause the proceedings to be transcribed.

When the administrative law judge dismisses an appeal for reasons other than failure to appear, the decision of the administrative law judge shall be an initial decision, which shall not be implemented until after the office of appeals completes its review and enters a final agency decision.

If the appellant fails to appear at a duly scheduled hearing, after having been given proper notice, without having given timely advance notice to the administrative law judge of acceptable good cause for inability to appear at the hearing at the time, date, and place specified in the notice of hearing, then the appeal shall be considered abandoned and an order of dismissal shall be entered by the administrative law judge and served upon the parties by the office of administrative courts. The dismissal order shall not be implemented until after the office of appeals completes its review and enters a final agency decision the appellant, however, shall be afforded a ten-day period from the date of the order of dismissal was mailed, to explain in a letter to the administrative law judge the reason for their failure to appear. If the administrative law judge finds that there was good cause for the appellant not appearing, the administrative law judge shall vacate the order dismissing the appeal and schedule another hearing date.

If the appellant does not submit a letter showing good cause within the ten-day period, the order of dismissal shall be filed with the office of appeals by the office of administrative courts. The office of appeals will issue a final agency decision upholding the dismissal of the appeal, which shall be served upon the parties. The county or contractor shall immediately carry out the necessary actions to provide assistance or services in the correct amount, terminate assistance or services, recover assistance incorrectly paid, and/or take other appropriate actions in accordance with the LEAP program rules.

If the appellant submits a letter alleging good cause and the administrative law judge finds that the stated facts do not constitute good cause, the administrative law judge shall enter an initial decision confirming the dismissal. The appellant may file exceptions to the initial decision for review by the office of appeals. 3.751.48 Decision, Notification, and Protections of The Appellant 3.751.481 Initial Decision Following the conclusion of the hearing, the administrative law judge has 20 days to prepare and issue an initial decision and file it with the office of appeals.

The initial decision shall make an initial determination whether the county or contractor or state department acted in accordance with the rules of the state department and/or written policies of the county or contractor for administering the program. The administrative law judge may determine whether statutes were properly interpreted and applied only when no implementing state rules or county or contractor policy exists. The administrative law judge has no jurisdiction or authority to determine issues of constitutionality or legality of departmental rules or county or contractor policy governing the program.

The initial decision shall advise the appellant that failure to file exceptions to the initial decision will waive the right to seek judicial review of a final agency decision which affirms those provisions.

The office of appeals shall promptly serve the initial decision upon each party by first class mail and shall transmit a copy of the decision to the state leap office.

The initial decision shall not be implemented until after the office of appeals completes its review and enters a final agency decision. 3.751.482 Review by the Office of Appeals The office of appeals of the state department, as the designee of the executive director, shall review the initial decision of the administrative law judge and shall enter a final agency decision affirming, modifying, or reversing the initial decision. The office of appeals may issue an order or remand upon receipt of the initial decision and identification of an issue that warrants an immediate remand before the initial decision is even mailed to the parties. Additionally, the office of appeals may issue an order of remand at the time of its substantive review of an initial decision for final agency decision due to its determination for the need for further clarification, findings, conclusions of law, and/or further proceedings before a final agency decision can be issued. An order of remand is not a final agency decision that is subject to judicial review.

Any party seeking an agency decision which reverses, modifies, or remands the initial decision of the administrative law judge shall file exceptions to the decision with the office of appeals within fifteen (15) days from the date the initial decision is mailed to the parties. Exceptions must state specific grounds for reversal, modification, or remand of the initial decision.

If the party filing exceptions asserts that the administrative law judge’s findings of fact are not supported by the weight of the evidence, the party shall simultaneously with or prior to the filing of exceptions request the office of administrative courts to cause a transcript of all or a portion of the hearing to be prepared and filed with the office of appeals. The exceptions shall state that a transcript has been requested, if applicable. Within five (5) days of the request for transcript, the party requesting it shall advance the cost to the transcriber designated by the office of administrative courts unless prior payment is waived by the transcriber.

A party who is unable because of indigency to pay the costs of a transcript may file a written request, which need not be sworn, with the office of appeals for permission to submit a copy of the hearing recording instead of the transcript. If submission of a recording is permitted, the party filing exceptions must promptly request a copy of the recording from the office of administrative courts and deliver it to the office of appeals. Payment in advance shall be required for the preparation of a copy of the recording.

If the exceptions do not challenge the findings of fact, but instead assert only that the administrative law judge improperly interpreted or applied state rules or statutes, the party filing exceptions is not required to provide a transcript or recording to the office of appeals.

The office of appeals shall serve a copy of the exceptions on each party by first class mail. Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties in which to file a written response to such exceptions. The office of appeals shall not permit oral argument.

The office of appeals shall not consider evidence which was not part of the record before the administrative law judge. However, the case may be remanded to the administrative law judge for rehearing if a party establishes in its exceptions that material evidence has been discovered which the party could not with reasonable diligence have produced at the hearing.

While review of the initial decision is pending before the office of appeals, the record on review, including any transcript or recording of testimony filed with the office of appeals, shall be available for examination by any party at the office of appeals during regular business hours.

The state leap office may file exceptions to the initial decision, or respond to exceptions filed by a party, even though it has not previously appeared as a party to the appeal. The state leap office’s exceptions or responses must be filed in compliance with these rules. Exceptions may be filed by the state leap office when it did not appear as a party at the hearing shall be treated as requesting review of the initial decision upon the state department’s own motion.

In the absence of exceptions filed by any party or the state leap office, the office of appeals shall review the initial decision, and may review the hearing file of the administrative law judge and the recorded testimony of witnesses before entering a final agency decision. Review by the office of appeals shall determine whether the decision properly interprets and applies relevant rules and statutes, and whether the findings of fact and conclusions of law support the initial decision. If a party or the state leap office objects to the final agency decision entered upon review by the office of appeals, the party or state leap office may seek reconsideration of the final agency decision.

The office of appeals shall mail copies of the final agency decision to all parties by first class mail.

For purposes of requesting judicial review, the effective date of the final agency decision shall be the third day after the date the decision is mailed to the parties, even if the third day falls on a Saturday, Sunday, or a legal holiday. The parties shall be advised of this in the final agency decision.

The state leap office or county department shall initiate action to comply with the final agency decision within three working days after the effective date. The state leap office shall comply with the decision within three working days after the effective date even if reconsideration is requested, unless the effective date of the final agency decision is postponed by order of the office of appeals or a reviewing court.

When an appeal results in a final agency decision that an action of the county or state leap office was not in accordance with the rules of the department, or when the county or state leap office so determines after a request for hearing is made, the adjustment or corrective payment will apply retroactively to the date of the incorrect action. 3.751.483 Reconsideration of Agency Decision A motion for reconsideration of a final agency decision may be granted by the office of appeals for the following reasons:

A. Upon a showing of good cause for failure to file exceptions to the initial decision within the fifteen (15) day period allowed by section 7.751.482; or B. Upon a showing that the final agency decision is based upon a clear or plain error of fact or law.

An error of law means failure by the office of appeals to follow a rule, statute, or court decision which requires a different decision.

The office of appeals shall mail a copy of the motion for reconsideration to each party of record and to the state leap office.

The appellant is to be fully informed of by the final agency decision of their further right to apply for judicial review of the final agency decision by filing an action for review in the appropriate state district court. Any such action must be filed in accordance with the Colorado rules of civil procedure within thirty (30) days after the final agency decision becomes effective.

The state leap office will establish and maintain a method for informing, in summary and depersonalized form, all county departments and other interested persons concerning the issues raised and decisions made on appeal. 3.751.484 Provider Appeals Unless properly designated as a representative of an individual, a provider of goods or services to applicants or recipients shall not be granted a hearing concerning an alleged adverse action to an applicant or recipient.

In the case of an appeal by a licensed or certified provider or vendor of services of an adverse action by a county department or contractor or the state department related to provider status, rates, or purchased services, the decision of the administrative law judge is the final agency decision and is not subject to state department review or modification. The decision of the administrative law judge is subject to judicial review pursuant to C.R.S. § 24-4-106 and C.R.S. § 26-1-106. 3.751.485 Confidentiality All information obtained by the county department or contractor concerning an applicant to or a recipient of assistance payments is confidential information. This is to prevent exploitation of applicants and recipients, to eliminate embarrassment to them, and is in recognition of their rights as self-determining individuals who are not limited because of their need for assistance.

The county or contractor shall educate county officials and other persons who have dealings with the state leap office as to the confidential nature of information which may come into their possession through transaction of county or contractor business.

When a technician consults a bank, former employer of an applicant, another social services agency, or other person or entity to obtain information or verification of information to determine eligibility, the identification of the technician as an employee of the county or contractor may, in itself, disclose that an application for assistance has been made by an individual. In this type of contact, the county or contractor should strive to maintain confidentiality whenever possible.

Privacy for interviewing and confidentiality of information are essential. This involves both office facilities and discretion by the technician. Office procedures and facilities should be such that information is not inadvertently revealed to persons not concerned with the affairs of the applicant or recipient. The technician must also use discretion in mentioning county or contractor business outside of the office.

General information not identified with any individual is not confidential and may be released for any

purpose, including publication in newspapers. This includes:

A. Total expenditures B. Number of recipients C. Statistical data obtained from studies D. Social data obtained from studies, reports, or surveys E. Expenditures by category of assistance F. Expenditures for administration G. Salaries paid to employees H. Sum of all state leap office expenditures Information secured by the county or contractor for the purpose of administering the assistance programs (e.g. determining eligibility) is deemed confidential.

Unless disclosure is specifically permitted by the state department, the following types of information are the exclusive property of and are restricted to use by the state, counties, and contractors:

A. Names and addresses of applicants for and recipients of assistance and/or the amounts of assistance B. Information contained in applications, correspondence, and other information concerning any applicant or recipient from whom, or about whom, information is obtained by the county or contractor C. Records of state, county, or contractor evaluations of the above information D. All information obtained through the state income and eligibility verification system (SIEVES) 3.751.486 Disclosure of Confidential Information No one outside of the county or contractor shall have access to records of the department except for individuals executing the state income and eligibility verification system (SIEVES), child support enforcement officials, federal and state auditors and private auditors for the county or contractor, and the applicant or recipient of public assistance. These individuals shall have access only for purposes necessary for the administration of the programs. Access to the records of the department may be permitted if one of the following conditions is met:

A. The applicant or recipient is notified and their prior permission for release of information is obtained, unless the information is to be used to verify income or eligibility under administration of the SIEVES. If, the information is needed to provide services to an emergency applicant, and the applicant or recipient is physically or mentally incapacitated to the extent that they cannot sign the release form, and time does not permit obtaining the applicant or recipient’s consent prior to release of information, the county or contractor must notify the applicant or recipient immediately after supplying the information. The notification shall include the name and address of the agency which requested the information, the reason the information was requested, and a summary of the information released. If the applicant or recipient does not have a telephone or cannot be contacted immediately, the county or contractor must send written notification containing the required information within three (3) working days from the date the information was B. A district attorney makes a written request for information for the purpose of either prosecution for fraud or tracing a parent who has deserted a child.

C. Verified information obtained from the internal revenue service through the SIEVES may be provided only to persons or agencies directly connected with the administration of the child support enforcement program (if administered by an agency outside of the county department), department of labor and employment, the social security administration, and other agencies in the state when necessary for the administration of other state or federally funded assistance programs or the unemployment insurance program. Counties and contractors shall not release information regarding applicants or recipients to law enforcement agencies, except as provided in this section 3.751.486.b and 3.751.486.d.

D. Upon request to the state department of human services by the Colorado bureau of investigation, with the responsibility for location and apprehension of fugitive felons (i.e., a person with an outstanding felony arrest warrant), the addresses of a fugitive felon who is a recipient shall be released.

The applicant or recipient shall have an opportunity to examine such pertinent records concerning themselves when those records constitute a basis for adverse action, a hearing, or an appeal. Other requests for information shall be honored only when the individual makes the request in person and their identity is verified or the request is in the form of a written, signed, and notarized statement.

If an applicant or recipient designates an individual, firm, or agency to represent the applicant or recipient at conferences, hearings, or appeals and the representative is designated by completion of form im-17 (“ designation of representative”), the representative shall have access to records pertinent to the conference, hearing, or appeal.

Information concerning an applicant or recipient may be released to a district attorney upon presentation of a written request accompanied by evidence that a situation involving fraud or a parent deserting their child is the basis for the request. The release is strictly conditioned upon the information being used solely for one of those two purposes and the person requesting the information must certify the use to be made of the information and that it will not be disclosed or used for any other purpose. No certification shall be required of the county board of social services when its members are acting in their official capacity in administration of social services programs.

The applicant or recipient may execute a formal written release for disclosure of information to other agencies. Before information is released, the county or contractor should be reasonably sure that the confidential nature of the information will be preserved, the information will only be used for purposes related to the function of the inquiring agency, and the standards of protection established by the inquiring agency are equal to those established by the state department.

Information obtained through SIEVES will be stored and processed so that no unauthorized personnel can acquire or retrieve the information. Counties and contractors are responsible for limiting access to SIEVES data to only those individuals requiring access to determine eligibility or otherwise administer the LEAP program.

All persons with access to information obtained through SIEVES will be advised of the circumstances under which access is permitted and the sanctions imposed for illegal use or disclosure of the information.

The name of an applicant or recipient shall not be disclosed to a group or individual sponsoring a holiday project without first contacting the applicant or recipient to determine if they would like to participate in the project.

Case records shall not be available to volunteer workers. Selected information concerning an individual or family may be made available to the volunteer worker only if the volunteer’s supervisor determines that access to the information is necessary.

Should a county commissioner or district attorney seek information about an applicant or recipient which is not in possession of the county or contractor, the requestor shall contact the state leap office. 3.751.487 Protection against Discrimination Counties and contractors are to administer LEAP in such a manner that no person will, on the basis of race, color, religion, creed, national origin, ancestry, sex, pregnancy, age, sexual orientation, gender identity, or physical or mental disability, be excluded from participation, be denied any aid, care, services, or other benefits of, or be otherwise subjected to, discrimination in such program.

The county or contractor shall not, directly or through contractual or other arrangements, on the basis of race, color, religion, creed, national origin, ancestry, sex, pregnancy, age, sexual orientation, gender identity, or physical or mental disability:

A. Provide any aid, care, services, or other benefits to an individual which is different, or is provided in a different manner, from that provided to others;

B. Subject any individual to segregation barriers or separate treatment in any manner related to access to or receipt of assistance, care, services, or other benefits;

C. Restrict any individual in any way in the enjoyment or any advantage or privilege enjoyed by others receiving aid, care, services, or other benefits provided under assistance programs;

D. Treat any individual differently from others in determining whether they satisfy any eligibility or other requirements or conditions which individuals must meet in order to receive aid, care, services, or other benefits provided under assistance programs;

E. Deny an individual an opportunity to participate in assistance programs through the provision of services or otherwise, or afford them an opportunity to do so which is different from that afforded others under assistance programs;

F. Deny an individual the opportunity to participate as a member of a planning or advisory body that is an integral part of the program.

The references to “aid, care, services or other benefits” includes all forms of assistance, including direct and vendor payments, social services, and information and referral services.

No distinction on the basis of race, color, religion, creed, national origin, ancestry, sex, pregnancy, age, sexual orientation, gender identity, or physical or mental disability is permitted in relation to the use of physical facilities, intake and application procedures, caseload assignments, determination of eligibility, and the amount and type of benefits extended by the county or contractor to applicants or recipients.

The county or contractor shall assure that all other agencies, persons, contractors, and other entities with which it does business are in compliance with the above prohibition against discrimination on a continuing

basis. The county and contractor staff are responsible for being alert to any discriminatory activity by other agencies and for notifying the state department concerning any such discriminatory situation.

The state department, through its contact with agencies, persons, and referral services, will be continuously alert to discriminatory activity and will take appropriate action to assure compliance with the prohibition against discrimination. If corrective action is not taken when discriminatory activity is suspected, the state department will notify the state leap office of termination of payments. The county or contractor, upon notification by the state department, will also terminate payments to and association with any agency, person, or resource being used which has been found to continue discriminatory activity in regard to applicants or recipients.

An individual who believes they are being discriminated against may file a complaint with the county, contractor, state department, or directly with the federal government. When a complaint is filed with the county, the county director is responsible for investigating the matter immediately and taking necessary corrective action to eliminate any discriminatory activities found. If such activities are not found, the individual shall be given a written explanation of the outcome of the complaint. If the individual is not satisfied with the explanation, they may direct their complaint, in writing, to the state department, which will be responsible for further investigation. The state department will also carry out an investigation, take necessary corrective action, if any, and provide a written response, upon receiving a complaint made to a contractor or received directly from an individual.

Upon receipt of a complaint alleging discrimination on the basis of race, color, religion, creed, national origin, ancestry, sex, pregnancy, age, sexual orientation, gender identity, or physical or mental disability, the state department shall explain LEAP policy to the complainant. If there is insufficient information as to the nature or other details concerning the complaint, the state department shall contact the county or contractor in writing to obtain such information. Copies of the letter shall be sent to the complainant. The county or contractor shall reply in writing.

If the state department determines that the county or contractor action is not discriminatory and the complainant disagrees, the complainant has the right to appeal the case to the state department.

If it is found that a county or contractor practice or action is discriminatory, the state department shall immediately initiate corrective action to ensure that any and all discriminatory practices are permanently terminated. 3.751.488 Notice of Appropriate Use of Electronic Benefit Transfer (EBT) Card [Rev. eff. 11/1/15]

An explanation shall be provided regarding the process of utilizing the Electronic Benefit Transfer (EBT)

card. This explanation shall include:

A. Identification of the following establishments in which clients shall not be allowed to access cash benefits through the electronic benefits transfer service from automated teller machines:

1. Licensed gaming establishments;

2. In-state simulcast facilities;

3. Tracks for racing;

4. Commercial bingo facilities;

5. Stores or establishments in which the principal business is the sale of firearms;

6. Retail establishments licensed to sell malt, vinous, or spirituous liquors;

7. Establishments licensed to sell medical marijuana or medical marijuana infused products, or retail marijuana or retail marijuana products, effective June 30, 2015; and, 8. Establishments that provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment, effective June 30, 2015.

B. An explanation that the cash portion issued on the EBT card may be suspended with identified misuse. 3.751.489 Electronic Benefit Transfer and Point of Sale Restriction Participants are prohibited from using his/her EBT card at automated teller machines and point of sale (POS) devices located in establishments as described in Section 3.751.49 A 1-84.

Individuals’ transactions shall be monitored monthly. Individuals who use prohibited ATMs or POS devices shall be contacted by the State Department. Inappropriate usage shall result in:

1. Warning that use of the EBT card in prohibited establishments will result in the card being disabled. The state department shall provide education about appropriate use, access, and alternatives.

2. If continued misuse occurs (identified in the usage report after a warning has occurred), the State Department will coordinate with the county department to disable the card and initiate contact with the individual for additional assessment.

3.751.5 RECOVERY PROCEDURES 3.751.51. Recoveries [Eff. 12/1/14]

County departments/Contractor must institute recoveries to ensure that Heating Fuel Assistance Program benefits do not exceed the maximum amounts described in these rules. 3.751.52 Determination of Recovery of Overpayment [Rev. eff. 10/1/01]

When overpayments, made directly to the client, have been verified by the county department/Contractor, a determination as to whether recovery is appropriate shall be made within fifteen (15) calendar days after receipt of reports issued by the State Department designed to assist county departments in identifying and correcting such payments. 3.751.53 Definition of Overpayment [Rev. Eff. 12/1/14]

Overpayment of Heating Fuel Assistance Program benefits shall mean a household has received benefits in excess of the amount due that household based on eligibility and payment determination in accordance with these rules. 3.751.54 Establishment of Recovery [Rev. eff. 11/1/08]

Recoveries shall be established for households that have received program benefits and are subsequently determined to be ineligible or which received benefit amounts greater than the household was entitled to for the eligibility period. 3.751.55 Recovery Procedures [Rev. eff. 12/1/07]

In any case where there has been an overpayment, there shall be no recovery from any recipient:

A. Who is without fault in the creation of the overpayment, and B. If such recovery would deprive the person of income required for ordinary and necessary living expenses or would be against equity and good conscience.

The case record shall document the reason why an overpayment is not being recovered.

When the county or contractor has determined that a recipient has received LEAP benefits to which they were not entitled, the state department:

A. Determines if the overpayment is to be recovered;

B. Determines if there was willful withholding of information and considers or rules out possible fraud;

C. Establishes the amount of overpayment; and D. Enters the amount of overpayment and other specific factors regarding the situation into the case record. 3.751.56 Fraudulent Acts 3.751.561 Definition – Fraud “fraud” means an individual secured or attempted to secure or aided and abetted another person in securing public assistance to which the individual was not entitled by means of willful misrepresentation or intentional concealment of an essential fact. 3.751.562 Referral to the District Attorney When the county or contractor determines that it has paid or is about to pay a recipient an assistance payment as a result of a fraudulent act, the facts used in the determination shall be reviewed with the department’s legal counsel within the attorney general’s office and/or a representative from the district attorney’s office. If suspected fraud is substantiated by the available evidence, the case shall be referred to the district attorney. All referrals to the district attorney shall be made in writing and shall include the amount of assistance fraudulently received by the recipient. 3.751.563 Penalties for Individuals Who Are Found Guilty of Committing Fraud Individuals who are found guilty of committing fraud, pursuant to section 26-1-127, C.R.S., in a prior program year shall be ineligible to participate in LEAP in the subsequent program year for the first violation, two program years for the second violation, and permanently for the third violation.

3.751.6 REPORTING AND MONITORING 3.751.61 Reporting All recoveries shall be reported to the State Department at the conclusion of the program year. 3.751.62 Reports and Fiscal Information [Rev. eff. 11/1/98]

County departments/Contractor shall provide the State Department with reports and fiscal information as deemed necessary by the State Department. 3.751.63 Monitoring [Rev. Eff. 11/1/98]

The State Department shall have responsibility for monitoring programs administered by the county departments/Contractor based on a monitoring plan developed by the State Department. Such plan shall include provisions for programmatic and local reviews and methods for corrective actions. 3.751.64 County Case File Review [Eff. 12/1/14]

County department/Contractor supervisory personnel shall review eligibility determinations monthly, from October 1st to May 30th, and submit the results of those reviews when requested by the state. At minimum the supervisor shall:

A. Pull a random sample of two determinations per technician;

B. Determine the correctness of eligibility determinations accomplished.

C. Ensure timely correction of any determination errors; and, D. Maintain a record of the cases reviewed for audit purposes.

3.751.7 REIMBURSEMENT AND SANCTIONS 3.751.71 Reimbursements [Rev. eff. 12/1/14]

Subject to allocations as determined by the State Department, county departments shall be reimbursed up to 100% for all allowable costs incurred for the operation of the Heating Fuel Assistance Program, outreach, and other administrative costs. 3.751.72 Sanctions [Rev. eff. 12/1/14]

County departments/Contractor, which fail to follow the rules of the Heating Fuel Assistance Program shall be subject to administrative sanctions as determined by the State Department (see 11 CCR 2508-1).

3.752 LOW-INCOME ENERGY ASSISTANCE PROGRAM: HEATING FUEL ASSISTANCE

PROGRAM [Rev. eff. 12/1/14] 3.752.1 APPLICATION PERIOD [Rev. eff. 11/1/13]

To apply for LEAP, the general public shall submit a State prescribed application form (IML-4) during the period of November 1st through April 30th. If April 30th for a particular calendar year falls on a holiday or weekend, then the eligibility periods shall be extended until midnight the next business day. These programs are contingent upon the continued availability of funds in accordance with Sections 3.750.15 and 3.758.48. The county department shall accept all application forms that are received or postmarked during the application period. Facsimile copies of completed application forms shall be accepted as valid.

Preference shall be given to application forms received from public assistance households (such as Colorado Works, Old Age Pension (OAP), Aid to the Needy Disabled (AND), Aid to the Blind (AB), and Supplemental Social Security Disability Benefits.) Such applications received prior to November 1st shall be accepted and may be processed; however, eligibility shall not be effective until November 1st.

Application forms received or postmarked after the closing date shall be denied. Eligibility will be determined based on the applicant's circumstances on the date the application is received by the county department. Although applications may be accepted and processed earlier, the effective date of application shall not be before November 1st. 3.752.2 PROGRAM ELIGIBILITY REQUIREMENTS [Rev. eff. 12/1/14]

To be determined eligible for a Heating Fuel Assistance Program payment, households must, at time of application, be vulnerable to the rising costs of home heating, and meet income and other requirements of the program as defined in these regulations.

The following factors shall be considered as of the date of application: Colorado state residency, U.S. citizenship/alien status, income, vulnerability, fuel type, household composition, shared living arrangements, dwelling type, and estimated home heating costs. 3.752.21 Countable Unearned Income [Rev. eff. 12/1/14]

Countable unearned income includes but is not limited to the following, as well as payments from any other source, which is considered to be a gain or benefit to the applicant or recipient:

A. Inheritance, gifts, and prizes;

B. Dividends and interest paid out or withdrawn on savings bonds, leases, bank accounts;

C. Proceeds of a life insurance policy to the extent that they exceed the amount expended by the beneficiary for the purpose of the insured recipient's last illness or burial that are not covered by other benefits;

D. Proceeds of a health insurance policy or personal injury lawsuit to the extent that they exceed the amount to be expended or required to be expended for medical care;

E. Strike benefits;

F. Income from jointly owned property: - in a percentage at least equal to the percentage of ownership or, if receiving more than percentage of ownership, the actual amount received;

G. Lease bonuses (oil or mineral) received by the lessor as an inducement to lease land for exploration are income in the month received;

H. Oil or mineral royalties received by the lessor are income in the month received;

I Supplemental Security Income (SSI) benefits received by an applicant or recipient shall be considered income in the month received. When determining income, do not consider cents in the gross benefit amount.

J. Income derived from monies (or other property acquired with such monies) received pursuant to the “Civil Liberties Act of 1988”, P.L. 100-383;

K. Amounts withheld from unearned income because of a garnishment are countable as unearned L. Public Assistance Income as defined in 3.751.1: Colorado Works, Old Age Pension (OAP); Aid To The Needy Disabled (AND); Aid To The Blind (AB); Non-Categorical Refugee Assistance (NCRA); Social Security Disability Insurance (SSDI).

M. Income received from adoption assistance or subsidies.

N. Income received from child support and spousal maintenance payments 3.752.211 Periodic Payments [Eff. 12/1/14]

The following types of periodic payments are among those included in countable unearned income:

A. Annuities - payments calculated on an annual basis which are in the nature of returns on prior payments or services; they may be received from any source;

B. Pension or retirement payments - payments to an applicant or recipient following retirement from employment; such payments may be made by a former employer or from any insurance or other public or private fund;

C. Disability or survivor's benefits - payment to an applicant or recipient who has suffered injury or impairment, or, to such applicant's or recipient's dependents or survivors; such payments may be made by an employer or from any insurance or other public or private fund;

D. Worker's compensation payments - payments awarded under federal and state law to an injured employee or to such employee's dependents; amounts included in such awards for medical, legal, or related expenses incurred by an applicant or recipient in connection with such claim are deducted in determining the amount of countable unearned income.

E. Veteran compensation and pension - payments based on service in the armed forces; such payments may be made by the U.S. Veterans Administration, another country, a state or local government, or other organization. Any portion of a VA pension that is paid to a veteran for support of a dependent shall be considered countable unearned income to the dependent rather than the veteran.

F. Unemployment compensation - payments in the nature of insurance for which one qualifies by reason of having been employed and which are financed by contributions made to a fund during periods of employment;

G. Railroad retirement payments - payments, such as sick pay, annuities, pensions, and unemployment insurance benefits, which are paid by the Railroad Retirement Board (RRB) to an applicant or recipient who is or was a railroad worker, or to such worker's dependents or survivors;

H. Social Security Benefits - Old Age (or Retirement), Survivors and Disability Insurance payments (OASDI or RSDI) made by the Social Security Administration; also included are special payments at age seventy-two (72) (Prouty benefits) and black lung benefits. When determining income, do not consider cents in the gross income amount.

I. Supplemental Security Income (SSI) - public assistance payments made by the Social Security Administration to an applicant or recipient sixty five (65) years of age or older, or who is blind or disabled; such payments are considered in accordance with requirements specified in the applicable assistance program chapter. When determining income, do not consider cents in the gross benefit amount.

K. Trusts – any interest or trust payments received in the income verification period. 3.752.212 Military Allotment [Eff. 12/1/14]

A military allotment received on behalf of an applicant or recipient for those individuals included in the budget unit shall be considered as income in the month received. 3.752.22 Income and Household Size Criteria [Rev. eff. 11/1/15]

A. All countable unearned income shall be the countable gross unearned income received in the income verification period, not to exceed one month’s income.

B. For purposes of determining a household's eligibility, earned ongoing income shall be the countable gross income in any four (4) weeks of the eight (8) weeks prior to the application date.

C. Determining Monthly Income If a household member is paid less than monthly, the county department shall determine gross monthly income by:

1. Weekly/Bi-Weekly Income a. Weekly Income Adding four gross weekly income amounts to obtain total monthly income.

b. Bi-Weekly Income Adding two gross bi-weekly income amounts to obtain total monthly income.

2. Semi-Monthly Income Adding two gross semi-monthly income amounts to obtain total monthly income.

3. Partial Month Income a. Terminated Income If a household member's income is terminated as of the application date, use actual income received in the income verification period.

b. Earned New Income If a household member has a new source of earned income as of the application date, use income received in the income verification period.

c. Unemployment/Other Unearned Income If a household member has not received his/her first check from this source of income as of the income verification period, do not count any income from this source. If the household member has received the income as of the income verification period, use actual income for the income verification period.

4. In-kind income is income received in exchange for employment and shall be considered as earned income whose value is based on the services rendered. The amount considered as earned income when a recipient is paid in lieu of cash is the declared value of the item or service provided.

D. All applicant households whose countable income for the eligibility period is up to and including 60 percent (60%) of the state median income level released by the U.S Department of Health and Human Services for federal fiscal year 2023 shall meet the income requirements for the heating fuel assistance program. The state department shall adjust the income limits annually based on funds available and the state median income guidelines.

The state median income level means the income level for a household as set forth in 45 C.F.R. § 96.85 (2025), and the Low Income Home Energy Assistance Program Information Memorandum 2025, which are hereby incorporated by reference, no later amendments or editions are incorporated. The regulation and memorandum are from the U.S. Department of Health and Human Services. The federal regulation is available for no cost at HTTPS://WWW.ECFR.GOV/.

The memorandum is available for no cost at HTTPS://ACF.GOV/OCS/POLICY- GUIDANCE/LIHEAP-IM2025-02-FEDERAL-POVERTY-GUIDELINES-AND-STATE-MEDIAN- INCOME-ESTIMATES. The federal regulation and memorandum are also available for public inspection and copying at the Colorado Department of Human Services, Food and Energy Assistance Division,1575 Sherman Street, Denver, Colorado, 80203, during regular business hours.

E. Households which have been denied basic benefits and have had changes in circumstances may reapply. 3.752.23 Income Exclusions [Rev. eff. 11/1/15]

To determine eligibility for financial assistance and the amount of the assistance payment, the following shall be exempt from consideration as either resources or income. Verification is not required in the case file but must be notated in the Report of Contact (ROC).

A. The value of food assistance and USDA donated foods;

B. Benefits received under Title III, Nutrition Program for the Elderly, of the Older Americans Act;

C. The value of supplemental food assistance received under the special food services program for children provided for in the National School Lunch Act and under the Child Nutrition Act, including benefits received from the special supplemental food program for Women, Infants and Children (WIC);

D. Home produce utilized for personal consumption;

E. The value of any assistance paid with respect to a dwelling unit under:

1. The United States Housing Act of 1937;

2. The National Housing Act;

3. Section 101 of the Housing and Urban Development Act of 1965;

4. Title V of the Housing Act of 1949; or, 5. Section 202(h) of the Housing Act of 1959.

F. Payments to volunteers serving as foster grandparents, senior health aides, or senior companions, and to persons serving in the Service Corps of Retired Executives (score) and Active Corps of Executives (ace), AmeriCorps and any other program under Title I (Vista) when the value of all such payments adjusted to reflect the number of hours such volunteers are serving is not equivalent to or greater than the minimum wage, and Title II and III of the Domestic Volunteer Services Act;

G. Compensation received by the applicant or recipient pursuant to the Colorado Crime Victims Compensation Act shall not be considered as income, property, or support available to the applicant or recipient. This is compensation paid to innocent victims or dependents of victims of criminal acts who suffer bodily injury;

H. Monies received pursuant to the Civil Liberties Act of 1988;

I. Any payment made from the Agent Orange Settlement Fund;

J. The value of any commercial transportation ticket, for travel by an applicant or recipient (or spouse) among the fifty (50) states, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the northern Mariana Islands, which is received as a gift by such applicant or recipient (or such spouse) and is not converted to cash;

K. Reparation payments made under Germany's law for compensation of national socialist persecution (German Restitution Act);

L. Any money received from the Radiation Exposure Compensation Trust Fund;

M. Reparation payments made under Sections 500 through 506 of the Austrian General Social Insurance Act;

N. Payments to applicants or recipients because of their status as victims of Nazi persecution;

O. Income paid to children of Vietnam veterans who were born with spina bifida;

P. All financial aid monies, including educational loans, scholarships, and grants, including work study;

Q. Earned income of children under the age of eighteen (18) who are residing with a parent or guardian;

R. Reimbursement received for expenses incurred in connection with employment from an employer;

S. Reimbursement for past or future expenses, to the extent they do not exceed actual expenses, and do not represent gain or benefit to the household;

T. Payments made on behalf of the household directly to others;

U. Payment received as foster care/kinship income; foster care/kinship individuals are not considered LEAP Household members;

V. Any home care allowance or Attendant Support Allowance Care, if paid to a non-household member;

W. State/county diversion payments;

X. Reverse mortgages;

Y. Subsidized housing utility allowances;

Z. G.I. Bill educational allowances, including housing and food allowances;

AA. A one-time resettlement grant received under the refugee admissions program.

BB. A bona fide loan is a debt that the borrower has an obligation to repay and expresses his or her intention to repay, as documented in a written agreement or by collateral contact from the lender;

CC. Funds received by persons fifty five (55) years of age and older under the Senior Community Service Employment Program (SCSEP) under Title V of the Older Americans Act;

DD. Income that is deemed necessary for the fulfillment of a Plan for Achieving Self-Support (PASS) under Title XVI of the Social Security Act.

EE. Money received in the form of non-recurring lump sum payments for income tax refunds, rebates, or credits; retroactive lump-sum social security, SSI, and public assistance payments.

FF. Supportive Services income received under the Colorado Works Program.

GG. Money obtained from the liquidation of personal resources.

HH. Any recurring or non-recurring health insurance subsidies paid directly to an employee by an employer to assist with the purchase of private health insurance. 3.752.24 Resources [Rev. eff. 10/1/01]

There are no resource criteria for the Low-Income Energy Assistance Program.

The value of the household’s resources shall not be considered for the purpose of determining eligibility for assistance. 3.752.25 Vulnerability [Rev. eff. 11/1/15]

A. A household shall be vulnerable in order to qualify for Heating Fuel Assistance Program benefits.

Vulnerability shall mean the household must be responsible for the costs of home heating as defined below:

1. The household is paying home heating costs directly to a vendor and is subject to home heating cost increases.

2. The household is living in non-subsidized housing and is paying home heating costs either in the form of rent or as a separate charge in addition to rent.

3. The household resides in subsidized housing as defined in the “Definitions” Section of these rules; and, 1) the unit has an individual meter which identifies specific heating usage of that unit and the household is subject to increased cost for home heating, or 2) the tenant is subject to a heating surcharge assessed by means other than an individual meter. Such surcharges may include percentage fees assessed to the tenant for home heating. Excess utility charges are to be specific to home heating and verified by the County Department/Contractor. Under no circumstances shall rental costs be assumed to be subject to change due to an increase in home heating costs unless otherwise verified by the county department/Contractor.

4. The applicant household in a residence where more than one household resides shall be considered vulnerable if the applicant household contributes toward the total expenses of the residence. These expenses include, but are not limited to, shelter and utilities.

5. The applicant household must live in a traditional dwelling.

6. Any applicant who shares a primary fuel, such as a shared natural gas meter, electric meter or propane tank, will be considered a shared household and the Estimated Home Heating Cost (EHHC) will be divided by the number of parties responsible for paying the shared heat expense.

B. Households in the following living arrangements shall not be considered to be vulnerable:

1. Institutional group care facilities, public or private, such as nursing homes, foster care homes, group homes, substance abuse treatment centers , or other such living arrangements where the provider is liable for the costs of shelter and home heating, in

part or in full, on behalf of such individuals;

2. Room and board, bed and breakfast;

3. Correctional facilities;

4. Dormitory, fraternity or sorority house;

5. Subsidized housing as defined in the “Definitions” section of these rules which does not have an individual check meter for heat for each unit or which cannot provide other evidence of responsibility for paying home heating surcharges;

6. Any applicant, or applicant household who is considered homeless or resides in nontraditional dwellings;

7. Commercial accounts or commercial properties that also serve as the client’s dwelling;

8. Hotels, unless proof that the household has lived or will live in the hotel continuously for thirty (30) calendar days at the time of application and that heat is included in rent. Proof may be shown by providing a monthly statement, billing statement or receipt indicating the monthly arrangement.

C. Landlords or other providers of shelter shall not be considered to be vulnerable unless they meet the definition of household and the eligibility requirements of the Heating Fuel Assistance Program.

D. Vulnerability shall be verified for all applicant households as defined in these rules. 3.752.26 Mandatory Weatherization [Rev. eff. 12/1/14]

Households approved to receive a LEAP benefit must agree to have their dwelling weatherized if contacted by a state-authorized weatherization agency. Failure to permit or complete weatherization may result in denial of LEAP benefits for the following year.

A. Exemptions 1. Households containing a member(s) whose mental or physical health could be exacerbated by weatherization shall be exempt.

2. A household whose landlord refuses to allow weatherization shall not have benefits denied.

3. The local weatherization agency shall fully document the circumstances permitting the exemption.

B. Households Who Refuse Weatherization 1. Households who refuse or terminate weatherization before completion shall not be approved for LEAP benefits for the following year and a LEAP denial hold shall be placed on the household at that address by the State LEAP office. The hold can only be removed by the State LEAP office.

2. If the household has moved to another address that has been weatherized, the household may be approved for a LEAP benefit if otherwise eligible. If the new dwelling is not already weatherized, weatherization must be completed before approved for LEAP.

3. If a denied household subsequently allows the dwelling to be weatherized or weatherization completed, the household must reapply and, as long as other eligibility criteria are met, may be approved for LEAP benefits after notification from the local weatherization agency that the weatherization is completed.

C. State Weatherization Office Responsibilities 1. Assure that standards, as delineated in Sections A and B above are applied uniformly and equitably.

2. Notify the state LEAP office by September 30th of all households who refuse weatherization.

3. Notify households who refuse weatherization, by first-class mail that their refusal may result in denial of LEAP benefits for the following year.

4. Weatherization shall be completed as soon as possible on dwellings where the household previously refused or didn't complete weatherization and subsequently allows the dwelling to be weatherized. 3.752.27 Mandatory Crisis Intervention Program (CIP) Inspection [Eff. 12/1/14]

Households that received assistance from the Crisis Intervention Program (CIP) must agree to have an inspection of the work performed, to ensure that the equipment is safe, when contacted by a state authorized agency. Failure to permit the inspection may result in denial of LEAP benefits for the following year.

A. Exemptions 1. Households containing a member(s) whose mental health concerns could be exacerbated by presence of the inspector shall be exempt.

2. A household whose landlord refuses to allow the inspector in the property shall not have benefits denied.

B. Households Who Refuse CIP Inspection 1. Households who refuse to allow the inspection shall not be approved for LEAP benefits for the following year and a LEAP denial hold shall be placed on the household at that address by the state LEAP office. The hold can only be removed by the state LEAP office.

2. If the household has moved to another address, the household may be approved for a LEAP benefit if otherwise eligible.

3. If a denied household subsequently allows the dwelling to be inspected, the household must reapply and, as long as other eligibility criteria are met, may be approved for LEAP benefits after notification from the inspecting agency that the inspection is completed.

C. State CIP Contractor’s Responsibilities The state contractor will:

1. Assure that standards, as delineated in Sections A and B, above, are applied uniformly and equitably.

2. Notify the state LEAP office by September 30th of each year of all households that refuse inspection.

3. Notify households that refuse inspection that their refusal may result in denial of LEAP benefits for the following year.

GENERAL REQUIREMENTS FOR CITIZENSHIP AND LAWFUL PERMANENT RESIDENCY [Eff.12/1/14] 3.753.1 CITIZENSHIP AND LAWFUL PERMANENT RESIDENCY STATUS [Eff. 12/1/14]

The following are citizens of the United States and are generally eligible to receive social services and public assistance.

A. Persons born in the United States, Puerto Rico, Guam, Virgin Islands (U.S.), American Samoa, or Swain's Island;

B. Persons who have become citizens through the naturalization process;

C. Persons born to U.S. citizens outside the United States with appropriate documentation. 3.753.11 Verification of Citizenship in the United States [Eff. 12/1/14]

Documents that are acceptable as verification of citizenship can be found at 1 CCR 204-30, Appendix A. 3.753.111 Verification of Questionable Citizenship Information [Eff. 12/1/14]

The following shall be used in considering questionable statement(s) of citizenship from applicant:

A. The claim of citizenship is inconsistent with statements made by the applicant, or with other information on the application, or on previous applications.

B. The claim of citizenship is inconsistent with information received from another reliable source.

Application of the above criteria by the eligibility worker must not result in discrimination based on race, religion, ethnic background or national origin, and groups such as migrant farm workers or Native Americans shall not be targeted for special verification. The eligibility worker shall not rely on a surname, accent, or appearance that seems foreign to find a claim to citizenship questionable. Nor shall the eligibility worker rely on a lack of English speaking, reading or writing ability as grounds to question a claim to citizenship. There are no additional identification requirements for citizenship or lawful permanent residency status. 3.753.13 Legal Immigrant [Eff. 12/1/14]

“Legal immigrant” means an individual who is not a citizen or national of the United States and who was lawfully admitted to the United States by the Citizenship and Immigration Services (CIS) as an actual or prospective permanent resident or whose physical presence is known and allowed by the CIS. 3.753.14 Documentation of Legal Immigrant [Eff. 12/1/14]

An alien considered a legal immigrant will normally possess one of the following forms provided by the Citizenship and Immigration Services (CIS) as verification:

A. I-94 arrival/departure record.

B. I-551: resident alien card I-551).

C. Forms I-688b or I-766 employment authorization document.

D. A letter from CIS indicating a person’s status.

E. Letter from the U.S. Dept. of Health and Human Services (HHS) certifying a person’s status as a victim of a severe form of trafficking.

F. Iraqi and afghan individuals who worked as translators for the U.S. military, or on behalf of the U.S. government, or families of such individuals; and have been admitted under a Special Immigrant Visa (SIV) with specific Visa categories of SI1, SI2, SI3, SI6, SI7, SI9, SQ1, SQ2, SQ3, SQ6, SQ7, or SQ9. Eligibility limitations are outlined in Section 3.710.31, I.

G. Any of the documents permitted by the Colorado Department of Revenue rules for evidence of lawful presence 1 CCR 204-30, APPENDIX B). 3.753.15 Verification with Systematic Alien Verification of Entitlement (SAVE) Program [Eff. 12/1/14]

Legal immigrants applying for public assistance must present documentation from CIS showing the applicant's status. All documents must be verified through SAVE (Systematic Alien Verification for Entitlements) to determine the validity of the document. 3.753.16 Qualified Alien [Eff. 12/1/14]

A “qualified alien” is defined as follows:

A. An alien lawfully admitted for permanent residence;

B. An alien paroled into the United States under the Immigration and Naturalization Act (INA) for a period of at least one year;

C. An alien granted conditional entry pursuant to Section 203(a) (7) of the INA prior to April 1, 1980;

D. A refugee;

E. An asylee;

F. An alien whose deportation is being withheld;

G. A Cuban or Haitian entrant;

H. A victim of severe form of trafficking who has been certified as such by the U.S. Department of health and Human Services (HHS);

I. Iraqis and Afghans granted Special Immigrant Visa status;

J. An alien who has been battered or subjected to extreme cruelty in the U.S. by a family member;

K. An alien admitted to the U.S. as an Amerasian immigrant;

L. An individual who was born in Canada and possesses at least fifty percent (50%) American Indian blood or is a member of an Indian tribe; 3.753.17 Aliens and Temporary Residents Not Eligible for Assistance [Eff. 12/1/14]

The following individuals are not eligible for public assistance or social services programs:

A. An alien with no status verification from the U.S. Citizenship and Immigration Service;

B. An alien granted a specific voluntary departure date;

C. An alien applying for a status; or, D. A citizen of foreign nations residing temporarily in the United States on the basis of Visas issued to permit employment, education, or a visit. 3.753.18 Citizenship Requirements [Eff. 12/1/14]

An applicant who does not meet lawful permanent residency or citizenship requirements shall not be included as a household member; however, all countable income of this individual shall be counted as

part of the household's total income. The household's application shall not be denied due to lack of documentation regarding citizenship requirements if there are other household members who meet the citizenship requirements (i.e., minors born in the United States). 3.753.2 Residence [Eff. 12/1/14] 3.753.21 Colorado Residency [Eff. 12/1/14]

To be eligible for assistance, an applicant shall be a resident of Colorado at the time application is made.

There shall be no durational residence requirement. An applicant or recipient who establishes intent to remain in Colorado shall, for public assistance purposes, is considered a current resident. “Intent to remain” may be established by any or all of the following:

A. Acquiring by purchase, rental, or other arrangements housing facilities used as a home;

B. Household effects, equipment, and personal belongings being located in the home or being in transit;

C. Securing employment or engaging in other self-supporting activity based in Colorado;

D. Parents entering children in local schools;

E. Completing the affidavit of intent – residence form; and/or;

F. Entering Colorado with a job commitment or in search of employment in Colorado. 3.753.22 Residency Requirements [Eff. 12/1/14]

Applicant households must meet the state residency requirements as contained in these rules. The household must reside at the address for which it applied to receive LEAP benefits. 3.754 REASONS FOR DENIAL OF ASSISTANCE [Eff. 12/1/14]

“Denial” means that an application shall be denied when the applicant fails to meet the eligibility requirements of the program. A denial also may be assessed on the basis of such factors as, but not limited to:

A. Refusal of the applicant to furnish information necessary to determine eligibility;

B. Applicant unwilling to have the county department/Contractor contact a collateral source to secure information and refusal of the applicant to sign the state-approved authorization for release of information form;

C. Applicant does not supply information or otherwise fails to cooperate with the county department within the standards of promptness time limits and after having received notification of the reason for delay;

D. Applicant moves to an unknown address before determination of eligibility has been completed;

E. Refusal of a third party to provide documentation of essential verifications. 3.754.1 FACTORS FOR DENIAL [Rev. eff. 11/1/15]

Any of the following factors shall be the basis for the denial of an applicant household:* A. Excess income; 3.752.22 (04).

B. Not vulnerable to rising home heating costs; 3.752.25 (03).

C. Not a U.S. citizen or a qualified alien; 3.753.16 (13).

D. A household is a duplicate household or was previously approved as part of another household;

3.751.2.A (06).

E. The household has voluntarily withdrawn its application; 3.756.18 (09).

F. The household has received Heating Fuel Assistance Program benefits from another county; 3.756.17 (10).

G. The household has failed to provide complete application information or required verification; 3.751.1, “Completed Application” (11).

H. The household is not a resident of Colorado; 3.753.21 (07).

I. The household failed to sign the application form; 3.751.1, “Completed Application”, (21).

J. The household filed an application outside of the application period; 3.752.1 (14).

K. Unable to locate the applicant; 3.756.19 (25).

L. Refused weatherization services from a state weatherization agency; 3.752.26 (26).

M. The applicant failed to provide valid identification; 3.753.11 (05).

N. The applicant failed to provide an affidavit; 3.753.12.B.2 (08).

O. The applicant failed to provide valid identification; 3.753.11, and the applicant failed to provide an affidavit; 3.753.12.B.2 (18).

P. Non-traditional dwelling; 3.751.1, (23).

Q. The household does not reside at the address for which it applied to receive benefits; 3.753.22 (24).

R. LEAP can only assist with the primary heating fuel for the primary heating source; 3.751.1, (22).

S. The applicant household refused a bulk fuel delivery, thereby relinquishing the benefit;

3.758.46.C (28).

T. The household refused inspection of the Crisis Intervention Program work; 3.752.27 (27).

U. The applicant has been convicted of fraud; 3.751.56 (29).

V. The household failed to provide necessary verification of income; 3.752.22 (02)

W. The household is homeless. 3.754.11 Appropriate Reason for Denial [Eff. 12/1/14]

The county department shall use the most appropriate reason for denial; if the county department is unclear as to the most appropriate reason for denial, it shall consult the State Department. 3.754.12 Notice of Denial [Eff. 12/1/14]

A notice of denial shall be provided to the applicant within seven (7) calendar days of the decision; the state will provide the notices to the county department/Contractor for distribution.

3.755 VERIFICATION POLICIES AND CASE RECORD DOCUMENTATION

3.755.1 GENERAL 3.755.11 Verification in Determining Initial Eligibility and Payment Amount [Rev. eff. 12/1/14]

Income, estimated home heating costs, and vulnerability shall be verified in determining initial eligibility and/or payment amount. If a household applied during the prior LEAP program year and there are no changes in the applicant, address and fuel provider, vulnerability may be copied from the prior year case file and provided in the current case file. 3.755.12 Conflicting Information [Rev. eff. 12/1/14]

If the county/contractor obtains information which would affect the initial determination of an applicant household's eligibility or payment level and which is different than information provided by the applicant, the county/contractor shall inform the applicant and provide an opportunity for response or explanation.

Eligibility shall be determined by using the correct information. In these cases, an applicant who meets eligibility criteria shall not be denied because the applicant provided information that was different than information subsequently obtained by the county/contractor. Information used to determine eligibility and benefit level shall be documented in the system. However, in appropriate cases, the counties/contractor may institute fraud proceedings. 3.755.13 Case Record [Rev. eff. 12/1/14]

The case record shall contain at a minimum:

A. The application and any other supplemental forms the applicant is required to submit;

B. Documentation of all verification as required in these rules;

C. Written explanation on the report of contact of any discrepancy between information contained on the application and information in the LEAP system;

D. Calculations used to compute income, documentation of the source of estimated home heating costs and any other written notations on the report of contact necessary to provide a clear and adequate record of action taken on the case.

E. Documentation of all written notices sent to the applicant household requesting missing information and/or verification necessary to determine eligibility and/or payment level.

F. Complete documentation in emergency or expedited cases including when, to whom, and how a vendor and/or client contact is made.

G. All historical data used must be present in the file and documented in the Report of Contact.

(ROC). The date of the roc entry into the state leap system shall be considered the current date stamp on the historical data. 3.755.14 Written Policy [Eff. 12/1/14]

Each county department/Contractor shall develop a written policy stipulating the order of the case record, and the content of all records in that county department shall be filed according to that county department policy. If the case record is not an electronic file the county department must stipulate that case record material must be fastened to the file folder in order to secure the information and maintain the filing order. 3.755.15 County Storage of Records [Eff. 12/1/14]

The county department shall be responsible for the provision of a safe place for storage of case records and confidential material. If a county department/Contractor shares building space with other county offices, locked files to store case material shall be used. Janitors and other maintenance personnel shall be instructed concerning the confidential nature of information. 3.755.16 State Authority Required for Removal of Case Records [Eff. 12/1/14]

Case records are the property of and shall be restricted to use by the State Department and county department or Contractor. Only on authority of the State Department may case records be removed from the office of the county department or Contractor. 3.755.17 Archiving Case Files [Eff. 12/1/14]

The county department/Contractor shall archive three (3) program years plus the current program year files and make them available to the State upon request.

3.755.2 VERIFYING INCOME 3.755.21 Adequate Verification of Income [Rev. eff. 11/1/15]

The case record shall contain adequate verification of income. Adequate verification is defined as any of the following:

A. Unearned income, such as pensions or retirement income, veteran's benefits, worker's compensation, unemployment or supplemental security income shall be verified in writing, such as an award letter or cost of living adjustment (COLA) letter, issued after the last general increase for that type of assistance, which shows the gross amount before any deductions. Acceptable verification includes documentation from federal/state/system inquiries (i.e., a copy of applicable CBMS screens). Copies of bank deposits or checks shall not be adequate verification of gross B. Verification of child support income shall include at a minimum:

1. Verification through the Automated Child Support Enforcement System (ACSES); or, 2. Verification through the Family Support Registry (FSR); or, 3. Copies of checks, money orders or other document(s) including written statements or affidavits from the non-custodial parent that documents the income paid directly to the custodial parent.

4. An exception shall be made in cases of domestic violence as defined in Section 18-6- 800.3(1), C.R.S., when the applicant provides evidence from a court or participation in the state’s Address Confidentiality Program (ACP) pursuant to Section 24-30-2104, C.R.S. Client declaration shall be sufficient in such cases.

C. Social Security income may be verified by an award letter, issued by the social security administration, after the last general increase. Acceptable verification includes documentation from federal/state/system inquiries (i.e., a copy of applicable CBMS screens). Gross Social Security income includes income before any deductions for Medicare or other medical insurance.

Copies of bank deposit or checks shall not be adequate verification of gross Social Security D. Earned ongoing income shall be verified for at least four (4) weeks of the eight (8) weeks prior to the application date and shall consist of pay stubs or statements from employers which state the actual gross income earned.

E. Public assistance income shall be verified through the most current active county records. The Low-Income Energy Assistance Program case record must specifically reference the source document of the income information via federal and/or state system inquiries (i.e., a copy of applicable CBMS screens).

F. Verification of income other than public assistance income of applicant households may be obtained through the most current active county records. The Low-Income Energy Assistance Program case record must specifically reference the source document of the income verification (i.e., source document name and/or number and document date).

G. Verification may be obtained by collateral contact, provided that the case record contains complete information on the name and title of the person contacted, the name of the employer or agency, the period of employment and the actual gross income received, earned or unearned.

H. In verifying zero income, including situations where the shelter expenses exceed income, the county shall examine income of all adult members of the household by using the Department of Labor and Employment (DOLE) verification system and one or more of the following methods:

1. Obtain a reasonable explanation from the household on how they meet shelter expenses and notate in the Record of Contact (ROC) when the explanation is verbally communicated.

2. Verify final date of employment with last employer;

3. Colorado Benefits Management System (CBMS).

I Verification of self-employment income shall include, at a minimum:

1. Written or verbal declaration of monthly gross income, which may include Profit and loss statements, i.e., self-employment ledger; and, 2. Receipts for business-related expenses are required in order to be considered as deductions:

a. Rent or mortgage is not an allowable expense when the applicant is operating a business from his or her residence.

b. Utilities, data and phone bills including cell phones are not allowable expenses when the account is in the name of an individual.

c. Fuel expenses are allowable for vehicles used solely for business and for individuals who use personal vehicles that are directly related to the work and necessary to conduct business. The county may accept gas receipts and/or documentation of mileage for those vehicles that are not used solely for business. If using a mileage log, the deduction is then based on the number of miles times the county’s established reimbursement rate.

D. Rental property allowable expenses shall be limited to the costs of maintenance of the property.

3. Credit card and bank statements are not allowable receipts for business related expenses.

J. Owners of LLC’s or S-Corps are considered employees of the corporation and therefore cannot be considered self-employed. Because they are not considered self-employed, they are not entitled to the exclusion of allowable costs of producing self-employment income. The income from these types of corporations should be counted as regular earned income, not selfemployment income. When owners do not pay themselves a salary, but instead pay their personal expenses from the business account, the amount of the personal expenses paid from the business account will be considered their gross earned income. Owners who do not pay themselves a salary, but instead pay their personal expenses from the business account may verify this information in the form of a written statement listing the expenses or can declare this verbally by collateral contact.

K Gift income shall be considered verified with applicant declaration. 3.755.3 (None)

3.755.4 VULNERABILITY 3.755.41 Evidence of Vulnerability [Rev. eff. 11/1/13]

All households shall be required to provide evidence of vulnerability for the primary heating fuel for the residence at the time of application. Evidence of vulnerability may be shown by one of the following:

1. A copy of the current or most recent fuel bill that the household is responsible for paying. The fuel bill is not to exceed one (1) program year prior to the date of application for non-approved vendors.

2. Collateral contact with the fuel provider to establish vulnerability. Contact is to be documented in the report of contact (ROC).

3. A copy of the current or previous month’s rent receipt if heat is included in rent is also acceptable.

The rent receipt must specifically notate that heat and/or utilities are included in rent. A lease, collateral contact or rent statement from the applicant's landlord is required if the rent receipt is not specific.

4. The county/contractor may use prior year's fuel bill if the information supplied matches the current application/information. If historical information is being used to verify vulnerability, a notation must be made in the case record. If the fuel bill that is submitted as evidence of vulnerability is in the name of a person other than the applicant household, the case record shall contain a notation that explains the discrepancy in names. 3.755.42 Subsidized Housing Rent Documentation [Rev. eff. 11/1/13]

Applicant households living in subsidized housing units shall be required to provide documentation specifying that the household is subject to heating surcharges when home heating usage exceeds the amount of the household's heating allowance, within the current LEAP program year, or evidence of a separate heating bill. 3.755.43 Wood Permits [Rev. eff. 6/1/09]

Applicants who cut their own wood shall be required to provide a copy of their wood cutting permit. If a permit is not available, the applicants must provide a written and signed statement that they cut their own wood, plus documented proof that they cut it on their own land or that they have permission from the landowner. 3.755.44 Wood Purchase/Other Bulk Fuels [Eff. 12/1/14]

Applicants who use wood as their primary heating fuel must provide a receipt from a wood vendor.

Receipts must include the vendor’s name, telephone number, date and the name and address of the buyer; it must also contain the amount of wood purchased, the date of the purchase and the cost. If the required information is not provided on the receipt, the county/contractor must document in ROC and provide further explanation. 3.755.45 Propane Purchase/Other Bulk Fuels [Eff. 11/1/15]

Applicants who use propane or other bulk fuels, referred to in definitions in these rules, as their primary heating fuel must provide a receipt or statement from their vendor. Receipts must include the vendor's name, date, and the name and service address of the buyer.

Applicants, who utilize propane bottles/other bulk fuels, as described in definitions in these rules or purchase propane as a cash account, are required to provide a copy of a receipt of purchase only from a retail store or other propane provider.

3.755.5 ESTIMATED HOME HEATING COSTS 3.755.51 Verification [Rev. eff. 11/1/15]

County departments/Contractor shall obtain verification of estimated home heating costs. Verification shall consist of evidence provided by the approved LEAP fuel vendor for the residence at the time of application.

If the county/Contractor changes the Estimated Home Heating Costs (EHHC) originally provided by the fuel vendor, the county/Contractor must obtain written verification or collateral contact of this change from the fuel vendor. The verification from the vendor shall be placed in the case record. 3.755.6 Other Factors Affecting Eligibility and Payment Amounts [Rev. eff. 9/1/11]

Other factors affecting eligibility and payment amounts of an applicant household may be verified if determined necessary.

3.756 PROCEDURES FOR PROCESSING APPLICATIONS AND NOTIFYING APPLICANT

HOUSEHOLDS

3.756.1 PROCEDURES 3.756.11 Application [Rev. eff. 12/1/14]

Heating Fuel Assistance Program applicants shall submit a completed application form as defined in the “Definitions” section 3.751.1 of these rules to the county department in order to be considered for Heating Fuel Assistance Program benefits. The county department/Contractor shall not require office interviews for purposes of determining eligibility. 3.756.12 Application Processing [Rev. eff. 11/1/13]

A. The county department/Contractor shall be required to date stamp all application forms, verification, and information upon receipt.

B. Beginning November 1st, all applications are to be screened upon receipt to determine if the application is in emergency status. All potential emergency applications are to be pended in two (2) business days from the date of application. All regular applications must be entered into the LEAP database in a pending status within ten (10) business days from the date the application is received in the county LEAP office. All applications received within the eligibility period must be added and either approved or denied no later than June 19th.

C. The county department/Contractor shall be required to review for duplicate applications. The county department/Contractor shall determine if an application is complete as defined in the “Definitions” section of these rules. If an application is not complete, the county department/Contractor shall notify the applicant household, in writing through a LEAP systemgenerated letter, of information or verification necessary to determine eligibility and/or payment level.

D. The applicant household shall be provided two (2) calendar weeks from the date the notice is postmarked to provide the requested information and/or verification. Clients who fail to submit the required verification shall have their application denied within processing timelines for emergency and regular applications. However, the county department may extend the period for submission by the applicant of the information requested by the county department/contractor to complete the application upon a showing of good cause for the applicant's failure to provide the necessary information or verification within the two (2) week period. The extended period shall not exceed two weeks. The term “good cause” as used above is defined as conditions outside the control of the individual such as sudden illness, hospitalization, fire, theft, acts of God, and natural disasters.

If the requested verification is provided after the application is denied, the county or contractor shall reopen and complete processing of the application within fifteen (15) calendar days of receipt. The requested verification must be received by June 15th of the current program year. 3.756.13 Lost Applications [Rev. 11/1/13]

If a household reports to the county/Contractor that it has mailed or otherwise made application for basic benefits and the county department/Contractor cannot locate the application for the household, such application shall be deemed “lost”. The procedures for handling “lost” applications shall be prescribed by the State Department. The client must notify the county/Contractor of the lost application no later than thirty (30) calendar days from the submission date. 3.756.14 Determination of Eligibility [Rev. eff. 11/1/93]

A county department/contractor shall have up to thirty (30) calendar days from the date of application as defined in section 3.751.1 of these rules to determine eligibility. The date of application is considered day zero (0). If the thirtieth (30) day falls on a weekend or a holiday, the county/contractor shall have until close of business on the following business day to determine eligibility.

Emergency applications for households shall be processed expeditiously and eligibility determined within eighteen (18) calendar days of notification of the emergency by the applicant to the county department/contractor. To allow for the full two (2) weeks for households to return requested verification, cases pending verification must not be denied prior to the fifteenth (15th) day in which the request has been mailed out. If the eighteenth (18) day falls on a weekend or holiday the eligibility determination shall be processed by the close of business the next business day.

Emergency applications for households shall be processed as expeditiously as possible not to exceed eighteen (18) calendar days. 3.756.15 Notification of Approval or Denial [Rev. eff. 10/1/01]

Upon determination of eligibility, the household shall be notified in writing of approval or denial in accordance with the notice requirements in these rules. 3.756.16 County of Residence [Rev. eff. 10/1/09]

The county of residence for applicant households shall be the county where the applicant household is residing as of the date of application. An application received from a non-resident of the county shall be forwarded to the county Department of Human Services in the county of residence or contractor in the county of residence within five (5) working days. Processing time begins upon receipt of the application by the county Department of Human Services in the county of residence or contractor in the county of residence. The county forwarding the application shall, simultaneously, notify the applicant household, in writing, of the name, address, and phone number of the county Department of Human Services to which the application was forwarded.

If the application is not forwarded within five (5) working days to the county Department of Human Services in the county of residence or contractor in the county of residence the receiving county department of human services will work the application to completion. If the receiving county department of human services pends the application prior to forwarding the application to the county Department of Human Services in the county of residence or contractor in the county of residence, the receiving county department of human services will work the application to completion. 3.756.17 Relocation [Rev. eff. 11/1/94]

If an approved household moves from one county to another within Colorado, the original county of residence in which eligibility was determined, shall remain responsible for processing that case throughout the program year. The new county of residence shall provide assistance to the case processing county as requested. If an applicant then applies in the new county of residence, the application shall be denied, and the applicant notified that benefits will be paid by the original county. 3.756.18 Withdrawn Application [Rev. eff. 11/1/08]

An applicant who voluntarily withdraws his/her application prior to eligibility being determined shall be denied. The applicant may notify the county either in writing or verbally that they are voluntarily withdrawing their application. Verbal notice must be documented in the report of contact (ROC). 3.756.19 Unlocated Applicant [Rev. eff. 10/1/09]

An applicant who cannot be located prior to eligibility being determined shall be denied. The county/Contractor must attempt to locate the applicant by mailing a forwardable letter to the last known address. If the applicant does not respond within fifteen (15) business days, the application shall be denied.

3.756.2 ADVANCE PAYMENT OF THE HEATING FUEL ASSISTANCE PROGRAM BENEFIT

(applicable only when a signed Vendor Agreement has not been secured) [Rev. eff. 12/1/14]

A. A shut-off notice or other documentation of intent to terminate heating services by the heating supplier or landlord or that termination of service has occurred; or, B. For households that use bulk fuel, a written or verbal declaration by the household that the fuel supply has been or will be depleted within the next two weeks and the specific amount needed to maintain heat in the home until payroll runs.

C. For households where heat is included in rent, an eviction notice and a written statement from the landlord that the client will not be evicted for thirty (30) days if request for advance of the payment is accepted.

For purposes of advance payment, notices of denial shall advise the applicants of the reason for denial, appeal rights and procedures including, but not limited to, a hearing.

3.757 PROCEDURE FOR REPORTING ELIGIBILITY AND PAYMENT INFORMATION 3.757.11 [Rev. eff. 9/1/11]

The county/Contractor will be required to correct any inaccuracies as they may result in an erroneous payment amount and/or incorrect eligibility determination. Information reported on the household's income, family size, estimated home heating costs, subsidized housing heat allowance, and number of separate households is the basis for the amount of LEAP benefit. 3.757.12 [Rev. eff. 9/1/11]

County departments/contractor shall enter completed applications into the LEAP automated system as eligibility is determined.

3.758 PAYMENT POLICIES

3.758.1 (NONE)

3.758.2 (NONE)

3.758.3 CHANGES IN HOUSEHOLD COMPOSITION AFFECTING ISSUANCE OF PAYMENT 3.758.31 Change in Household Circumstances [Rev. eff. 12/1/14]

If, prior to payment, an eligible household's circumstances change, which involves separation or divorce of a marriage or common law arrangement, and the household includes dependent children, the Heating Fuel Assistance Program payment(s) shall be provided to the parent or guardian who resides with and has the responsibility for the care of the dependent children.

If the household does not include dependent children, the Heating Fuel Assistance Program payment(s) shall be paid to the person listed as applicant. 3.758.32 Death of Payee Affecting Issuance of Payment [Rev. eff. 12/1/14]

When the payee for a Heating Fuel Assistance Program benefit dies, any payment to which the payee was entitled shall be kept available according to the following rules:

A. The surviving spouse or other household member shall be entitled to the Heating Fuel Assistance Program payee's benefit provided that the surviving spouse or other household member was included as part of the Heating Fuel Assistance Program payee's household upon Heating Fuel Assistance Program eligibility determination.

C. In the case of a single member household client payment the executor of the estate may claim the payment. If the client payment is not claimed the payment will expunge two hundred seventyfour (274) days. In the case of a single member household vendor payment, the vendor will follow the process outlined in the vendor agreement.

3.758.4 PAYMENT METHODS 3.758.41 Heating Fuel Assistance Program Payment [Rev. eff. 12/1/14]

For an approved household which pays home heating costs directly to a fuel vendor, payment shall be made as a vendor payment, provided a written vendor agreement has been secured. The State Department shall be required to provide vendors servicing their county with an opportunity to sign the state prescribed vendor agreement. County departments/Contractor shall provide vendors with applications, brochures, envelopes, and other outreach material. In cases where a written vendor agreement has not been secured, payment shall be issued directly to the eligible household.

For an approved household that pays home heating costs to a landlord, payment of the Heating Fuel Assistance Program payment shall be made directly to the eligible household. Under no circumstances shall a direct payment be made to a landlord. 3.758.42 - 3.758.45 (None) 3.758.46 Vendor Payment Procedures [Rev. eff. 12/1/14]

A. When a direct vendor payment is made, the county department/Contractor shall be required:

1. To notify each household of the amount and month such assistance is scheduled to be paid on its behalf, 2. To notify the household of the vendor to be paid on the household's behalf, 3. To contact the vendor to explain the vendor payment process, when applicable.

4. To notify each eligible household in writing of the eligible household's responsibilities to continue to pay toward the household's heating costs. Such notification shall advise the household that the Heating Fuel Assistance Program payment is not intended to totally pay a household's heating costs.

If the household has received a notice from the vendor to terminate services or has already had services terminated, the household is responsible to negotiate a payment arrangement with their vendor.

5. To notify the vendor in writing of each household's eligibility and projected payment amount.

B. Prior to any Heating Fuel Assistance Program payment being made directly to a fuel vendor on behalf of an eligible household, the following terms of agreement shall be obtained from the fuel vendor in writing and notice of the same shall be included with the Heating Fuel Assistance Program payment in accordance with a State prescribed form. Any revision or modification of the assurances below, necessitated by unique circumstances, shall be submitted in writing to the State Department for approval prior to execution of the vendor agreement.

C. Refer to the State approved vendor agreement for specific requirements, conditions and procedures. This agreement is available on the Colorado Department of Human Services web site at www.colorado.gov/CDHS/LEAP. 3.758.47 Methodology for Calculating Heating Fuel Assistance Program Benefits [Rev. eff. 11/1/15]

The payment amount for an eligible Heating Fuel Assistance Program household shall be determined in accordance with the following method:

Step A. Determine Estimated Home Heating Costs (EHHC)

The county department/Contractor shall determine estimated home heating costs for November 1st through April 30th for the household's current residence at the time of application. The methodology for calculating estimated home heating costs is outlined below.

The county department/Contractor shall determine the applicant household's estimated home heating costs as follows:

1. An applicant household's estimated home heating cost shall consist of the total actual home heating costs for the primary heating fuel for November 1st through April 30th, of the prior year's heating season. Vendors serving applicant households shall be required to supply actual home heating costs for November 1st through April 30th of the prior year's heating season.

2. For any applicant whose home heating costs for the prior year's heating season are not available or determined by the county department to be invalid, the county department shall use the flat rate amount. The State Department shall adjust the flat rate amounts annually, based on the average actual home heating costs found in the LEAP system by dwelling type for the prior year's heating season contained in the annual LEAP training manual.

3. The State Department shall adjust the standard rates for heating costs that are included in rent annually, based on the flat rate amounts adjustment contained in the annual LEAP training manual.

Step B Initial Statewide Adjustment The State LEAP office will adjust benefit levels at the beginning of each LEAP program year based upon the projected number of LEAP applications to be received and the estimated level of funding. Annually, this calculation determines the percentage of the estimated home heating costs (EHHC) of the applicant household to be adjusted.

Step C. Adjustment for Electric Heat Households using electric heat will have their electric usage costs reduced to the percentage amounts listed below.

HEAT PORTION OF TOTAL ELECTRIC EHHC

House/mobile home 62% for heat Townhouse / duplex / triplex / fourplex 48% for heat Apartment, condominium, hotel, Cabin, Tiny Home 43% for heat RV, 5th wheel, camper 50% for heat Step D. Adjustment Household Income Contribution The state department shall reduce the amount the of estimated home heating costs (EHHC) based on the chart below to determine the household income contribution:

LEVEL OF FEDERAL POVERTY LEVEL EHHC ADJUSTMENT

0 – 75% FPL 0%

75.01 – 125% FPL 10%

125.01– 175% FPL 20% 175.01+% + 30%

Step E. Adjustment for Shared Living Arrangements The estimated home heating costs shall be adjusted if the household shares living arrangements with other households but is determined to be a separate household as defined in the “Definitions” section of these rules. If the household shares living arrangements with other households, the estimated home heating cost shall be divided by the number of separate households sharing the living arrangements, whether or not all households sharing the living arrangements are eligible for the Heating Fuel Assistance Program.

Step F. Adjustment for Subsidized Housing Home Heating Allowance The State Department shall adjust the amount of estimated home heating cost remaining after Step B if the household resides in subsidized housing (as defined in the “Definitions” section of these rules). A flat rate rental cost allowance for heating ($30 per month or $180 per heating season) shall be deducted from the remaining amount of estimated home heating costs. If the household does not live in subsidized housing, the amount remaining after Step B shall be the estimated home heating cost.

Step G. Determine Heating Fuel Assistance Program Amount The State Department shall determine a benefit amount for each eligible household by subtracting the applicable adjustments listed above, in Steps B-F from the household’s estimated home heating costs (EHHC) determined in Step A, 1-3. Any eligible household will receive at least the minimum, up to and including, the maximum benefit amount established by the Department for the LEAP program year. 3.758.48 Adjustments [Rev. eff. 9/1/11]

The State Department will provide the county departments advance written notice of any statewide benefit level adjustments.

Any statewide adjustment to the LEAP benefit level cannot be appealed.

The benefit amount in a prior LEAP program year is not indicative of a current LEAP program year benefit amount and benefit levels may vary from program year to program year depending on funding and the applicant pool. 3.758.49 Forfeiture of Benefit [Eff. 11/1/98]

If the benefit is not properly claimed within the current federal fiscal year for the period of intended use, the household will forfeit the remaining benefit.

3.759 OUTREACH AND REFERRAL

3.759.1 COUNTY DEPARTMENTS 3.759.11 Operation [Rev. eff. 12/1/14]

The county department has responsibility for the operation of a county wide outreach program. The outreach program shall be operated in accordance with guidelines contained in this section. The county may opt to contract with other agencies to perform all or part of the required outreach activities. Counties must assure that outreach includes:

A. Coordination with other agencies, organizations, and groups to facilitate the participation of potentially eligible persons with emphasis on most vulnerable (e.g., elderly, disabled, home bound, non-English speaking);

B. Access to Heating Fuel Assistance Program information and application forms. Outreach staff must identify locations in the county, such as community action programs, Social Security offices, low income housing sites, etc., for distribution of information, taking of applications, etc., through these sites. In addition, the county must have sufficient telephone lines to ensure access to information without requiring office visits;

C. An effective county wide information and referral system involving local agencies and organizations;

D. A referral system to weatherization and other energy conservation programs in the county;

E. Special efforts to meet the needs of target groups (e.g., home visits for home bound, out stationing of outreach staff, etc.). County departments shall assist disabled and elderly (as defined in the “Definitions” section of these rules) applicants in completing applications and securing the required verification;

F. Regular communications with cooperating agencies to identify concerns, problems, etc.;

G. Encourage utility companies to refer their customers to the county departments. 3.759.12 Outreach Plan [Rev. eff. 11/1/03]

The county department shall develop an outreach plan which describes specific activities the county will perform to carry out the specific responsibilities outlined in 3.759.11, above. The plan shall be available for public inspection at the county department. 3.759.13 Reporting Requirements County departments shall comply with outreach reporting requirements as prescribed by the State Department. Failure to comply may result in the recovery of outreach funds.

3.759.2 OUTREACH ACTIVITIES 3.759.21

Outreach materials shall be distributed to various community agencies targeting groups such as elderly, persons with disabilities, veterans, migrant seasonal workers, renters, Native Americans, and non-English or limited English speaking communities. 3.759.3 (None) [Rev. eff. 2/1/12]

3.759.4 WEATHERIZATION REFERRAL 3.759.41 [Rev. eff. 11/1/83]

Eligible households shall be referred for participation in weatherization, energy conservation and other related assistance upon the household's request. 3.760 (NONE) [Rev. eff. 9/15/12] 3.770 ALLOCATION FOR ADMINISTRATION AND OUTREACH [Rev. eff. 11/1/96]

The county may transfer funds from Program Code 4510 Administration to Program Code 4520 Outreach.

The county may not transfer funds from Program Code 4520 Outreach to Program Code 4510 Administration.

The county is to budget its allocation of funds for Program Code 4510 Administration and Program Code 4520 Outreach to cover all expenditures which may be incurred from October 1 to the following September 30. The county department shall not be reimbursed for expenditures in excess of the county's allocation of Program Code 4510 and Program Code 4520 funds. The county's allocation of Program Code 4510 Administration funds will not be increased unless the State Department allocates additional funds to all counties or unless the county meets the following criteria:

A. The county submits a written letter of request which includes the county's original budget plan for expenditure of its allocation of administrative funds, a description of expenditures to date for administrative costs, a budget of anticipated costs for the remainder of the program, and a narrative justification of actual and anticipated expenditures for the program.

B. The request for additional funds must be justified on the basis of one or both of the following factors:

1. That the county incurred or expects to incur extraordinary costs which were or are beyond county control and were or will be necessary to implement the program:

2. That the county's caseload in relation to its allocation of administrative funds was significantly greater than the caseload of other similar sized counties in relation to their allocation of administrative funds.

Actual provision of additional funds is contingent upon availability of administrative funds.

The county's allocation of Program Code 4520 Outreach funds shall not be increased unless the county submits a request for additional outreach funds, which explains and justifies the need for such funds or unless the state department allocates additional funds to all counties. _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Rules 3.750.12-13, 3.751.1, 3.751.31, 3.751.41-43, 3.751.51, 3.751.53, 3.751.71-72, 3.752.1, 3.752.22- 23, 3.754.1, 3.756.2 eff. 09/15/2012. Rule 3.760-3.760.53 repealed eff. 09/15/2012.

Rules 3.744.F-G, 3.746.A-F, emer. rules eff. 11/09/2012.

Rules 3.720, 3.721.22, 3.744.A-B emer. rules eff. 02/01/2013.

Rules 3.744.F-G, 3.746. A-F eff. 03/02/2013.

Rules 3.720-3.720.32, 3.721.22, 3.744.A-B eff. 05/01/2013.

Rules 3.751.1, 3.751.34, 3.752.1-3.752.22.E, 3.752.25, 3.754.1, 3.754.1.K, 3.755.13-3.755.42, 3.756.12- 3.756.13, 3.756.2, 3.758.1, 3.758.47 eff. 11/01/2013.

Rules 3.700, 3.720-7.746 eff. 03/02/2014.

Rules 3.750-3.751.53, 7.751.6-3.756.11, 7.756.2-7.759.13 eff. 12/01/2014.

Rules 3.751.44, 3.751.56, 3.752.22, 3.752.22.D, 3.752.23, 3.752.23.P-DD, 3.752.25, 3.754.1, 3.754.1.C, 3.755.21, 3.755.21.A, 3.755.21.B.4, 3.755.21.I.3, 3.755.45, 3.755.51, 3.758.47, 3.758.47 Step A.2-3 eff. 11/01/2015.

Rule 3.751.56 eff. 04/01/2016.

Rules 3.710, 3.711 recodified as 9 CCR 2503-3 eff. 09/01/2016.

Rule 3.750 eff. 11/01/2016.

Entire rule eff. 11/01/2017.

Rules 3.751.1, 3.752.22 D, 3.753.12 A, 3.754.1, 3.755.13 D, 3.755.14, 3.755.21 H-I, 3.755.41 3, 3.755.51, 3.756.2 B, 3.758.47 eff. 11/01/2018. Rules 3.700-3.746 repealed eff. 11/01/2018.

Rules 3.751.1, 3.751.41-3.751.489, 3.751.51, 3.751.55-3.751.563, 3.752.22 D, 3.752.23 GG, 3.754.1 W, 3.755.13 G, 3.755.21 D, J, 3.755.45, 3.756.12 D, 3.756.16, 3.758.47 emer. rules eff. 11/01/2019.

Rules 3.751.1, 3.751.41-3.751.489, 3.751.51, 3.751.55-3.751.563, 3.752.22 D, 3.752.23 GG, 3.754.1 W, 3.755.13 G, 3.755.21 D, J, 3.755.45, 3.756.12 D, 3.756.16, 3.758.47 eff. 12/30/2019.

Rules 3.751.1, 3.752.1 emer. rules eff. 05/01/2020.

Rules 3.751.1, 3.752.1 eff. 07/01/2020.

Rules 3.751.1, 3.752.1, 3.752.21 B,N, 3.752.22 D, 3.752.23 V, 3.752.25 B.7, 3.753.12 B.1.F, 3.755.41 1, 3.755.44, 3.756.12 D, 3.758.47 eff. 11/01/2020.

Rules 3.751.1, 3.752.1 emer. rules eff. 05/07/2021.

Rules 3.751.1, 3.752.1 eff. 07/30/2021.

Rules 3.751.1, 3.752.1, 3.752.21, 3.752.22 D, 3.752.23 F, 3.753.12 B.1.F, 3.755.12, 3.755.21 D, 3.755.21 I.2.D, 3.755.45, 3.756.14, 3.758.32 B, 3.758.47 2-3 eff. 11/01/2021.

Rules 3.751.1, 3.751.22, 3.751.55 D, 3.752.2, 3.752.211 K, 3.752.22 D, 3.752.23 BB, 3.752.23 HH, 3.753.1, 3.753.111, 3.753.18, 3.755.11, 3.755.21 K, 3.755.45, 3.758.32 C, 3.758.47 Step A eff. 11/01/2022. Rules 3.753.12, 3.753.19 repealed eff. 11/01/2022.

Rules 3.751.1, 3.752.21 B, 3.752.22 D, 3.755.44, 3.755.45, 3.756.12 D, 3.756.14 eff. 11/01/2023.

Rules 3.751.1, 3.751.472, 3.751.486, 3.751.487, 3.751.55, 3.751.562, 3.751.563, 3.752.21 M, 3.752.22 D, 3.752.23 U, GG, 3.752.27, 3.758.47 Step B, 3.758.47 Step D emer. rules eff. 11/01/2024.

Rules 3.751.1, 3.751.472, 3.751.486, 3.751.487, 3.751.55, 3.751.562, 3.751.563, 3.752.21 M, 3.752.22 D, 3.752.23 U, GG, 3.752.27, 3.758.47 Step B, 3.758.47 Step D eff. 12/30/2024.

Rules 3.752.22 D, 3.753.18 eff. 11/01/2025.

Annotations

Rule 3.751.44 (adopted 10/03/2014) was not extended by Senate Bill 15-100 and therefore expired 05/15/2015.

Rule 3.751.56 (adopted 09/09/2016) was not extended by Senate Bill 17-083 and therefore expired 05/15/2017.

##### **9 CCR 2503-8** Administrative Procedures for the Colorado Child Care Assistance Program {#sec-9-ccr-2503-8 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-8}

DEPARTMENT OF HUMAN SERVICES

ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM

9 CCR 2503-8 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.840 COUNTY DISPUTE RESOLUTION PROCESS In order to resolve disputes between county departments of social services or the service delivery agency and applicants/recipients, county departments shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple non-adversarial format for the informal resolution of disputes.

3.840.1 OPPORTUNITY FOR CONFERENCE .11 The county department or local service delivery agency, prior to taking action to deny, terminate, recover, initiate vendor payments or modify financial assistance or public assistance, to an applicant or recipient, shall, at a minimum, provide the individual opportunity for a county dispute resolution conference. 3.840.12 The right of an individual to a local conference is primarily to assure that the proposed action is valid, to protect the person against an erroneous action concerning benefits, and to assure reasonable promptness of county action. The individual may choose, however, to bypass the county dispute resolution process and appeal directly to the state Office of Administrative Courts, pursuant to the section on appeal and state hearing. .13 The applicant/recipient is entitled to:

A. be represented by an authorized representative, such as legal counsel, relative, friend, or other spokesman, or he may represent himself;

B. with the exception of names of confidential informants, privileged communications between the county department and its attorney, and the nature and status of pending criminal prosecutions, examine the contents of the case file and all documents and records used by the county department or agency in making its decision at a reasonable time before the conference as well as during the conference;

C. present new information or documentation to support reversal or modification of the proposed adverse action; .14 Failure of the applicant/recipient to request a local conference within the prior notice period, or failure to appear at the time of the scheduled conference without making a timely request for postponement, shall constitute abandonment of the right to a conference, unless the applicant/recipient can show good cause for his failure to appear. .15 “Good Cause” includes, but is not limited to: death or incapacity of an applicant/recipient, or a member of his immediate family, or the representative; any other health or medical condition of an emergency nature; or, other circumstances beyond the control of the applicant/recipient, and which would prevent a reasonable person from making a timely request for a conference or postponement of a scheduled conference.

3.840.2 CONDUCT OF COUNTY DISPUTE RESOLUTION CONFERENCE .21 The local dispute resolution conference shall be held in the county department or agency where the proposed decision is pending, before a person who was not directly involved in the initial determination of the action in question. The individual who initiated the action in dispute shall not conduct the local level dispute resolution conference. .22 The person designated to conduct the conference shall be in a position which, based on knowledge, experience, and training, would enable him to determine if the proposed action is valid. .23 Two or more county departments/service delivery agencies may establish a joint dispute resolution process. If two or more counties/service delivery agencies establish a joint process, the location of the conference need not be held in the county or agency taking the action, but the conference location shall be convenient to the applicant/recipient. .24 The local level conference may be conducted either in person or by telephone. A telephonic conference must be agreed to by the applicant/recipient. .25 The county/agency caseworker or other person who initiated the action in dispute, or another person familiar with the case, shall attend the local level conference and present the factual basis for the disputed action. .26 The local level dispute resolution conference shall be conducted on an informal basis. Every effort is to be made to assure that the applicant/recipient understands the county department/agency's specific reasons for the proposed action, and the applicable state department's rules, or county policy. In the event the applicant/recipient does not speak English, an interpreter shall be provided by the county department/agency. .27 The county/agency shall have available at the conference all documents and records in the case file pertinent to the specific action in dispute. 3.840.28 To the extent possible, the local dispute resolution conference shall be scheduled and conducted within the prior notice period. If the county department cannot conduct the conference within this period, for whatever reason, the adverse action shall be delayed and benefits continued until such conference can be held, unless continued benefits are waived by the individual.

The county department/local service agency shall provide reasonable notice to the individual of the scheduled date, time and location for the conference, or the date, time and call-in telephone number of the scheduled telephone conference. Notice should be in writing, however, verbal notice may be given to facilitate the dispute resolution process. 3.840.29 The county department may consolidate disputes with any other public assistance program if the facts are similar and consolidation will facilitate resolution of all disputes.

3.840.3 NOTICE OF DISPUTE RESOLUTION CONFERENCE DECISION

At the conclusion of the conference, the person presiding shall have the agreement entered into by the parties reduced to writing. Such agreement shall be signed by the parties and/or their representatives and shall be binding upon the parties. A copy of the written decision shall immediately be provided to the applicant/recipient and/or his representative. If the conference is held by telephone, the agreement need only be signed by the person presiding. A copy of the agreement will be promptly mailed or delivered to the other party(s). In the event the dispute is not resolved, the person presiding shall prepare a written statement indicating that the dispute was not resolved. 3.840.31 The decision shall include a statement explaining the applicant or recipient's right to request a state level fair hearing before an Administrative Law Judge, the time limit for requesting a state level hearing, and if appropriate, a statement that applicable benefits will continue pending a final state decision if appealed to the state within 10 calendar days from the date of the conference decision.

3.850 APPEAL AND STATE LEVEL FAIR HEARING

3.850.1 APPEAL AND STATE LEVEL FAIR HEARING

3.850.11 [REV. EFF. 9/15/12]

These rules apply to all state-level appeals of county department actions concerning child care assistance and benefits, social services, medical assistance eligibility, child welfare services, adult protective services, and child care, unless such actions have appeals procedures explicitly specified elsewhere in department rules/regulations. An affected individual who is dissatisfied with a county department action or the result of a county dispute resolution conference or failure to act concerning benefits may appeal to the office of administrative courts for a fair hearing before an administrative law judge. This will be a full evidentiary hearing of all relevant and pertinent facts to review the decision of the county department. The time limitations for submitting a request for an appeal are:

A. When the individual elects to avail himself of a county dispute resolution conference, but is dissatisfied with that decision, the request must be submitted in writing and mailed or delivered within ten (10) calendar days of the date the county dispute resolution conference decision was mailed or delivered to the applicant or recipient in order to receive continued benefits pending state appeal; otherwise, the ninety (90) day period specified in b, below, applies;

B. When the individual elects not to avail himself of a county dispute resolution conference but wishes to appeal directly to the state, a written request for an appeal must be mailed or delivered not later than 90 calendar days from the date prior notice of the proposed action was mailed to the person;

C. A request for an appeal must be mailed or delivered to the office of administrative courts. 3.850.12 Requests for state hearings may result from such reasons as:

A. The opportunity to make application or reapplication has been denied;

B. An application for assistance or services has not been acted upon within the maximum time period for the category of assistance;

C. The application for assistance has been denied, the benefit has been modified or discontinued, vendor payments have been initiated, requested reconsideration or a benefit amount deemed incorrect has been refused or delayed, payment has been delayed through the holding of payments, the county is demanding repayment for any

part of an award to a recipient or former recipient which the recipient does not believe is justified, or the applicant or recipient disagrees with the type or level of benefits or services provided. 3.850.13 the basic objectives and purposes of the appeal and state hearing process are:

A. To safeguard the interests of the individual applicant or recipient;

B. To provide a practical means by which the applicant or recipient is afforded a protection against incorrect action on the part of the representatives of the state or county departments;

C. To bring to the attention of the state department and county department information which may indicate need for clarification or revision of state and county policies and procedures;

D. To assure equitable treatment through the administrative process without resort to legal action in the courts. 3.850.14 Any clear expression in writing by the individual, or someone legally authorized to act for him, that he wants an opportunity to have a specific action of a county department reviewed by the state department is considered an appeal and a request for a hearing. The county department shall, when asked, aid the person in preparation of a request for a hearing. If the request for a hearing is made orally, the county department shall immediately prepare a written request for the individual's signature or have the recipient prepare such request, specifying the action on which the request is based and the reason for appealing that action. 3.850.15 The applicant/recipient is entitled to:

A. Be represented by an authorized representative, such as legal counsel, relative, friend, or other spokesman, or he may represent himself;

B. With the exception of the names of confidential informants, privileged communications between the county departments and its attorney, and the nature and status of pending criminal prosecutions, examine the complete case file and any other documents, records, or pertinent material to be used by the county at the hearing, at a reasonable time before the date of hearing and during the hearing. 3.850.16 The applicant/recipient, staff of the county department, and staff of the state department are entitled to:

A. Present witnesses;

B. Establish all pertinent facts and circumstances;

C. Advance any arguments without undue interference;

D. Question or refute any testimony or evidence, including opportunity to confront and crossexamine adverse witnesses.

3.850.2 AUTHORITY AND DUTIES OF STATE ADMINISTRATIVE LAW JUDGE

3.850.21 [REV. EFF. 9/15/12]

One or more persons from the state department of general support services/personnel, office of administrative courts, are appointed to serve as administrative law judges for the state department of human services. .22 The state administrative law judge shall, prior to the hearing, review the reasons for the decision under appeal and be prepared to interpret applicable departmental rules and/or official written county policies pertaining to the issue under appeal in preparation for conduct of the hearing. .23 For purposes of these rules, the terms “official written county policies governing the program area” or “county policies” are policies or amendments which have been formally adopted by the county board of commissioners in that county, subject to the requirements of state rules, state law, federal regulations, and federal law. Such policies include county plan submittals required by the state department.

The county shall forward copies of its policies and any subsequent amendments, including effective dates, to the state department and to the office of appeals. Individuals appealing a county action shall be provided reasonable opportunity to examine the county's policies. .24 When the applicant/recipient and/or the department are not represented by legal counsel, the administrative law judge shall assist in bringing forth all relevant evidence and issues relating to the appeal. This will include granting the right of either party to submit pertinent questions to the other pursuant to appropriate rules of civil procedure.

3.850.3 STATE RESPONSIBILITIES

3.850.31 [REV. EFF. 9/15/12]

Upon receipt by the office of administrative courts of an appeal request, it is assigned a number.

A hearing date is set at least ten (10) days in advance, and a letter by first class or certified mail is sent to the appellant and the county department notifying them of the date, time, and place of the hearing. The appellant is told that if these arrangements are not satisfactory to notify the office of administrative courts and, if good cause therefore exists, consideration will be given to changing them. An information sheet shall be enclosed to explain the hearing procedures to the appellant. The appellant is informed of his right to representation, that he or his representative has the right to examine all materials to be used at the hearing, before and during the hearing.

The appellant also is informed that failure to appear at the hearing as scheduled, without having secured a proper extension in advance, or without having shown good cause for failure to appear, shall constitute abandonment of the appeal and cause a dismissal thereof. Information which the appellant or his representative does not have an opportunity to see shall not be made a part of the hearing record or used in a decision on an appeal. No material made available for review by the administrative law judge may be withheld from review by the appellant or his representative. .32 In assistance payments and medical assistance eligibility appeals, the administrative law judge has 20 days from the hearing date to arrive at an initial decision. The initial decision shall not be implemented pending review by the office of appeals and entry of a final agency decision. All agency decisions on these appeals shall be made within ninety (90) days from the date of the request for hearing is received. .33 In all other appeals, the administrative law judge shall arrive at an initial decision (which is not to be implemented) within a reasonable timeframe. All final agency decisions on those matters shall also be made within a reasonable period of time. .34 Once the initial decision has been made, it shall immediately be delivered to the state department of human services, office of appeals, for determination of the final agency decision.

3.850.4 COUNTY RESPONSIBILITIES

3.850.41 [REV. EFF. 9/15/12]

When the applicant/recipient has had a local dispute resolution conference and wishes to appeal the county department's decision, the following procedures are to be followed:

A. As part of the local conference the applicant or recipient is informed that if he wishes to appeal to the office of administrative courts for a hearing, the county department will assist him in organizing the facts supporting his claim, if he so desires, and that he may have the opportunity to examine materials as described in the section concerning opportunity for state level fair hearing;

B. The county will forward a copy of the decision and a copy of the written notification given to the applicant/recipient of the proposed adverse action to the office of administrative courts.

3.850.42 [REV. EFF. 9/15/12]

When the applicant/recipient makes his/her appeal directly to the office of administrative courts, a copy of the notice to the appellant setting a date for the hearing is forwarded to the county department. Upon receipt by the county department, the county department prepares and mails a letter to the appellant with a copy to the office of administrative courts, no later than five (5) days prior to the hearing, giving the following information:

A. The reasons for the decision of the county department and specific explanation of each factor involved, such as the amount of excess property or income, assignment or transfer of property, residence factors, service needs;

B. The specific state rules and/or the official written county policy(s) on which the decision is based and numeric reference to each such rule, including the appropriate code of colorado regulations (ccr) cites;

C. Notice that the county department will assist him/her in organizing the facts supporting his/her claim, if s/he so desires, and that s/he may have the opportunity to examine regulations and other materials to be used at the hearing concerning the basis of the county decision.

3.850.43 [REV. EFF. 9/15/12]

If the appellant indicates that s/he desires to withdraw his/her appeal, a statement to that effect shall be obtained from him/her in writing and forwarded to the office of administrative courts. The county department shall also advise the office of administrative courts by telephone, as soon as it is ascertained that the appeal has been withdrawn and that the appellant will not attend the hearing.

3.850.44 [REV. EFF. 7/1/89]

If an individual who files an appeal is to be represented by legal counsel, or other representative, at the pending hearing, the county department will not discuss with the individual the merits of the appeal or the question of whether or not to proceed with it unless in the presence of, or with the permission of, such counsel or such other designated representative.

3.850.45 [REV. EFF. 7/1/89]

If the county department learns that the applicant or recipient will be represented by legal counsel, the county department shall make every effort to insure that it too is represented by an attorney at the hearing. The county department may be represented by an attorney in any other appeal that it considers such representation desirable.

3.850.46 [REV. EFF. 7/1/89]

If the appellant has a language difficulty, the county department shall arrange to have present at the hearing a qualified interpreter who will be sworn to translate correctly.

3.850.47 [REV. EFF. 9/15/12]

The fact that an appellant and the county department have been notified that a hearing will be held does not prevent the county department from reviewing the case and considering any new factors which might change the status of the case, taking such action as may be indicated to reverse its decision or otherwise settle the issue. Any change which results in a voiding of the cause of appeal shall be immediately reported to the office of administrative courts by telephone.

3.850.48 [REV. EFF. 7/1/89]

Upon receipt of notice of a state hearing on an appeal, the county department shall arrange for a suitable hearing room appropriate to accommodate the number of persons, including witnesses, who are expected to be in attendance, taking into consideration such factors as privacy; absence of distracting noise; need for table, chairs, electrical outlet, adequate lighting and ventilation, and conference telephone facilities.

3.850.5 CONDUCT OF STATE HEARINGS 3.850.50 Conference telephonic hearings may be conducted unless otherwise requested by any of the parties, as an alternative to face-to-face hearings. All applicable provisions of the face-to-face hearings procedures will apply, such as the right to be represented by counsel, the right to examine and cross-examine witnesses, the right to examine the contents of the case file, and the right to have the hearing conducted at a reasonable time and date. 3.850.51 The administrative law judge shall conduct the hearings in accordance with the colorado administrative procedure act (section 24-4-105, c.r.s.). 3.850.52 The county department shall have the burden of proof, by a preponderance of the evidence, to establish the basis of the ruling being appealed. Every party to the proceeding shall have the right to present his case or defense by oral and documentary evidence, to submit rebuttal evidence, and to conduct such cross-examination as may be required for a full and true disclosure of the facts. Subject to these rights and requirements, where a hearing will be expedited and the interests of the parties will not be subsequently prejudiced thereby, the administrative law judge may receive all or part of the evidence in written form or by oral stipulations.

3.850.6 PROCEDURE OF HEARING

3.850.61 PROCEDURE BEFORE ALJ [REV. EFF. 9/15/12]

The following provisions govern the procedure at state hearings before the administrative law judge:

A. The hearing is private; however, any person or persons whom the appellant wishes to appear for him may be present, and, if requested by the appellant and in the record, such hearing may be public;

B. The purpose of the hearing is to determine the pertinent facts in order to arrive at a fair and equitable decision in accordance with the rules of the state department. In arriving at a decision, only the evidence and testimony introduced at the hearing is considered, except that the administrative law judge may permit the introduction of medical or other evidence after the hearing, provided the opposing party is also furnished a copy and is afforded the opportunity to controvert or otherwise respond to such evidence, in circumstances when it is shown, at the hearing, that such evidence could not, for good cause, be obtained in time for the hearing. Delays in rendering the initial decision will be charged to the party requesting the delay;

C. Although the hearing is conducted on an informal basis and an effort is made to place all the parties at ease, it is essential that the evidence be presented in an orderly manner so as to result in an adequate record;

D. A complete and exact record of the proceedings shall be made by electronic or other means. When required, the office of administrative courts shall cause the proceedings to be transcribed. 3.850.62 When the administrative law judge dismisses an appeal for reasons other than failure to appear, the decision of the administrative law judge shall be an initial decision, which shall not be implemented pending review by the office of appeals and entry of an agency decision. 3.850.63 The administrative law judge shall not enter a default against any party for failure to file a written answer in response to the notice of hearing, but shall base the initial decision upon the evidence introduced at the hearing. An appellant may be granted a postponement of the hearing, however, if the county department has failed to provide the statement required by section 3.850.42 and the appellant has therefore been unable to prepare for the hearing.

3.850.64 [REV. EFF. 9/15/12]

When an appellant fails to appear at a duly scheduled hearing, having been given proper notice, without having given timely advance notice to the administrative law judge of acceptable good cause for inability to appear at the hearing at the time, date and place specified in the notice of hearing, then the appeal shall be considered abandoned and an order of dismissal shall be entered by the administrative law judge and served upon the parties by the office of administrative courts. The dismissal order shall not be implemented pending review by the office of appeals and entry of an agency decision.

The appellant, however, shall be afforded a ten-day period from the date the order of dismissal was mailed, during which the appellant may explain in a letter to the administrative law judge the reason for his/her failure to appear. If the administrative law judge then finds that there was acceptable good cause for the appellant not appearing, the administrative law judge shall vacate the order dismissing the appeal and reschedule another hearing date.

If the appellant does not submit a letter seeking to show good cause within the 10-day period, the order of dismissal shall be filed with the office of appeals of the state department. The office of appeals shall confirm the dismissal of the appeal by an agency decision, which shall be served upon the parties. The county department shall immediately carry out the necessary actions to provide assistance or services in the correct amount, to terminate assistance or services, to recover assistance incorrectly paid, and/or other appropriate actions in accordance with the rules.

If the appellant submits a letter seeking to show good cause and the administrative law judge finds that the stated facts do not constitute good cause, the administrative law judge shall enter an initial decision confirming the dismissal. The appellant may file exceptions to the initial decision pursuant to section 3.850.72, a.

3.850.65 INTERIM RELIEF (NOT APPLICABLE TO CHILD CARE ASSISTANCE PROGRAMS) 3.850.651

Upon written sworn application accompanied by appropriate financial statement, the appellant may, at any time prior to the hearing of an action concerning termination or reduction of assistance or services, apply for an agency order (the administrative law judge is designated as representing the agency in such matters) granting interim relief to prevent irreparable injury. The order, if made, shall continue in force until the final agency decision. The order shall contain a specific finding based upon evidence submitted to the administrative law judge that specified irreparable damage will result if the order is not granted. A copy of such decision shall be sent to the county department. In the event the final agency decision is against the appellant, recovery shall be considered for all funds expended under the order of interim relief subject to recovery rules. 3.850.652 The county department shall provide to the appellant the assistance or service specified in an agency order granting interim relief as soon as possible but not later than ten calendar days from the date of receipt of such order. 3.850.653 The appellant need not request interim relief if he/she is eligible for continued benefits pursuant to

section 3.800.34 of this staff manual.

3.850.7 DECISION AND NOTIFICATION

3.850.71 INITIAL DECISION

Following the conclusion of the hearing, the administrative law judge shall promptly prepare and issue an initial decision and file it with the office of appeals of the state department of human services.

The initial decision shall make an initial determination whether the county or state department or its agent acted in accordance with, and/or properly interpreted, the rules of the state department.

The administrative law judge may determine whether statutes were properly interpreted and applied only when no implementing state rules or county department policy exist. The administrative law judge has no jurisdiction or authority to determine issues of constitutionality or legality of departmental rules.

The initial decision shall advise the applicant/recipient that failure to file exceptions to provisions of the initial decision will waive the right to seek judicial review of a final agency decision which affirms those provisions.

The office of appeals shall promptly serve the initial decision upon each party by first class mail, and shall transmit a copy of the decision to the division of the state department which administers the program(s) pertinent to the appeal.

The initial decision shall not be implemented pending review by the office of appeals and entry of an agency decision.

3.850.72 REVIEW BY THE OFFICE OF APPEALS [REV. EFF. 9/15/12]

The office of appeals of the state department, as the designee of the executive director, shall review the initial decision of the administrative law judge and shall enter a final agency decision affirming, modifying, reversing, or remanding the initial decision.

A. Any party seeking an agency decision which reverses, modifies, or remands the initial decision of the administrative law judge shall file exceptions to the decision with the state department, office of appeals, within fifteen (15) days (plus three days for mailing) from the date the initial decision is mailed to the parties. Exceptions must state specific grounds for reversal, modification or remand of the initial decision.

If the party asserts that the administrative law judge's findings of fact are not supported by the weight of the evidence, the party shall simultaneously with or prior to the filing of exceptions request the office of administrative courts to cause a transcript of all or a portion of the hearing to be prepared and filed with the office of appeals. The exceptions shall state that a transcript has been requested, if applicable. Within 5 days of the request for transcript, the party requesting it shall advance the cost therefore to the transcriber designated by the office of administrative courts unless prior payment is waived by the transcriber.

A party who is unable because of indigency to pay the cost of a transcript may file a written request, which need not be sworn, with the office of appeals for permission to submit a copy of the hearing recording instead of the transcript. If submission of a recording is permitted, the party filing exceptions must promptly request a copy of the recording from the office of administrative courts and deliver it to the office of appeals.

Payment in advance shall be required for the preparation of a copy of the recording.

If the exceptions do not challenge the findings of fact, but instead assert only that the administrative law judge improperly interpreted or applied state rules or statutes, the party filing exceptions is not required to provide a transcript or recording to the office of appeals.

The office of appeals shall serve a copy of the exceptions on each party by first class mail. Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties in which to file a written response to such exceptions. The office of appeals shall not permit oral argument.

The office of appeals shall not consider evidence which was not part of the record before the administrative law judge. However, the case may be remanded to the administrative law judge for rehearing if a party establishes in its exceptions that material evidence has been discovered which the party could not with reasonable diligence have produced at the hearing.

While review of the initial decision is pending before the office of appeals, the record on review, including any transcript or recording of testimony filed with the office of appeals, shall be available for examination by any party at the office of appeals during regular business hours.

B. The division(s) of the state department responsible for administering the program(s) relevant to the appeal may file exceptions to the initial decision, or respond to exceptions filed by a party, even though the division has not previously appeared as a party to the appeal. The division's exceptions or responses must be filed in compliance with the requirements of 3.850.72, a, above. Exceptions filed by a division that did not appear as a party at the hearing shall be treated as requesting review of the initial decision upon the state department's own motion.

C. In the absence of exceptions filed by any party or by a division of the state department of human services, the office of appeals shall review the initial decision, and may review the hearing file of the administrative law judge and/or the recorded testimony of witnesses, before entering a final agency decision. Review by the office of appeals shall determine whether the decision properly interprets and applies the rules of the state department, or relevant statutes, and whether the findings of fact and conclusions of law support the decision. If a party or division of the state department objects to the agency decision entered upon review by the office of appeals, the party or division may seek reconsideration pursuant to section 3.850.73, below.

D. The office of appeals shall mail copies of the final agency decision to all parties by first class mail.

E. For purposes of requesting judicial review, the effective date of the final agency decision shall be the third day after the date the decision is mailed to the parties, even if the third day falls on saturday, sunday, or a legal holiday. The parties shall be advised of this in the agency decision.

F. The state or county department shall initiate action to comply with the final agency decision within three working days after the effective date. The department shall comply with the decision even if reconsideration is requested, unless the effective date of the agency decision is postponed by order of the office of appeals or a reviewing court.

3.850.73 RECONSIDERATION OF AGENCY DECISION

A motion for reconsideration of a final agency decision may be granted by the office of appeals for the following reasons:

A. Upon a showing of good cause for failure to file exceptions to the initial decision within the 15 day period allowed by section 3.850.72, a; or B. Upon a showing that the agency decision is based upon a clear or plain error of fact or law. An error of law means failure by the office of appeals to follow a rule, statute, or court decision which controls the outcome of the appeal.

No motion for reconsideration shall be granted unless it is filed in writing with the office of appeals within 15 days of the date that the agency decision is mailed to the parties. The motion must state specific grounds for reconsideration of the agency decision.

The office of appeals shall mail a copy of the motion for reconsideration to each party of record and to the appropriate division of the state department. 3.850.74 When an appeal results in a decision that an action of the county or state department was not in accordance with rules of the department, or when the county or state department so determines after a request for a hearing is made, the adjustment or corrective payment is made retroactively to the date of the incorrect action.

3.850.75 [REV. EFF. 9/15/12]

The applicant/recipient is to be fully informed by the final agency decision of his further right to apply for judicial review of the agency decision by the filing of an action for review in the appropriate state district court. Any such action must be filed in accordance with the rules of civil procedure for courts of record in colorado within thirty five (35) days after the final agency decision becomes effective. 3.850.76 The state department will establish and maintain a method for informing, in summary and depersonalized form, all county departments and other interested persons conceming the issues raised and decisions made on appeals. 3.850.77 The executive director or designee shall have the power to enter declaratory orders. The executive director or designee may, in his/her discretion, entertain and promptly dispose of petitions for declaratory orders to terminate controversies and/or remove uncertainties as to the applicability to the petitioners of any statutory provisions or of any rule. The order of the executive director or designee disposing of the petition shall constitute final agency action subject to judicial review.

3.850.8 GROUP HEARINGS AND EXCEPTIONS .81 When a number of individual requests for hearing are received and if the sole issue involved is one of state or federal law or changes in state or federal law, a single group hearing may be conducted. In all group hearings, the policies governing hearings must be followed. Each individual shall be permitted to present his own case or be represented by his authorized representative and is entitled to receive a copy of the written decision. .82 A hearing shall not be granted when either state or federal law requires an automatic benefit adjustment for classes of recipients unless the sole reason for an individual appeal is incorrect benefit computation. Furthermore, a hearing shall not be granted when either state or federal law requires or results in a reduction or deletion of a benefit. .83 Unless properly designated as a representative of an individual, a provider of assistance, or any other provider of goods and services to applicants or recipients, shall not be granted a hearing concerning an alleged adverse action to an applicant or recipients.

3.850.9 PROVIDER APPEALS

In the case of an appeal by a licensed or certified provider or vendor of services of an adverse action by a county department or the state department related to provider status, rates, or purchased services, the decision of the Administrative Law Judge is a final agency decision and is not subject to state department review or modification. The decision of the Administrative Law Judge is subject to judicial review, pursuant to 24-4-106 and 26-1-106, C.R.S. _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.000-3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, COLORADO CHILD CARE ASSISTANCE PROGRAM.

History Rules 3.800.51-52, 3.810.13, 3.830.22-24, 3.840.12, 3.850.11, 3.850.21, 3.850.31, 3.850.41-43, 3.850.47, 3.850.61, 3.850.64, 3.850.72, 3.850.75, eff. 09/15/2012. Rules 3.800.53-54, 3.800.6, 3.810.6-3.810.62, 3.811-3.811.57 repealed eff. 09/15/2012.

Rule 3.800.7 eff. 01/01/2016.

Rules 3.840.11, 3.840.14-15, 3.840.22, 3.840.27-29, 3.840.3, 3.840.31, 3.850.11, 3.850.2-3.850.4, 3.850.50, 3.850.6-3.850.9, eff. 03/01/2020. Rules 3.800-3.830.31, 3.850.23, 3.850.65, 3.860- 3.880 repealed eff. 03/01/2020.

Rules 3.850.1-3.850.77 emer. rules eff. 04/03/2020.

Rules 3.850.1-3.850.77 eff. 07/01/2020.

##### **9 CCR 2503-9** COLORADO CHILD CARE ASSISTANCE PROGRAM RULES AND REGULATIONS [Repealed eff. 07/30/2024] {#sec-9-ccr-2503-9 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-9}

DEPARTMENT OF HUMAN SERVICES

Income Maintenance (Volume 3)

COLORADO CHILD CARE ASSISTANCE PROGRAM - Repealed eff. 07/30/2024 9 CCR 2503-9 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ NOTE: COLORADO CHILD CARE ASSISTANCE PROGRAM RULES AS PROMULGATED BY THE COLORADO DEPARTMENT OF EARLY CHILDHOOD MAY BE FOUND AT 8 CCR 1403-1. _________________________________________________________________________ Editor’s Notes Primary sections of 9 CCR 2503-1 have been recodified effective 09/15/2012. See list below. Versions and rule history prior to 09/15/2012 can be found in 9 CCR 2503-1. Prior versions can be accessed from the All Versions list on the current rule page.

Rule section 3.100, et seq. has been recodified as 9 CCR 2503-1, (Reserved for Future Use).

Rule section 3.200, et seq. has been recodified as 9 CCR 2503-2, (Reserved for Future Use).

Rule section 3.300, et seq. has been recodified as 9 CCR 2503-3, COLORADO REFUGEE SERVICES PROGRAM (CRSP).

Rule section 3.400, et seq. has been recodified as 9 CCR 2503-4, (Reserved for Future Use).

Rule section 3.500, et seq. has been recodified as 9 CCR 2503-5, ADULT FINANCIAL PROGRAMS.

Rule section 3.600, et seq. has been recodified as 9 CCR 2503-6, COLORADO WORKS PROGRAM.

Rule section 3.700, et seq. has been recodified as 9 CCR 2503-7, LOW-INCOME ENERGY ASSISTANCE PROGRAMS (LEAP).

Rule section 3.800, et seq. has been recodified as 9 CCR 2503-8, ADMINISTRATIVE PROCEDURES FOR THE COLORADO CHILD CARE ASSISTANCE PROGRAM.

Rule section 3.900, et seq. has been recodified as 9 CCR 2503-9, (Repealed eff. 07/30/2024).

History Rules 3.905-3.905.A, 3.905.B.10-11, 3.910, 3.919, 3.919.F-3.919.H.1 eff. 11/01/2013.

Rules 3.905-3.905.B.10 eff. 10/01/2014.

Rules 3.901-3.903, 3.904.1.A-3.904.1.B, 3.905, 3.908.1, 3.909-3.910, 3.913, 3.915.2-3.915.3, 3.919, 3.921.D-3.921.E eff. 12/01/2014.

Rules 3.905.B.12-13 eff. 10/01/2015.

Rules 3.905, 3.905.B.12 emer. rules eff. 12/04/2015.

Rules 3.905, 3.905.B.12 eff. 03/01/2016.

Rules 3.903, 3.905.B.2.f, 3.905.B.14, 3.910.F, 3.913.CCC- FFF, 3.919.E.3.d, 3.919.I.3.a, 3.919.I.3.e, 3.921.A.4 emer. rules eff. 05/06/2016.

Rules 3.903, 3.905.B.2.f, 3.905.B.14, 3.910.F, 3.913.CCC- FFF, 3.919.E.3.d, 3.919.I.3.a, 3.919.I.3.e, 3.921.A.4 eff. 09/01/2016.

Entire rule eff. 09/30/2016.

Entire rule eff. 01/01/2018.

Rules 3.903, 3.905.1 H, 3.910 P emer. rules eff. 06/01/2018; expired 09/29/2018.

Income Maintenance Entire rule eff. 09/30/2018.

Rule 3.905.1 H.2 emer. rule eff. 11/02/2018.

Rule 3.905.1 H.2 eff. 02/01/2019.

Entire rule eff. 07/01/2019.

Rule 3.905.1 H.2 emer. rule eff. 10/01/2019.

Rule 3.905.1 H.2 eff. 12/30/2019.

Rules 3.903, 3.911 H.8, 3.911 I emer. rules eff. 05/08/2020.

Rule 3.911 emer. rule eff. 08/01/2020.

Rules 3.903, 3.911.H.8, 3.911 I eff. 08/14/2020.

Entire rule eff. 10/01/2020.

Rule 3.911 eff. 07/01/2021.

Rule 3.915.1 E emer. rule eff. 08/01/2021.

Rule 3.915.1 E eff. 09/30/2021.

Rule 3.905.1 H emer. rule eff. 10/01/2021.

Rule 3.905.1 H eff. 11/30/2021.

Rules 3.903, 3.905.1 C.2, 3.905.1 F.1, 3.905.2 H, 3.905.3 A, 3.906.1 F-L, 3.906.2 B, 3.907, 3.907.1 F, 3.908, 3.909 B.5, 3.912 V-FF, TT-NNN, 3.914.1 B.2, 3.915.2 eff. 07/01/2022.

Entire rule repealed eff. 07/30/2024.

##### **9 CCR 2503-10** Energy-Electronic Benefit Transfer (e-Ebt) {#sec-9-ccr-2503-10 omnilex-key=us-co-regs-official--department-9--9 CCR 2503-10}

DEPARTMENT OF HUMAN SERVICES

ENERGY-ELECTRONIC BENEFIT TRANSFER (E-EBT)

9 CCR 2503-10 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 3.10.00 ENERGY-ELECTRONIC BENEFIT TRANSFER (E-EBT)

3.10.10 E-EBT DEFINITIONS

“Client” means a current or past recipient of SNAP.

“Colorado Electronic Benefit Transfer System (CO/EBTS)” means the electronic system that enables SNAP participants or their authorized representatives to redeem their SNAP and E-EBT benefits at pointof-sale terminals.

“EBT account” means the account linked to the EBT card where the state department deposits benefits.

“EBT card” means the card issued to persons authorized to receive benefits to which the household’s allotment is credited.

“Energy Electronic Benefit Transfer Benefit (E-EBT Benefit)” means the fuel assistance payment to eligible SNAP households of at least $20.01 that qualifies those households for the heating and cooling standard utility allowance.

“Heating/Cooling Utility Allowance (HCUA)” means a fixed deduction applied to any household that incurs a heating or cooling expense.

“Household” means a group of individuals who live together and customarily purchase and prepare food together for home consumption.

“Low-Income Home Energy Assistance Program (LEAP)” means the Colorado program designed to help low-income clients pay a portion of their winter heating costs.

“Periodic Report Form (PRF)” means the report that must be submitted by the household during the twelfth (12th) month of a twenty-four (24) month certification period. The purpose of this form is to allow the household to report any changes that occurred during the first half of the twenty-four (24) month certification period and for the state department to determine the household’s continued eligibility for the remaining twelve (12) months of the household’s certification period.

“Person experiencing homelessness” means an individual who lacks a fixed and regular nighttime residence or whose primary residence is: a supervised shelter designed for temporary accommodations; a halfway house or similar facility that provides temporary residence; a place not designed for or ordinarily used as regular sleeping accommodations for human beings; or a temporary accommodation in the residence of another individual for ninety (90) days or less.

“Public assistance (PA)” means the same as section 26-2-103(7), C.R.S.

“SNAP” means Supplemental Nutrition Assistance Program, formerly known as the Food Assistance program, administered by the state department in Colorado.

“State department” means the office/division within the Colorado Department of Human Services that administers E-EBT. Currently, this is the Food and Energy Assistance Division within the Office of Economic Security.

3.10.20 OVERVIEW AND REQUIREMENTS 3.10.20.1 Purpose of E-EBT The state department shall make the fuel assistance payments to eligible households that receive SNAP benefits but that do not receive assistance under LEAP in order to qualify those households for the standard utility allowance to maximize their SNAP benefits.

The rules and regulations herein are promulgated in accordance with Program regulations of the United States Department of Agriculture (USDA), 7 U.S.C.A. § 2014(e)(6)(C)(iv):

Subject to subclause (II), a State agency elects to use a standard utility allowance that reflects heating and cooling costs, the standard utility allowance shall be made available to households that received a payment, or on behalf of which a payment was made, under the Low-Income Home Energy Assistance Act of 1981 (42 U.S.C. § 8621 et seq.) or other similar energy assistance program, if in the current month or in the immediately preceding 12 months, the household either received such a payment, or such a payment was made on behalf of the household, that was greater than $20 annually, as determined by the Secretary. 3.10.20.2 E-EBT Benefit Amount The E-EBT benefit is a cash payment of at least $20.01. All eligible SNAP households receive the standard benefit amount regardless of income, expenses, household size, or living arrangement. The E- EBT benefit amount may be adjusted annually on October 1st based on available funding. 3.10.20.3 Program Eligibility Requirements There is no application for the E-EBT program.

A. A household is automatically eligible to receive the E-EBT benefit if they meet all of the following criteria:

1. The household is determined to be eligible for SNAP and is currently receiving SNAP benefits;

2. The household has not received LEAP at any address in the previous 12 months; and 3. The household has not received E-EBT at any address in the previous 12 months.

B. Households containing persons experiencing homelessness are eligible for E-EBT if they meet the above three requirements.

C. Verification of utility expenses is not required.

3.10.30 BENEFIT ISSUANCE

A. Electronic benefit issuance shall be handled by the state department through the Colorado Electronic Benefit Transfer System (CO/EBTS).

B. The E-EBT benefit shall be issued onto the household’s existing EBT card through the EBT account where SNAP benefits are issued.

C. If a SNAP household already receives cash assistance from another state public assistance program, then the E-EBT benefit shall be issued through the same payment mechanism as the other cash assistance. 3.10.30.1 Initial Benefit Issuance All eligible SNAP households shall be issued their initial E-EBT benefit upon implementation of the program. In the same month that a household is determined eligible for E-EBT, the household shall be eligible for the HCUA in their SNAP budget.

After the initial benefit issuance, the eligibility of households for E-EBT will be determined at the time of their SNAP application, recertification, or periodic report. 3.10.30.2 Ongoing Benefit Issuance At the time of SNAP application, recertification, or periodic report, it shall be confirmed if the household has received LEAP in the previous 12 months.

If the household has not received LEAP in the previous 12 months and also has not received E-EBT in the previous 12 months, they shall be determined eligible for the E-EBT benefit. In the same month that a household is determined eligible for E-EBT, the household shall be eligible for the HCUA in their SNAP budget.

3.10.40 NORMAL PROCESSING STANDARDS

Determination of eligibility occurs at the time of SNAP application, recertification, or periodic report. Upon approval of benefits, E-EBT recipients shall be notified by the state department with the following information:

A. The amount of the household's E-EBT benefit;

B. The EBT card point of sale limitations as listed in section 26-2-104(2), C.R.S.; and C. The timelines for expungement as listed in 3.10.60.

3.10.50 USING E-EBT BENEFITS

A. The state department shall not:

1. Impose any restriction, either direct or implied, on a client’s use of their benefit payment including, but not limited to, requesting a client to provide receipts or proof of how the money has been spent;

2. Require the client to account for the use of the benefit payment, except for the Electronic Benefit Transfer (EBT) card point of sale limitations listed in 26-2-104(2), C.R.S.; or 3. Give assistance to creditors in the collection of the client’s debts.

B. Clients shall not be allowed to access the E-EBT benefit through the Electronic Benefit Transfer services from automated teller machines and point of sale (POS) devices as described in Section 26-2-104(2)(II)(A), (B), (C), (D), and (E), C.R.S.

3.10.60 EXPUNGEMENT

Any E-EBT benefits issued to the EBT account that are unused after 274 days from the date of issuance will be expunged and removed from the account.

3.10.70 ERRONEOUS PAYMENTS

E-EBT payments received during a time period in which the household was later determined to not be eligible for SNAP are not considered erroneous payments and will not be collected. _________________________________________________________________________ Editor’s Notes

History New rule emer. rule eff. 07/01/2024.

Entire rule eff. 08/30/2024.

## **2504** Child Support Services (Volume 6)

##### **9 CCR 2504-1** Rule Manual Volume 6, Child Support Services Rules {#sec-9-ccr-2504-1 omnilex-key=us-co-regs-official--department-9--9 CCR 2504-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 6, CHILD SUPPORT SERVICES RULES

9 CCR 2504-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, AND, SPECIFIC STATUTORY AUTHORITY OF REVISIONS

MADE TO THE CHILD SUPPORT SERVICES STAFF MANUAL

A rewrite of staff manual Volume 6, (Child Support Enforcement) was finally adopted at the 11/1/85 State Board meeting, with an effective date of 1/1/86. Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to section 6.201.2 - 6.210.4 were finally adopted following publication at the 9/11/87 State Board meeting, with an effective date of 11/1/87 (Document 17). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to section 6.201.2 were finally adopted following publication at the 12/4/87 State Board meeting, with an effective date of 2/1/88 (Document 3). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.200 - 6.201 were finally adopted following publication at the 1/8/88 State Board meeting, with an effective date of 3/1/88 (Document 5). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.101 - 6.102 and 6.240 - 6.260 were emergency adopted at the 7/8/88 State Board meeting, with an effective date of 8/22/88 (CSPR# 88-4-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.101 - 6.102 and 6.240 - 6.260 were finally adopted emergency at the 8/5/88 State Board meeting, with an effective date of 8/22/88 (CSPR# 88-4-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.000 - 6.002, 6.200 - 6.210, and 6.260 - 6.270 were emergency adopted at the 9/9/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-6-7-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.000 - 6.002, 6.200 - 6.210, and 6.260 - 6.270 were final adoption of emergency at the 10/7/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-6-7-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.700 - 6.802 and 6.803 - 6.902 were finally adopted following publication at the 10/7/88 State Board meeting, with an effective date of 12/1/88 (CSPR# 88-8-12-3). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.000 - 6.002, 6.201 - 6.210, and 6.260 - 6.270 were finally adopted following publication at the 11/4/88 State Board meeting, with an effective date of 1/1/89 (CSPR#'s 88-6-28-3, and 88-8-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.100 - 6.102, 6.260 - 6.300, 6.500 - 6.600 and 6.804 - 6.805 were finally adopted following publication at the 2/3/89 State Board meeting, with an effective date of 4/1/89 (CSPR#'s 88-8- 30-1, 88-10-6-1 and 88-10-14-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to sections 6.000, 6.102, 6.200 - 6.201, 6.240 - 6.270, 6.400, 6.700 - 6.802, 6.803 - 6.804 and 6.805 - 6.902 were finally adopted following publication at the 3/3/89 State Board meeting, with an effective date of 5/1/89 (CSPR#'s 88-9-13-1, 88-11-18-1 and 88-11-18-2). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.260 - 6.270 were emergency adopted at the 4/7/89 State Board meeting, with an effective date of 5/1/89 (CSPR# 88-10-25-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.260 - 6.270 were final adoption of emergency at the 5/5/89 State Board meeting, with an effective date of 5/1/89 (CSPR# 88-10-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions and additions to sections 6.000 - 6.002, 6.201 - 6.210, and 6.260 were finally adopted following publication at the 6/2/89 State Board meeting, with an effective date of 8/1/89 (CSPR# 89-3-13-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.120 - 6.140 and 6.805 - 6.902 were finally adopted following publication at the 7/7/89 State Board meeting, with an effective date of 9/1/89 (CSPR#'s 89-1-11-1 and 89-2-17-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to section 6.200 - 6.201.2 were finally adopted following publication at the 8/4/89 State Board meeting, with an effective date of 10/1/89 (CSPR# 89-5-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.100 - 6.102, 6.803 - 6.804, and 6.900 - 6.902 were adopted emergency at the 8/4/89 State Board meeting, with an effective date of 8/4/89 (CSPR# 89-6-9-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.100 - 6.102, 6.803 - 6.804, and 6.900 - 6.902 were final adoption of emergency at the 9/8/89 State Board meeting, with an effective date of 8/4/89 (CSPR# 89-6-9-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Addition of sections 6.701 through 6.715.3 were final adoption following publication at the 2/2/90 State Board meeting, with an effective date of 4/1/90 (CSPR# 89-9-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.000 - 6.002 and 6.250 - 6.260 were adopted emergency at the 6/1/90 State Board meeting, with an effective date of 6/1/90 (CSPR# 90-5-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.000 - 6.002 and 6.250 - 6.260 were final adoption of emergency at the 7/6/90 State Board meeting, with an effective date of 6/1/90 (CSPR# 90-5-15-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.701 - 6.715 and 6.804 - 6.805 were adopted emergency at the 7/6/90 State Board meeting, with an effective date of 7/6/90 (CSPR#'s 90-6-4-1a and 90-6-6-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.000 - 6.101, 6.120 - 6.130, 6.200 - 6.201, 6.240 - 6.260, 6.270 - 6.300, 6.400 - 6.700, 6.800 - 6.803, and 6.804 - 6.902 were final adoption following publication at the 8/3/90 State Board meeting, with an effective date of 10/1/90 (CSPR#'s 90-3-15-2, 90-3-20-2, and 90-3-23-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.701 - 6.715 and 6.804 - 6.805 were adopted emergency and final at the 8/3/90 State Board meeting, with an effectives date of 7/6/90 and 8/3/90 (CSPR#'s 90-6-4-1a and 90-6-6-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.201, 6.260, and 6.600 - 6.700 were adopted emergency at the 10/5/90 State Board meeting, with an effective date of 10/5/90 (CSPR#'s 90-6-27-1 and 90-8-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.201 and 6.600 - 6.700 were final adoption of emergency at the 11/2/90 State Board meeting, with an effective date of 10/5/90 (CSPR# 90-6-27-1). Revisions to section 6.260 were adopted emergency and final at the 11/2/90 State Board meeting, with effective dates of 10/5/90 and 11/2/90 (CSPR# 90-8-13-1).Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to section 6.260 were adopted emergency at the 1/4/91 State Board meeting, with an effective date of 1/4/91 (CSPR# 90-11-29-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to section 6.260 were final adoption of emergency at the 2/1/91 State Board meeting, with an effective date of 1/4/91 (CSPR# 90-11-29-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.120 through 6.140 and 6.270 through 6.300 were final adoption following publication at the 2/1/91 State Board meeting, with an effective date of 4/1/91 (CSPR# 90-11-9-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.260, 6.701 - 6.707, 6.710 - 6.711, and 6.713 - 6.715 were final adoption following publication at the 5/3/91 State Board meeting, with an effective date of 7/1/91 (CSPR# 91-1-22-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.102 through 6.110 were final adoption following publication at the 8/2/91 State Board meeting, with an effective date of 10/1/91 (CSPR# 91-4-23-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.000 - 6.102, 6.803 and 6.805 were adopted emergency at the 1/10/92 State Board meeting, with an effective date of 1/10/92 (CSPR# 91-12-4-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.120 - 6.140 and 6.270 - 6.300 were final adoption following publication at the 1/10/92 State Board meeting, with an effective date of 3/1/92 (CSPR#'s 91-7-10-2, and 91-10-7-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.000 - 6.102, 6.803 and 6.805 were adopted emergency and final at the 1/10/92 State Board meeting, with effective dates of 1/10/92 and 2/7/92 (CSPR# 91-12-4-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.600 through 6.603 and 6.711 through 6.715 were adopted emergency at the 7/10/92 State Board meeting, with an effective date of 8/1/92 (CSPR# 92-5-28-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.600 through 6.603 and 6.711 through 6.715 were final adoption of emergency at the 8/7/92 State Board meeting, with an effective date of 8/1/92 (CSPR# 92-5-28-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.002, 6.102, 6.200 - 6.201, 6.230, 6.260, 6.400 - 6.706, 6.800 - 6.803, 6.804, 6.805 and 6.903 were final adoption following publication at the 8/7/92 State Board meeting, with an effective date of 10/1/92 (CSPR# 91-12-3-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.710 - 6.711, 6.713 - 6.715, 6.804, and 6.805 were adopted emergency at the 8/7/92 State Board meeting, with effective dates of 8/1/92 and 8/7/92 (CSPR#'s 92-6-12-1 and 92-6-17- 1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.710 - 6.711, 6.713 - 6.715, 6.804, and 6.805 were final adoption of emergency at the 9/4/92 State Board meeting, with effective dates of 8/1/92 and 8/7/92 (CSPR#'s 92-6-12-1 and 92-6- 17-1, respectively). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.102 and 6.803 were adopted emergency at the 10/2/92 State Board meeting, with an effective date of 10/2/92 (CSPR# 92-8-7-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.102 and 6.803 were final adoption of emergency at the 11/6/92 State Board meeting, with an effective date of 10/2/92 (CSPR# 92-8-7-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.002, 6.500 - 6.506, 6.710 - 6.711, 6.805, and 6.900 - 6.902 were adopted emergency at the 11/6/92 State Board meeting, with an effective date of 11/6/92 (CSPR# 92-9-16-1 and 92-9-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.002, 6.500 - 6.506, 6.710 - 6.711, 6.805, and 6.900 - 6.902 were final adoption of emergency at the 12/4/92 State Board meeting, with an effective date of 11/6/92 (CSPR# 92-9-16-1 and 92-9-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 6.803 were final adoption following publication at the 2/5/93 State Board meeting, with an effective date of 4/1/93 (CSPR# 92-11-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 6.710 - 6.715 and 6.900 - 6.902 were adopted emergency at the 4/2/93 State Board meeting, with an effective date of 4/2/93 (CSPR# 93-2-23-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 6.710 - 6.715 and 6.900 - 6.902 were final adoption of emergency at the 5/7/93 State Board meeting, with an effective date of 4/2/93 (CSPR# 93-2-23-2). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.000 - 6.002, 6.240 - 6.260 and 6.712 - 6.715 were final adoption following publication at the 5/7/93 State Board meeting, with an effective date of 7/1/93 (CSPR# 92-12-17-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to section 6.700 were adopted emergency and final at the 7/9/93 State Board meeting, with an effective date of 7/9/93 (CSPR# 93-4-26-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.110, 6.201, 6.230, and 6.600 - 6.603 were final adoption following publication at the 10/1/93 State Board meeting, with an effective date of 12/1/93 (CSPR# 93-7-9-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 6.260, 6.701 - 6.702 and 6.711 - 6.715 were final adoption following publication at the 12/3/93 State Board meeting, with an effective date of 2/1/94 (CSPR# 93-9-2-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to section 6.210 were adopted emergency at the 1/7/94 State Board meeting, with an effective date of 1/7/94 (CSPR# 93-10-26-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to section 6.210 were final adoption of emergency at the 2/4/94 State Board meeting, with an effective date of 1/7/94 (CSPR# 93-10-26-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department Revisions to sections 6.205 - 6.207 and 6.240 - 6.260 were final adoption following publication at the 6/3/94 State Board meeting, with an effective date of 8/1/94 (CSPR# 93-12-28-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 6.000 - 6.102, 6.230 - 6.250, 6.261, 6.600 - 6.702, and 6.712 - 6.715 were adopted emergency at the 7/8/94 State Board meeting, with an effective date of 7/1/94 (CSPR# 94-5-23-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.000 - 6.102, 6.230 - 6.250, 6.261, 6.600 - 6.702, and 6.712 - 6.715 were final adoption of emergency at the 8/5/94 State Board meeting, with an effective date of 7/1/94 (CSPR# 94-5- 23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 6.000 - 6.002, 6.110 - 6.260, 6.261 - 6.603, 6.707 - 6.715, 6.804 - 6.805, and 6.903 were final adoption following publication at the 8/5/94 State Board meeting, with an effective date of 10/1/94 (CSPR# 94-3-3-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 6.230 and 6.261 were final adoption following publication at the 12/2/94 State Board meeting, with an effective date of 2/1/95 (CSPR# 94-9-7-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Revisions to sections 6.002, 6.201, 6.220, 6.600 - 6.700, 6.707 - 6.710, and 6.711 - 6.715 were final adoption following publication at the 3/3/95 State Board meeting, with an effective date of 5/1/95 (CSPR# 94-12-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 6.803 and 6.805 were adopted emergency at the 3/3/95 State Board meeting, with an effective date of 4/7/95 (CSPR# 95-2-15-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Revisions to sections 6.803 and 6.805 were final adoption of emergency at the 5/5/95 State Board meeting, with an effective date of 4/7/95 (CSPR# 95-2-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to sections 6.002 - 6.101, 6.110, 6.201, 6.205, 6.240 - 6.250, 6.261, and 6.701 - 6.715 were final adoption following publication at the 5/5/95 State Board meeting, with an effective date of 7/1/95 (CSPR# 95-2-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 6.600 through 6.700 were adopted emergency at the 6/2/95 State Board meeting, with an effective date of 6/2/95 (CSPR# 95-4-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Revisions to sections 6.600 through 6.700 were adopted emergency and final at the 7/7/95 State Board meeting, with effective dates of 6/2/95 and 7/7/95 (CSPR# 95-4-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to sections 6.002, 6.220, 6.261, 6.707 - 6.711, and 6.712 - 6.715 were final adoption following publication at the 10/6/95 State Board meeting, with an effective date of 12/1/95 (CSPR# 95-7-11-2).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 6.002, 6.101, 6.700 - 6.702, and 6.802 - 6.803 were final adoption following publication at the 11/3/95 State Board meeting, with an effective date of 1/1/96 (CSPR#'s 95-4-12-1 and 95-8-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 6.110 and 6.600 - 6.603 were final adoption following publication at the 12/1/95 State Board meeting, with an effective date of 2/1/96 (CSPR# 95-9-14-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of Revisions to the Table of Contents and sections 6.002, 6.260, and 6.600 - 6.700 were final adoption following publication at the 1/5/96 State Board meeting, with an effective date of 3/1/96 (CSPR# 95-10-5- 1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the Table of Contents and sections 6.210 - 6.220 and 6.700 were final adoption following publication at the 2/2/96 State Board meeting, with an effective date of 4/1/96 (CSPR#'s 95-9-22-1 and 95-11-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the sections 6.100 - 6.102, 6.210, and 6.805 were final adoption following publication at the 6/7/96 State Board meeting, with an effective date of 8/1/96 (CSPR# 96-3-20-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of Revisions to the sections 6.002, 6.101 - 6.102, 6.110, 6.201 - 6.205, 6.210 - 6.220, 6.261, 6.700, 6.707 - 6.715, 6.805, and 6.900 - 6.903 were adopted emergency at the 6/7/96 State Board meeting, with an effective date of 7/1/96 (CSPR# 96-5-8-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Revisions to the sections 6.002, 6.101 - 6.102, 6.110, 6.201 - 6.205, 6.210 - 6.220, 6.261, 6.700, 6.707 - 6.715, 6.805, and 6.900 - 6.903 were final adoption of emergency at the 7/12/96 State Board meeting, with an effective date of 7/1/96 (CSPR# 96-5-8-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Revisions to the sections 6.000 - 6.002, 6.110, 6.201 - 6.205, 6.230 - 6.250, 6.260 - 6.261, 6.270 - 6.400, 6.600 - 6.710, and 6.711 - 6.715 were final adoption following publication at the 8/2/96 State Board meeting, with an effective date of 10/1/96 (CSPR# 96-4-11-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to the sections 6.002, 6.110, 6.210 - 6.220, 6.261, 6.700, 6.710 - 6.712, and 6.903 were final adoption following publication at the 12/6/96 State Board meeting, with an effective date of 2/1/97 (CSPR# 96-9-16-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the sections 6.002, 6.110, 6.210 - 6.220, 6.261, 6.700, 6.710 - 6.712, and 6.903 were repromulgated final adoption following publication at the 3/7/97 State Board meeting, with an effective date of 5/1/97 (CSPR# 96-9-16-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the sections 6.200 through 6.201, 6.230, and 6.260, 6.261, 6.400 through 6.702, 6.900 through 6.902, and 6.903 were final adoption following publication at the 5/2/97 State Board meeting, with an effective date of 7/1/97 (CSPR# 97-2-24-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Revisions to the sections 6.600 through 6.603 and 6.710 through 6.715 were adopted emergency and final at the 6/6/97 State Board meeting, with an effective date of 7/1/97 (CSPR# 97-2-24-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to the sections 6.800 through 6.802 and 6.805 were adopted emergency at the 6/6/97 State Board meeting, with an effective date of 7/1/97 (CSPR# 97-5-19-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Rewrite of the entire Child Support Enforcement manual was final adoption following publication at the 10/3/97 State Board meeting, with an effective date of 12/1/97 (CSPR# 97-6-5-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of Revisions of sections 6.270 and 6.903 were final adoption following publication at the 3/6/98 State Board meeting, with an effective date of 5/1/98 (CSPR#'s 97-12-22-1 and 97-12-23-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of Revisions of sections 6.000 - 6.002, 6.800 - 6.802, and 6.805 were final adoption following publication at the 9/4/98 State Board meeting, with an effective date of 11/1/98 (CSPR# 98-6-22-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions of sections 6.002 through 6.102, 6.205 through 6.230, 6.261, 6.500 through 6.505, 6.600 through 6.603, 6.700, 6.706 through 6.708, 6.711 through 6.712, and 6.805 were final adoption following publication at the 11/6/98 State Board meeting, with an effective date of 1/1/99 (CSPR# 98-8-11-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions of sections 6.260, 6.300 through 6.400, and 6.601 through 6.700 were final adoption following publication at the 12/4/98 State Board meeting, with an effective date of 2/1/99 (CSPR# 98-9-16-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions of sections 6.261, 6.700 - 6.715 and 6.903 were final adoption following publication at the 5/7/99 State Board meeting, with an effective date of 7/1/99 (CSPR# 99-2-8-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of Revisions of section 6.260 were adopted emergency at the 5/7/99 State Board meeting, with an effective date of 5/7/99 (CSPR# 99-3-24-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions of section 6.260 were final adoption of emergency at the 6/4/99 State Board meeting, with an effective date of 5/7/99 (CSPR# 99-3-24-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Revisions of sections 6.002, 6.803, and 6.902 were final adoption following publication at the 6/4/99 State Board meeting, with an effective date of 8/1/99 (CSPR#'s 98-12-21-1 and 99-3-30-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions of sections 6.002 and 6.210 were final adoption following publication at the 7/9/99 State Board meeting, with an effective date of 9/1/99 (CSPR# 99-4-6-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Revisions of sections 6.002 and 6.805 were final adoption following publication at the 8/6/99 State Board meeting, with an effective date of 10/1/99 (CSPR# 99-5-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Revisions to the manual's Table of Contents and section 6.804 were final adoption following publication at the 11/5/99 State Board meeting, with an effective date of 1/1/2000 (CSPR# 99-8-19-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of Section 6.905 was final adoption following publication at the 04/07/2000 State Board meeting, with an effective date of 6/1/2000 (CSPR# 99-10-12-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Public Affairs, Department of Human Services.

Revisions to Sections 6.002, 6.210, 6.240, 6.261, 6.601, 6.700, and 6.902 were final adoption following publication at the 5/5/2000 State Board meeting, with an effective date of 7/1/2000 (CSPR# 00-2-8-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Public Affairs, Department of Human Services.

Revisions to Sections 6.902 and 6.904 were final adoption following publication at the 6/2/2000 State Board meeting, with an effective date of 8/1/2000 (CSPR# 00-2-9-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of Public Affairs, Revisions to Sections 6.002, 6.101, 6.261, 6.710, - 6.712, and 6.902 - 6.903 were final adoption following publication at the 8/4/2000 State Board meeting, with an effective date of 10/1/2000 (CSPR#s 00-5-16-1 and 00-5-16-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Sections 6.002, 6.110, 6.210, 6.805, and 6.905 were final adoption following publication at the 9/8/2000 State Board meeting, with an effective date of 11/1/2000 (CSPR#s 00-6-26-1, 6-27-1 and 00-7-7-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Section 6.906 were adopted as emergency at the 12/1/2000 State Board meeting, with an effective date of 12/1/2000 (CSPR# 00-10-23-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to Section 6.906 were final adoption of emergency at the 1/5/2001 State Board meeting, with an effective date of 12/1/2000 (CSPR# 00-10-23-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Section 6.902 and 6.906 were final adoption following publication at the 1/5/2001 State Board meeting, with an effective date of 3/1/2001 (CSPR#'s 00-8-23-1 and 00-10-13-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Revisions to Sections 6.261, 6.603 - 6.700, 6.709 - 6.710, 6.711 - 6.712, and 6.900 - 6.904 were final adoption following publication at the 4/6/2001 State Board meeting, with an effective date of 6/1/2001 (CSPR# 01-1-10-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Sections 6.260, 6.702, 6.712, 6.905, and 6.906 were final adoption following publication at the 2/1/2002 State Board meeting, with an effective date of 4/1/2002 (CSPR# 01-11-14-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Revisions to Sections 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.15, and 6.903.11 were adopted emergency at the 7/12/2002 State Board meeting, with an effective date of 7/1/2002 (CSPR# 02-4-5-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Revisions to Sections 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.15, and 6.903.11 were final adoption of emergency at the 8/2/2002 State Board meeting, with an effective date of 7/1/2002 (CSPR# 02-4-5-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Revisions to Sections 6.261 through 6.261.9, were adoption following publication at the 11/1/2002 State Board meeting, with an effective date of 1/1/2003 (CSPR# 02-8-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Sections 6.002, 6.805, 6.805.31 through 6.805.34, and 6.805.9 through 6.805.97 were adoption following publication at the 1/3/2003 State Board meeting, with an effective date of 3/1/2003 (Rule-making# 02-10-21-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to Sections 6.102.2, 6.205.1-6.205.11, 6.261.8, 6.710.17, 6.711.6, 6.712.4, 6.712.9, 6.902.12- 6.902.13, and 6.903.11, and addition of Section 6.604-6.604.5, were adopted following publication at the 4/4/2003 State Board meeting, with an effective date of 6/1/2003 (Rule-making #s 02-11-6-1 and 03-1-8- 1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Revisions to Sections 6.002, 6.805 and 6.805.1 were adopted following publication at the 11/7/2003 State Board meeting, with an effective date of 1/1/2004 (Rule-making #03-8-1-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, Revisions to Sections 6.805.4 and addition of Sections 6.908-6.908.6 were adopted following publication at the 12/5/2003 State Board meeting, with an effective date of 2/1/2004 (Rule- making #03-9-24-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Revisions to Sections 6.002, 6.201.1, 6.230.16, 6.260.22-6.260.23, 6.261.7-6.261.8, 6.604-6.604.4, 6.902.12-6.902.13, and 6.903.11 were adopted following publication at the 4/2/2004 State Board meeting, with an effective date of 6/1/2004 (Rule-making #03-12-29-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Sections 6.205.23, 6.205.3, 6.250.11 - 6.250.12, 6.250.27, 6.260.51-6.260.52, 6.601.1, 6.702.1, and 6.906 - 6.906.6 were adopted following publication at the 5/7/2004 State Board meeting, with an effective date of 7/1/2004 (Rule-making #04-2-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Sections 6.001.11-6.001.12, 6.102.21, 6.201.2, 6.201.5, 6.206, 6.230.1, 6.230.16, 6.230.3 - 6.230.7, 6.260.23, and 6.260.51 - 6.260.52 were adopted following publication at the 8/6/2004 State Board meeting, with an effective date of 10/1/2004 (Rule-making #04-5-4-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, Revisions to Sections 6.002, 6.260.53, 6.260.55, 6.803.11-6.803.15, 6.803.2-6.803.23, 6.803.31, 6.803.33, 6.803.46-6.803.47, 6.805.11, 6.805.13, 6.805.15, 6.805.35, 6.905.1, 6.906-6.906.1, 6.906.21 - 6.906.22, 6.906.3, 6.906.4, 6.906.5, 6.906.6, and 6.907.1 were adopted following publication at the 9/9/2005 State Board meeting, with an effective date of 11/1/2005 (Rule-making #05-5-9-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Revisions to Sections 6.700.31 through 6.700.32, and 6.700.37 through 6.700.38 were adopted following publication at the 12/2/2005 State Board meeting, with an effective date of 2/1/2006 (Rule-making #05-8- 9-1);and a technical correction to 6.906 (TL# VI-05-1/Rule-making #05-5-9-1) is being republished.

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Revisions to Section 6.902.3 (formerly 6.902.24) were adopted following publication at the 1/5/2007 State Board meeting, with an effective date of 3/1/2007 (Rule-making #06-10-20-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, Revisions to Sections 6.002, 6.210.13-6.210.15, 6.700.33, 6.805.32-6.805.35, 6.901-6.902.3, addition of Sections 6.210.7 and 6.902.4, and revisions to Sections 6.905.1-6.905.3, 6.906-6.908.6 were adopted following publication at the 3/9/2007 State Board meeting, with an effective date of 5/1/2007 (Rule-making #'s 06-12-7-1 and 06-12-18-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to Sections 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, and 6.903.11 were adopted as emergency at the 9/7/2007 State Board meeting, with an effective date of 10/1/2007 (Rule-making#07-6- 1-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Sections 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, and 6.903.11 were final (permanent) adoption of emergency rules at the 10/5/2007 State Board meeting, with an effective date of 10/1/2007 based on the prior emergency rules (Rule-making#07-6-1-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Sections 6.905-6.905.1 and 6.905.4-6.906 were final adoption following publication on 11/2/2007 and re-adopted following public notice and hearing at the 12/7/07 State Board meeting, with an effective date of 2/1/2008 (Rule-making#07-7-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Revisions to Sections 6.001.1-6.001.22, 6.002, 6.201.2-6.201.3, 6.201.6, 6.261.1-6.261.5, 6.261.7- 6.261.9, 6.700.31-6.700.32, 6.709.4, 6.710.14, 6.803.1-6.803.12, 6.803.14-6.803.21, and 6.903.11 were final adoption following publication at the 5/2/2008 State Board meeting, with an effective date of 7/1/2008 (Rule-making# 08-2-19-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Revisions to Sections 6.210.12-6.210.13, 6.803.45-6.803.48, 6.804.1-6.804.2, 6.804.5-6.804.61, and 6.804.8 were adopted on an emergency basis at the 7/11/2008 State Board meeting, with an effective date of 7/11/2008 (Rule-making# 08-5-14-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Revisions to Sections 6.210.12-6.210.13, 6.803.45-6.803.48, 6.804.1-6.804.2, 6.804.5-6.804.61, and 6.804.8 were final adoption (permanent) of emergency rules at the 8/1/2008 State Board meeting, with an effective date of 10/1/2008 (Rule-making# 08-5-14-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Revisions to Sections 6.002, 6.201.3-6.201.6, 6.240.12-6.240.18, 6.250.27, 6.260.54, 6.400.17-6.400.19, 6.500-6.501, 6.602.2, 6.603.2, 6.700.22-6.700.24, 6.700.31, 6.700.35, 6.700.38, 6.702.2, 6.709.1, 6.713.1-6.714.2, 6.801.15-6.801.18, 6.805, 6.805.2, 6.805.31, 6.805.5, 6.902.1-6.902.12, and 6.902.14 were final adoption following publication at the 8/7/2009 State Board meeting, with an effective date of 10/1/2009 (Rule-making# 09-4-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Deletion of Sections 6.110 through 6.110.72 and revisions to Sections 6.102.21, 6.201.2, 6.601.32, 6.702.1, 6.902.17, 6.905.2, 6.906.1, 6.906.22, 6.906.4, 6.906.6, 6.907.1-6.907.2, and 6.908.3-6.908.6 were final adoption following publication at the 1/8/2010 State Board meeting, with an effective date of 3/2/2010 (Rule-making# 09-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 6.207-6.207.4, 6.250.18, 6.250.25-6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2-6.601.32, 6.602.1, 6.603.1, 6.603.3, and 6.714.1-6.714.4 were adopted on an emergency basis at the 7/8/2011 State Board meeting, with an effective date of 8/10/2011 (Rule-making# 11-4-8-2).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Revisions to Sections 6.207-6.207.4, 6.250.18, 6.250.25-6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2-6.601.32, 6.602.1, 6.603.1, 6.603.3, and 6.714.1-6.714.4 were final (permanent) adoption at the 8/5/2011 State Board meeting, with an effective date of 10/1/2011 (Rule-making# 11-4-8-2). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Revisions to Sections 6.101-6.101.2, 6.102.3-6.102.32, 6.130-6.140.1, 6.205.21-6.205.23, 6.240- 6.240.20, 6.250.18-6.250.291, 6.270-6.280.1, 6.300-6.300.23, 6.503-6.506.4, 6.700.33-6.700.38, 6.702.4, 6.715-6.715.3, 6.801-6.801.19, 6.806.5-6.805.7, and 6.805.82 were final adoption following publication at the 1/6/2012 State Board meeting, with an effective date of 3/1/2012 (Rule-making# 11-9-2-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Revisions to Sections 6.260.22-6.260.23 and 6.800 through 6.809.6 were final adoption following publication at the 7/13/2012 State Board meeting, with an effective date of 9/15/2012 (Rule-making# 11- 9-2-3). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 6.102.2-6.102.21, 6.210.13-6.210.15, 6.261-6.261.1, 6.261.3-6.261.8, 6.600-6.606, 6.700-6.715.1, 6.804.4, 6.902-6.902.11, 6.902.14-6.902.175, 6.902.23, 6.902.3-6.902.4, 6.903.11, 6.906, and 6.906.21; and, addition of Sections 6.240-6.240.2 were final adoption following publication at the 2/1/2013 State Board meeting, with an effective date of 4/1/2013 (Rule-making# 11-9-2-5). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Revisions to Sections 6.250 through 6.250.3, 6.260.51, and 6.806 were adopted on an emergency basis at the 4/5/2013 State Board meeting, with an effective date of 4/5/2013 (Rule-making# 13-2-8-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Revisions to Sections 6.250 through 6.250.3, 6.260.51, and 6.806 were final (permanent) adoption at the 5/3/2013 State Board meeting, with an effective date of 7/1/2013 (Rule-making# 13-2-8-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Revisions to Sections 6.002, 6.205 and 6.205.1, 6.205.13, 6.205.2, 6.210.12, 6.210.13, 6.210.2, 6.210.3, 6.210.42, 6.210.5, 6.210.6 through 6.210.67, 6.220, 6.260.23, 6.260.3 through 6.260.31, 6.400, 6.400.1, and 6.500 through 6.503 were final adoption following publication at the 9/6/2013 State Board meeting, with an effective date of 11/1/2013 (Rule-making# 13-4-3-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board 6.000 CHILD SUPPORT SERVICES PROGRAM 6.001 INTRODUCTION 6.001.1 PURPOSE The Colorado Child Support Services (CSS) Program is established to collect support, to reimburse, in

part or whole, Title IV-A grants paid to families, help remove IV-A recipients from the IV-A program by assuring continuing support payments, and assist persons who do not receive IV-A or IV-E foster care to remain financially independent. Such purpose is achieved by: locating noncustodial parents, establishing the parentage of children born out of wedlock, establishing child support obligations and health insurance, reviewing the order for a possible adjustment, and enforcing and collecting support. Although this program must be closely coordinated with the IV-A, Medicaid, and foster care programs, it is a separate and distinct program with defined functions, which must be performed by a distinct administrative unit.

This manual sets forth the policies and rules by which the Colorado Child Support Services (CSS) program must be administered and describes the coordination that must take place with the IV-A and foster care programs. IV-A and IV-E foster care cases in these rules are also referred to as public assistance (PA) cases. Cases that do not contain IV-A or IV-E recipients and cases receiving continued services are referred to as non-public assistance (Non-PA; NPA) cases. Non-IV-E foster care and Medicaid cases are also included in NPA cases. The policies and rules for the IV-A, Medicaid, and foster care programs are set forth in the respective staff manuals.

6.002 DEFINITIONS

“Abandoned Collections Account” - the state IV-D account into which undeliverable collections are transferred once a determination has been made that the payment cannot be disbursed. This account is used to reimburse state expenditures.

“ACSES” - the acronym for the Automated Child Support Enforcement system, a comprehensive statewide online computer system providing case management, financial management, reports, statistics and an extensive cross-reference system.

“Adjustment” or “Modification” - is a legal action to change the amount of the child support or foster care fee order, which can increase or decrease based upon application of the state's presumptive guideline; or to add a provision for medical support or to change the party ordered to provide medical support.

“Administrative Costs” - the amount of court ordered costs that must be repaid to the Child Support Services Unit such as genetic tests, service of process fees, or attorney's costs.

“Administrative Lien and Attachment” - a notice to withhold child support, child support arrearages, child support debt, or retroactive support due from a noncustodial parent's workers' compensation benefits that is issued to any person, insurance company, or agency providing such benefits.

“Administrative Process Action (APA)” - determination of parentage and/or support obligations through a non-judicial process.

“Administrative Review” - a county or state level review of the following four issues only: the payments made, the arrearage amounts, the distribution of amounts collected, or a mistake in the identity of the person who owes the child support.

“Alleged Parent” - a person who has been identified as the possible biological parent of a child and/or who may be the legal parent of a child.

“Allocation” - the process of apportionment of a collection to a specific noncustodial parent's obligation based on the legal order for support to satisfy the various classes of the noncustodial parent's receivables.

“APA – Petitioner” – The party who has applied or been mandatorily referred for Child Support Services.

“APA – Respondent” – The party that did not apply for Child Support Services and was not mandatorily referred for Child Support Services.

“APA Stipulated Order” – An order that is agreed to and signed by both the APA-Petitioner and the APA- Respondent or an order that is agreed to and signed by the APA-Respondent in the absence of the APA- Petitioner.

“APA Temporary Order” – An order that establishes a monthly support obligation only and that is entered when the APA-Petitioner and/or the APA-Respondent does not agree with the terms of the proposed stipulated order.

“APA Default Order” – An order that is entered when the APA-Respondent (1) fails to attend the currently scheduled negotiation conference, (2) fails to sign and deliver to the county delegate child support enforcement unit at or prior to the time of the currently scheduled negotiation conference the stipulated order, or (3) fails to appear for or cooperate with a genetic testing appointment.

“Application” - the state prescribed form which indicates that the individual is applying for Child Support Services. The application is signed by the individual applying for services and an application fee is assessed.

“Application Fee” - A fee assessed upon receipt of an application as required by Federal Regulation, to be paid out of State funds in the amount of 10 cents ($0.10).

“Arrearages” - the total amount of the court ordered support obligations that are past due and unpaid.

Such amount is calculated by multiplying the amount of the support obligation (including any modification thereto) by the number of months that have elapsed since the inception of the order and subtracting from the product the amount of support paid by the noncustodial parent, through the court, directly to the obligee, Child Support Services Unit, or Family Support Registry (FSR).

“Assignment of Support Rights” - the determination that a family is eligible for IV-A benefits automatically invokes a state law (Section 26-2-111(3), C.R.S., as amended) that assigns to the State Department all rights that the applicant may have to support from any other person on their own behalf or on behalf of any other family member for whom application is made. The assignment is effective for both current support and support that accrues as arrears during the period that the family receives assistance. The assignment is limited by the total amount of IV-A assistance received. When a child is placed in foster care, all rights to current and accrued child support for the benefit of the child are assigned to the State Department pursuant to Section 26-13-113, C.R.S.

“Automated Child Support Enforcement System (ACSES)” - the statewide computer program used by Child Support Services for daily operations.

“Caretaker” - a person who is related to the dependent child by blood or by law, or who lives with the child and who exercises parental responsibility (care, control and supervision) of the child in the absence of the child's parent.

“Case Category” - category of a case identifies the type of IV-D case. Case categories must be maintained on the automated child support system as prescribed by the State Department.

“Cash Medical Support” - see definition of “specific dollar amount for medical purposes”.

“Challenge” - when either party disagrees in writing with the review results because the guideline calculation contained an alleged mathematical or factual error. The parties' right to challenge is included in the Post Review Notice or the Administrative Process, Notice of Financial Responsibility for Modification.

“Child Support Services (CSS) Unit”- the county unit administering or supervising the contract for another private or public entity to administer the Child Support Services (CSS) Program.

“Colorado Central Registry” - the unit within the Colorado Division of Child Support Services which receives and distributes responding cases and has oversight responsibility for intergovernmental IV-D “Colorado Date of Receipt” (CDOR) - the date the child support payment is first received by the Child Support Services program, either the Family Support Registry or the Child Support Services Unit.

“Commencement Date” – a day within the month in which a new or modified monthly support obligation begins.

“Confidential” - privileged information of individuals which is private and not for release, disclosure, or distribution unless specifically authorized in statute, regulation, or rule.

“Consumer Credit Reporting Agency” - any person who, for monetary fees, dues, or on a cooperative nonprofit basis, regularly engages in whole or in part, in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties, and which uses any means or facility of interstate commerce for the purpose of preparing or furnishing consumer reports.

“Continued Services Cases” – non-public assistance Child Support Services cases in which the Child Support Services Unit continues to provide services after IV-A financial or IV-E foster care eligibility ceases unless notified by the custodial party that continued services are not desired.

“Cost Effectiveness Ratio” - the ratio of total child support collections to total administrative costs.

“County Department” - a county department of social services, human services, housing and human services, or health and human services. “C.R.S.” - Colorado Revised Statutes.

“CSS Case” - a child support case in which services are provided to establish, modify, and enforce support and medical obligations pursuant to the state IV-D plan.

“Currently Scheduled Negotiation Conference” – The date and time of the APA negotiation conference as scheduled in the notice of financial responsibility or the date and time of a continued negotiation conference whichever date is later.

“Custodial Party” - the legally responsible parent, blood relative, adoptive relative, adult who exercises responsibility for a dependent child(ren), or agency. Also known as the caretaker relative, custodial relative, custodian, government agency (for foster care cases) or, on ACSES, as the recipient/applicant and abbreviated as R/A.

“Date of Withholding” - the date the employer withheld the child support from the employee's wages.

“Deliver” – Delivery of a document or documents includes delivery by hand (in person), by first-class mail, or by electronic means if mutually agreed upon.

“Discharge From Custody” - As defined in title 17 of the Colorado Revised Statutes.17-22.5-402(1)

“Disbursement” - processing of the payable to payees other than the Department of Human Services.

“DISH” –The acronym for the Data Information Sharing System of the Colorado Judicial Department. It is also the process of electronically transmitting information on a case or data on an order by and between the county CSS unit and the court clerk.

“Disposition” - the date on which a support order is officially established and/or recorded or the action is dismissed.

“Distribution” - application of the allocated collection to the IV-D retained and/or payable accounts according to federal regulations based on assignment of rights to support, continued services, and application for services.

“EFPLS” - Expanded Federal Parent Locator Service “Enforcing County” - Colorado county responsible for processing the case and providing Child Support “Erroneous Disbursement” - see “Unfunded Disbursement”.

“Excess Pass Through Amount” – means an assigned child support collection (applied to current support) that the state elects to pay to the family rather than retain to reimburse for assistance provided to the family over the Pass Through Amount.

“Expedited Processes” - administrative or expedited judicial processes or both which increase effectiveness and meet specified processing time frames and under which the presiding officer is not a judge of the court. Actions to establish or enforce support obligations in IV-D cases must be completed within the time frames specified in federal regulations.

“Family Support Registry (FSR)” - the contracted fiscal agent responsible for processing all child support payments.

“FFP” - Federal Financial Participation.

“Federal Tax Information (FTI)” - any information contained in, or derived from, a federal tax return.

“Financial Institution Data Match (FIDM)” - Federal mandate requiring the state to do a periodic match of noncustodial parents who owe arrearages to accounts maintained at financial institutions.

“Financial Institution Data Match Lien and Levy” - a notice generated by the Colorado Department of Human Services, Division of Child Support Services, to freeze and seize assets contained in financial accounts. The notice is issued to any financial institution or state entity maintaining accounts for obligors with child support arrearages, child support debt or retroactive support.

“FIPS” - Federal Information Processing Standard - a code number assigned to each state and county within the United States.

“Former Arrears Due (FAD) Case” - any IV-D case in which the custodial party or the child(ren) formerly received IV-A cash assistance or IV-E maintenance but no longer receives CSS services and where there are still assigned arrears due.

“Former Assistance Case” - any IV-D case in which the custodial party or the child(ren) formerly received IV-A cash assistance or IV-E maintenance.

“Foster Care Fee Debt” - the amount of support due in a foster care case from the placing parent for the time period between the date the child was placed in out-of-home placement to the date the fee order was established.

“Foster Care Fee Order” - a monthly amount assessed by application of the Colorado Child Support guidelines, which are found under 14-10-115(7), C.R.S., to the legally responsible person(s) whose child(ren) are receiving substitute care through a foster care placement as ordered by a court or through administrative process by a county Child Support Services Unit. These orders may be reinstated without further action of the court, upon the child returning to placement for a new decree.

“FPLS” - Federal Parent Locator Service.

“Genetic Testing” - a scientific test that shows the probability of biological parentage of a child which can lead to the establishment of parentage.

“Health Care Coverage/Health Insurance” – Fee for service, health maintenance organization, preferred provider organization, and other types of private health insurance and public health care coverage under which medical services could be provided to the dependent child(ren).

“HHS” - the U.S. Department of Health and Human Services.

“High Volume Automated Administrative Enforcement in Interstate Cases” - the use of automated data processing on interstate cases to search various state databases and seize identified assets of delinquent obligors, using the same techniques as used in intrastate cases upon request of another state.

“Income Assignment” - the process whereby an obligor’s child support payments are taken directly from the obligor’s income and forwarded to the FSR through a notice to the employer, trustee, or other payor of funds.

“Initial Date of Receipt” (IDOR) - the date on which the support collection is initially received by the Title IV-D agency or the legal entity of any state or political subdivision actually making the collection or, if made via income assignment, the date of withholding, whichever is earliest.\ “Initiating State/Jurisdiction” - A. The state/jurisdiction which requests CSS services from the state/jurisdiction where the noncustodial parent resides, has property, or derives income; or, B. The state where the custodial party resides if a modification has been requested and it is appropriate for that state to review the order.

“Inmate” - As defined in title 17 of the Colorado Revised Statutes.17-1-102(6.5)

“Intergovernmental Case” - a CSS services case which involves more than one state, country or tribe.

“In-State Case” - a case being worked in Colorado with no other jurisdiction involved.

“IV-A Cash Assistance” - payments paid to or on behalf of families with children pursuant to Title IV-A of the Social Security Act.

“IV-A Case” - a case referred from the IV-A Unit to the CSS office for child support services when the family has been approved for IV-A financial benefits and/or medical benefits.

“IV-A Unit” - the county unit administering the IV-A cash assistance program.

“IV-D Program” - Child Support Services Program pursuant to Title IV-D of the Social Security Act.

“IV-E Foster Care Case” - a case with a child(ren) who qualifies for public assistance under Title IV-E of the Social Security Act. These cases are mandatory referrals to the CSS Unit.

“IV-E Payment” - payment made on behalf of a child for the child’s foster care maintenance in accordance with Title IV-E of the Social Security Act.

“Judgment” - by operation of law, a child support payment becomes a final money judgment when it is due and not paid. A missed payment, or a series of missed payments, may also be reduced into a single judgment by the court.

“Legal Parent” - see “Parentage”.

“Locate” - information concerning the physical whereabouts of the noncustodial parent or the noncustodial parent's employer(s), other sources of income, or assets, as appropriate, which is sufficient to take the next appropriate action in a case.

“Medicaid Referral Cases” - cases in which families, with a noncustodial parent, receive Medicaid and are referred to CSS from a Medicaid agency for CSS services if the Medicaid recipient voluntarily wants CSS services.

“Medical Coverage” - any health coverage provided for a child(ren), including: 1) private health insurance;

2) publicly-funded health coverage; 3) cash medical support; or 4) payment of medical bills, including dental or vision.

“Medical Support” - a subset of medical coverage which includes health coverage provided for a child(ren) in a IV-D case in which there is a medical support order. This includes: 1) private health insurance; 2) publicly-funded health coverage, if a parent is ordered by a court or administrative process to provide cash medical support payments to help pay the cost of Medicaid or State Child Health Insurance Program (SCHIP); 3) cash medical support, including payment of health insurance premiums; and 4) payment of medical bills, including dental or vision. Indian health service and Tricare are acceptable forms of medical support.

“Modification” - see “Adjustment”.

“Monthly Amount Due” - the monthly amount the obligor is expected to pay toward the arrearages.

“Monthly Payment Due” - the monthly amount that the obligor is expected to pay each month; the amount includes the court ordered current support and the monthly amount due towards any arrears.

“Monthly Support Obligation (MSO)” - the monthly obligation amount ordered by a court or through administrative process by a IV-D agency to be paid on behalf of (a) child(ren) or (b) child(ren) and former spouse, if established in the same court order and if the former spouse is living with the child(ren).

“National Medical Support Notice (NMSN)” - a federally mandated notice sent to employers by the delegate CSS Units. The NMSN requires an employer to enroll a child(ren) in the employer’s health insurance plan if it is available, the employee is eligible, and it is reasonable in cost.

“Non-IV-E Foster Care Case” - a case with a child(ren) receiving Title IV-B foster care services who does not qualify for IV-E public assistance. These cases are classified by the State CSS Division on the automated child support system as a Non-PA case, but are treated like public assistance cases because they originate within Child Welfare Services and, pursuant to statute, contain an automatic assignment of support.

“Non-Public Assistance (Non-PA) Case” - a IV-D case in which the family currently does not receive public assistance. Non-PA cases include Medicaid referral cases.

“Noncustodial Parent (NCP)” - the legally responsible parent, adoptive parent, or alleged parent who is not living with the dependent children. Also known on ACSES as the absent parent and abbreviated as “A/P”.

“Not in Child's Best Interest” - order would not be reviewed based on a good cause determination in cases with an assignment of rights as defined in Section 6.230.1.

“Notice of Collection” - a periodic report of Child Support collection information which is sent by the Child Support Services Unit to current and former Colorado Works Program recipients who have assigned their rights to support.

“Obligee” - the party to whom an obligation of support is owed.

“Obligor” - the party bound by a court or administrative order to provide support. This may or may not be the party with the least number of overnights with the child for the purposes of calculating child support guidelines.

“OCSE” - Office of Child Support Enforcement. The Health and Human Services agency responsible for the supervision of state child support enforcement programs pursuant to Title IV-D of the Social Security Act.

“Original Order” - means the first support order that orders a parent to pay support for a child.

“Parole” - As defined in title 17 of the Colorado Revised Statutes.17-2-207(3)

“Parties to the Action” - those individuals or entities named in a petition, motion, or administrative process notice of financial responsibility and joined, or to be joined, in a legal action.

“Pass Through Amount” – means an assigned child support collection (applied to current support) that the state elects to pay to the family rather than retain to reimburse for assistance provided to the family. In current-assistance cases, the federal share will be waived for up to $100 per month for TANF families with one child and up to $200 per month for families with two or more children, as long as both the federal and state share of the Pass Through are paid to the family and are disregarded in determining the TANF Basic Cash amount of assistance provided to the family.

“Parentage” - is the legal establishment of maternity or paternity, for a child, either by court determination, administrative process, or voluntary acknowledgment.

"Past-Due Support" - the amount of a delinquency, determined and/or accrued under a court order, or an order of an administrative process established under state law, for support and maintenance of a child (whether or not a minor), or of a child (whether or not a minor) and the parent with whom the child is living. Expenses owed between the parties, such as extracurricular expenses, post-secondary education, and attorney fees do not meet the definition of past-due support.

“Permanently Assigned Arrears” - arrears which accrued under a court or administrative order and were assigned prior to October 1, 1997, plus all arrears which accrue while a family is receiving public assistance after October 1, 1997.

“Placing Parent” - the legally responsible parent who the child(ren) was living with prior to foster care placement.

“Post Assistance Arrears” - the arrears that accrue under a court or administrative order on a continued services case after the obligee discontinues IV-A services.

“Pre-Assistance Arrears” - the arrears that accrued from October 1, 1997, forward, under a court or administrative order before the obligee started receiving IV-A assistance.

“Pre-Offset Notice” - a notice generated yearly by the state Office of Child Support Services notifying noncustodial parents of the enforcement remedies that may be applied to their cases and advising of their right(s) to request an administrative review.

“Pre-Review Screening” - an assessment of the IV-D case to determine the appropriateness for review.

Presumed Parent” - a person who is more likely than not to be the legal parent of a child because certain facts exist.

“Primary Contact County” - the county that the obligee will contact to resolve issues concerning an unfunded disbursement balance.

“Procedure” - processes developed by county Child Support Services Units and/or the State Department to implement state policy and rules.

“Public Assistance” - assistance payments provided to or on behalf of eligible recipients through programs administered or supervised by the State Department under Titles IV-A or IV-E of the Social Security Act or under Child Welfare Services.

“Public Assistance (PA) Case” - a case that has met established criteria by the IV-A or IV-E divisions to be referred to the CSS Unit for child support services.

“Responding State/Jurisdiction” - the state/jurisdiction where the obligor resides, has property, or derives income, which provides Child Support Services Unit services upon request from another state/ jurisdiction.

“Retroactive Support Due” - the amount of support due for a time period prior to the entry of an order establishing parentage and/or support.

“Review” - an evaluation of the parties’ income information to determine the child support order amount and whether a medical support provision needs to be added to the child support order or if the party ordered to provide medical support needs to change.

“Sentence” - Means the post-conviction stage of the criminal justice process, in which the defendant is brought before the court for the imposition of a penalty. Sentences can vary in the way they are implemented or carried out. A sentence can be concurrent, meaning it is served at the same time as any other sentences imposed; or, consecutive meaning there is a conviction on several counts and the sentences are added to each other so each sentence begins immediately upon the expiration of the previous one. In the case of the conviction of a sexual offense, Colorado may also impose an indeterminate sentence of “not more than” or “not less than” a certain period of time.

“Service Fee” – the annual fee charged to an obligee who has never received cash public assistance.

“Specific Dollar Amount for Medical Purposes or Cash Medical Support” - an amount ordered to be paid toward the cost of health insurance provided by a public entity or by another party through employment or otherwise, or for other medical costs not covered by insurance.

“SPLS” - the State Parent Locator Service.

“State Department” - the Colorado Department of Human Services.

“State Plan” - the comprehensive statement submitted by the State Department to the Department of Health and Human Services describing the nature and scope of its Child Support Services Program and giving assurance that it will be administered in conformity with the specific requirements stipulated in Title IV-D of the Social Security Act and other official issuances of Health and Human Services.

“Support” - a medical support order and/or financial amount ordered by a court or through administrative process by a county Child Support Services Unit on behalf of (a) child(ren) or (b) child(ren) and former spouse, if established in the same court order and if the former spouse is living with the child(ren).

“Termination of Review and Adjustment” - the review/adjustment activity ceases based on specific criteria which are set forth in Section 6.261.5.

“Total Program Expenditures” - the total amount of costs associated with the Child Support Services program billed to the federal government for reimbursement.

“UIFSA” - Uniform Interstate Family Support Act, Title 14, Article 5, Colorado Revised Statutes (C.R.S.) which governs interstate case processing.

“UMP” - Unreimbursed Maintenance Payments. The amount of IV-E foster care maintenance payments which have not been reimbursed by child support collections or other recoveries.

“Unassigned Arrears” - any arrears that are not assigned to the state, either because the obligee never received public assistance or because, for an obligee who is or was receiving public assistance, the arrears accrued during a time period when the obligee was not receiving public assistance.

“Unfunded Disbursement” - a disbursement that is paid but subsequently found to contain an error or found to have insufficient funds to pay the disbursement.

“UPA” - Unreimbursed Public Assistance. The amount of IV-A payments which have not been reimbursed by child and spousal support collections or reduced by IV-A established recoveries.

“URESA” or “RURESA” - The Revised Uniform Reciprocal Enforcement of Support Act, Title 14, Article 5, C.R.S., as amended. Repealed in Colorado on January 1, 1995, the effective date of Uniform Interstate Family Support Act.

“Unenforceable” - A case is determined unenforceable when there is no collection on a case for two years and all administrative or legal remedies have been attempted and determined to be ineffective. Ineffective has three elements: 1. The obligor is unable to pay, 2. The obligor has no known income or assets, 3.

There is no reasonable prospect that the obligor will be able to pay in the foreseeable future; or, there is nothing to enforce on the case as benefits were paid but uncollectable due to the fact the recipient does not have custody of the children or there is shared custody.

“Unsworn Declaration” - A statement or document that is not notarized but is made under the penalty of perjury under the law of Colorado that it is true and correct. An unsworn declaration may be used in lieu of an affidavit.

6.100 ADMINISTRATION OF THE COLORADO CHILD SUPPORT SERVICES PROGRAM

6.101 STATE DEPARTMENT OF HUMAN SERVICES

The State Department of Human Services is responsible for statewide supervision or administration and, as provided in these rules, direct administrative activities concerning the Child Support Services Program as required by the federal government under its provisions for financial participation. 6.102 County Departments Of Social Services 6.102.1 County departments shall strictly administer the Child Support Services Program in accordance with the rules set forth in this manual. 6.102.2 Duties Of The County Department 6.102.21 The duties of the county department or its delegate shall include the following:

A. Establishing, maintaining, and implementing specific written procedures for the operation of the Child Support Services Program in accordance with these rules;

B. Maintaining the Child Support Services staff manual, required state forms, and copies of county letters;

C. Establishing and monitoring agreements with local law enforcement officials, legal services providers and other organizations for the provision of services in support of the Colorado Child Support Services Program;

D. Securing compliance with the requirements of the Colorado Child Support Services Program in operations delegated under any agreement;

E. Implementing and utilizing a statewide, comprehensive automated child support system, as prescribed by the state department;

F. Certifying delinquent cases to the state department for the interception of Internal Revenue Service refunds and for interception of state income tax refunds;

G. Ensure the accuracy and integrity of the automated child support system;

H. Conduct an administrative review at the request of the obligee as a result of the notice of collections mailed to the obligee or posted to the CSS website by the state department. the county will review its files prior to or at the administrative review as provided for in state regulations at Section 6.805.41. The notice will be generated for current and former IV-A recipients with support obligations who have assigned their rights to support and shall contain:

1. Explanation of the assignment of support rights, 2. Name of the noncustodial parent from whom the support is collected, 3. The starting date of the period reported, 4. The ending date of the period reported, 5. A separate listing of payments collected from each noncustodial parent when more than one noncustodial parent owes support, 6. Amount collected from each noncustodial parent which was retained to reimburse public assistance, 7. Amount collected from each noncustodial parent which was paid to the family in the form of excess collections, I. Periodically, not less than annually, publicizing the availability of Child Support Services, including address and telephone number of the county Child Support Services Unit;

J. Establishing an order for either party to provide medical support in new or modified court or administrative orders for child support, and enforcing the medical support provision when health insurance is accessible and available at reasonable cost to the obligor;

K. Obtaining information regarding the health insurance available through the custodial party and/or noncustodial parent when a change in circumstance occurs that would warrant a change in the health insurance status and reporting such information on the automated child support system.

The automated child support system will generate a report to the state Medicaid Third Party Resource Section;

L. Conducting administrative reviews of contested arrears;

M. Using diligent efforts to complete all actions appropriately and within the time frames required by the applicable federal regulations, statute or rule. Diligent efforts shall include the following:

1. Initiating a task within the required time period;

2. Completion of the task, including any follow up activities within the required time period;

3. Taking the necessary actions in response to receipt of information that indicates that the task may not be on track to be completed within the required time frame. 6.102.3 Establishment of the County Department Child Support Services Unit Allocation of Staff: Sufficient staff shall be assigned to the Child Support Services Unit to provide the following child support services functions: intake, locate, legal determination of parentage, establishment of the legal obligation, collection, enforcement, investigation and reporting as prescribed by these rules.

6.103 CERTIFICATION REQUIREMENTS FOR CHILD SUPPORT SERVICES EMPLOYEES

6.103.1 ADMINISTRATIVE PROCESS ACTION (APA) CERTIFICATION

A. APA Certification by the State Division of Child Support Services is required for:

1. Child Support Services Unit employees that conduct APAs as described in sections 6.261 and 6.700.

2. County employees that supervise employees that conduct APAs, unless the direct supervisor of an employee conducting APAs is the county human or social services director and the director has designated another individual to review and sign APA default orders as required by sections 6.710.1(c), 6.711.1(c), and 6.714.1(a), below.

3. Supervisors, administrators, or attorneys that have been designated, in writing, by the county human or social services director to review and sign APA default orders, pursuant to section 26-13.5-106 C.R.S. and required by sections 6.710.1(c), 6.711.1(c), and 6.714.1(a), below.

B. APA recertification must occur every three (3) years. A certified employee may transfer his or her certified status from one county to another if the transfer is requested within ninety (90) days of terminating employment with the first county.

C. The county Child Support Services Unit must ensure that employees fulfill all certification and recertification training and testing requirements prior to conducting or continuing to conduct APAs.

D. The county director or their authorized designee must determine and authorize, in writing, which Child Support Services Unit employees may conduct APA and negotiation conferences based upon the employee's APA certification status, classification, and experience. The county director or their authorized designee must ensure that only those employees with adequate skills, knowledge and training conduct negotiation conferences.

E. In the event that a county does not have an APA certified supervisor, administrator, attorney, or county director, due solely to temporary staffing changes, the county shall notify the State Division of Child Support Services and coordinate with another county that has agreed to provide coverage for continuity of services, as identified in the annual program plan.

6.103.2 AUTOMATED ENFORCEMENT CERTIFICATION

A. Certification by the State Division of Child Support Services is required for Child Support Services Unit employees that perform, or supervise employees that perform, any enforcement actions associated with the following automated enforcement remedies:

1. Administrative Offset 2. Child Support Lien Network (CSLN)

3. Credit Reporting (CRA)

4. Department Of Corrections (DOC)

5. Driver's License Suspension (DLS)

6. Federal Tax Offset (IRS)

7. Financial Institution Data Match (FIDM)

8. Gambling (GAM)

9. Lottery (LOT)

10. Passport Denial 11. Professional/Occupational License Suspension (POLS)

12. Recreational License Suspension (RLS)

13. State Revenue Offset (REV)

14. Unclaimed Property Offset (UPO)

15. Unemployment Compensation Benefits (UCB)

16. Vendor Offset (VO)

17. Worker's Compensation (WC)

18. Automated Enforcement of Interstate Cases (AEI)

B. Recertification must occur every three (3) years. A certified employee may transfer his or her certified status from one county to another if the transfer is requested within ninety (90) days of terminating employment with the first county.

C. The county Child Support Services Unit must ensure that employees fulfill all certification and recertification training and testing requirements prior to performing or continuing to perform the enforcement actions described in this section.

D. The county director or their authorized designee must determine and authorize, in writing, which Child Support Services Unit employees may perform the enforcement actions described in this

section based upon the employee's certification status, classification, and experience. The county director or their authorized designee must ensure that only those employees with adequate skills, knowledge and training perform these actions. 6.104 - 6.110 (None)

6.120 REIMBURSEMENT OF EXPENDITURES 6.120.1

The state department shall pass through to county departments of social services federal matching funds as prescribed by the state department for necessary expenditures for child support services and activities provided to PA recipients and NPA families in accordance with these rules. 6.120.2 Federal matching funds will not be passed through to county departments of social services for: 21 Activities not related to the Child Support Services Program; 22 Construction or major renovations; 23 Purchases of child support services which are not secured in accordance with these rules and regulations; 24 Education and training programs and educational services except the direct costs of approved short-term training, as defined and approved by the state department; 25 Activities related to investigation or prosecution of fraud except for referring the discovery of same to the appropriate program; 26 Activities that are beyond the scope of these rules as determined by the state department; 27 Activities performed pursuant to an agreement that has expired and has not been renewed in accordance with these rules; and 28 The amount of any fees, costs, or interest on child support collections deposited in a financial institution and collected by the CSS Unit that have not been used to reduce county CSS program 6.130 STATE DEPARTMENT TO SUPERVISE CSS PROGRAM The Colorado Department of Human Services is responsible for statewide supervision and direct administrative activities concerning the CSS program as required by the Federal government under its provisions for financial participation.

County departments shall strictly administer the CSS program in accordance with the requirements of Title IV-D of the Social Security Act, and the federal and state rules and regulations which govern the operations of the CSS program.

6.140 PENALTY FOR FAILURE TO COMPLY WITH STATE AND FEDERAL REGULATIONS

If a county fails to comply with the requirements of Title IV-D of the Social Security Act, and the federal and state rules and regulations which govern the operations of the CSS program, the State Department may reduce or withhold incentive payments or take other actions as provided for in state statute or Department rules referenced in Colorado Department of Human Services' rule manual Volume 1 (9 CCR 2501-1).

6.200 GENERAL PROVISIONS 6.201 Application Requirements County CSS Units shall establish procedures to ensure that all appropriate functions and activities regarding applications and information on available services are undertaken and completed within the time frames specified and that all activities are documented on ACSES. 6.201.1 Public Assistance (PA) Cases A. Public assistance cases shall be provided full support services as required by the Child Support Services program upon referral without an application requirement. Referral is defined as the Colorado Benefits Management System (CBMS) generated automated referral and the State prescribed Social Services Single Purposes Application (SSSPA) form or another county form containing, at a minimum, the information found in the State prescribed form.

B. The following information shall be provided to PA clients on the appropriate state prescribed form:

1. The assignment of rights to support payments;

2. Available services;

3. The individual's rights and responsibilities;

4. Fees, cost-recovery and distribution policies;

5. Case categorization and the information necessary to change the category;

6. The requirement, in appropriate cases, for good cause exemption from referral to the CSS Unit to be granted by the county director or the designate IV-A staff; and 7. The lack of an attorney-client relationship.

C. Counties must document in the case record the date of referral, which is the date the recipient received the program information.

6.201.2 NON-PUBLIC ASSISTANCE (NPA) CASES

A. Continued Services Cases 1. The Child Support Services Unit shall provide to the person whose IV-A grant or IV-E foster care eligibility is discontinued, continued CSS services, without a formal application unless the CSS agency is notified to the contrary by the person whose IV-A grant or IV-E foster care eligibility is discontinued.

2. The Notice of Action and the CSE 34 Notice are notices that inform the recipient of public assistance, when they have discontinued temporary aid to needy families (TANF) that their child support case will remain open unless they request that the county close their case. These notices will be generated and mailed to the recipient ten (10) days prior to the effective date of the discontinuation.

3. Form SS-4, Notice of Social Service Action, will be completed by the county services worker and mailed to recipients when a person(s) is discontinued from IV-E foster care.

The form will be sent to the recipient five (5) days prior to the effective date of the discontinuation.

The Notice Of Action, the CSE 34 Notice, and the Notice of Social Service Action (SS-4) shall:

a. Notify the person whose IV-A grant or IV-E foster care has been discontinued, that the CSS Unit shall continue to provide CSS services unless the CSS Unit is notified by the former IV-A or IV-E foster care recipient to the contrary;

b. Specify the CSS services that are available;

c. Inform the person that the quality of information provided will affect the category of the case;

d. Specify the name of the person whose IV-A grant and/or IV-E foster care has been discontinued; and, e. Specify the household number;

f. Specify the unique case identifiers;

g. Require the signature of the person discontinued who wishes to terminate CSS services;

h. Specify the CSS unit will collect overdue support to repay past IV-A or IV-E foster care maintenance.

i. Contain any other information deemed appropriate by the State Department.

B. Application Cases 1. Persons who do not receive public assistance or continued CSS services may apply for full CSS services by completing the Application for Child Support Services, as prescribed by the State Department. Applications for child support services shall be readily accessible to the public. Applications will not be accepted if all of the children associated with a specific obligee and obligor are emancipated, as defined in the existing child support order and the laws of the state where the child support order was entered. This same requirement applies to new interstate referrals sent to Colorado from another initiating state or jurisdiction. In a responding intergovernmental case, if the case was opened in the other state prior to emancipation and/or has state debt due, the application shall be accepted.

2. Upon application, the services established for IV-A recipients to locate, establish parentage of a child (or children), establish court orders for child support, review and modify orders for child support, and secure support from noncustodial and/or alleged parents shall also be made available on behalf of children who are or were deprived of parental support due to the absence of a parent or parents, but, for other reasons, are not recipients of IV-A, including those children who are receiving foster care services from funds other than Title IV-E of the Social Security Act.

3. The application on behalf of the child for child support services may be made by either of the child's parents (custodial or noncustodial), an alleged parent, legal guardian, or other person or agency.

4. When the applicant is not a parent of the child, an application for child support services must be obtained for each noncustodial parent.

5. Requests for Application a. When an individual requests an application or CSS services in person, the CSS Unit shall provide an application on the day requested.

b. When an individual requests an application by phone or in writing, the application shall be sent by the county CSS Unit within no more than five (5) business days from the date of request.

c. The application shall include the following information:

1) available services;

2) the individual's rights and responsibilities;

3) fees, cost recovery and distribution policies;

4) case categorization and the information necessary to change the category; and 5) the lack of an attorney-client relationship.

6. The application for non-PA CSS services shall be made on the Application for Child Support Services, as prescribed by the state department. The standard Application for Child Support Services shall include the following elements:

a. The full name of the noncustodial parent;

b. The full name, date of birth, place of birth, sex and social security number of each child for whom support is sought;

c. The signature, address, telephone number, date of birth and social security number of the applicant and date of application.

7. Acceptance of Applications a. An application may be filed in any CSS office. If there is an existing case in another county, then the application shall be forwarded to the appropriate enforcing county within two (2) working days of receipt in the original county.

b. An application shall be accepted as filed on the date it is received in the CSS office, if one or more of the children associated with a specific obligee and obligor are not emancipated as defined in the child support order and the laws of the state where the child support order was entered, and it includes the following information:

1) applicant's name, address and social security number;

2) the name of the noncustodial parent(s), if known;

3) name, birth date, sex, place of birth and social security number, if available, for each child;

4) applicant's signature, either handwritten or electronic.

c. Acceptance of an application involves recording the date of receipt on the application. The application must be entered into the ACSES for the application fee to be assessed..

8. County CSS Units may collect costs incurred in excess of fees. These costs shall be determined on a case by case basis and shall be used to reduce CSS program 9. Non-PA obligees shall be charged an annual twenty-five dollar ($25) certification fee for collection of IRS tax refunds only if an actual intercept occurs. The fee shall be deducted from the tax refund intercept. The certification fee must be used to reduce CSS program If there is more than one tax refund intercept for a case, the twenty-five dollar ($25) certification fee will be charged only once, regardless of the number of obligors, and will be deducted from the first intercept(s) that occurs. If the total amount of all tax refunds for a case is less than twenty-five dollars ($25), the amount of refunds will satisfy the certification fee.

10. Non-PA obligees shall be charged an annual thirty-five dollar ($35) service fee once five hundred and fifty dollars ($550) has been disbursed to the family.

The service fee will be reported to the federal government as program income, and will be shared between the federal, state, and county governments.

The service fee will be collected for each case set in all intrastate in-state and initiating intergovernmental cases on the ACSES if the $550 disbursement threshold is reached.

C. Locate Only Cases Persons who request only noncustodial parent locator service may complete the Request for Parent Locator Service. The Colorado State Parent Locator Service shall provide such caretaker with instructions for completing the form and fees to be paid by the caretaker. A non-PA application form is not required.

6.201.3 FOSTER CARE CASES

A. Appropriately referred IV-E or non-IV-E foster care cases pursuant to the CDHS Social Services staff manual (12 CCR 2509-1) shall be provided the full range of services as required by the Child Support Services program upon referral. Cases that are not appropriate for referral shall not be initiated.

B. Referral is defined as receipt of the referral packet from the county child welfare agency or the date the case appears in the county’s on-line referral list. If the referral is manual, counties must document the date received by the CSS Unit as the referral date on the ACSES.

C. Child support services applications are not required for IV-E foster care cases. An application for child support services, as prescribed by the State Department, shall be completed by the county department having custody of the child(ren) for all non-IV-E foster care cases.

6.201.4 MEDICAID REFERRAL CASES

Appropriately referred Medicaid cases shall be provided the full range of services required by the Child Support Services (CSS) program without an application requirement. “Appropriately referred” means that the Medicaid applicant requested CSS services. 6.202 - 6.204 (None)

6.205 ENFORCING COUNTY

Designation of the county responsible for accepting the Child Support Services application or processing the case, or both, provides for centralized legal and financial activities and prevents duplication of effort and establishment of unnecessary orders for support when an order exists.

Provisions pertaining to enforcing county designation and responsibilities shall apply to all new Child Support Services cases and for existing cases where there is a dispute regarding an enforcing county issue.

A. The enforcing county is the county responsible for processing a case for Child Support Services, including locating the noncustodial parent, establishment of parentage, establishment and modification of a support order and enforcement of a support order. Enforcing county means the enforcing county on the automated child support system. The enforcing county is responsible for financial management of the case.

The enforcing county is also the county responsible for the case for audit purposes. When the noncustodial parent resides outside of Colorado, the enforcing county is the county responsible for initiating an intergovernmental action or appropriate instate action for CSS services. If the noncustodial parent is the only party in the case residing in Colorado and there is no existing court order and no public assistance has been paid in Colorado, the enforcing county will be considered the county where the noncustodial parent resides.

B. For all cases, the enforcing county for a Colorado Child Support Services case is the first county where a Child Support Services application or referral was made.

C. When there is a new application or referral in a county other than the enforcing county, the county of the new application or referral shall assist in the completion of the application and any intergovernmental or other necessary documents. The county of the new application or referral shall forward the application and documents to the enforcing county, as appropriate, utilizing the form as prescribed by the State Department. Unless the CSS Units in the interested counties agree or there is enforcing county resolution to change enforcing county designation, the enforcing county remains the enforcing county until the case is closed in accordance with this manual. The enforcing county does not change when the parties in the case relocate.

D. When a IV-D unit requests enforcing county designation and the interested CSS Units cannot agree, within five (5) calendar days, upon which county should be the enforcing county, the county directors, or their designees, in the counties will resolve the issue. If agreement cannot be reached, the CSS office shall refer the matter to the State Division of Child Support Services for resolution in accordance with the state procedure and prescribed form. The state decision is final and binding on the interested counties.

6.205.1 ENFORCEMENT OF ORDER AND FINANCIAL MANAGEMENT

A. The enforcing county shall enforce the original order and any subsequent modifications, and modify, as appropriate. Copies of all legal actions, such as modifications, and judgments shall be filed into the original order.

B. When IV-A or foster care placement costs (maintenance and services) have been expended in another Colorado county or counties, the enforcing county must contact all such counties and, within ten (10) working days, such counties shall provide the amount of unreimbursed public assistance or the costs for foster care placement to be included in the establishment of an order or to modify an order for UPA or foster care costs reimbursement. The enforcing county is responsible for coordinating arrearage balances of all interested counties.

C. The enforcing county shall enforce the existing order to the extent possible even if the order was issued by another county. If a court hearing is necessary, the enforcing county may request the IV-D unit in the county of the existing order to have its CSS attorney appear on behalf of the enforcing county. When requested, the CSS attorney in the order-issuing county shall appear on behalf of the enforcing county and represent the case as if it were their own county's case.

D. In cases in which the obligor has now become the obligee, known as role reversal, the county enforcing the existing order shall initiate the role reversal case and modify the existing court order to reflect the new change in circumstance, or initiate a reciprocal action to another jurisdiction, if appropriate, whether the role reversal occurred prior to or after the IV-D referral or application. 6.205.11 Change of Venue Change of venue shall not be initiated for purposes of having the attorney for the order county take court action or to change the enforcing county for the case. A change of venue may be completed when the court determines it is in the best interests of the custodian, child, or non-custodial parent. Change of venue does not change the enforcing county, except upon agreement of the counties involved. 6.205.12 Controlling Order In cases with multiple actions or orders, the enforcing county will determine the controlling order pursuant to Section 14-5-207, C.R.S., et seq. 6.205.13 Registration Of Order In intergovernmental cases, the enforcing county may register a foreign order or enforce administratively, when enforcement is requested by the initiating agency.

There shall be no registration of Colorado orders.

6.205.2 INTERGOVERNMENTAL ENFORCING COUNTY

Responding intergovernmental cases are cases received from a jurisdiction outside Colorado requesting Child Support Services because the noncustodial parent resides, is employed or derives income in Colorado. The county that shall work the responding intergovernmental case is determined as follows:

A. If there is an existing open cases, a responding intergovernmental action shall be forwarded to the existing enforcing county.

B. If there is no open enforcing county designation, the responding intergovernmental action will be forwarded to the county where a Colorado order has been entered or a foreign order registered that involves the same obligor and children.

C. If there is no open enforcing county designation and no previous Colorado order or registration of a foreign order, a responding intergovernmental action will be forwarded to the county of the noncustodial parent's place of residence.

D. If there is no open enforcing county designation, no previous Colorado order or registration of a foreign order, and a noncustodial parent's residential location cannot be identified or verified, a responding intergovernmental action will be forwarded to the county of the noncustodial parent's place of employment.

E. If there is no open enforcing county designation, no previous Colorado order or registration of a foreign order, and a noncustodial parent's residential and employment location cannot be identified or verified, a responding intergovernmental action will be put into sixty (60) day closure by the Interstate Unit. It will be returned to the initiating state if the obligor’s residence or employment cannot be verified in Colorado within that time frame. However, if the intergovernmental action was received from a foreign country, it will be forwarded to the county of the noncustodial parent's last known place of residence, if one was provided, or county of last known employment.

F. If the responding case is the enforcing case and is closed by the other state, the current in-state case must take enforcing county designation. If there is more than one current case, the rules for determining the enforcing county shall be followed. 6.206 - 6.209 (None) 6.210 Safeguarding And Protecting Confidential Information All information contained in electronic or paper case files of the Child Support Services program concerning the name(s) or identifying information of custodial parties, noncustodial parents, or children shall be considered confidential and shall be protected, except when otherwise provided for in this

section. 6.210.1 Release Of Information 6.210.11 Before any information is released and before any discussion is held with any individual or entity concerning an individual case, the requestor’s identity must be verified and the purpose of the contact or request must be confirmed. If the request is made by fax, phone or Internet, information shall not be released until the requestor’s identity has been verified by requiring the requestor to provide unique identifying information such as Social Security Number, dates of birth for self or child(ren), court case number, child support case number, or Family Support Registry account number. 6.210.12 Child Support Services workers shall release the name, mailing and/or residential address, Social Security Number, place of employment, day care amount, income, health insurance information, and date of birth of custodial parties, noncustodial parents or children, and establishment or enforcement information concerning the legal obligation for support only in the following circumstances:

A. When clarification of information is required to provide the next appropriate Child Support Services Unit service authorized in Colorado law and described in the Child Support Services state plan. For example, if a worker from a clerk and recorder’s office calls to clarify information contained in a Child Support Services Unit’s request for a lien to be placed on real property, the child support worker may confirm what action is being requested of the clerk and recorder.

B. In the administration of the plan or any program approved under Part A (Temporary Assistance to Needy Families), Part B (Child Welfare), Part D (Child Support Enforcement), Part E (Foster Care) or Part F (Child Care Services) or Titles XIX (Medicaid) or XXI (State Children’s Health Insurance Program) of the Social Security Act, and the Supplemental Nutrition Assistance Program, including data which is necessary for fraud investigation or audit.

1. To assist any investigation, prosecution, or criminal or civil proceeding conducted in connection with the administration of any such state plans or programs.

2. To report to the appropriate state or county department staff information that has been reported, to a Child Support Services worker, of suspected mental or physical injury, sexual abuse or exploitation, or negligent treatment or maltreatment of a child who is the subject of a child support services activity under circumstances which indicate that the child’s health or welfare is threatened.

C. In response to a request received from a party to the action or the party’s attorney of record, the requester can receive information specific to themself only, and not the other party. Each party may verify the accuracy of the information related to themself only that is in the possession of the Child Support Services Unit. If the requestor is shown as a child on the case action, even if the child has since reached the age of emancipation, that requestor is not a party to the action and the information shall not be released except upon issuance of a court order.

D. To provide statutorily required information to the court on child support orders and other documents that are completed by the CSS Unit and then filed with the court, unless there has been a court order of non-disclosure entered to suppress such information on that particular party.

E. To inform the parties of information regarding the amount of public assistance benefits paid to the family which could be used in an administrative or court proceeding to establish or enforce an order for the past assistance. 6.210.13 Disclosure Disclosure of any Child Support Services case information is prohibited in the following circumstances:

A. At the request of all private collection agencies, unless the requesting agency is a state or county contractor and bonded as required by state or federal statute.

B. In response to a written complaint from the party (constituent) received by a legislator. Child Support Services Units may provide only information which indicates what progress is being made on the case or what action has or will be taken to move the case forward.

C. At the request of any attorney who is not the attorney of record as reflected on the automated child support system or in the court files.

D. At the request of a current spouse or other individual even if that person has a notarized statement from the noncustodial parent.

E. Any information received from the Internal Revenue Service that has not been verified by an independent source. Such information can only be released to the taxpayer.

F. Information obtained through the State Income and Eligibility Verification System (IEVS) shall not be disclosed to anyone. The information shall be used exclusively by the Child Support Services program.

G. Disclosure to any committee or legislative body (federal, state, or local) of any information that identifies any party to the action by name or address.

H. Genetic test results can only be released to the parties of the action. Pursuant to Sections 19-1- 308 and 25-1-122.5, Colorado Revised Statutes, the parties are prohibited from disclosing the information to anyone else.

I. The information obtained from the access of records using the Social Security Number, pursuant to Section 14-14-113, C.R.S., shall only be used for the purposes of establishing parentage or child support ordered, modifying or enforcing child support orders.

J. Upon receipt of a non-disclosure affidavit and required documentation from either party, the county child support services worker shall create the affidavit of non-disclosure and the affidavit shall be forwarded to the court of jurisdiction. In this instance an individual’s identity or location can be released only upon receipt of a court order requiring the override of the non-disclosure.

The county child support worker shall update the non-disclosure indicator on the automated child support system within five working days of the date of receipt of the affidavit. Interjurisdictional cases will be handled as follows:

1. Initiating Interjurisdictional Cases: Treated the same as an in-state case with the exception that the affidavit will be sent to the responding jurisdiction along with the other required intergovernmental forms.

2. Responding Interjurisdictional Cases: If the initiating jurisdiction indicates that there is a nondisclosure granted in that jurisdiction, the county child support worker shall update the non-disclosure indicator on the automated child support system within five working days of the date of receipt of the intergovernmental request.

K. No Financial Institution Data Match information or Federal Tax information from the Internal Revenue Service may be disclosed outside of the administration of the Title IV-D program.

L. No information from the National Directory of New Hires or the Federal Case Registry may be disclosed outside of the administration of the Title IV-D program except:

1. In the administration of the plan or any program approved under Part B and Part E of the Social Security Act to locate parents and putative parents for the purpose of establishing parentage or establishing parental rights with respect to a child.

2. In the administration of the plan or any program approved under Part A, Part B, Part D, and Part E of the Social Security Act, which is incorporated by reference; no amendments or editions are included. They may be examined during regular business hours by contacting the Colorado Department of Human Services, Director of the Division of Child Support Services, 1575 Sherman Street, Denver, Colorado 80203; or at any State Publications Depository Library. The Social Security Act is also available on-line at: http://www.ssa.gov/op_home/ssact/ssact.htm.

6.210.2 PAYMENT RECORDS

Child support payment records that do not identify the source of the payments are considered public records and may be released upon request of any person pursuant to Section 24-72-202, C.R.S. No federal tax information, address or any other location information shall be included in the documents provided to the requestor or included for use in any court.

6.210.3 CONFLICT OF INTEREST

Child Support Services Units shall establish processes in which certain case files are worked only by a supervisor or in a manner that provides limited access to case information. An example of these files: employee files or court ordered “sealed” files. Any employee with a personal interest in a case, including but not limited to the employee’s own case or a case of a relative or friend, shall not engage in any Child Support Services activity related to that case and may not view any case information maintained on the automated child support system for that case.

6.210.4 RECORDS 6.210.41 Taxpayer Records Federal tax return information obtained from the Internal Revenue Service shall be safeguarded to comply with Internal Revenue Service safeguarding standards, which include storing information in a locked cabinet or by shredding the information. Disclosure of, or access to, unverified data shall be restricted to individuals directly involved in the administration of the Child Support Services program.

“Unverified” means information which has not been independently verified with the taxpayer or through a third party collateral source. While obtaining verification of locate information, the Child Support Services worker shall not divulge the source of the data being requested for verification. 6.210.42 Financial Records Financial records of an individual are to remain confidential, unless they are part of an action to establish a child support order or to complete a review and adjustment of an existing child support order, in which case, supporting financial documentation used to calculate the monthly support obligation shall be provided to both parties. Any person disclosing financial information inappropriately could face civil damages.

6.210.5 ADOPTION INFORMATION

Adoption information such as adoptive parents’ names, biological parents’ names, or other identifying information shall not be data entered on the automated child support system. The date of adoption or relinquishment shall be documented in the case file to indicate that any prior arrears owed could be assigned to the state.

6.210.6 ACCESS TO INFORMATION

A. No online computer access to electronic records through the automated child support system or other systems or databases will be provided to parties or non-parties.

B. Access to the automated child support system or other systems or databases for any personal reason is prohibited. Access is restricted to business use only and can only be accessed in the usual course of business.

C. County directors of social services or their written designee shall establish written processes to assure that system access is only provided to employees which corresponds to each workers' case assignment.

D. No other division within the state department shall have access to the automated child support system without specific approval from the state Division of Child Support Services. Child Support Services information will be released by granting access to specific automated child support system data elements or by making an extract file of case information available, at the state level, for other programs to access.

E. County directors or their written designees must request from the state Child Support Services Unit access to the automated child support system, for companies or individuals who have entered into contracts or agreements with state and/or county Child Support Services Units, by including the request to access case information in the contract or agreement.

F. State and county Child Support Services Units must perform a background check on all employees prior to authorizing access to Child Support Services information. Employees shall have their fingerprints taken by a local law enforcement agency or any third party approved by the Colorado Bureau of Investigation to obtain a fingerprint-based criminal history record check.

Additionally, the background check must include a Colorado Civil Court record check to obtain any child support case history of the employee.

G. All information eligible for release to related agencies (such as Internal Revenue Service, lottery, Department of Labor, credit reporting agencies, Department of Revenue, Motor Vehicle, Workers'

Compensation, financial institutions, state regulatory agencies, the state controller, and Social Security) will be made available at the state level. 6.210.7 Access to Electronic Vital Records Maintained by the Colorado Department of Public Health and Environment (CDPHE)

A. In order to be granted access to the electronic vital records system maintained by the Colorado Department of Public Health and Environment (CDPHE), an employee of a county delegate Child Support Services Unit must complete and provide to CDPHE a criminal background check and all required forms.

B. Each county delegate Child Support Services Unit must complete a safeguard assessment for each location where employees will be accessing the electronic vital records system using the form prescribed by CDPHE. The safeguard assessment will be completed on a yearly basis thereafter.

C. Each county delegate Child Support Services Unit shall ensure that its employees access the electronic vital records system maintained by CDPHE only for child support services purposes.

D. If a current or former child support services employee’s access to the electronic records system maintained by CDPHE is terminated or needs to be terminated due to a change of employment or job duties, the county delegate Child Support Services Unit shall notify CDPHE and the Colorado Department of Human Services, Division of Child Support Services, within two (2) business days.

The county delegate Child Support Services Unit shall request that access to the electronic vital records system be terminated when an employee no longer needs access for child support enforcement purposes. However, if there is an emergency situation involving a security breach, the county delegate Child Support Services Unit shall notify CDPHE of the need to terminate access, at least on a temporary basis, by the end of the next business day following discovery of the breach. A security breach is defined in the access agreement signed by county delegate child support services staff.

E. If a county delegate Child Support Services Unit determines that the electronic vital records system has been accessed or may have been accessed for non-child support services purposes or accessed by anyone not authorized to do so, it shall report this to CDPHE and the Colorado Department of Human Services, Division of Child Support Services, by the end of the next business day following discovery.

F. A county delegate Child Support Services Unit shall cooperate with any investigation into a security breach relating to the electronic vital records system, including providing any documentation requested to CDPHE and the Colorado Department of Human Services, Division of Child Support Services.

6.220 FEDERAL TAX INFORMATION

A. Federal Tax Information is not to be viewed, either on a computer screen or on a printout of a computer screen, by anyone other than Child Support Services (CSS) staff, CSS contract staff, or CSS attorneys. If an unauthorized person inspects or discloses Federal Tax Information, county CSS staff must report this violation to the State Child Support Services Internal Revenue Service’s point of contact.

B. Federal Tax Information is not to be printed from the automated child support system except if that Federal Tax Information was originally provided by the taxpayer, unless the screen print is appropriately logged and either filed with secure storage controls or appropriately destroyed. The log must contain the following information:

1. Which screen was printed;

2. Who printed the screen;

3. Who had access to the screen print;

4. The name of the obligor;

5. The IV-D case number;

6. The storage location of the screen print; and, 7. The date, method of destruction, and person who destroyed the screen print.

C. CSS Units are prohibited from transmitting Federal Tax Information via a facsimile device or via any form of electronic mail.

D. Only an agency-owned computer and/or other device shall be used to remotely connect and gain access to the automated child support system.

E. If a county uses a visitor’s log in its CSS Unit, the log must include the following items:

1. Date;

2. Visitor’s name;

3. Visitor’s place of business;

4. Driver’s license number, state, and expiration date;

5. The purpose of the visit;

6. The person who escorted the visitor; and, 7. The time the visitor came into the building and the time the visitor left the building.

6.230 COOPERATION BY CUSTODIAL PARTY 6.230.1 Good Cause Good cause is defined as circumstances under which cooperation with the Child Support Services Unit may not be “in the best interests of the child.” In the case of a IV-A referral, the county director or the designate IV-A staff shall make the determination of good cause exemption from referral of a custodial party to the Child Support Services Unit. The Child Support Services Unit may provide information or participate with the county director or designate IV-A staff, as appropriate, to make the determination of good cause exemption. 6.230.11 Cooperation Requirements The custodial party is required to cooperate with the county Child Support Services Unit in:

A. Providing sufficient, verifiable information about the identity and location of the noncustodial parent(s) of the child(ren). Information is sufficient if it includes:

1. Noncustodial parent's full name and Social Security Number; or, 2. Noncustodial parent's full name and at least two of the following items:

a. Noncustodial parent's date of birth;

b. Noncustodial parent's address;

c. Noncustodial parent's telephone number;

d. Noncustodial parent's employer's name and address;

e. The names of the parents of the noncustodial parent;

f. Noncustodial parent's vehicle information (manufacturer, model and license);

g. Noncustodial parent's prison record;

h. Noncustodial parent's military record; or, 3. Noncustodial parent's full name and additional information which leads to the location of the noncustodial parent, or if unable to comply with any of the above.

B. Provide all of the following that the custodial party has or can reasonably obtain that may lead to the identity of noncustodial parent:

1. If parentage has not been established, provide a sworn statement of conception;

2. Statements as to the identity or location of noncustodial parent from other individuals;

3. Records or information as to the whereabouts of records, from specific agencies;

4. Utility bills, parking tickets, credit card receipts, etc., that contain information about noncustodial parent;

5. Telephone numbers or addresses of others who knew the noncustodial parent;

6. Sworn statement documenting efforts taken by custodial party and obstacles encountered by custodial party in pursuit of information about the noncustodial parent;

7. Any other information that may assist the CSS Unit in identifying or locating the noncustodial parent.

C. Establishing parentage of children for whom parentage has not been legally established or is in dispute and for whom assistance or foster care services is requested or provided.

D. Establishing orders for financial and medical support and obtaining medical support for each child, when available to either party, as ordered by the court.

E. Obtaining support payments for the recipient/applicant and for each child for whom assistance or foster care services is requested or provided, and to which the department is entitled to collect pursuant to the assignment of support rights.

F. Obtaining any other payments or property to which the custodial party and/or each child for whom assistance is provided may be entitled, and to which the department is entitled to collect, pursuant to the assignment of support rights. 6.230.13 Cooperation in Foster Care Cases As a condition of continuing eligibility for assistance or to comply with part of the foster care treatment plan, unless exempted for good cause, the custodial party is required to make a good faith effort to provide information about the noncustodial parent(s) of the child(ren) to the Child Support Services Unit. 6.230.2 Cooperation Defined “Cooperation”, as used in this context, is defined as, but not limited to:

A. Appearing at the county department of social services office or other related agency to provide verbal and/or written information, or documentary evidence that is known by, in the possession of, or reasonably obtainable by the individual and which is relevant and necessary;

B. Appearing as a witness in court or other relevant hearing or proceeding;

C. Providing information or attesting to the lack of information requested, under penalty of perjury;

D. Submitting to genetic tests during an administrative or court proceeding conducted to determine parentage;

E. Paying to the CSS Unit of the county department of social services all child support payments received from an obligor or a court after being determined eligible for IV- A or foster care services; and, F. Signing legal documents, as appropriate. 6.230.3 Cooperation Determination The county IV-D administrator, or a designee, is responsible for making the determination of whether a public assistance or foster care recipient has cooperated with the CSS Unit for the purposes of establishing and enforcing child or medical support. 6.230.4 Notification The county CSS Unit shall notify immediately the IV-A unit, foster care unit, or Medicaid unit of any IV-A recipient, foster care placing parent, or Medicaid referral case recipient who fails to fulfill the cooperation requirements of this section. The notification shall describe the circumstances of the non-cooperation and the date(s) upon which it occurred.

The county CSS Unit will not attempt to establish parentage and support or collect support or third party information for medical support in those cases where the custodial party is determined to have good cause for refusing to cooperate. 6.230.5 Custodial Party Cooperates After the CSS Unit has notified the IV-A or foster care units of the custodial party's failure to cooperate, the custodial party may decide to cooperate rather than face penalties with the assistance grant or foster care treatment plan. Should this occur, the CSS Unit shall provide notification to the IV-A or foster care units that the custodial party is now cooperating. The CSS Unit shall provide the notification to the IV-A or foster care units within two (2) working days from the date the custodial party cooperated with the CSS Unit. 6.230.6 Request for Review Through Title IV-A When the custodial party requests a review through IV-A of the determination that they have failed to cooperate with the CSS Unit, the county IV-D administrator, or a designee, shall appear at the IV-A dispute resolution conference and/or state level hearings to provide information concerning the basis for the determination that the custodial party has failed to cooperate with the CSS Unit.

6.240 MEDICAL SUPPORT ESTABLISHMENT AND ENFORCEMENT

6.240.1 MEDICAL SUPPORT ESTABLISHMENT

For all cases in which current child support is being sought (including zero dollar orders), the Child Support Services Unit shall include a provision for either parent to provide health care coverage for the child(ren).

6.240.2 MEDICAL SUPPORT ENFORCEMENT

Unless the child(ren) are receiving public health care coverage, the National Medical Support Notice (NMSN) must be sent to the obligor’s employer if the obligor is ordered to provide health insurance, the obligor is eligible for health insurance, the health insurance is accessible to the child(ren), and the monthly premiums are reasonable in cost.

A. A notice must be sent to the obligor, informing the obligor that the NMSN was sent to their employer and describing the rights and conditions regarding the issuance of the NMSN. The obligor has ten (10) calendar days from the date of the mailing to object with the Child Support Services Unit if the obligor believes there is a mistake in identity and they are not the obligor, there is no order for the obligor to provide health insurance, the health insurance is not accessible to the children, or the monthly premiums are not reasonable in cost.

1. Health insurance is considered not accessible to the child(ren) if the child(ren) resides outside the geographic area of coverage.

2. A premium amount is considered reasonable in cost if the premium payments (child(ren)’s portion) are less than five percent (5%) of the paying parent’s gross income or application of the premium payment (child(ren)’s portion) on the guidelines does not result in a Monthly Support Obligation of fifty dollars($50) or less.

B. The Child Support Services Unit will have ten (10) calendar days from the date the objection is mailed to determine if the objection is valid. If the obligor objects to the enforcement of the NMSN claiming it exceeds the reasonable cost standard, the Child Support Services Unit must determine if the premium amount is five percent (5%) or more of the obligor’s gross monthly income.

C. If the obligor’s objection is valid, the Child Support Services Unit must send a notice of termination to the obligor’s employer with a copy to the obligor. If the obligor’s objection is not valid, the Child Support Services Unit must notify the obligor that the NMSN will remain in effect and that the obligor has the right to object with the court.

D. In subsidized adoption cases, CSS units have the option of enforcing medical support through a NMSN. Verification of the subsidized adoption is required if the Child Support Services Unit chooses not to enforce.

6.250 PROVISION OF SERVICES IN INTERGOVERNMENTAL IV-D CASES BY CHILD SUPPORT

SERVICES (CSS) UNITS

6.250.1 INITIATING STATE/JURISDICTION RESPONSIBILITIES

County CSS Units shall ensure management of the initiating intergovernmental CSS caseload to ensure provision of necessary services, including maintenance of case records and periodic review of program performance on interstate cases.

A. When applicable, use long arm statutes to establish parentage or support. Also, determine if enforcement action can be completed through an instate action such as direct income withholding to the noncustodial parent's out of state source of income.

B. Within twenty (20) calendar days of locating the noncustodial parent in another state, Tribe or country, determine if the filing of an intergovernmental action is appropriate and refer the intergovernmental filing to the Interstate Central Registry of the appropriate state, to the Tribal IV- D program, or to the central authority of the foreign country, or take the next appropriate action.

C. Ask the appropriate intrastate tribunal or refer the case to the appropriate responding state IV-D agency for a determination of the controlling order and a reconciliation of arrearages, if such a determination is necessary.

D. The twenty (20) day time frame begins on the date the obligor’s location is verified and/or necessary documentation to process the case is received, whichever date is later. UIFSA petitions are to be sent directly to the Interstate Central Registry of the appropriate state, to the Tribal IV-D program, or to the central authority of the foreign country.

E. Provide sufficient and accurate information on appropriate standardized interstate forms with each action referred to enable the responding agency to take action. The Intergovernmental Child Support Enforcement Transmittal form and other standardized interstate forms, as prescribed by the state, shall be used for each intergovernmental action request.

F. Request that the responding state include health insurance in all new and modified orders for support.

G. Within thirty (30) calendar days of request, provide additional information and any order and payment record information requested by a state IV-D agency for a controlling order determination and reconciliation of arrearages, or notify the requesting office when information will be provided.

H. Within ten (10) working days of receipt of new case information, submit information to the CSS office in the responding agency. New information includes case status change or any new information that could assist the other agency in processing the case.

I. Instruct the responding agency to close its intergovernmental case and to stop any withholding order or withholding notice that the responding agency has sent to an employer, before transmitting a withholding order or withholding notice, with respect to the same case, to the same or another employer, unless an alternative agreement is reached with the responding agency regarding how to proceed.

J. Notify the responding agency within ten (10) working days when a case is closed and the reason for closure.

K. The CSS Unit may provide any documentation, notification, or information through any electronic means, as long as the electronic transaction is appropriately documented in the case record.

L. If the initiating agency has closed its case pursuant to Section 6.260.5 and has not notified the responding agency to close its corresponding case, the initiating agency must make a diligent effort to locate the obligee, including use of the Federal Parent Locator Service and the State Parent Locator Service, and accept, distribute, and disburse any payment received from a responding agency.

6.250.2 RESPONDING STATE/JURISDICTION RESPONSIBILITIES

County CSS Units shall ensure management of the interstate CSS caseload to ensure provision of necessary services, including maintenance of case records and periodic review of program performance on interstate cases.

A. Ensure that organizational structure and staff are adequate to provide services in intergovernmental CSS cases.

B. County CSS Units must initiate any electronic or manual referral from the Colorado Central Registry within twenty (20) calendar days of the date of referral as found on the ACSES responding interstate recently referred list.

C. If the noncustodial parent is located in another county within ten (10) working days of receipt of the intergovernmental case, the case shall be moved to the county of the noncustodial parent's residence unless:

1. The county was the open enforcing county prior to the intergovernmental referral; or, 2. The county has registered a foreign order; or, 3. The county is the county of the original order.

If the case does need to be moved, the county shall contact the Colorado Central Registry to move the case to the county of the noncustodial parent's residence.

D. Within ten (10) working days of locating the noncustodial parent in another state or country, the CSS Unit will notify the initiating state of the new address. At the direction of the initiating agency, the case may be closed or the case may be forwarded to the appropriate Central Registry, to the Tribal IV-D program, or to the central authority of the foreign country in which the noncustodial parent now resides. 6.250.21 Provide Necessary CSS Services as In state Title IV-D Cases Provide all necessary CSS services as would be provided in instate IV-D cases by:

A. Establishing parentage and attempting to obtain a judgment for costs if parentage is established; if parentage has been determined by another state, whether it was established through voluntary acknowledgment, administrative process or judicial process, it shall be enforced and otherwise treated in the same manner as an order of this state;

B. Establishing child support obligations;

C. Establishing an order for either party to provide medical support in all new or modified orders for child support, if not addressed in the original order;

D. Processing and enforcing orders referred by another agency, pursuant to the UIFSA or other legal processes;

E. Enforcing medical support if there is evidence that health insurance is accessible and available to the obligor at a reasonable cost;

F. Collecting and monitoring support payments for the initiating agency and forwarding payments to the location specified by the initiating CSS office within two business days of the Colorado date of receipt;

G. If a determination of controlling order has been requested, file the request as defined by Section 14-5-207, C.R.S., with the appropriate tribunal within thirty (30) calendar days of receipt of the request or location of the noncustodial parent, whichever occurs later. Notify the initiating agency, the controlling order state, and any state, country, or Tribe where a support order in the case was issued or registered of the controlling order determination and any reconciled arrearages within thirty (30) calendar days of receipt of the determination from the tribunal.

H. Provide timely notice to the CSS office in the initiating agency of any formal hearing regarding establishment or modification of an order. Respond to inquiries regarding intergovernmental case activity within five (5) working days.

I. Respond to inquiries regarding intergovernmental case activity within five (5) working days.

J. Within ten working days of receipt of new information on a case, submit information to the initiating agency. New information includes case status change or any new information that could assist the other agency in processing the case.

K. Notify the initiating state within ten (10) working days of the case closure when a case is closed.

6.250.3 PAYMENT AND RECOVERY OF COSTS IN INTERSTATE IV-D CASES

The responding agency is responsible for payment of genetic tests for establishing parentage. The responding agency is responsible for attempting to obtain judgment for genetic test costs.

The responding agency is responsible for payment of all costs it incurs in the processing of an interstate The responding agency may not recover costs from a Foreign Reciprocating Country (FRC) or from a foreign obligee in that FRC, when providing services under Sections 454(32) and 459A of the Social Security Act. The documents are incorporated by reference; no amendments or editions are included.

They may be examined during regular business hours at the Colorado Department of Human Services, Director of the Division of Child Support Services, 1575 Sherman Street, Denver, Colorado 80203; or at any state publications depository library. The Social Security Act is also available on-line at: http://www.ssa.gov/OP_Home/ssact/ssact.htm. 6.260 Case Management 6.260.1 CSS Case Definition A CSS case is defined as a noncustodial parent who has a duty, or has been alleged to have a duty, of support (not necessarily a court order) whether or not there has been a collection of support. If the noncustodial parent is responsible for the support of children in more than one family, the noncustodial parent is considered as a separate case with respect to each separate family. 6.260.2 Case Records 6.260.21 Case Record Procedures County CSS Units shall establish procedures to ensure that all appropriate functions and activities related to opening a case record are undertaken and completed within the time frames specified. The time frames begin on the date of referral or acceptance of an application and end when the case is ready for the next appropriate activity, e.g. locate, establishment of parentage, establishment of a support order, or enforcement. All activities must be documented on ACSES within five working days. 6.260.22 Opening a Case Within twenty (20) calendar days of receipt of an application or referral of a case, the Child Support Services (CSS) Unit must:

A. Open a case by initiating a case record on the State approved automated child support system by following established procedures.

B. For Title IV-A inter-county transfer cases, the new county must initiate the case on the automated child support system within five (5) working days of referral from IV-A in the new county.

C. Determine necessary action needed.

D. Solicit necessary information from the custodial party or other sources.

E. Initiate verification of information.

F. If location information is inadequate, refer the case for further location.

G. Initiate an automated ledger if an order for support exists, including posting Monthly Support Obligation to the correct class and initiating any arrears balances, if such information is known. If order information is unknown when the case is initiated, the ledger must be initiated within twenty (20) days of when the order information becomes available to the Child Support Services Unit. 6.260.23 Maintenance of Records A. For all cases, the Child Support Services Unit shall maintain an electronic or physical case record for each noncustodial or alleged parent which contains all information collected pertaining to the case. Such information shall include, but is not limited to the following:

1. A chronological listing of information maintained on the State approved automated child support system. Such information shall include:

a. Any contacts with the recipient of IV-A or foster care placing parent who is required to cooperate with the Child Support Services Unit, the date and reason, and the results of such contact;

b. Any contacts with the non-PA custodial party for Child Support Services, the date and reason, and the results of such contact;

c. Any contacts with the noncustodial parent, the date and reason therefore, and the results of such contact;

d. Any contact with any other agency involved in the case.

e. Actions taken to establish or modify a support obligation, establish child support debt, establish parentage, or enforce a support obligation, the dates and results;

f. Identification of the reason for and date of case closure; and g. Any other significant actions taken regarding the case as deemed necessary for caseload documentation and management.

2. The referral document received from the IV-A or foster care units, or the Application for Child Support Enforcement Services form;

3. The written request from the recipient/applicant or the initiating jurisdiction in a responding intergovernmental case to terminate Child Support Services;

4. Information Concerning Noncustodial Parent form, as prescribed by the State Department or similar county created form;

5. A record of efforts to utilize local locate resources and the dates and results of these efforts;

6. A copy of the court or administrative order;

7. A copy of communications to and from the IV-A or the foster care program;

8. A copy of communications to and from the State Department;

9. A copy of communications to and from other Child Support Services Units or agencies;

10. A record of case categories and priorities assigned and reassigned to the case, the date of such determination, and identification of the individual who made the determination;

11. A copy of notices to the noncustodial parent and decisions concerning contested arrears.

12. An accurate and updated automated system ledger, including posting the court ordered Monthly Support Obligation and an accurate arrears balance.

B. Child Support Services staff shall change case categories as prescribed by the state immediately on the automated child support system when the case is ready for the next activity in order to provide documentation that the time frames have been met.

6.260.3 CATEGORIZATION OF WORKLOAD 6.260.31

The CSS Unit shall provide equal services to all cases in the caseload. 6.260.32 The CSS Unit may utilize a case assessment and category system. Such system shall:

A. Include all cases in the system.

B. Ensure that no service including location, establishment of parentage, establishment and enforcement of support obligation is systematically excluded by the system.

C. Provide for notice to the custodial party that the information provided to the CSS Unit, either initially or subsequently, may affect the relative category of the case.

D. Provide that case assessment and category setting shall occur only after the intake information has been reviewed for accuracy and completeness and an attempt has been made to obtain the missing information.

E. Provide for periodic review of cases and notification to the custodial party in those cases that new information may result in a category change for the case. 6.260.33 The CSS Unit shall modify the category of cases as case conditions change. 6.260.4 (None)

6.260.5 CLOSURE OF CASES 6.260.51 Notice and Reasons for Closure Unless otherwise noted, case closure requires a sixty (60) day advance notice of closure to the custodial party. For closure reasons that require notice, the Child Support Services Unit must notify the custodial party of the unit's intent to close the case by sending a notice of closure on the form prescribed by the State Department either by paper or electronic notification sixty (60) calendar days prior to closing a public assistance or non-public assistance case. The case must be left open if the custodial party or initiating agency supplies information in response to the notice which could lead to the establishment of parentage or a support order or enforcement of an order. If the case is a responding interstate case, the notice shall be sent to the initiating agency. Responding intergovernmental cases can only be closed using closure reasons “H” or “I” of this section. If the case is a foster care case, the notice of closure is not required because the custodial party (county department) initiated the request for closure based on the child(ren)'s termination from foster care placement. All records of closed cases must be retained for a minimum of three years. All documentation concerning the closure must remain in the case file.

Public assistance and non-public assistance cases may be closed for one or more of the reasons listed below or in Section 6.260.52 or 6.260.53.

A. There is no longer a current support order and, 1. All arrearages in the case are assigned to the state or;

2. The arrearages are under $500.

B. The noncustodial parent or putative parent is deceased and the death has been verified through sources such as:

1. A newspaper obituary;

2. A death certificate;

3. Contact with the funeral home;

4. The custodial party's statement has been recorded in the case record; or, 5. The Social Security Death Index, and no further action, including a levy against the estate, can be taken.

C. The Child Support Services Unit determines that parentage cannot be established because:

1. The child is at least 18 years old and the action is barred by a statute of limitations;

2. The results of genetic testing have excluded the alleged parent as the parent of the child;

3. A court or administrative process has excluded the alleged parent;

4. The Child Support Services Unit determines it is not in the best interest of the child to establish parentage in a case involving incest, rape, or in any case where legal proceedings for adoption are pending;

5. The identity of the biological, alleged, putative, or presumed parent is unknown and cannot be identified after diligent efforts, including at least one interview by the Child Support Services Unit with the custodial party; or, 6. The child(ren) in the case has had their adoption(s) finalized.

D. The noncustodial parent's location is unknown and the Child Support Services Unit has made diligent efforts using multiple sources, pursuant to Section 6.500, all of which have been unsuccessful in locating the noncustodial parent:

1. Over a two-year period when there is sufficient information to initiate an automated locate effort; or, 2. Over a one-year period when there is not sufficient information to initiate an automated locate effort. Sufficient information is defined as a name and Social Security Number and/or Individual Tax Identification Number (ITIN).

3. After a one-year period when there is sufficient information to initiate an automated locate effort, but locate interfaces are unable to verify a Social Security Number.

All cases in the Child Support Services caseload will be transmitted from the state case registry to the federal case registry. One step in the transmission will be to submit the case to the Enumeration Verification System (EVS) which will assist in identifying and verifying a Social Security Number.

E. The noncustodial parent cannot pay support for the duration of the child's minority (or the child has reached the age of majority), because the parent has been institutionalized in a psychiatric facility, is incarcerated with no chance for parole, or has a medically verified total and permanent disability with no evidence of support potential above the subsistence level, which is defined as the federal poverty level. The Child Support Services Unit must determine that no income or assets are available to the noncustodial parent which could be levied or attached for support.

F. The noncustodial parent’s sole income is from Supplemental Security Income (SSI) payments, or both SSI payments and Social Security Disability Insurance (SSDI). This closure criterion does not apply when the parent is receiving only SSDI benefits. parentage and support must be established in order to use this closure criterion.

G. The noncustodial parent is a citizen of, and lives in, a foreign country, and does not work for the United States government or a company which has its headquarters or offices in the United States and the noncustodial parent has no reachable domestic income or assets and the federal office and the state have been unable to establish reciprocity with the foreign country.

H. The initiating jurisdiction has requested in writing that the interstate case be closed. The sixty (60) day advance notice of closure is not required for these cases. Any income withholding order must be terminated and the responding case closed within ten (10) working days of the request from the initiating agency unless an alternative agreement is reached with that agency.

I. The Child Support Services Unit documents failure by the initiating agency to take action which is essential for the next step in providing services.

J. If a case was closed and then subsequently reopened to process child support payments received after case closure, the case should be closed once payment processing is completed.

The sixty (60) day advance notice of closure is not required for these cases.

K. There has been a change in legal custody in the case.

L. The custodial parent is deceased.

M. The responding jurisdiction does not have statutory authority to take the next appropriate action in the case.

N. Unenforceable as defined in section 6.002. 6.260.52 Closure of Non-Public Assistance Cases Non-public assistance cases may be closed for one of the following reasons or the closure reasons in

Section 6.260.51. Unless otherwise noted, case closure requires a 60-day advance notice of closure to the custodial party.

A. The Child Support Services Unit is unable to contact the custodial party within a 60 calendar day period despite a good faith effort to contact the recipient through at least two different methods: mail, electronic, or telephone. If contact is reestablished with the custodial party in response to the notice which could lead to the establishment of parentage or support, or enforcement of an order, the case must be kept open. After a notice of case closure has been sent, if the custodial party reports a change in circumstances within the 60 days contained in the advance notice of closure, the case shall remain open.

B. The Child Support Services Unit documents non-cooperation of the custodial party and that cooperation of the custodial party is essential for the next step in providing support enforcement services. The notice shall include the basis of the recipient's failure to cooperate and the dates on which it occurred. The applicant requests closure of the case in writing and there are no arrears owed to the State. The 60 day advance notice of closure is not required for these cases.

C. The Child Support Services Unit has provided location only services as requested. The 60 day advance notice of closure is not required for these cases.

D. The status of the case has changed from non-public assistance to public assistance. The 60 day advance notice is not required for these cases.

E. The children have reached the age of majority, the noncustodial parent is entering or has entered long-term care arrangements (such as a residential care facility or home health care), and the noncustodial parent has no income or assets available above the subsistence level that could be levied or attached for support.

F. The noncustodial parent is living with the minor child (as the primary caregiver or in an intact two parent household), and the IV-D agency has determined that services are not appropriate or are no longer appropriate. 6.260.53 Closure of Public Assistance Cases Public assistance cases may be closed for one of the following reasons or the closure reasons in Section 6.260.51. Unless otherwise noted, case closure requires a 60 day advance of closure to the custodial party.

A. The 60 day advance notice of closure is not required for these cases. There has been a finding by the county director or designated IV-A staff of good cause or other exceptions to cooperation with the Child Support Services Unit and the county has determined that support enforcement may not proceed without risk of harm to the child or caretaker relative.

B. The public assistance case has been closed and all possible assigned arrearages have been collected. The Child Support Services Unit is no longer providing services for the current monthly support obligation. The 60 day advance notice of closure is not required for these cases.

C. The public assistance case has been closed, the obligor owes no public assistance arrearages, and a case has been subsequently opened as a Child Support Services non-public assistance case. The 60 day advance notice of closure is not required for these cases.

D. The public assistance case has been closed, there is no order for child support, child support debt, medical coverage, foster care fees, and where, pre 1984, the custodial parent did not request continued child support services (by signing the CSE-34), or post-1984, the obligee requested closure of their child support case in writing. The 60 day advance notice of closure is not required.

E. The children have reached the age of majority, the noncustodial parent is entering or has entered long-term care arrangements (such as a residential care facility or home health care), and the noncustodial parent has no income or assets available above the subsistence level that could be levied or attached for support.

F. The noncustodial parent is living with the minor child (as the primary caregiver or in an intact two parent household), and the IV-D agency has determined that services are not appropriate or are no longer appropriate. 6.260.54 Closure of Foster Care Cases A. In addition to the same closure reasons as public assistance cases under Section 6.260.53, foster care fee cases may also be closed because:

1. The child(ren)'s foster care placement has been terminated; and, 2. There is no longer a current support order; and, 3. Either no arrears are owed or arrearages are under $500 or unenforceable under state law.

B. If the child(ren) is in foster care placement, a foster care fee or foster care child support case may be closed:

1. If there is an order terminating parental rights; and, 2. There is no longer a current support order; and, 3. Either no arrears are owed or arrearages are under $500 or unenforceable under state law.

A sixty day advance notice of closure is required to close a foster care child support case, but is not required to close a foster care fee case. 6.260.55 Closure of Caretaker Relative Cases Child support staff shall not close, at the request of the caretaker relative, one of the two cases against biological parents in caretaker relative cases where each of the biological parents have child support 6.260.56 Tribal Closure Tribal closure codes will be used by the County Child Support Services Unit when dealing with Tribal IV-D programs. These codes will designate the different closure requests made by the tribal nations.

6.260.6 IMAGING

Certified forms of the imaging of the case records may be substituted for the original case records upon prior written approval by the State Department.

Such approval may be granted when the Child Support Services Unit provides the State Department with the methods and procedures that conform to federal standards for the imaging of records.

6.260.7 EXPEDITED PROCESSES FOR CHILD SUPPORT ESTABLISHMENT AND ENFORCEMENT

ACTIONS

County child support units must develop, have in effect, and use procedures for all cases which ensure compliance with expedited process requirements. The procedures must include meeting the expedited process time frames for processing CSS actions based upon the following criteria:

A. Actions to establish an order for support (and parentage, if not previously established) must be completed from the date of service of process to the time of disposition within the following time frames:

1. Seventy five percent (75%) in six (6) months; and, 2. Ninety percent (90%) in twelve (12) months.

B. When an order is established using long arm jurisdiction and disposition occurs within twelve (12) months of service of process on the alleged parent or noncustodial parent, the case may be counted as a success within the six-month tier of the expedited process time frame, regardless of when disposition actually occurs within those twelve (12) months.

6.261 REVIEW AND ADJUSTMENT OF CHILD SUPPORT ORDERS

The Child Support Services Unit is responsible for the following functions in sub-sections 6.261.2 through 6.261.8 regarding the review and adjustment of child support orders for all cases.

6.261.1 (NONE)

6.261.2 NOTICE OF RIGHT TO REQUEST REVIEW

Both parties or their attorney(s) of record, if any, subject to an order must be notified of their right to request a review.

A. The obligee shall receive notification of the right to request a review on the Social Services Single

Purpose Application (SSSPA), the Child Support Services application for services, and/or on the Administrative Process Orders or Judicial Order forms for cases having a support order established or modified by the Child Support Services Unit. At least every thirty-six (36) months, the obligee or the obligee’s attorney of record shall receive notification of the right to request a review via the right to request notice which is automatically generated when a residence or mailing address exists on the obligee's personal record and the order date or the notice date is thirty-six (36) months or older.

B. The obligor or the obligor’s attorney of record shall receive notification of the right to request a review via the right to request notice which is automatically generated when a residence or mailing address exists on the obligor's personal record and the order date or the notice date is thirty-six (36) months or older, whichever is later. The right to request notice generated by the Automated Child Support Enforcement System document generation will automatically be documented in chronology. The obligor or the obligor’s attorney of record shall also receive notification on the administrative process orders or judicial order forms for cases having a support order established or modified by the Child Support Services Unit.

C. The enforcing county delegate Child Support Services Unit must respond to the Automated Child Support Enforcement System's calendar review message indicating the automatic generation of the right to request review notice of each party or their attorney of record. The calendar review alerts the worker when a child(ren) has reached the age of emancipation. Within five (5) business days of receiving the calendar review message and the generation of the right to request review notices, the worker must read the active order and determine if the child(ren) included in the order is emancipated pursuant to Section 14-10-115, Colorado Revised Statutes. If the child(ren) is emancipated and is not the last or only child on the order, the worker shall mail a right to request review notice to each party or their attorney of record.

D. The obligee or the obligee’s attorney of record and the obligor or the obligor’s attorney of record shall receive notification of the right to request a review via the right to request notice which is automatically generated within fifteen (15) business days of when incarceration information is populated as verified indicating incarceration for more than one hundred and eighty (180) days on the obligor’s personal record. The right to request notice generated by the Automated Child Support Enforcement System document generation program will automatically be documented in chronology.

E. Upon reinstatement of a foster care fee order, if it has been greater than six (6) months since enforcing the monthly support obligation, the county child support services unit shall notify the obligor or the obligor’s attorney of record of the right to request a review by generating and mailing the right to request notice within five (5) business days of reinstatement.

6.261.3 CASES SUBJECT TO REVIEW AND ADJUSTMENT

A. Either party in cases with an active order may request a review of the order. The request shall include the financial information from the requesting party necessary to conduct a calculation pursuant to the Colorado Child Support guidelines. The requesting party shall provide his or her financial information on the form required by the Division of Child Support Services.

If the requestor fails to provide the necessary financial information with their request, the review process shall be denied.

B. The delegate Child Support Services Unit may initiate a review of a current child support order upon its own request.

C. In cases containing an active assignment of rights, the Child Support Services Unit shall review the order at least once every thirty six (36) months to determine if an adjustment of the order is In the case of an automatic review with an active assignment of rights, both parties are considered non-requestors and have twenty days from the date of the review notice to provide the necessary financial information.

D. Only the enforcing county delegate Child Support Services Unit shall assess a request for review of a child support order and deny it or grant it and initiate a review.

E. If the current county receives the written request for review, the request must be forwarded to the enforcing county within five calendar days of receipt of the request.

F. Within fifteen (15) business days of receipt of a written request for review, the worker shall determine whether Colorado or another jurisdiction has authority (Continuing, Exclusive Jurisdiction (CEJ)) to conduct the review and modify the child support order. If Colorado has CEJ, the worker will make the assessment as to whether the request for review will be granted or denied pursuant to the standards set forth in paragraph H, below.

G. If another jurisdiction has CEJ:

1. The Child Support Services worker shall determine whether or not a full UIFSA action is needed. If this is needed, the worker shall initiate the reciprocal and generate the general testimony and the uniform support petition. If not, the worker shall generate the last two pages of the Interstate Income and Expense Affidavit. The appropriate forms shall be sent to the requester within five (5) business days of the determination.

2. The forms generated from the automated child support system document generation will 3. The requester shall return the last two pages of the Income and Expense Affidavit to the enforcing county within twenty (20) calendar days.

4. If the requester fails to return the requested documentation within twenty (20) calendar days, the process stops.

5. Within twenty (20) calendar days of receipt of the information from the requester, the Child Support Services worker shall send it to the other state that is to conduct the review.

H. If Colorado has CEJ, and:

1. It has been thirty-six (36) months or more since the last review or adjustment of the support order, the child support services worker must begin the review process following the procedures set forth in Section 6.261.4, unless:

a. It is a request for review of a spousal maintenance order;

b. It is a request for the emancipation of a child who has not emancipated in accordance with Section 14-10-115, C.R.S.;

c. There is a pending administrative process action, court action for modification or a pending “add-a-child action”;

d. It is a request for a change in the allocation of parental responsibility or parenting time;

e. The IV-D case is closed; if so, the requester will be advised in writing that s/he may apply for services;

f. The delegate county Child Support Services Unit is enforcing only arrearages; or, g. The last or only child is within one year of the legal age of emancipation and the modification process may not be able to be completed before the child reaches the legal age of emancipation; the requesting party must be informed of the right to request a modification through court.

2. It has been fewer than thirty-six (36) months since the last review or adjustment of the support order, the child support services worker will begin the review process following the procedures set forth in Section 6.261.4, unless:

a. The requester has not provided a reason for such review or the reason for review arises from the circumstances of the requesting party and the requesting party fails to provide supporting documentation or otherwise fails to demonstrate that there has been a substantial and continuing change in circumstances as set forth in Section 14-10-122, C.R.S., with their request;

b. It is a request for review of a spousal maintenance order;

c. It is a request for the emancipation of a child who has not emancipated in accordance with Section 14-10-115, C.R.S.;

d. It is a request for a change in the allocation of parental responsibility or parenting time;

e. There is a pending administrative process action or court action for modification or a pending add-a-child action;

f. The IV-D case is closed, if so the requester will be advised in writing that s/he may apply for services;

g. The delegate county Child Support Services Unit is enforcing only arrearages; or, h. The last or only child is within one year of the legal age of emancipation and the modification process may not be able to be completed before the child reaches the legal age of emancipation; the requesting party will be informed of the right to request a modification through court.

I. If a request for review of a child support order is denied pursuant to paragraph H, the worker shall inform the requesting party in writing within five (5) business days of receipt of the request. The worker shall also document the date of the request and the reason for the denial in the Automated Child Support Enforcement System. If the request is granted the worker shall initiate the review process within five (5) business days pursuant to Section 6.261.4.

J. If a county delegate CSS unit who is enforcing a current monthly support obligation receives a request for review of a child support order, which does not contain medical support provisions or which contains a request to change the party ordered to provide medical support, the request shall be granted and the review conducted, including a review of the MSO, regardless of the date of the last review or adjustment. The modified order shall state that “either” party, “respondent” or “petitioner” party shall provide medical support unless it is a caretaker or foster care fee order.

K. Within fourteen (14) days of information and confirmation that the Obligor is incarcerated and has been sentenced to one hundred-eighty (180) days or greater, the delegate county child support services unit shall initiate a review of the order if the current monthly support obligation is not already a minimum order amount.

6.261.4 CONDUCTING THE REVIEW

A. The Child Support Services worker shall send the following documents to the requesting party or their attorney of record, except in foster care cases where the requesting party is the county department, at least thirty (30) calendar days prior to commencement of the review:

1. The Review Notice; and, 2. At county option, the county may choose to send the Administrative Subpoena to obtain additional income/financial information.

The forms generated from the automated child support system document generation will B. The Child Support Services worker shall send the following documents to the non-requesting party or their attorney of record, except in foster care cases where the non-requesting party is the county department, thirty (30) calendar days prior to commencement of the review. In interjurisdictional cases, a copy shall also be sent to the other agency involved in the case:

1. The Review Notice; and, 2. The Income and Expense Affidavit.

The forms generated from the automated child support system document generation will C. The Child Support Services worker shall conduct the review on or before the thirtieth calendar day following the date the Review Notice is sent to the parties using income information from each party's Income and Expense Affidavit and/or the Department of Labor and Employment records and/or other reliable financial/wage information. The review may be conducted in person at the Child Support Services office, via United States mail, or via an electronic communication method.

D. The delegate Child Support Services Unit may grant a continuance of the review for good cause.

The continuance shall be for a reasonable period of time and shall not exceed thirty (30) calendar days.

E. When conducting the review, the Child Support Services worker shall apply the child support guidelines to determine any inconsistencies between the existing child support award amount and the amount resulting from application of the child support guidelines.

F. If the non-requesting party or their attorney of record fails to provide financial or wage information, the Child Support Services worker shall use income information which is available to the Child Support Services Unit through Colorado Department of Labor and Employment records and/or other verified sources such as the State Parent Locator Service, the Expanded Federal Parent Locator Service, and the State Employment Security Administration. Information from the other party/parent or from a prior review or establishment action may also be used.

G. If the Child Support Services Unit determines that a parent is voluntarily unemployed or underemployed or in the absence of reliable information, the Child Support Services Unit shall then determine, and document for the record, the parent’s potential income. In determining potential income, the Child Support Services Unit shall consider the specific circumstances of the parent to the extent known, including consideration of the following when said information is available: the parent’s assets, residence, employment and earnings history, job skills, educational attainment, literacy, age, health, criminal record and other employment barriers, and record of seeking work, as well as the local job market, the availability of employers willing to hire the parent, prevailing earnings level in the local community, and other relevant background factors in the case. All steps taken to obtain financial information must be documented.

H. In conducting the review, the Child Support Services worker shall examine the existing order to determine if a medical support provision needs to be added or modified.

6.261.5 TERMINATION OF REVIEW

If the applicant for services or continued services party requests case closure after a review of the order has been initiated, the county CSS shall complete the review (and modification, if appropriate) before the IV-D case is closed. If the results of the review indicate a post-order change of physical care, the review and modification shall be completed and then the case closed, if appropriate. 6.261.6 (Reserved for Future Use)

6.261.7 REVIEW RESULTS, NO ADJUSTMENT REQUIRED

Judicial and Administrative Process Orders: After completion of the review, the child support services worker may determine that there is no adjustment required in the ordered child support amount because the guideline calculation does not indicate at least a ten percent change in the ordered child support amount and/or the provision for medical support is already a part of the order.

Within five (5) business days of completing the review, the Child Support Services worker shall provide to each party or their attorney of record, including the foster care agency and other child support agencies:

A. The Post Review Notice stating that a “substantial and continuing change of circumstances” has not been shown but that a party may file his or her own motion to modify with the court.

B. The Guideline Calculation Worksheets.

C. The forms generated by the automated child support system document generation will 6.261.8 REVIEW RESULTS, ADJUSTMENT REQUIRED A. Judicial Orders: After completion of the review, the Child Support Services worker may determine an adjustment is necessary because the guideline calculation indicates at least a ten percent change in the ordered child support amount and/or a change in or addition of medical support provision is needed.

1. Within five (5) business days of completing the review and determining that an adjustment is required, the Child Support Services worker shall provide to the obligor and obligee or their attorney of record and to the other agency involved in interjurisdictional cases:

a. The Post Review notice;

b. The guideline calculation worksheets;

c. All supporting financial documentation used to calculate the monthly support obligation; and, d. The order/stipulation.

2. Either party may file a challenge to the review results based on the post review notice or the proposed order:

a. The challenge must be received no later than the fifteenth day following the Post Review Notice date.

b. The challenge must be in writing.

c. The challenge must be based on alleged mathematical or factual error in the calculation of the monthly support obligation.

d. The delegate Child Support Services Unit may grant an extension of up to fifteen (15) calendar days to challenge the review results based upon a showing of good cause.

e. The delegate Child Support Services Unit shall have fifteen (15) calendar days from the date of receipt of the challenge to respond to the challenge.

f. If a challenge results in a change in the monthly support obligation, the delegate Child Support Services Unit shall provide an amended notice of review and a new order/stipulation to the parties.

g. Both parties are then given fifteen (15) calendar days from the date of the amended notice of review to challenge the results of any subsequent review.

3. Within five (5) business days of determining that a review indicates that a change to the monthly support obligation is appropriate, and the review is not challenged or all challenges have been addressed, the delegate Child Support Services Unit shall file with the court:

a. A Motion to Modify; and, b. The order/stipulation.

4. Upon receipt of the order/stipulation from the court, the Child Support Services worker shall send copies to the parties or their attorneys of record and to the other agency involved in interjurisdictional cases. The Child Support Services worker shall document the automated child support system chronology with this activity.

5. Within five (5) business days of determining that a challenge cannot be resolved, the Child Support Services worker shall file with the court:

a. A Motion to Modify;

b. The order/stipulation;

c. The Guideline Calculation Worksheets; and, d. The Imputing Potential Income Checklist, with comments made in the Guideline Worksheet, if applicable, e. Income and Expense Affidavits of the parties.

6. Within eighteen (18) days of determining that a challenge cannot be resolved, the Child Support Services worker shall check for the court’s signature on the order; if the court has not signed the order, set a hearing pursuant to local court rules.

7. After a hearing has been set, the Child Support Services worker shall send copies of the notice of hearing to the parties or their attorneys of record and to the other agency involved in interjurisdictional cases and document the automated child support system’s chronology with this activity.

8. If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless another agency is enforcing an interjurisdictional case or the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:

a. Send a notice to withhold income for support within fifteen (15) calendar days of the date the modified order is entered;

b. Send a notice to withhold income for support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires;

c. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the modified order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

B. Administrative Process Orders: After completion of the review the Child Support Services worker may determine an adjustment is necessary because the guideline calculation indicates at least a ten percent change in the ordered child support amount and/or a change to or an addition of a medical support provision is needed.

1. Within five (5) business days of completing the review and determining that a modification is required, the Child Support Services worker shall provide to the obligor and obligee or their attorney of record and to the other agency involved in interjurisdictional cases:

a. The Administrative Process Notice of Financial Responsibility for Modification form, which schedules a negotiation conference fifteen (15) days from the review date, b. The Guideline Calculation Worksheets, c. All supporting financial documentation used to calculate the monthly support obligation; and, d. The Administrative Process Modified Order of Financial Responsibility.

2. Either party may file a challenge to the review results based on the Administrative Process Notice of Financial Responsibility for Modification or the Administrative Process Modified Order of Financial Responsibility:

a. The challenge must be received no later than the fifteenth (15th) day following the date of the review results or date of the negotiation conference.

b. The challenge must be based on alleged mathematical or factual error in the calculation of the monthly support obligation.

c. The delegate Child Support Services Unit may grant an extension of up to fifteen (15) calendar days to challenge the review results based upon a showing of good cause.

d. The delegate Child Support Services Unit shall have fifteen (15) calendar days from the date of receipts of the challenge to respond to the challenge.

e. If a challenge results in a change in the monthly support obligation, the delegate Child Support Services Unit shall deliver, as defined in 6.002 -definitions, an amended notice of review and a new Notice Of Financial Responsibility For Modification to the parties or their attorney of record and to the other agency involved in interjurisdictional cases. The notice must include a date and time for the negotiation conference.

f. Both parties are then given fifteen (15) calendar days from the date of the amended notice of review to challenge the results of any subsequent review.

3. If the APA-Petitioner and APA-Respondent sign the Administrative Process Modified Order of Financial Responsibility at the negotiation conference or returns it in the mail prior to the negotiation conference date, then the county director or APA certified county CSS staff member signs the Administrative Process Modified Order of Financial Responsibility. The Child Support Services worker shall, within five (5) business days, file with the court:

a. The Administrative Process Notice of Financial Responsibility for Modification;

b. Income and Expense Affidavits of the parties;

c. The Guideline Calculation Worksheets; and, d. The Imputing Potential Income Checklist, with comments made in the Guideline Worksheet, if applicable, and, e. The Administrative Process Modified Order of Financial Responsibility.

4. The Administrative Process Modified Order of Financial Responsibility shall also be provided to the parties and to the other agency involved in interjurisdictional cases on the same date it is filed with the court.

5. If the APA-Petitioner and APA-Respondent does not sign and return the Administrative Process Modified Order of Financial Responsibility, but:

a. A party appears at the negotiation conference and does not agree, the Child Support Services worker within five (5) business days shall file with the court:

1) The Administrative Process Notice of Financial Responsibility for Modification;

2) The Guideline Calculation Worksheet;

3) The Imputing Potential Income Checklist and affidavit, if any;

4) The delegate Child Support Services Unit's request for court hearing; and, 5) Income and Expense Affidavits of the parties.

After a hearing is set, the Child Support Services worker shall file a Notice of Hearing with the court and send copies of the Notice of Hearing to the parties or their attorneys of record and to the other agency involved in interjurisdictional b. If the APA-Petitioner and the APA-Respondent does not appear at the negotiation conference, the Child Support Services worker, within five (5) business days shall file with the court:

1) The Administrative Process Notice of Financial Responsibility for Modification;

2) Income and Expense Affidavits of the parties;

3) The Guideline Calculation Worksheets;

4) The Affidavit of Non-Appearance for modification; and, 5) The Administrative Process Default Order of Financial Responsibility (modified).

c. Upon receipt of a copy of the default order with signed approval by the judge or magistrate, the Child Support Services worker shall send copies to the parties or their attorneys of record and to the other agency involved in interjurisdictional d. The Child Support Services worker shall document this activity on the automated 6. If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless another agency is enforcing an interjurisdictional case or the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:

a. Send a notice to withhold income for support within fifteen (15) calendar days of the date the modified order is entered;

b. Send a notice to withhold income for support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires, c. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the modified order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

6.262 POST-ORDER CHANGE OF PHYSICAL CARE

A. If it is alleged that there has been a post-order change of physical care the enforcing county CSS shall initiate a review of the order. If a change in physical care is indicated, the enforcing county CSS shall pursue a judicial modification of the order.

B. If the child’s residence has changed to a caretaker, who is currently not a party to the case, the CSS shall also file a motion and order to join that person as a party to the case, if their identity and location is known. In the motion to modify the existing order, the enforcing county shall also request the establishment of an order against the parent who previously had custody. The order of modification shall modify the existing order and establish the new order against the parent who previously had custody all in the same action under the same docket number. This shall be completed even if the new caretaker does not want child support services. The modification shall be completed and the IV-D case closed, if appropriate, after entry of the order of modification.

6.270 CHILD SUPPORT SERVICES PROGRAM PLAN

Each county department shall forward its CSS County Program Plan for the next calendar year to the State Department by December 31 of each year. The plan shall be submitted to the State Department on prescribed State form. If the plan is disapproved, the county department will negotiate mutually acceptable goals with the State Department. If agreement cannot be reached, counties may request reconsideration by the Executive Director or a designee of the Colorado Department of Human Services.

The county department will be bound by the decision of the Executive Director or designee. Satisfactory completion of this process is required to ensure the county department receives continued federal financial participation. 6.270.3 Each county's program plan must set county goals in order to meet annual statewide goals set by the State Division of Child Support Services.

A. If a county fails to:

1. Submit an annual county program plan; revised annual county program plan as required by the state office; or 2. Submit a plan which establishes goals consistent with statewide goals, B. Then the State Division will take appropriate corrective action to ensure that a satisfactory county program plan is submitted and approved.

6.280 REPORTING

County departments shall provide the State Department with reports and fiscal information as deemed necessary by the State Department. 6.300 (None)

6.400 INTAKE

County Child Support Services Units shall establish procedures to ensure that all activities regarding intake are undertaken and completed within the time frames, along with appropriate and specified functions pursuant to Section 6.260.22. The time frames begin when the application or referral is received and end when the case is ready for the next appropriate activity, e.g., locate, parentage establishment, establishment of a support order, or enforcement. All activities must be documented on the automated 6.400.1 INTAKE FUNCTIONS The following functions are the responsibility of the Child Support Services Unit with regard to intake of child support services cases:

A. The Child Support Services Unit shall assure that for each noncustodial or alleged parent of children for whom Child Support Services are sought for non-public assistance cases, a Form CSS-6 shall be completed by the applicant; however, an application is not required in a responding intergovernmental case. The Child Support Services Unit shall provide an application to the applicant pursuant to Section 6.201.2.

B. The Child Support Services Unit shall assure that for all cases for which IV-A and/or foster care is being provided that the custodial party cooperate, unless a finding of good cause exemption from referral to the Child Support Services Unit has been granted by the county director or designee, in:

1. Location of noncustodial or alleged parents;

2. Determination of parentage;

3. Establishment and modification of support orders, both financial and medical; and, 4. Enforcement of support orders.

C. Upon receipt of a good cause determination from the county director or designee, the Child Support Services Unit shall close the Child Support Services case.

D. The Child Support Services Unit shall assure that written explanations about Child Support Services and custodial party rights and responsibilities are provided to public assistance recipients receiving Child Support Services pursuant to Section 6.201.1 E. Within twenty (20) calendar days of receipt of an application or referral, the Child Support Services Unit must open a case and take appropriate action pursuant to Section 6.260.22. When CSS is enforcing an existing order, the county must send the state prescribed documents regarding payment options and possible enforcement remedies to the parties in the case.

F. The Child Support Services Unit shall assure that Form CSS-7 be forwarded to the IV-A unit or that other written notice be sent to the foster care unit within five (5) working days of failure to cooperate by the custodial party of a child receiving IV-A or by the placing parent of a child in foster care placement, unless good cause exemption from referral to the Child Support Services Unit has been granted by the county director or designee.

G. The Child Support Services Unit shall assure that for each noncustodial or alleged parent, a unique case number is established to identify the case.

H. The Child Support Services Unit shall assure that all cases are categorized as set forth in these rules.

I. The Child Support Services Unit shall assure that case records and financial records be established for each child support services case according to these rules and procedures prescribed by the State Department.

6.500 LOCATE

Attempts to determine the physical whereabouts of noncustodial parents, placing parents, or the noncustodial or placing parents' employer(s), other sources of income or assets, as appropriate, for parentage establishment, establishment or modification of a child support order or enforcement of an order are a required service of the Child Support Services program. Locate activity is provided for all 6.501 LOCATE PROCEDURES County Child Support Services Units shall establish procedures to ensure that all appropriate locate activities are undertaken and completed within the time frames specified. The time frames begin when it is determined that location of the noncustodial or placing parent is necessary and end when the noncustodial or placing parent is located and the case is ready for the next appropriate activity, e.g. establishment of parentage, establishment or modification of a support order or foster care fee order, or enforcement. All locate activities must be documented by source (Division of Motor Vehicles, Department of Labor and Employment, no hit, etc.) on the automated child support system.

6.502 LOCATE FUNCTIONS

Within seventy-five calendar days of determining that location is necessary, the Child Support Services Unit must access all appropriate locate sources including transmitting appropriate cases to the Expanded Federal Parent Locator Service and ensuring that information is sufficient to take the next appropriate action in a case. In intergovernmental cases, it is the responsibility of the initiating agency, rather than the responding state, to access the Expanded Federal Parent Locator Service when appropriate, and provide new locate information to the responding agency. However, if the initiating agency is a foreign country, the responding agency should access the expanded Federal Parent Locator Service. 6.502.1 The Child Support Services Unit must assess each locate case to determine appropriate locate sources.

Available locate sources include:

A. State locate sources such as the Department of Labor and Employment and the Division of Motor Vehicle, Workers' Compensation and state directory of new hires;

B. Current or past employers;

C. Local telephone company, United States Postal Service, financial references, unions, fraternal organizations, parole and probation records and police records;

D. Expanded Federal Parent Locator Service and other state parent locators;

E. Local offices administering public assistance, general assistance, medical assistance, food assistance, and social services;

F. Custodial party, friends, and relatives of noncustodial parents;

G. Credit reporting agencies.

1. A full credit report may be obtained only if a child support order exists, except as provided in Section 6.709.3.

2. If a child support order does not exist, an inquiry using the Social Security Number will provide residential and employment information, if available. 6.502.2 A Child Support Services Unit may obtain information from public utilities through the utilization of an administrative subpoena. The Child Support Services Unit must submit a request for administrative subpoena to the State parent locator by documenting in the chronology of the case the following:

A. All locate resources have been accessed.

B. No location information has been obtained.

6.503 LOCATION IN INTERGOVERNMENTAL CASES

The initiating agency must forward a State Parent Locate Service (SPLS) request through manual or electronic means to the IV-D agency of any other jurisdiction within twenty (20) calendar days of receiving information that the noncustodial or alleged parent may be in another jurisdiction. However, if the initiating agency is a foreign country, the responding agency should access the expanded Federal Parent Locator Service.

Upon receipt of information regarding the noncustodial or alleged parent, all appropriate follow up must be completed by the Child Support Services Unit to verify the location information received.

6.504 REPEATED LOCATION ATTEMPTS

Location attempts, except for Federal Parent Locater Service (FPLS), shall be repeated quarterly or immediately upon receipt of new information when adequate identifying and other information exists which may aid in location, whichever occurs sooner.

A. Quarterly attempts may be limited to automated sources, but must include accessing the Department of Labor and Employment files.

B. When repeated location attempts are necessary because of new information, all appropriate locate sources must be accessed within seventy-five (75) calendar days.

6.600 ESTABLISHMENT OF PARENTAGE

6.600.1 STATUTE OF LIMITATIONS

In a IV-D case involving a child for whom parentage has not been legally established, the Child Support Services Unit shall attempt to establish the parentage of such child if the action can be brought prior to the child’s eighteenth birthday:

A. Unless a good cause exemption on a mandatory referral to the Child Support Services Unit has been determined by the county director or designated staff.

B. If the statute of limitations in effect at the time of the child's birth was less than eighteen years, the county Child Support Services Unit may bring an action on behalf of the child at any time prior to the child's twenty-first birthday.

C. An action brought solely to establish parentage is not a CSS function.

6.601 PARENTAGE ESTABLISHMENT TIME FRAMES

County Child Support Services Units shall establish procedures to ensure that all appropriate parentage establishment activities are undertaken and completed within the timeframes specified. In judicial cases the timeframes begin when the alleged or presumed parent is located. For APA cases, it begins when the APA-Respondent is located and ends when parentage and a support obligation are established or the alleged or presumed parent is excluded. All parentage establishment activities must be documented on the automated child support system.

A. Within ninety (90) calendar days of locating the alleged parent or when the APA-Respondent is located, the Child Support Services Unit must:

1. Document unsuccessful attempts to serve process, or, 2. Complete service of process, establish parentage, and establish an order for support.

B. Repeated unsuccessful service of process attempts are not a valid reason for not meeting the time frames. If service of process is unsuccessful because of a poor address, the case shall be referred back to the locate function.

6.601.1 GOOD CAUSE

If good cause exemption has not been established and the custodial party or placing parent fails to cooperate with the Child Support Services Unit, the Child Support Services Unit shall complete a Notice of Non-Cooperation of Caretaker and forward the notice to the county IV-A unit, or the Division of Child Welfare.

6.602 DETERMINATION OF PARENTAGE STATUS

A. Before initiating a judicial or APA case, the CSS shall conduct parentage and order research to determine if parentage of the child has been established by a judicial or APA order or determined pursuant to the laws of Colorado or another state.

B. For all Colorado births, the CSS Unit shall research the Colorado Vital Information System (COVIS) to determine if the parents’ names are listed on the child’s birth certificate and the method/grounds used to list a non-birthing parent, if any. The CSS shall determine if, for any listed non-birthing parent:

1. A presumption of parentage based on marriage or a civil union exists, 2. A court or APA order establishing parentage exists, or 3. A voluntary acknowledgment of parentage has been filed.

C. The CSS Unit shall examine the child’s birth certificate, if obtained and the COVIS record for the parents and child to determine if the parents’ names are listed on the certificate according to law.

If not, the CSS shall notify Colorado vital records of any inconsistency or error and take other appropriate actions to correct the error or omission.

6.602.1 ESTABLISHMENT OF PARENTAGE

A. If parentage has not been established or determined for the child, the CSS Unit shall pursue the establishment of parentage.

B. If parentage has been established or determined for the child, the CSS Unit shall not pursue the establishment of parentage but shall pursue the establishment of child support actions as 6.602.2 PRESUMPTION OF PARENTAGE A. The CSS Unit shall determine if a presumption of parentage exists pursuant to Section 19-4-105, C.R.S. or 14- 15-101, et seq., C.R.S. as to one or more alleged or presumed parents of the child.

B. The CSS Unit shall only use the judicial process to establish parentage if multiple alleged/presumed birthing parents or multiple alleged/presumed non-birthing parents of a child exist.

6.603 VOLUNTARY ACKNOWLEDGEMENT OF PARENTAGE

County Child Support Services Units shall provide all parents who are applying for services with or are referred to the Child Support Services Unit with the opportunity to voluntarily acknowledge parentage at the Child Support Services office. The Child Support Services Unit shall provide to parents the voluntary acknowledgment form prescribed and furnished by the state registrar and oral and written state prescribed standardized notices stating the alternatives to, the legal consequences of, and the rights and responsibilities that arise from signing the acknowledgment. Either the Child Support Services Unit or a party of the case shall forward the completed acknowledgement of parentage form to the Department of Public Health and Environment, the Division of Health Statistics and Vital Records, according to the instructions provided on the form.

6.603.1 RESCISSION AND CONTEST OF A VOLUNTARY ACKNOWLEDGEMENT OF PARENTAGE

A. A signed voluntary parentage acknowledgment is considered a legal finding of parentage, subject to the right of either party who signed the acknowledgment to rescind the acknowledgment within the earlier of:

1. Sixty (60) calendar days from the date signed; or, 2. The date of a prior administrative or judicial proceeding relating to the child in which the person who signed the parentage acknowledgment is a party.

B. When a party in a IV-D case notifies the Child Support Services Unit of their desire to rescind their signature on a voluntary acknowledgement of parentage or to contest parentage based on a voluntary acknowledgement of parentage and the voluntary acknowledgement of parentage was filed with the Colorado Department of Public Health and Environment, Division of Health Statistics and Vital Records, and parentage has not been established by or pursuant to the laws of Colorado or another state, the Child Support Services Unit shall, through administrative process, if appropriate, pursue the establishment of parentage and support and order genetic testing.

1. If the results of the genetic testing establish a threshold of probability of parentage of ninety-seven percent (97%) or higher and the party continues to contest parentage, the Child Support Services Unit shall proceed with administrative process procedures to establish a temporary support order and request a court hearing to obtain a court finding and order.

2. If the results of the genetic testing establish a threshold of probability of parentage of ninety-seven percent (97%) or higher and the party does not continue to contest parentage, the Child Support Services Unit shall proceed with administrative process procedures to establish an appropriate administrative process parentage and support 3. If the results of the genetic testing do not establish a threshold of probability of parentage of at least ninety-seven percent (97%), the Child Support Services Unit may dismiss the action or take such other appropriate action as allowed by law, including filing a request for court hearing.

4. If the court finds that the parent who signed the voluntary acknowledgment of parentage is not the legal parent of the child and orders that such parent’s name be removed from that child’s birth certificate, the Child Support Services Unit shall notify the Department of Public Health and Environment, Division of Health Statistics and Vital Records, and request that they remove the party's name from the child's birth certificate. The notification shall be either a certified copy of the court order or a modified report of paternity determination, as prescribed by the Division of Health Statistics and Vital Records.

6.603.2 CONTESTING PARENTAGE ESTABLISHED BY A VOLUNTARY ACKNOWLEDGEMENT OF

PARENTAGE

A. When a party in a IV-D case notifies the county Child Support Services Unit of the desire to rescind their signature on or contests parentage established by a voluntary acknowledgement of parentage and there has been a prior administrative process or judicial proceeding involving the party concerning the support of the child, the party shall be advised to contact the court for resolution.

B. When a party in a IV-D case notifies the county Child Support Services Unit of the desire to rescind their signature on or contests parentage established by a voluntary acknowledgement of parentage and there has been no prior administrative process or judicial proceeding involving the party concerning the parentage or support of the child, and the current proceeding is being conducted through an administrative process action and it has been sixty or more calendar days since the acknowledgment was signed and the parent's name is on the child(ren)’s birth certificate, and parentage has not been established by or pursuant to the laws of Colorado or another state, the Child Support Services Unit shall:

1. Enter an administrative process order for genetic testing, then 2. Establish an administrative process temporary order of financial responsibility and request a court hearing to obtain a permanent court finding and order if the genetic testing results show a ninety seven percent (97%) or greater probability of parentage and the party continues to contest parentage, or 3. If the genetic testing results show a less than ninety-seven percent (97%) probability of parentage, the county Child Support Services Unit may dismiss the action or take such other appropriate action as allowed by law.

C. If the party withdraws their contest of parentage at any time, even after genetic testing has been done and the parent's name is on the child’s birth certificate, the delegate Child Support Services Unit shall enter the appropriate administrative process order if the genetic testing results do show a ninety-seven percent (97%) or greater probability of parentage.

6.604 CONTESTING PARENTAGE BASED ON OTHER PRESUMPTIONS OF PARENTAGE

Whether or not a parent's name is listed on a child’s birth certificate, if one or more presumptions of parentage of a child exist pursuant to Section 19-4-105, C.R.S., including the execution of a voluntary acknowledgment of PARENTAGE for one or more possible birthing parents or one or more possible nonbirthing parents, the delegate Child Support Services Unit shall pursue the establishment of parentage and support for that child judicially and all alleged and/or presumed parents shall be joined as parties in the case, if possible, pursuant to Section 19-4-110, C.R.S.

However, if child support or parentage has already been established against a parent by an administrative or judicial order or parentage has been established pursuant to the laws of another state, a support only order shall be pursued against such parent.

6.604.1 CONTESTING PARENTAGE – NON IV-D CASE

Parties who do not have a IV-D case and request the Child Support Services Unit to assist them in rescinding a voluntary acknowledgment of parentage, and it has been less than sixty (60) days since the voluntary acknowledgment of parentage was signed, and there has been no prior administrative process or judicial proceeding involving the party concerning the support of the child, shall be advised that they may apply for full child support services, or may contact the court for assistance. If it has been more than sixty (60) days since the voluntary acknowledgment of parentage was signed, or there has been a prior administrative process or judicial proceeding involving the party concerning the support of the child, or the party wants to disestablish parentage, the party shall be referred to the court.

6.605 GENETIC TESTING

A. County Child Support Services Units shall require that the child and all other parties in a contested parentage case submit to genetic testing, upon the request of any party, except in cases:

1. Where good cause has been determined; or, 2. Where parentage has been determined by or pursuant to the laws of another state; or, 3. Where parentage has been established by a Colorado administrative process or judicial B. The parties are required to use the genetic testing laboratory designated by the Child Support Services Unit.

C. Counties, or the state Division of Child Support Services on behalf of counties, shall competitively procure, according to county or state procedures, services from genetic testing laboratories which have been accredited. The state Division of Child Support Services shall provide a list of genetic testing laboratories which have been accredited to the county Child Support Services Units.

Genetic testing laboratories procured by the counties must perform, at reasonable cost, legally and medically acceptable genetic tests to identify the parent or exclude the alleged parent. Proof of competitive procurement may be requested by the Colorado Department of Human Services at any time.

D. County Child Support Services Units shall pay the costs of the genetic testing for all parties for instate cases, including long-arm establishment of parentage. For interstate cases, the responding state is responsible for the genetic testing costs, as stated in Section 6.605.2.

E. Genetic testing services may only be provided on open IV-D cases.

F. If genetic testing results excluding the alleged parent are obtained in an APA case, the results shall be filed:

1. In the county and in the court case where an action relating to support is pending, 2. In the court where an order has been entered but is silent as to child support, or 3. In the county where the APA case was conducted.

6.605.1 OBJECTION TO GENETIC TESTING RESULTS

Any objection to the genetic testing results shall be made in writing at least fifteen (15) days before the hearing where the results may be introduced, or fifteen (15) days after the Motion for Summary Judgment is served. If, however, the results were not received at least fifteen days before the hearing, the objection to the genetic testing results shall be made at least twenty-four (24) hours prior to the hearing. In APA cases, the objection must be made at or before the currently scheduled negotiation conference. If no objection is made, the test results shall be entered as evidence of parentage in a parentage action without the need for proof of authenticity or accuracy.

Upon receipt of an objection to the genetic testing results, the delegate Child Support Services Unit will take the following action:

A. If the case is an Administrative Process case, establish a temporary order if appropriate, and file a Child Support Services Unit Request for Court Hearing as required in Section 6.713.

B. If the case has been filed through the Judicial process, request the court to set a hearing to resolve the objection and decide the issue of parentage and child support.

C. The Notice of Hearing must be sent to the parties by the delegate Child Support Services Unit.

6.605.2 GENETIC TESTING COSTS

In all cases, when parentage is adjudicated, the county Child Support Services Units may attempt to enter a judgment for the costs of genetic testing for full payment or prorated payment with a specified monthly amount due to liquidate those costs. In intergovernmental cases, the responding jurisdiction is responsible for the cost of initial genetic testing.

6.606 REPORTING THE DETERMINATION OF PARENTAGE TO THE COLORADO DEPARTMENT

OF PUBLIC HEALTH AND ENVIRONMENT, DIVISION OF HEALTH STATISTICS AND VITAL

RECORDS

A. After a child's parentage has been established, either judicially or administratively, the Child Support Services Unit shall complete and file the State prescribed forms with the Colorado Department of Public Health and Environment, Division of Health Statistics and Vital Records, or with comparable respective agencies in other jurisdictions, to ensure that the parent's name is added to the child's birth record. These documents shall be filed with the Division of Health Statistics and Vital Records within ten (10) days of the judicial or administrative order establishing parentage.

B. The Child Support Services Unit shall document in the Automated Child Support Enforcement System the date on which the State prescribed forms are sent to the Colorado Department of Public Health and Environment, Division of Health Statistics and Vital Records or with comparable respective agencies in other jurisdictions C. Within forty-five (45) days after the State prescribed forms are sent to the Colorado Department of Public Health and Environment, Division of Health Statistics and Vital Records, or with comparable respective agencies in other jurisdictions, the Child Support Services Unit shall attempt to determine whether or not the parent's name has been added to the child's birth record.

If the Child Support Services Unit determines that the parent's name has not been added to the child's birth certificate, they shall attempt to determine why the name has not been added and take all reasonable steps to correct the situation including requesting assistance from the State Division of Child Support Services where appropriate.

D. If the Child Support Services Unit has contact with the Colorado Department of Public Health and Environment, Division of Health Statistics and Vital Records or with comparable respective agencies in other jurisdictions, about corrections needed to the State prescribed forms, the worker shall take all steps reasonably necessary and within their ability to resolve the issue so that the parent's name can be added to the child's birth record. This may include requesting assistance from the State Division of Child Support Services where appropriate.

E. The Child Support Services Unit shall document in the automated child support system the date on which the parent's name has been verified to be on the child's birth record.

6.700 ESTABLISHMENT OF SUPPORT OBLIGATIONS

The following functions are the responsibility of the Child Support Services Unit with regard to the establishment of child support obligations for all Child Support Services cases.

6.700.1 EXPEDITED PROCESS

A. County Child Support Services Units shall establish procedures to ensure that all appropriate functions and activities to establish support obligations are undertaken and completed within the time frames specified. The time frames begin when the APA-Respondent is located and end when a temporary or permanent order is established or service of process is unsuccessful. All support activities must be documented on the automated child support system.

B. Within ninety (90) calendar days of locating the alleged parent or noncustodial parent in judicial cases or the APA-Respondent in APA cases, the Child Support Services Unit must check to ensure that the child(ren) has not reached the age of emancipation; and, 1. Document unsuccessful attempts to serve process, or 2. Complete service of process (or obtain a waiver of service) and establish an order for support (and parentage, if not already established or determined).

C. Actions subject to expedited process must be completed from the time of successful service of process (or obtaining a waiver of service) to the time of disposition within the required time frames.

D. Repeated unsuccessful service of process attempts are not a valid reason for not meeting the time frames. If service of process is unsuccessful because of a poor address, the case shall be referred back to the locate function.

6.701 ESTABLISHING SUPPORT OBLIGATIONS

A. All child support obligations must be established using the Colorado child support guidelines as found in Section 14-10-115, C.R.S., to determine the amount to be ordered. Child Support Services staff shall not deviate from the guidelines. Child Support Services Units shall refer to

Section 6.707 for rules on how to determine income to use in the guideline calculation.

B. In the instance of an adoption subsidy paid for a child, the case shall be handled judicially and when establishing an order against the adoptive parents, the amount of the monthly support order established against the adoptive parent(s) receiving the monthly adoption assistance payments cannot exceed the amount of the monthly adoption assistance payment. If the calculated guideline amount for the monthly support order exceeds the amount of the monthly adoption assistance payment, the Child Support Services Unit must treat this as a deviation and request a court hearing pursuant to Section 6.713 to request the court to accept the adoption assistance payment amount as the order.

C. In all cases, the Child Support Services Unit shall attempt to establish child support obligations and medical support from any person who is legally liable for support of a child.

1. In a foster care referral case, the county Child Support Services Unit shall attempt to establish a foster care fee obligation.

2. In public assistance and foster care referral cases, the Child Support Services Unit shall not pursue the establishment of a child support obligation, child support debt, retroactive support or medical support if good cause exemption has been determined by the county director or designee.

D. Establishing the legal obligation to provide child support includes activities related to establishing the amount of retroactive support due, determining the ability of both parents to provide support, and determining the amount of the support obligation.

E. If the applicant for services or continued services party requests case closure after process has issued in an APA case or a petition has been filed with the court on a judicial case, the county CSS shall complete the establishment case and establish an order (if appropriate) before the IV- D case is closed.

F. In APA establishment cases, including add-a-child actions, the CSS unit shall establish a commencement date of the monthly support obligation as follows:

1. If the order was submitted to the court between the 1st and the 15th of the month, the 1st of the next month, 2. if the order was submitted to the court between the 16th and the last day of the month, the 1st of the month two months in the future, and 3. if a default order is submitted to the court, the 1st of the month two months in the future.

G. In judicial establishment cases, including add-a-child actions, the CSS Unit shall establish a commencement date of the monthly support obligation as follows:

1. If the order was established between the 1st and the 15th of the month, the 1st of the next month, 2. If the order was established between the 16th and the last day of the month, the 1st of the month two months in the future, and 3. If a default order is established, the 1st of the month two months in the future.

6.701.1 HEALTH INSURANCE

For all cases in which current child support is being sought, including zero dollar MSO orders, the Child Support Services Unit shall include a provision for either parent to provide health insurance for their children.

6.702 ESTABLISHING DEBT OR RETROACTIVE SUPPORT

The Child Support Services Unit has the discretion to establish an obligation for Temporary Assistance For Needy Families (TANF) debt, foster care fee debt, and/or retroactive support due based on the county’s procedure.

6.702.1 DEBT

Action taken to establish debt must be pursued in accordance with Section 14-14-104, C.R.S. Debt may be established on public assistance and foster care referral cases.

A. A CSS may establish a debt-only order in APA or judicial cases if public assistance paid for the child(ren) terminates before an order is established and the person who received the public assistance does not want continued services.

B. If additional child support obligations need to be established subsequent to the establishment of a debt only order, the CSS shall use the establishment process, referenced in 6.701(c), including new service of process.

C. If not already established, parentage shall be established in a debt only action and a judgment for costs may also be established.

D. Debt shall not be established for months in which a good cause exemption from referral was in place or months in which the county child welfare department determined that a referral is not 6.702.2 RETROACTIVE SUPPORT A. An order for a reasonable amount of retroactive support due may be included in any action, except a debt-only action, if requested by a custodial party, if there is a time period which occurred prior to or after the receipt of public assistance benefits for which such support can be established.

B. The custodial party shall be required to complete an “Affidavit of Retroactive Support” and return it to the Child Support Services Unit before the initiation of any judicial or administrative action to establish retroactive support. A Child Support Services Unit shall not establish an order for retroactive support unless an “Affidavit for Retroactive Support” has been received from the custodial party. The county Child Support Services Unit shall use the State prescribed “Affidavit of Retroactive Support”.

C. If the custodial party is waiving the right to retroactive support, this shall be reflected in the support order. If the Child Support Services Unit does not establish retroactive support on behalf of custodial parties, the order shall contain a statement to this effect and also an advisement to the noncustodial parent that the custodial party may pursue the establishment of retroactive support separately.

D. Retroactive support shall not be established for:

1. Any months for which the custodial party received public assistance.

2. Any months in which a good cause exemption from referral was in place.

3. Any months in which the county child welfare department determined that a referral is not 4. Any months for which the children did not reside with the custodial party, including months in which the child(ren) were in out of home placement.

5. Any months when the custodial party, noncustodial parent, and the child(ren) lived in the same household.

6. If the retroactive support is being established in a divorce or legal separation action, the amount of retroactive support will be based upon the number of months after the date of physical separation of the parents, the filing date of the action, or the date of service upon the respondent, whichever date is latest.

6.702.3 CALCULATING RETROACTIVE SUPPORT AND CHILD SUPPORT DEBT

A. If action is taken to establish debt in a public assistance case, including Title IV-A, Title IV-E foster care, and non-IV-E foster care referral cases, because no order for a monthly support obligation existed at the time public assistance was paid, the Child Support Services Unit shall use the current monthly support order amount determined by using the Colorado Child Support Guidelines times the number of months that the custodial party received public assistance or the total amount of public assistance paid, whichever amount is lower as the initial basis for the amount of child support debt owed by the noncustodial parent.

1. In a IV-E foster care case, the amount of the foster care fee debt is limited by the total of the unreimbursed maintenance payments for that child(ren).

2. In a non-IV-E foster care case, the amount of the foster care fee debt is limited by the total cost of placement for that child(ren).

B. If action is taken to establish retroactive support, the Child Support Services Unit shall use the current monthly support order amount determined by using the Colorado child support guidelines times the number of months that the children lived in the custodial party’s home without the presence of the noncustodial parent as the initial basis for the amount of retroactive support owed by the noncustodial parent.

C. If either the custodial or noncustodial parent does not agree to the proposed amount of retroactive support, a temporary order, according to Section 6.712, must be established and the case referred for a court hearing. The temporary order may not include any amount for child support debt or retroactive support.

6.703 DISMISSAL

If the court or administrative authority dismisses a party or a case for a support order without prejudice, the Child Support Services Unit shall, at the time of dismissal, examine the reasons for dismissal and determine when it would be appropriate to seek an order in the future, and seek a support order at that time. This shall be documented on automated child support system chronology and a review date set.

6.703.1 WITHDRAWAL

When a IV-D case is closed, the CSS shall file with the court a notice of withdrawal in the case.

6.703.2 IMAGING DOCUMENTS

A. A CSS may maintain APA and judicial case orders and documents electronically (imaging).

B. Upon confirmation by a supervisor or IV-D administrator of the CSS, that a true, correct and complete electronic copy of a document has been made, the CSS may shred the original paper.

This confirmation shall be recorded in CSES chronology on the IV-D case.

C. When a IV-D case is closed or APA is no longer appropriate, the CSS shall print a complete copy of the imaged case order and other documents and file them with the court.

6.703.3 ATTORNEY OF RECORD IN APA CASES

A. If a party retains an attorney to represent him or her in an APA case, the party must deliver to the CSS a written notice of representation, signed by the party and the attorney, to the CSS for the notice to be effective.

B. The notice shall state the name of the party, the name, address and telephone number of the attorney and state that the attorney is representing the party/client in the APA case.

C. An entry of appearance or filing a document with a court in a court case is not sufficient.

D. A party must notify the CSS in writing if a party terminates the attorney-client relationship and representation in the APA case.

E. Upon receipt of a notice of representation, the CSS shall deliver a copy of all APA documents to the parties’ attorney of record.

F. Once an attorney withdraws as attorney of record or the attorney-client relationship is terminated by the party, the CSS shall cease further communication with that attorney about the APA case.

G. An attorney of record may not sign a stipulated order on behalf of his or her client, the party must sign the order as well.

6.704 ADMINISTRATIVE PROCEDURES TO ESTABLISH CHILD SUPPORT AND PARENTAGE

Pursuant to Article 13.5 of Title 26, C.R.S., the delegate Child Support Services Unit is authorized to establish certain parentage and child support obligations through administrative procedures.

6.704.1 CASES SUBJECT TO ADMINISTRATIVE PROCESS

A. Administrative procedures to establish a monthly support obligation, foster care fee order, child support debt, foster care debt, medical support and/or retroactive support, or to modify an order established by administrative process shall be used by the delegate Child Support Services Unit in all cases to establish these obligations as appropriate, unless:

1. A court order exists that was issued in this or any other state, tribe, or reciprocating country, which establishes any child support obligation; or, 2. An order for the obligation already exists but excluding appropriate administrative process, add-a-child actions; or, 3. The case requires parentage establishment and the case involves multiple presumed and/or alleged parent(s); or, 4. One or both of the parents in the case is under age eighteen (18); or, 5. A hearing has been scheduled by the court or a request for hearing has been filed with the court by any party on the issue of child support; or, 6. Another state’s order was entered judicially and a modification must be conducted.

7. The court has exercised jurisdiction over a child support issue; or, 8. A court’s parentage only order is not silent as to a child support obligation. If the judicial parentage only order is silent as to child support APA may be used.

B. Administrative process shall be utilized in cases in which a divorce decree is silent on the issue of child support and service in the divorce was by publication. In these cases, the administrative process action (APA) will be filed under a new court number.

C. In cases in which there is a pending court action relating to child support, the Child Support Services Unit shall proceed to utilize administrative process as set forth in these rules. Copies of all documents, including the APA order, shall be filed by the Child Support Services Unit in the existing court case, utilizing the case number of the existing court case.

6.704.2 ESTABLISHING AN ORDER FOR WORK ACTIVITIES

A delegate Child Support Services Unit may establish an administrative order for a noncustodial parent who is unemployed, not incapacitated, and has an obligation of support to a child receiving assistance.

The order would require the noncustodial parent to enter into one or more of the following work activities: private or public employment, job search activities, community service, vocational training, or any other employment related activities available to that particular individual.

6.704.3 ENFORCING COUNTY APPLICATION TO ADMINISTRATIVE PROCESS

Only the enforcing county delegate Child Support Services Unit may initiate an administrative process action (APA). The enforcing county must close an open APA on ACSES before the enforcing county designation can be changed.

6.705 NOTICE OF FINANCIAL RESPONSIBILITY, NOTICE OF FINANCIAL RESPONSIBILITY-

PARENTAGE ACTION OR AMENDED NOTICE OF FINANCIAL RESPONSIBILITY

A. A Notice of Financial Responsibility or amended Notice of Financial Responsibility for add a child cases, as prescribed by the State Department, shall be issued in all establishment cases subject to administrative procedure within twenty-one (21) days of locating the APA-Respondent by the enforcing county delegate Child Support Services Unit.

B. “Issued” shall be defined to mean the date the Notice of Financial Responsibility or amended Notice of Financial Responsibility is delivered to: the United States mail for service by certified mail, or the delegate Child Support Services Unit employee authorized to serve the process, or the delegate Child Support Services Unit's contractual process server, or the U.S. mail for service by first class mail only in an action to modify an existing administrative order.

C. The Notice of Financial Responsibility or amended Notice of Financial Responsibility shall be signed by the county director or an employee of the delegate Child Support Services Unit designated in writing by the county director.

D. The delegate Child Support Services Unit issuing a Notice of Financial Responsibility or amended Notice of Financial Responsibility shall:

1. Check on the automated child support system, R/A Financial History, and the Colorado Benefits Management System (CBMS) to determine all amounts of public assistance expended for the children's benefit by all Colorado counties and include the total amount on the Certification of Official Record.

2. Check the automated child support system to determine the total unreimbursed maintenance payments for Title IV-E foster care cases and with the foster care unit to determine the total unreimbursed costs of foster care placement for non-IV-E foster care cases and include the total amount on the Foster Care Arrearage/Unreimbursed Maintenance Payment Calculation or similar form used by the county Child Support Services Unit.

3. Schedule a negotiation conference date on the Notice of Financial Responsibility or amended Notice of Financial Responsibility thirty-five (35) calendar days from the date the Notice or amended Notice is issued, and 4. Data enter the issuance date and negotiation conference date on the automated child support system within five (5) working days of issuing the Notice or amended notice of Financial Responsibility.

In any instance in which the thirty-fifth (35th) day would fall on a Saturday, Sunday or holiday, the Child Support Services Unit shall set the negotiation conference on the next working day immediately following.

6.705.1 SUBPOENA TO PRODUCE

A. A Subpoena to Produce, as prescribed by the State Department, shall be served on the APA- Respondent with every Notice of Financial Responsibility or amended Notice of Financial Responsibility.

B. The CSS may issue a subpoena to produce to the APA–Petitioner or any third party, person or entity having information and or documents regarding a party that is relevant to any issue in a 6.705.2 INCOME AND EXPENSE AFFIDAVIT The delegate Child Support Services Unit shall include an income and expense affidavit as prescribed by the State Department with every Notice or amended Notice of Financial Responsibility issued.

6.705.3 SERVICE OF THE NOTICE OF FINANCIAL RESPONSIBILITY

A. The delegate Child Support Services Unit shall serve the Notice or amended Notice of Financial Responsibility on the APA-Respondent at least fifteen (15) calendar days prior to the date stated in the Notice or amended Notice for the negotiation conference.

B. The following forms shall be included in the packet served on the APA-Respondent.

1. Notice or amended Notice of Financial Responsibility, 2. Subpoena to Produce, and 3. Income and Expense Affidavit.

C. Either a Return of Service or a Waiver of Service must be obtained in all cases. Within five (5) working days of receipt of a Return of Service or a Waiver of Service, the delegate Child Support Services Unit shall data enter the date of service or the waiver on the automated child support system and send notice of the negotiation conference to all parties or their attorney of record and the other state, if appropriate.

D. If service was by certified mail restricted delivery, the return receipt shall be attached to the return of service. If service was effected by the county director or delegate Child Support Services Unit employee designated in writing by the county director, the director or designated employee shall complete the return of service within five (5) working days of effecting service of process and attach the “green card”.

E. The notice shall be delivered, as defined in section 6.002 – definitions, to the APA-Petitioner at least fifteen (15) calendar days prior to the date stated in the notice or amended notice for the 6.705.4 DELIVERY OF NOTICES AND OTHER DOCUMENTS A. Except for service of process on the APA-Respondent, any order, notice of other document may be delivered to a party or his or her attorney of record by:

1. Hand delivery (including FedEx, UPS etc.) , 2. First class U.S. mail or 3. Fax, e-mail or other form of electronic delivery if consented to by the party/attorney in writing.

B. The written consent for electronic delivery shall state the method of delivery, the phone number, e-mail address and/or any other information necessary to effect delivery and must be agreed to by the CSS.

C. If a preferred method of delivery fails, the CSS may use another authorized form of delivery.

D. Genetic testing information and results are confidential. If mailing, the CSS shall mark the envelope “confidential”. If sending electronically, the communication shall be marked “confidential” and encrypted, if possible.

6.705.5 ADD A CHILD

A. Add-a-child is an establishment action and the CSS shall follow the procedures stated in 26-13.5- 103.5, C.R.S.

B. The CSS unit must ensure the caption in an APA add-a-child case includes the names of all subsequent child(ren) in all documents in the add-a-child case. CSS does not and is not required to file a motion and order with a court to amend a caption in an APA add-a-child case.

6.705.6 COSTS OF COLLECTION

A. A judgment for child support costs may be entered against the APA-Petitioner and/or the APA- Respondent in an APA case or judicially by the court.

B. A judgment for the same costs shall not be entered against both parties.

6.706 NEGOTIATION CONFERENCE

a. Child Support Services Unit employees must be certified by the State Division of Child Support Services to conduct APA and negotiation conferences. Certification requirements are found in

section 6.103.1.

B. The negotiation conference date is originally scheduled in the notice or amended notice. This date can be continued and the “currently scheduled” date is the date of the notice or amended notice or, if continued, the date in the notice of continuance, whichever date is later.

C. The negotiation conference will be conducted in-person (face-to-face) or if requested by the party, the conference may be conducted by telephone, computer program, e-mail, fax or by mail.

However, the party that requested an alternative to an in-person negotiation conference will be responsible for signing and delivering a copy of the signed order to the CSS at the time the conference concludes.

D. A copy of any document used by the CSS to calculate the MSO shall be provided to the parties with a copy of the order.

E. Prior to concluding the negotiation conference, the child support specialist must review the order commencement date, payment options and possible enforcement remedies with the parties as provided by a state prescribed document.

F. If a default order is issued, the county must send the state prescribed documents regarding payment options and possible enforcement remedies with a copy of the order to the parties of the 6.706.1 STANDARD CONTINUANCES A. Upon request of the APA-Petitioner or the APA-Respondent, the negotiation conference shall be continued once per party, not to exceed seven (7) calendar days from the currently scheduled date.

B. If a continuance is requested by a party, the delegate Child Support Services Unit shall issue and deliver a Notice of Continuance of the Negotiation Conference to parties, or their attorneys of record and the other state if appropriate. The notice shall contain the rescheduled date.

C. If a continuance is requested by a party, the delegate Child Support Services Unit shall data enter the type and reason for the continuance and the date for the rescheduled negotiation conference on the automated child support system.

6.706.2 CONTINUANCES FOR GOOD CAUSE

A. More than one continuance and for any number of days may be granted only for good cause as defined in Section 6.706.2(E).

B. Continuances for good cause may be granted only by the county director or delegate Child Support Services employee designated in writing by the county director.

C. If a continuance for good cause is granted, the delegate Child Support Services Unit shall issue a Notice of Continuance of Negotiation Conference to the noncustodial parent, the custodial party, or their attorney of record and the other state if appropriate. The notice shall contain the rescheduled date and will be provided by first class mail or hand delivery.

D. If a continuance for good cause is granted, the delegate Child Support Services Unit shall data enter the type and reason for the continuance and the date for the rescheduled negotiation conference on the automated child support system.

E. A finding of good cause may be made for the following reasons:

1. The case involves a parentage determination and genetic tests results are needed to proceed; or, 2. A valid contest of parentage is made and parentage has not been established pursuant to the laws of another state; or, 3. Additional time is needed to verify income or other information necessary to calculate a child support order pursuant to the Colorado Child Support Guidelines, Section 14 10 115, C.R.S. as amended; or, 4. An allegation of fraud and referral for investigation; or, 5. A party or their attorney, is unable to appear at the negotiation conference due to a sudden severe illness, an accident, or other particular occurrence which, by its emergency nature and drastic effect, prevents a party or their attorney's appearance at the negotiation conference, the burden of proof to show cause of this type shall be upon the party; or, 6. No Child Support Services Unit employee authorized to conduct negotiation conferences is able to attend the negotiation conference due to a sudden severe illness, an accident, or other particular occurrence which, by is emergency nature and drastic effect, prevents an authorized Child Support Services Unit employee from attending the negotiation conference.

6.706.3 POSSIBLE RESULTS OF A NEGOTIATION CONFERENCE – ESTABLISHMENT CASES

A. If both parties appear for the negotiation conference and agree with the order and/or sign a stipulated order prior to or at the negotiation conference, the CSS Unit shall enter a stipulated order if appropriate, B. If neither party appears for the negotiation conference, the CSS Unit shall enter a default order if appropriate, C. If both parties appear and one appearing party does not agree with the proposed order, the CSS Unit shall enter a temporary order, if appropriate, D. If the APA-Respondent appears and agrees with the order, but the APA-Petitioner does not appear, the CSS Unit shall enter a stipulated order if appropriate, E. If the APA-Respondent does not appear the CSS Unit shall enter a default order if appropriate.

6.707 CALCULATING THE MONTHLY CHILD SUPPORT OBLIGATION

A. In any order for financial responsibility, the delegate Child Support Services Unit shall calculate the monthly child support obligation pursuant to the Colorado Child Support Guidelines, Section 14-10-115, C.R.S. The delegate Child Support Services Unit shall not deviate from the amount calculated pursuant to Section 14-10-115, C.R.S.

B. In the instance of adoption assistance services, when establishing an order against the adoptive parents, the amount of the monthly support order established against the adoptive parent(s) receiving the monthly adoption assistance payments cannot exceed the amount of the monthly adoption assistance payment. If the calculated guideline amount for the monthly support order exceeds the amount of the monthly adoption assistance payment, the Child Support Services Unit must treat this as a deviation and request a court hearing pursuant to Section 6.713 to request the court to accept the adoption assistance payment amount as the order.

6.707.1 DETERMINING INCOME

A. The delegate Child Support Services Unit shall calculate the monthly support obligation using reliable information concerning the parents’ actual and/or potential income, as appropriate, which may include, but is not limited to, the following:

1. Wage statements;

2. Wage information obtained from the Department of Labor and Employment;

3. Tax records;

4. Verified statement by the obligee, as prescribed by the State Department;

5. Income and Expense Affidavit, as prescribed by the State Department; or 6. Information from a consumer credit reporting agency.

B. If the Child Support Services Unit determines that a parent is voluntarily unemployed or underemployed or in the absence of reliable information, the Child Support Services Unit shall then determine, and document for the record, the parent’s potential income. In determining potential income, the Child Support Services Unit shall consider the specific circumstances of the parent to the extent known, including consideration of the following when said information is available: the parent’s assets, residence, employment and earnings history, job skills, educational attainment, literacy, age, health, criminal record and other employment barriers, and record of seeking work, as well as the local job market, the availability of employers willing to hire the parent, prevailing earnings level in the local community, and other relevant background factors in the case. All steps taken to obtain financial information must be documented.

6.707.2 NEGOTIATE DEBT AMOUNT

The delegate CSS Unit shall not negotiate the amount of child support or foster care debt unless:

A. No other county or state has unreimbursed public assistance or unreimbursed maintenance payments or unreimbursed costs of foster care placement; or, B. All other counties and states with UPA or UMP or unreimbursed costs of foster care placement have agreed to the negotiated amount in writing; and, C. Automated child support system chronology is updated by the enforcing county delegate Child Support Services Unit to document the agreed upon negotiation.

6.708 ISSUANCE OF APA ORDER OF FINANCIAL RESPONSIBILITY

A. If a stipulation is agreed upon at the negotiation conference, the delegate Child Support Services Unit shall prepare and issue an Order of Financial Responsibility, as prescribed by the State Department.

B. The order shall be signed by the APA-Respondent and the APA Petitioner, if appropriate and by the county director or employee of the delegate Child Support Services Unit designated in writing by the county director.

C. The order shall specify that the noncustodial parent send all payments to the Family Support Registry.

D. The order shall be prepared and signed at the conclusion of the negotiation conference. The order shall advise the noncustodial parent that the unpaid child support balance is entered as judgment.

E. The original order and one copy shall be filed with the clerk of the district court in the county which issued the notice of financial responsibility or in the district court where an action relating to child support is pending or an order exists but is silent on the issue of child support within five (5) business days of the negotiation conference.

F. The following documents shall be filed with the order:

1. Notice or amended Notice of Financial Responsibility;

2. Return of Service or Waiver of Service: if service was by certified mail, the return receipt must be attached to the Return of Service;

3. Guidelines worksheets;

4. Income and Expense Affidavit for noncustodial parent and custodial party;

5. Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if 6. Subpoena to Produce; and 7. Retroactive support affidavit, if the action is for support of the child(ren) prior to entry of the support order.

G. Upon receipt of a copy of the order with a docket number assigned by the court or upon confirmation of receipt from the court clerk through DISH pursuant to Section 6.715, the delegate Child Support Services Unit shall within five (5) working days:

1. Update automated child support system with court order and initiate a ledger; and, 2. Send a copy of the order to the noncustodial parent, or their attorney of record, and to the custodial party of the child by first class mail.

3. For intergovernmental cases, send a copy to the initiating agency.

6.708.1 NOTICE TO WITHHOLD INCOME

If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(II)(A), C.R.S.:

A. Send a notice to withhold income for support within fifteen (15) calendar days of the date the order is entered;

B. Send a notice to withhold income for support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires;

C. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

6.709 ISSUANCE OF ORDER ESTABLISHING PARENTAGE AND FINANCIAL RESPONSIBILITY

A. The delegate Child Support Services Unit shall issue an order establishing parentage and financial responsibility after a negotiation conference if:

1. Neither the custodial party nor the noncustodial parent is contesting the issue of parentage, and 2. A parent's Parentage Advisement and Admission, as prescribed by the State Department, is provided to and signed by the custodial and noncustodial parent.

A. The order shall be signed, electronically or by hand, by APA-Respondent and APA-Petitioner, if appropriate and by the county director or the employee of the delegate Child Support Services Unit designated in writing by the county director.

B. The order shall be prepared and signed at the conclusion of the negotiation conference. The order shall advise the obligor that the unpaid child support balance is entered as judgment.

6.709.1 CONTESTING PARENTAGE

A. If any party contests parentage, the delegate Child Support Services Unit shall issue an Order for Genetic Testing unless parentage has already been established or determined pursuant to the laws of another state. The negotiation conference may be continued in accordance with the provision of Section 6.706.2.

B. A finding of good cause to reschedule genetic testing may be made for the following reasons:

1. A parent is unable to appear at the appointed time or place for genetic testing due to a sudden severe illness, an accident, or other particular occurrence which, by its emergency nature and drastic effect, prevents their appearance at the time or place for genetic testing.

The burden of proof to show good cause of this type shall be upon the parent.

2. Any other reason beyond a party’s control (i.e., if the person authorized to collect the genetic testing sample is unable to appear or fails to appear at the time and place for genetic testing).

C. Rescheduling of the time and place for genetic testing may be granted only by the county director or delegate Child Support Services employee designated in writing by the county director.

D. If rescheduling for good cause is granted, the delegate Child Support Services Unit shall issue an Order for Genetic Testing to the parties with the new date for the genetic testing which shall be delivered to the parties.

E. If the birthing parent or caretaker, and child(ren) fail to appear for or submit to genetic testing, the case shall be set for hearing pursuant to Section 6.713. Upon receipt of the test results, if a stipulation is not reached, the case shall be set for hearing pursuant to Section 6.713.

6.709.2 REQUEST FOR COURT HEARING WHEN PARENTAGE IS AT ISSUE]

If no stipulation is agreed upon at the negotiation conference because a party contests the issue of parentage, the delegate Child Support Services Unit shall file the Notice or amended Notice of Financial Responsibility, genetic testing results, if any, the appropriate APA order, if any and proof of service with the clerk of the court, and shall request the court set a hearing in accordance with Section 6.713.

6.709.3 FILING THE ORDER

The original order and one copy shall be filed with the clerk of the district court in the county which issued the notice of financial responsibility or in the district court where an action relating to child support is pending or an order exists but is silent on the issue of child support within five (5) working days of the A. The following documents shall be filed with the order:

1. Notice or amended Notice of Financial Responsibility (Parentage Action);

2. Return of Service or Waiver of Service: if service was by certified mail, the return receipt must be attached to the Return of Service.

3. Parentage Advisement and Admission;

4. Guideline Worksheets;

5. Income and Expense Affidavits;

6. Subpoena to Produce;

7. Retroactive support affidavit, if the action is for support of the child(ren) prior to the entry of the order establishing parentage;

8. Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if applicable; and 9. Genetic testing results, if any.

B. Upon receipt of a copy of the order with a docket number assigned by the court, the delegate Child Support Services Unit shall within five (5) working days:

1. Update automated child support system with parentage, court order and initiate a ledger, and 2. Send a copy of the order to the noncustodial parent, the custodial party, or their attorney, and the initiating agency, if appropriate, by first class mail.

C. If the obligor’s employer’s address is known, the delegate child support Services unit shall, unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(a), 1. Send a notice to withhold income for support within fifteen (15) calendar days of the date the order is entered;

2. Send a notice to withhold income for support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires.

D. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

E. The order shall specify that the noncustodial parent send all payments to the Family Support Registry.

6.710 ISSUANCE OF DEFAULT ORDER OF FINANCIAL RESPONSIBILITY

A. After service pursuant to Section 6.705.3, if the noncustodial parent fails to appear for the negotiation conference as stated in the Notice or amended Notice of Financial Responsibility, and fails to reschedule the negotiation conference prior to the date and time stated in the Notice or amended Notice of Financial Responsibility, or fails to appear for a rescheduled negotiation conference, the delegate Child Support Services Unit shall:

1. Within five (5) working days of the date of the negotiation conference; or, 2. Within fifteen (15) calendar days of the negotiation conference if the delegate Child Support Services Unit has mailed the noncustodial parent a stipulated order and it has not been signed and returned by the noncustodial parent or a rescheduled negotiation conference has not been conducted within the fifteen (15) days.

File an original Order of Default, as prescribed by the State Department, and one copy with the clerk of the district court in the county in which the Notice of Financial Responsibility was issued, or in the district court where an action relating to child support is pending or an order exists but is silent on the issue of child support.

B. A Default Order of Financial Responsibility will not be issued when the noncustodial parent is incarcerated and fails to appear for the negotiation conference or the rescheduled negotiation conference. In these circumstances, the delegate Child Support Services Unit's worker shall close the administrative process action for the reason that a hearing has been requested. The delegate Child Support Services Unit's worker shall follow the process for requesting a court hearing pursuant to Section 6.713.

6.710.1 FILING THE ORDER OF DEFAULT

A. The following documents shall be filed with the Order of Default:

1. Return of Service or Waiver of Service and, if service was by certified mail, the return receipt must be attached to the Return of Service;

2. Affidavit of Non-Appearance as prescribed by the State Department;

3. Notice or amended Notice of Financial Responsibility;

4. Verified Statement of Obligee, as prescribed by the State Department, used to set the monthly support obligation, or other documentation supporting the guideline calculation of the monthly support obligation such as wage information obtained from the Department of Labor and Employment;

5. Affidavit and Certification of Official Record or Foster Care Arrearage/Unreimbursed Maintenance Payment Calculation as prescribed by the State Department, or documentation supporting the calculation of child support debt such as public assistance payment records, foster care payment records, or arrears calculation information, if appropriate;

6. Guidelines worksheets;

7. Subpoena to Produce;

8. Income and Expense Affidavit for each parent, if available;

9. Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if applicable; and 10. Retroactive Support Affidavit, if any.

B. The default order shall be signed by the county director or employee of the delegate Child Support Services Unit designated in writing by the county director.

C. The order and accompanying documents shall be reviewed by the county director, IV-D administrator, IV-D attorney or supervisor of the APA certified employee of the delegate Child Support Services Unit designated entering the order before the order is filed with the court. The reviewer shall sign the order confirming that the review has been conducted.

D. The delegate Child Support Services Unit shall not take any action to enforce the default order until a copy signed by the court approving the default order is received.

E. If the court has not approved or denied approval of the default order within thirty-six (36) days after filing with the court, the delegate Child Support Services Unit must notify the court that the deadline for approval or denial is in seven (7) days on the forty-second (42nd) day.

F. If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(A), 1. Send a Notice to Withhold Income for Support within fifteen (15) calendar days of the date the order is entered;

2. Send a Notice to Withhold Income for Support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires;

3. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

G. The order shall specify that the obligor send all payments through the Family Support Registry.

H. The effective date of the default order shall be the date signed by the court approving the default I. If the default order is returned to the Child Support Services Unit by the court as not approved, the delegate Child Support Services Unit shall take appropriate action to cure the defect stated by the court as grounds for disapproval.

6.710.2 RECEIPT OF THE ORDER OF DEFAULT

Upon receipt of a copy of the default order approved by the court, the delegate Child Support Services Unit shall within five (5) working days:

A. Update automated child support system with court order and initiate a ledger, and B. Send a copy of the order to the noncustodial parent, the custodial party, or their attorney, and to the initiating agency, if appropriate, by first class mail.

6.711 ISSUANCE OF DEFAULT ORDER ESTABLISHING PARENTAGE AND FINANCIAL

RESPONSIBILITY

A. A default order may be issued in cases where parentage is at issue if, after service pursuant to

Section 6.705.2:

1. The alleged parent fails to appear for the initial negotiation conference as scheduled in the Notice of Financial Responsibility and fails to reschedule a negotiation conference prior to the date and time stated in the Notice of Financial Responsibility or fails to appear for a rescheduled negotiation conference;

2. The alleged parent fails to take or appear for a genetic test and a finding of good cause as described in Section 6.709.1 has not been made; or, 3. The genetic test results, if any, show a ninety-seven percent (97%) or greater probability that the alleged parent is the parent of the child(ren), and the parent fails to appear at the negotiation conference and fails to reschedule the negotiation conference.

B. The delegate Child Support Services Unit shall within five (5) working days of the date of the negotiation conference, or the date of the scheduled genetic test, or within fifteen (15) calendar days of the negotiation conference if the delegate Child Support Services Unit has mailed the noncustodial parent a stipulated order and it has not been signed and returned by the noncustodial parent or a rescheduled negotiation conference has not been conducted within the fifteen (15) days, file an original Order of Default, as prescribed by the State Department, and one copy with the clerk of the District Court in the county in which the Notice or amended Notice of Financial Responsibility-Parentage Action was issued, or in the District Court where an action relating to parentage and child support is pending.

C. A Default Order Establishing Parentage and Financial Responsibility will not be issued when the noncustodial parent is incarcerated and fails to appear for the negotiation conference or the rescheduled negotiation conference. In these circumstances, the delegate Child Support Services Unit's worker shall close the administrative process action for the reason that a hearing has been requested. The delegate Child Support Services Unit's worker shall follow the process for requesting a court hearing pursuant to Section 6.713.

6.711.1 FILING THE ORDER OF DEFAULT

A. The following documents shall be filed with the Order of Default:

1. Return of Service or Waiver of Service: if service was by certified mail, the return receipt must be attached to the Return of Service;

2. Affidavit of Non-Appearance as prescribed by the State Department;

3. Notice or amended Notice of Financial Responsibility (Parentage Action);

4. Verified Affidavit of Obligee as prescribed by the State Department, regarding parentage and genetic tests, if any;

5. Other documentation supporting the guideline calculation of the monthly support obligation such as wage information obtained from the Department of Labor and Employment;

6. Affidavit and Certification of Official Record or foster care arrearage/unreimbursed maintenance payment calculation, as prescribed by the State Department, or documentation supporting the calculation of child support debt such as public assistance payment records, foster care payment records, or arrears calculation information, if appropriate;

7. Guidelines worksheets;

8. Subpoena to Produce;

9. Income and Expense Affidavit for each parent if available;

10. Retroactive Support Affidavit, if any; and, 11. Genetic testing results, if any;

12. Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if 13. Statement Of Parentage; and, B. The default order shall be signed by the county director or employee of the delegate Child Support Services Unit designated in writing by the county director.

C. The order and accompanying documents shall be reviewed by the county director, IV-D administrator, IV-D attorney or supervisor of the APA certified employee of the delegate Child Support Services Unit designated entering the order before the order is filed with the court. the reviewer shall sign the order confirming that the review has been conducted.

D. The delegate Child Support Services Unit shall not take any action to enforce the default order until a copy signed by the court approving the default order is received.

E. If the court has not approved or denied approval of the default order within thirty-six (36) days after filing with the court, the delegate child support services unit must notify the court that the deadline for approval or denial is in seven days (7) on the forty-second (42nd) day.

F. If the obligor’s employer’s address is known, the delegate Child Support Services Unit shall, unless the case meets one of the good cause criteria specified in Section 14-14-111.5(3)(a)(ii)(A), 1. Send a Notice to Withhold Income for Support within fifteen (15) calendar days of the date the order is entered;

2. Send a Notice to Withhold Income for Support to the obligor’s employer within two (2) business days from the report of the obligor’s employment through the state directory of new hires;

3. Send a National Medical Support Notice to initiate health insurance coverage within fifteen (15) calendar days of the date the order is entered or within two (2) business days from the report of the obligor’s employment through the state directory of new hires, if the obligor is the party ordered to provide health insurance and the employer has health insurance available at reasonable cost, as defined in Section 6.240.2, A, 2.

G. The court shall specify that the noncustodial parent send all payments through the Family Support Registry.

H. The effective date of the default order shall be the date signed by the court approving the default I. If the default order is returned to the Child Support Services Unit by the court as not approved, the delegate Child Support Services Unit shall take appropriate action to cure the defect stated by the court as grounds for disapproval.

J. Upon receipt of a copy of the default order approved by the court, the delegate Child Support Services Unit shall within five (5) working days:

1. Update automated child support system with court order, parentage information and initiate a ledger, and 2. Send a copy of the order to the noncustodial parent or his attorney of record to the custodial party and the initiating agency, if appropriate, by first class mail.

6.712 ISSUANCE OF A TEMPORARY ORDER IF NO STIPULATION IS REACHED

If no stipulation is agreed upon at the negotiation conference and parentage is not an issue, or if any party contests parentage and the genetic test results are ninety-seven percent (97%) or higher probability of parentage has previously been determined by another state, the delegate Child Support Services Unit shall issue temporary orders for current child support, arrears, foster care, maintenance, medical support and reasonable support for a time period prior to the entry of the order for support. The Notice or amended Notice of Financial Responsibility and proof of service shall be filed with the clerk of the court.

The Child Support Services Unit shall file a request for hearing in accordance with Section 6.713.

6.713 REQUEST FOR COURT HEARING

A. A request for a court hearing is made when:

1. No stipulation is agreed upon at a negotiation conference and a temporary order is completed; or, 2. the APA-Respondent is incarcerated and does not participate in a negotiation conference or sign a stipulated order, or 3. An alleged or presumed parent is excluded by genetic testing results but facts exist that the person may be a psychological parent, or 4. The APA-Respondent, after valid service of process or execution of a waiver of service, “opts-out” of APA by delivering a written request for court hearing prior to the commencement of the negotiation conference, or 5. A case is referred to court without entry of an administrative order because adoption subsidy payments are being made for a child; or, 6. An order needs to be established but for other reasons cannot be established at the B. No judicial complaint or new service of process is necessary for the transfer of subject matter jurisdiction to the court in these situations, however, the CSS shall issue and file with the court and deliver to all parties a notice of hearing. In these instances, a hearing shall be held and appropriate permanent orders shall be entered without the necessity of a complaint being issued or served on the parties. The delegate Child Support Services Unit shall request the court to set a hearing in the matter by:

1. Filing a Child Support Services Unit Request for Court Hearing, as prescribed by the State Department, with the clerk of the district court in the county in which the Notice of Financial Responsibility was issued or in the district court where an action relating to child support is pending or an order exists but is silent on the issue of child support.

2. Attaching to the Child Support Services Unit Request for Court Hearing the following:

a. Notice of Hearing, as prescribed by the State Department;

b. Notice of Financial Responsibility;

c. Return of Service or Waiver of Service: if service was by certified mail, the return receipt must be attached to the Return of Service;

d. Income and Expense Affidavits of each parent, if available;

e. Temporary Order of Financial Responsibility;

f. Adoption Assistance Agreement, if applicable.

C. The delegate Child Support Services Unit shall file a request for hearing within ninety (90) days of service of the Notice of Financial Responsibility or Notice of Financial Responsibility-Parentage Action on the APA-Respondent or within five (5) of determining that APA is no longer appropriate and that the case must be referred to court, whichever date is earlier.

D. The Notice of Hearing must be sent to the noncustodial parent or the noncustodial parent's attorney and the custodial party and other agency, if appropriate, by the delegate Child Support Services Unit if delegated and authorized by the court in writing.

E. The delegate Child Support Services Unit is responsible for notifying the court of the last day for a hearing to be held in order to decide the issue of child support within ninety days after receipt of notice, commencing on the date the service of the Notice or amended Notice of Financial Responsibility is accomplished. This is the date on the return receipt if service is by certified mail or the date on the return of service, if through personal services.

6.714 MODIFICATION OF ADMINISTRATIVE ORDERS

A. If the current order was established or modified using administrative process and APA is still appropriate, the CSS Unit shall use APA to modify the order.

B. The CSS Unit shall follow the provisions of Sections 26-13-121, 26-13.5-112, and 14-10-122, C.R.S. and Sections 6.261.4 through 6.261.8 and this section of these rules in conducting the review and any modification of the current APA order.

C. At the negotiation conference, the CSS Unit shall enter an order as follows:

1. If both parties appear and agree to the terms of the proposed order, enter a stipulated order of modification, 2. If neither party appears for the negotiation conference, enter a default order of modification, 3. If one or both parties appear and one or both do not agree to the terms of the proposed order, the CSS Unit shall not enter an APA order of modification but shall request a court hearing on the modification and continue to enforce the current order until modified by the court.

6.714.1 DEFAULT ORDER OF MODIFICATION

If a default order of modification is entered:

A. The order and accompanying documents shall be signed by the APA certified employee of the county CSS or county director and be reviewed by the county director, IV-D administrator, IV-D attorney or supervisor of the APA certified employee of the delegate Child Support Services Unit designated entering the order before the order is filed with the court. The reviewer shall sign the order confirming that the review has been conducted.

B. The following documents shall be filed with the court:

1. Affidavit of Non-Appearance;

2. Default Order of Modification;

3. Notice of Financial Responsibility – Modification 4. Guidelines Worksheet(s);

5. Imputing Potential Income Checklist with comments made in the Guideline Worksheet, if 6. Subpoena to Produce;

7. Income and Expense Affidavit, if any; and 8. Documentation supporting the guidelines calculation, if any.

C. If the court has not approve or denied approval of the default order within the thirty-six (36) days after filing with the court, the delegate child support services unit must notify the court that the deadline for approval or denial is in seven (7) days on the forty-second (42nd) day.

D. The effective date of the order shall be the date the order is approved by the court.

6.715 DATA INFORMATION SHARING (DISH) AND CUSTODIAN OF THE RECORD (COR)

A. If an APA stipulated order establishing or modifying child support obligations is entered, the CSS shall use the DISH process for transmitting data elements of the order to the court clerk in lieu of filing the paper order and other documents with the court unless:

1. The order is to be filed in a pending court case relating to child support, 2 The order is to be filed in a county other than the county where APA was conducted, or 3. Non-Disclosure of Information (NDI) is indicated on the IV-D case.

B. CSS shall request the court clerk send a dish transmission back to the CSS confirming receipt of the required data elements of the order upon which the order becomes effective, valid and enforceable.

C. When DISH procedures are used in lieu of filing the paper order with the court, the CSS becomes the Custodian of the Record (COR) of the original order and other APA documents in the case.

As the COR, the CSS shall maintain the original order and documents until they are filed with the court. Upon request of parties or other CSS agencies entitled to such orders, the CSS shall provide certified copies of the order.

D. When a IV-D case is closed or APA is no longer appropriate, the CSS shall file the original order and other APA documents with the court thereby transferring the COR designation and duties to the court clerk.

6.716 SURVIVABILITY OF AN APA ORDER

A. If the parents of a child marry each other after an APA order is established, the order survives the marriage of the parties and remains in full force and effect except for provisions of the order that:

1. Establish an MSO payable between the parents only, 2. Establish a judgment for retroactive support between the parents only, or 3. Result in arrears due between the parents.

B. If an APA order is filed into a pending court case relating to child support (the “parent case”) and the parent case is subsequently dismissed by the court, the APA shall survive such dismissal and remain in full force and effect unless the court specifically states in the order of dismissal that the APA order is also dismissed.

C. The CSS need take no action in these situations.

6.800 COLLECTION

6.801 PROCESSING COLLECTIONS 6.801.1 Family Support Registry A. All support collections shall be receipted timely by the Family Support Registry and the county department of social services as prescribed by the state.

B. All child support collections receipted in the Family Support Registry or the county department of social services shall be processed on the automated child support system. 6.801.2 Colorado Date of Receipt Collections shall be entered on the automated child support system screens using the Colorado Date of Receipt. 6.801.3 County Processes The county department shall assure that procedures for processing the flow of support payments be established and maintained, including the following functions:

A. Establish, maintain, and employ procedures which assure that persons responsible for handling cash receipts of support payments are not responsible for accounting functions of processing and monitoring such payments;

B. Ensure that only collections received by the Child Support Services Unit or the Family Support Registry are recorded as IV-D payments on the Automated Child Support Enforcement System (ACSES) ledger or the Automated Child Support Enforcement System and reported to the state office as child support Services collections;

C. Establish, maintain, and employ procedures which assure that all support payments received are accounted for in the financial records; and, D. Establish, maintain, and employ procedures which provide for the allocation, distribution, and disbursement of child and spousal support payments and/or specific medical dollar order amounts. 6.801.4 Information on Automated Systems Amounts allocated, distributed, and disbursed according to the information available on the automated child support system, the Colorado Benefits Management System, and Trails regarding the public assistance or placement status of a child(ren) during an eligible month shall remain as such even if the eligibility or placement status of the child changes in the current or a later month.

6.802 ALLOCATION

A. The court-ordered Monthly Support Obligation (MSO) shall be posted each month on all IV-D ledgers where a current obligation is due for the current accounting month. The monthly support obligation shall be retroactively posted for each month that it was due for which the CSS Unit was responsible for enforcing the MSO that month, but it was previously not posted.

B. If there is a Monthly Medical Obligation (MMO) due, the entire monthly support obligation, monthly medical obligation, and arrears balances shall be posted on a manual ledger for all IV-D cases where a current medical obligation is due for the current accounting month.

C. Allocations shall be made at a child level.

D. All collections shall be allocated within two (2) business days after being receipted in the Family Support Registry or the Child Support Services Unit.

E. All manual overrides of allocation on the automated child support system shall be documented in the automated child support system case chronology.

F. Allocation to multiple arrears obligations on the same ledger shall prorate to class of balances as listed below under Section 6.802.2, “Collections on Cases with Support Orders”.

G. Allocation to multiple arrears obligations on the same ledger shall satisfy the most recent obligation first based on the beginning accrual date of the obligation. 6.802.1 Voluntary Collections on Cases With No Support Orders If collections are received on a case that has no support order established yet, the county will first initiate a voluntary ledger. The collections shall then be allocated to the ledger in the following order:

A. The collection will first satisfy any noncustodial parent erroneous disbursement ledger balance.

B. If there is any remaining amount, the user shall first post the Monthly Support Obligation to zero and then shall allocate the payment to the Monthly Support Obligation. 6.802.2 Collections on Cases With Support Orders All collections, except those from a federal income tax intercept or designated as a judgment payment, shall be allocated to the ledger as follows:

A. First, to the Monthly Support Obligation (MSO) where the Monthly Support Obligation has been posted for the current accounting month, prorated among each class of Monthly Support Obligation posted on the ledger.

B. Second, to A Monthly Medical Obligation (MMO) when there is a specific dollar amount ordered.

C. Third, to non-assigned arrears balances. Arrears payments are allocated in the following order to the various types of balances due. Within those types of balances due, an arrears payment will allocate to: 1) non-IV-A, either never assistance or post assistance, ordered specific dollar amounts for medical, non-IV-E foster care, or non-IV-D, and 2) IV-A unassigned pre-assistance, and shall be prorated across ledger balances.

1. In-state current delinquency.

2. In-state non-judgment obligations.

3. In-state judgment obligations.

4. Out-of-state current delinquency.

5. Out-of-state non-judgment obligations.

6. Out-of-state judgment obligations.

D. Fourth, to obligor erroneous disbursement ledger balances.

E. Fifth, to costs due, in the following order:

1. Judgment costs due the county.

2. In-state costs due the Child Support Services Unit that incurred the cost.

3. Out-of-state costs due another state.

4. Costs due to the custodial party.

F. Sixth, to Title IV-A or Title IV-E assigned arrears balances. Arrears payments are allocated in the following order to the various types of balances due, and shall be prorated across ledger balances:

1. In-state current delinquency.

2. In-state non-judgment obligations.

3. In-state judgment obligations.

4. Out-of-state current delinquency.

5. Out-of-state non-judgment obligations.

6. Out-of-state judgment obligations.

If there is a balance for IV-A assigned pre-assistance arrears for an accounting period prior to October 1, 2009, these arrears will be paid before permanently assigned arrears.

G. Seventh, to prepay if an ongoing monthly support obligation exists. Counties must research the ledger to ensure that the payments should be considered prepay payments.

H. Eighth, to obligor over collect, if no obligation or arrears balance exists on the ledger. Counties must research the ledger to ensure that the payments should be considered over collect payments prior to disbursing to the obligor. 6.802.3 IRS Collections Collections made via an IRS refund shall be allocated to the ledger as follows:

A. First, to any pre-assistance arrears owed to the state.

B. Second, to title IV-A, Title IV-E, or medical assigned arrears balances. Arrears payments are allocated in the following order to the various types of balances due and shall be prorated across ledger balances:

1. In-state current delinquency.

2. In-state non-judgment obligations.

3. In-state judgment obligations.

4. Out-of-state current delinquency.

5. Out-of-state non-judgment obligations.

6. Out-of-state judgment obligations.

C. Third, to non-assigned arrears balances, including non-IV-A post, non-IV-A never, or non-IV-E.

Arrears payments are allocated in the following order to the various types of balances due and shall be prorated across ledger balances:

1. In-state current delinquency.

2. In-state non-judgment obligations.

3. In-state judgment obligations.

4. Out-of-state current delinquency.

5. Out-of-state non-judgment obligations.

6. Out-of-state judgment obligations.

D. Fourth, to obligor over collect, and shall be refunded to the noncustodial parent. If the intercepted collection was based on a joint tax return, the over collect refund will be issued in both joint filers' names. 6.802.4 Judgment Collections Collections made specifically for a judgment arrears balance shall be allocated to the ledger as follows:

A. First, to the Monthly Support Obligation (MSO) where the Monthly Support Obligation has been posted for the current accounting month, prorated among each class of Monthly Support Obligation posted on the ledger.

B. Second, to a Monthly Medical Obligation (MMO) when there is a specified dollar amount ordered.

C. Third, to non-assigned judgment balances, pro-rated across ledger balances.

D. Fourth, to judgment costs due the department.

E. Fifth, to Title IV-A, Title IV-E, or medical assigned judgment balances, prorated across balances.

Any assigned pre-assistance balance for an accounting period prior to October 1, 2009, shall be paid before a permanently assigned balance.

F. Sixth, to noncustodial parent over collect, if no obligation or arrears balance exists on the ledger.

Counties must research the ledger to ensure that the payments should be considered over collect payments prior to disbursing to the obligor.

6.803 DISTRIBUTION OF SUPPORT COLLECTIONS 6.803.1 Distribution from a Title IV-A Allocation The Pass Through of current child support collections is dependent upon legislative funding availability.

When Pass Through is funded, the Deficit Reduction Act (DRA) distribution rules shall apply. When Pass Through is not funded, standard distribution rules shall apply.

DRA Distribution of collections from a Title IV-A allocation shall be as follows:

A. Amounts applied to the monthly support obligation (MSO) shall be applied in the following order:

1. First towards any unfunded disbursement balance according to the agreement with the obligee, up to 10% of the payment received or $10.00, whichever is greater, from current support; to the family if there is no unfunded disbursement balance.

B. Amounts applied to a IV-A arrears balance shall first apply towards any obligee unfunded disbursement balance and then toward any unreimbursed public assistance and/or unreimbursed specific medical dollar order amounts.

1. Unreimbursed public assistance will be satisfied first in the enforcing county for all periods of public assistance, then Last In First Out (LIFO) for all other counties for all periods of public assistance for each county until all IV-A assigned arrears are collected.

Payments to other counties will be made by means of an inter-county transfer of funds as prescribed by the state.

2. In the event no other county has such monetary interest in the case, excess over unreimbursed public assistance will be paid to the obligee.

Standard Distribution of collections from a Title IV-A allocation shall be as follows:

A. Amounts applied to the monthly support obligation (MSO):

1. Shall apply towards any obligee unfunded disbursement balance.

2. Shall be used to reimburse the total unreimbursed public assistance (UPA) provided to the family.

3. Shall be sent to the family as excess over unreimbursed public assistance if there is no unreimbursed public assistance (UPA) balance.

B. Amounts applied to a IV-A arrears balance shall first apply towards any obligee unfunded disbursement balance, and are then used to reimburse unreimbursed public assistance and/or unreimbursed specific medical dollar order amounts.

1. Unreimbursed public assistance will be satisfied first in the enforcing county for all periods of public assistance, and then Last in First Out (LIFO) for all other counties for all periods of public assistance for each county until all IV-A assigned arrears are collected.

Payments to other counties will be made by means of an inter-county transfer of funds as prescribed by the state.

2. In the event no other county has such monetary interest in the case, excess over unreimbursed public assistance will be paid to the obligee. 6.803.2 Distribution From a Title IV-E Allocation Distribution of collections from a Title IV-E allocation shall be as follows:

A. Amounts applied to the monthly support obligation (MSO):

1. Shall be used to reimburse the foster care maintenance payment for the month in which the maintenance payment was made.

2. Shall be forwarded to the county business office to be applied according to the state’s reporting and accounting procedures, if the amounts applied to the monthly support obligation exceed the foster care maintenance payment.

3. Amounts of the foster care maintenance payment that exceed the monthly support collection are added to the balance of unreimbursed maintenance payments (UMP).

B. Amounts applied to Title IV-E assigned arrears balances:

1. Shall be used to reimburse unreimbursed maintenance payments.

2. Shall be used to reimburse unreimbursed public assistance, if any exists on the case and there is no unreimbursed maintenance payments balance. Any remaining collections are paid to other counties that have a monetary interest in the case.

Unreimbursed public assistance and/or unreimbursed maintenance payments will be satisfied first in the enforcing county for all periods of public assistance, then Last in First Out (LIFO) for all other counties for all periods of public assistance for each county until all IV-A OR IV-E assigned arrears are collected. Payments to other counties will be made by means of an inter-county transfer of funds as prescribed by the state.

3. In the event no other county has such monetary interest in the case:

a. Any remaining collections are forwarded to the county business office if the child is actively in placement at the time the payment was allocated; or, b. Forwarded to the obligee if the child is not actively in placement at the time the payment was allocated. 6.803.3 Distribution From a Non-IV-A Allocation Distribution of collections from a non-IV-A allocation shall be as follows:

A. Amounts applied to the monthly support obligation (MSO) or any arrears balance:

1. Shall first apply towards any unfunded disbursement balance according to the agreement with the obligee.

2. Shall then be applied to any non-PA service fee still owed by the obligee, whether or not such fee has already been reported to the federal government.

3. Shall be paid to the family.

4. Amounts that represent payment on the required support obligation for future months shall be applied to those future months and shall be paid to the family.

B. Non IV-A applicants shall be charged a twenty-five dollar ($25) certification fee only if an actual federal tax intercept occurs. The certification fee shall be deducted yearly from the first Federal Income Tax refund intercept that occurs, regardless of the number of obligors. If the total yearly amount of all tax refunds for a case is less than twenty-five dollars ($25), that amount will satisfy the certification fee. 6.803.4 Distribution From a Non-IV-E Allocation Distribution of collections from a non-IV-E allocation shall be as follows:

All payments allocated to the current monthly amount due or to any arrears balances shall be forwarded to the county business office.

6.804 DISBURSEMENT OF SUPPORT COLLECTIONS

Any disbursement to a family shall be made to the resident parent, legal guardian, or caretaker relative having custody of or responsibility for the child(ren), judicially-appointed conservator with a legal and fiduciary duty to the custodial parent and the child, or alternate caretaker designated in a record by the custodial parent. An alternate caretaker is a nonrelative caretaker who is designated in a record by the custodial parent to take care of the children for a temporary time period. 6.804.1 Disbursement from a Title IV-A Allocation Disbursement of collections from a title IV-A allocation shall be as follows:

A. Disbursements of Pass Through or Excess Pass Through amounts shall be paid to the family within two (2) business days from the Colorado date of receipt if sufficient information identifying the payee is provided.

B. Disbursements to excess over UPA shall be paid to the family within two (2) business days of the end of the month in which the collection was received if sufficient information identifying the payee is provided.

C. If the collection was received from a federal income tax return, the excess over unreimbursed public assistance payment must be sent to the family within thirty (30) calendar days of the Colorado date of receipt unless based on a joint tax return (see Section 6.804.6). 6.804.2 Disbursement From a Title IV-E Allocation Disbursement of collections from a Title IV-E allocation shall be as follows:

A. Disbursements to the IV-E agency shall be forwarded to the business office within fifteen (15) business days of the end of the month in which the collection was received.

B. Disbursements to excess over UMP which are due to the obligee and not child welfare shall be paid to the obligee within two (2) business days of the end of the month in which the collection was received if sufficient information identifying the payee is provided.

C. If the collection was received from a federal income tax return, the collection must be forwarded to the IV-E agency or to the family as appropriate, within thirty (30) calendar days of the Colorado initial date of receipt unless based on a joint tax return (see Section 6.804.6). 6.804.3 Disbursement from a Non-IV-A Allocation Disbursement of collections from a non-IV-A allocation shall be as follows:

A. If any moneys are owed for the non-PA service fee, those moneys will be held from any disbursement being sent to the obligee, whether from the current monthly support obligation or from an arrears or judgment disbursement.

B. All disbursements for the monthly support amount and arrears amounts shall be paid to the family within two (2) business days from the Colorado initial date of receipt if sufficient information identifying the payee is provided unless the collection was received from a federal IRS tax return (see Section 6.804.6).

6.804.4 DISBURSEMENT FROM A NON-IV-E ALLOCATION

Disbursement of collections from a non-IV-E allocation shall be as follows:

A. Disbursements to child welfare shall be paid within fifteen (15) business days of the end of the month in which the collection was received.

B. If the collection was received from a federal income tax return, the collection must be forwarded to child welfare within thirty (30) calendar days of the Colorado initial date of receipt unless based on a joint tax return (see Section 6.804.6). 6.804.5 Disbursement in Intergovernmental Cases Disbursement of collections on intergovernmental cases shall be as follows:

A. In responding intergovernmental cases, for which collections are made on behalf of another child support Services agency, the payment must be forwarded to the location specified by the initiating child support Services agency. Collections must be forwarded to the initiating child support Services agency within two (2) business days of the Colorado date of receipt if sufficient information identifying the payee is provided and within thirty (30) calendar days of the date the payment is received from tax offset collections.

B. In transmitting collections, the responding child support Services agency must provide the initiating child support Services agency with sufficient information to identify the case, the initial date of receipt, and the responding agency’s FIPS code. 6.804.6 Disbursements From Federal Income Tax Return Allocations Disbursements of collections from federal income tax return allocations must be sent to the family within thirty (30) calendar days of the Colorado initial date of receipt, except if a disbursement is from a joint federal income tax refund, the county Child Support Services Unit may delay disbursement to the family until:

A. The Child Support Services Unit is notified that the unobligated spouse’s proper share of the refund has been paid; or, B. For a period not to exceed six months from notification of offset, whichever date is earlier.

C. A disbursement to obligor over-collect must be sent within a reasonable time period. 6.804.7 Erroneous Intercept Collection When an intercept collection is identified as an erroneous certification intercept collection such as the amount was not owed at the time of certification or the wrong person was intercepted, the Child Support Services Unit shall refund the collection within two (2) working days from the time the erroneously intercepted person provides notice of intercept. This payment shall be disbursed even if the erroneous intercept collection has not been received by the county Child Support Services Unit. The County Child Support Services Unit must submit the state prescribed notice to the State Child Support Services Division when an erroneous intercept occurs. 6.804.8 Erroneous Collection From an Enforcement Remedy When a collection from any enforcement remedy is identified as an erroneous withholding, the Child Support Services Unit shall refund the withheld monies within two (2) working days from the date the obligor provides notice of erroneous withholding. This payment shall be disbursed to the obligor even if the erroneous withholding was not retained by the Child Support Services Unit. The County Child Support Services Unit must submit the state prescribed notice to the State Child Support Services Division when an erroneous collection is received due to an enforcement remedy action.

6.805 ADMINISTRATIVE REVIEW OF CONTESTED ARREARS

6.805.1 COUNTY LEVEL REVIEW

A. The county department shall establish procedures for reviewing arrearage amounts that are to be reported to a consumer credit reporting agency or have been certified for the administrative offset program, administrative lien and levy, tax offset, lottery intercept, workers’ compensation attachment, state vendor offset program, gambling intercept, license suspension, or administrative lien and attachment of insurance claim payments, awards, and settlements.

B. Upon written request for an administrative review, within the time frame specified on the advance notice for reporting arrears to a consumer credit reporting agency, the pre offset notice for tax purposes, the notice of intercept of lottery winnings, the Administrative Lien and Attachment for workers’ compensation benefits, the notice for license suspension, The Notice of License Denial, the notice of administrative lien and levy, the notice for state vendor offset program, the notice of intercept of gambling winnings, the notice for federal administrative offset program, or the notice of administrative lien and attachment of insurance claim payments, awards, and settlements, the county Child Support Services Unit shall:

1. Schedule and advise the obligor, and the obligee in a non-public assistance case, of the date, time and place of the review and initiate administrative review information on the administrative review tracking system screen in the automated child support system.

2. Request from the obligor copies of any modifications of the support order.

3. Request from the obligor records of payments made by the obligor.

4. Advise the obligor this review is a review of the records only and not a judicial determination.

5. Request proof from the obligor if they have contested being the obligor.

6. Advise the obligor that a decision will be rendered within thirty (30) days of the request for a review.

C. The county department shall notify the obligor that an administrative review will only be held if the request for an administrative review concerns an issue of mistaken identity of the obligor or the amount of arrearages specified on the advance notice for reporting to a consumer credit reporting agency, the pre-offset notice for tax offset, the notice for lottery intercept, administrative lien and attachment for workers’ compensation benefits, the notice of license suspension, the notice for federal administrative offset program, the notice for state vendor offset program, the notice of intercept of gambling winnings, the notice for administrative lien and levy, or the notice of administrative lien and attachment of insurance claim payments, awards, and settlements.

D. On the date established, the county department shall review the child support case record and the documents submitted by the obligor and determine the arrears.

E. Within ten (10) calendar days of the decision rendered, the county department shall update the automated child support system, take any additional action appropriate to reflect the decision, notify the obligor, and the obligee in a non-public assistance case, of the decision rendered. The written decision shall include the time frames reviewed, balance due for that time frame, court orders reviewed including the child support terms of those orders, payment records reviewed, and amounts credited based on those records.

F. The county department shall notify the obligor of the right to request a further review by the State Department. The obligor must be advised that the request must be made in writing and be received by the state office within thirty (30) calendar days of the mailing of the county decision to the obligor.

6.805.2 STATE LEVEL REVIEW

Upon written request from the obligor to the State Department for review of arrearage amounts, that are to be reported to a consumer credit reporting agency, or have been certified for tax offset, for lottery intercept, for workers’ compensation benefits attachment, license suspension, license denial, federal administrative offset program, state vendor offset program, gambling intercept, administrative lien and levy, and administrative lien and attachment of insurance claim payments, awards, and settlements, the State Department shall A. Determine if a county level administrative review occurred.

1. If not and the obligor is within the time frame specified on the notice, forward the request to the appropriate county and ensure that the county conducts an administrative review within thirty (30) calendar days of receiving the request from the State Department.

2. If not and the obligor is outside of the time frame specified on the notice, the obligor has lost the right to contest the arrears through the administrative review process.

3. If yes, set a date, time, and place for the review, which shall be within thirty (30) calendar days from the date the written request for review was received by the State Department.

B. Provide a written notice to the obligor, and the obligee in a non-public assistance case, of the date, time, and place of the review. This notice shall contain a statement which advises the parties:

1. The only issues to be reviewed are a mistake in the identity of the obligor or a disagreement of the amount of arrears.

2. The review is a review of the records only and not a judicial determination.

3. The obligor must provide all records of support payments made.

4. That a decision will be rendered within thirty (30) days of the review.

C. Request that the county provide:

1. The records that established the arrearages; and, 2. A copy of its decision if not previously provided by the noncustodial parent.

D. On the date established for the review, the State Department shall review the records and determine the arrears. If more time is required to review the records or render a decision, the State Department may extend the time for rendering a decision by an additional thirty (30) days.

E. Within ten (10) calendar days of the decision rendered, the State Department shall notify, in writing, the obligor, the obligee in a non-public assistance case, and the county Child Support Services Unit of the decision rendered. Any party shall have the right to appeal the decision. The written decision shall include the time frames reviewed, balance due for those time frames, court orders reviewed including the child support terms of those orders, payment records reviewed, and amount credited based on those records.

F. Update the Automated Child Support Enforcement system to reflect the administrative review.

G. A decision will be rendered within thirty (30) calendar days of the receipt of the written request for review unless the parties fail to provide the required information.

H. Advise the parties of their right to appeal the state decision by filing an action for judicial review with the State District Court within thirty-five (35) calendar days of the effective date of the state decision. The state decision is effective on the date of the decision. 6.805.21 Reflect Decision Rendered The county department, upon receiving the decisions rendered by the State Department after a state level review, shall, within ten (10) calendar days, adjust the Automated Child Support Enforcement System records to reflect the decision rendered and take any additional action appropriate. 6.805.3 Intergovernmental Review Procedure for Reviewing arrearage amounts that have been certified and submitted for a federal income tax refund offset on an intergovernmental case.

A. Within ten (10) calendar days of the receipt of a written request for an administrative review where Colorado is the submitting state and the requester has requested that the order-issuing state conduct the review or Colorado, as the submitting state, cannot resolve the matter, the county CSS Unit shall notify the order-issuing state and send all necessary information which was considered in the decision of an arrearage amount. Colorado, as the submitting state, shall be bound by the decision of the order-issuing state.

B. Within ten (10) calendar days of the receipt of a written request for an administrative review where Colorado is the order-issuing state and the requester has requested that the order-issuing state conduct the review or the submitting state cannot resolve the matter, the county Child Support Services Unit shall:

1. Schedule and advise the obligor, and the obligee in a non-public assistance case, and the other state, of the date, time, and place of the administrative review.

2. Advise the obligor, and the obligee in a non-public assistance case and the other state that a decision will be rendered within forty five (45) calendar days of the receipt of the submitting state's request and information.

3. On the date established, the order-issuing state shall review the child support case record, and the documents submitted by the requester and forwarded by the submitting state, and determine the arrears.

4. Within ten (10) calendar days of the decision rendered, the order-issuing state shall notify in writing, the obligor, the obligee, and the submitting state of the decision rendered. The written decision shall include the time frames reviewed, balance due for those time frames, court orders reviewed including the child support terms of those orders, payment records reviewed, and amounts credited based on those records.

5. The county department shall notify the obligor of the right to request a further review by the State Department. The obligor must be advised that the request must be made in writing and be received by the state office within thirty (30) calendar days of the mailing of the county decision to the obligor.

6. The county department, upon receiving the decisions rendered by the other state shall, within ten (10) calendar days, adjust the Automated Child Support Enforcement System records to reflect the decision rendered and take any additional appropriate action. 6.805.4 Administrative Review of Contested Distribution of Amounts Collected 6.805.41 County Responsibility A. Following verbal or written contact from an obligee regarding questions or disagreement about distribution of amounts collected, the CSS unit shall review the distribution and respond verbally or in writing. The obligee must be advised that if there is still disagreement, the obligee must submit a written request for an administrative review by the Child Support Services Unit.

B. Within ten (10) calendar days of the receipt of a written request for an administrative review, the Child Support Services unit shall:

1. Schedule and advise the obligee of the date, time and place of the review;

2. Request from the obligee copies of any modification of the support order that have not been previously provided to the Child Support Services Unit;

3. Request from the obligee records of any payments made directly to the family from the obligor;

4. Advise the obligee that a written decision will be rendered within thirty (30) days of the date of the review;

5. Request from the obligee any other information to support the contention that the collections were distributed in error.

C. If the request for an administrative review concerns an issue other than the distribution of current support and/or arrearage payments, the Child Support Services unit shall notify the obligee that a review will not be held.

D. On the date established for the administrative review, the Child Support Services unit shall review the child support case record and any information submitted by the obligee and determine if the distribution of the amounts collected was correct.

E. The Child Support Services unit shall promptly notify the obligee in writing of the decision rendered and will provide a copy of the decision to the State Department within five (5) days of the date the decision is rendered.

F. The Child Support Services Unit shall notify the obligee in writing of the right to request a further review by the State Department. The obligee will be advised that the written request must be received by the state office within thirty (30) calendar days of the mailing of the county decision to the obligee.

G. The Child Support Services Unit, upon receiving the decision rendered by the State Department after a state level review shall, within ten (10) calendar days, adjust the automated child support enforcement system records to reflect the decision rendered and take any additional action as 6.805.42 State Responsibilities Upon written request for further administrative review, the State Department shall:

A. Provide notice to the obligee, which shall contain:

1. A statement that the only issue to be reviewed is the distribution of current support and/or arrearage payments collected;

2. A statement that the review is a review of the records only and not a judicial determination and that the review will be limited to the documentation in the CSS file and any written material the obligee wishes to present.

B. Request from the CSS Unit or obtain from the automated child support system, the records used for the distribution;

C. Request from the CSS Unit a copy of its decision;

D. Request from the county records of support payment paid directly to the family which were provided by the obligee during the administrative review;

E. Advise the obligee that a written decision will be made within thirty (30) calendar days of the receipt of the request;

F. Advise the obligee of the right to appeal the state decision by filing an action for judicial review with the State District Court within thirty-five (35) calendar days of the effective date of the state decision. The state decision is effective on the date of the decision. 6.805.43 Notify of Decision Rendered The State Department shall, within thirty days of the date of the state level review, promptly notify in writing the obligee and the county CSS Unit of the decision rendered. 6.805.5 Appeal of Joint Account Collection From FIDM When a FIDM notice of lien and levy is made on a joint or shared ownership account, as defined at

Section 15-15-201(5), C.R.S., the non-debtor account holder may appeal the seizure of his or her share of the funds (see Section 6.906.5), first through the Colorado Department of Human Services, Division of Child Support Services, and then, if still disputed, judicially. If the appeal is approved, the Colorado Department of Human Services, Division of Child Support Services, shall release all or part of the lien and levy within two (2) working days from the date the appeal decision is made by the Colorado Department of Human Services, Division of Child Support Services, or within two working days of the receipt of the judicial order approving the appeal. In the event that the financial institution has already remitted payment to the Family Support Registry at the time of the appeal ruling, the payment shall be refunded to the nondebtor account holder pursuant to the appeal ruling.

6.806 INTEREST

Collection of interest is optional for county Child Support Services Units. If a county chooses to collect interest, the following rules shall apply.

A. Interest on support collections that are deposited in a financial institution in interest bearing accounts shall be used to reduce administrative costs as prescribed by the State Department.

B. Interest collected through support arrears/debt shall be considered a support collection and shall be used to reduce the UPA/UMP balances or, for non IV-A cases, paid to the family.

1. In order to collect interest on a Colorado order, the interest rate will be calculated as prescribed by the State Department on the balance past due at the current interest rate in effect as set forth in Sections 5-12-101 and 14-14-106, C.R.S.

2. Interest on arrears balances will be calculated for a specific amount of arrearages/debt covering a specific period of time. The amount of interest will be listed separately from the amount listed for child support arrears/debt and shall be added to the IV-D ledger on the automated child support enforcement system using the appropriate interest adjustment reason codes. The two figures will be added together to show the total amount of judgment or non-judgment balances.

3. A county may charge interest on a Colorado child support order according to statute. If a county intends to calculate interest, it must:

a. Send a written notice to the obligor or the obligor’s attorney of record, if one exists, that interest will be assessed on the order.

b. Only assess interest beginning with the date of the notice referenced in paragraph a, of this section.

c. Complete an updated interest calculation every six (6) months for all cases where notice, in paragraph “a” of this section, was provided and shall provide written notification of the amount of interest assessed to the obligor or the obligor’s attorney of record, if one exists.

d. Notify the responding agency in an initiating reciprocal action, at least annually, and upon request in an individual case, of interest charges, if any, owed on overdue support.

4. The county Child Support Services Unit may waive the collection of interest if it wishes to use interest as a negotiating tool to reach a payment settlement on both public assistance and non-public assistance cases.

5. Counties must collect interest on interjurisdictional cases if they are enforcing another jurisdiction’s order and the jurisdiction requests collection of interest.

6.807 DISBURSEMENTS ON HOLD

A. If a disbursement returns as undeliverable mail, if there is no existing address on the automated child support system, or if a disbursement has been reported as lost or stolen, the user shall put all disbursements for that ledger on hold until the issue is resolved.

B. Child Support Services Units shall ensure that procedures are established in the county to work the scheduled disbursements daily.

C. The county Child Support Services Unit shall utilize all appropriate local, state, and federal sources to determine the location of the payee.

D. If the obligee cannot be located within ninety (90) calendar days of the original warrant issue date of the disbursement to the obligee, the Child Support Services worker shall allocate the payment(s) first to any obligor erroneous disbursement balance and second to any assigned arrears balance.

E. If there are no obligor erroneous disbursement or assigned arrears balances, the Child Support Services worker shall allocate the payment to obligor over collect and disburse to the obligor.

F. If the obligor cannot be located within ninety (90) calendar days of the original warrant issue date of the disbursement to the obligor, the Child Support Services worker shall, by the ninety-first (91 ST ) calendar day, mark the collection to transfer to the abandoned collections account on the disbursement record on the automated child support enforcement system.

The automated child support enforcement system will automatically reimburse any obligee unfunded disbursement balance on the ledger before the payment is transferred to the abandoned collections account.

G. If the payee requests payment of the disbursement once it has been transferred to the abandoned collections account, the transfer will be reversed through a problem log to the state office, and the disbursement will be scheduled.

6.808 UNFUNDED DISBURSEMENTS

A. The county Child Support Services Unit shall make every reasonable effort to recover unfunded disbursements.

B. If the payment was allocated to the wrong account, the county Child Support Services Unit shall allocate and disburse the payment to the correct account within five (5) working days of discovering the error, even if the county has not received a recovery from the payee who received the original disbursement. 6.808.1 Notification A. The county Child Support Services Unit must ensure that the obligee or the initiating jurisdiction has received notification of the unfunded disbursement prior to automatic recovery of the unfunded disbursement amount. This notification may occur through the application for Colorado Works, Child Support Services, or through the automated child support system noticing process.

B. The county Child Support Services Unit must have an agreement with the obligee in order to recover the unfunded disbursement. If the obligee does not agree to the unfunded disbursement recovery, county Child Support Services Units may pursue recovery through civil means or may write off the unfunded disbursement amount.

C. The notice of the unfunded disbursement amount will inform the obligee or the initiating jurisdiction of her/his responsibility to repay the balance and will state that failure to respond to the notice constitutes an agreement of her/his part. 6.808.2 Recovery A. The primary contact county shall be responsible for any negotiations with the obligee and for ensuring that the statewide unfunded disbursement balance is paid. The automated child support enforcement system will determine the primary county.

B. Any county CSS Unit can accept a cash payment from the obligee to recover the unfunded disbursement amount.

C. The automated process will recover one hundred percent (100%) of any Title IV-A distribution.

County CSS staff can negotiate a percent or amount of recovery with the obligee on a non-IV-A distribution but the automated child support system will automatically recover at least ten percent (10%) of the payment or ten dollars ($10), whichever is greater. 6.808.3 Balance Statement The county Child Support Services Unit must send an unfunded disbursement balance statement to the obligee if one is requested. Balance statements requested on intergovernmental cases will be sent to the other agency. 6.808.4 Balance Write-Off The Automated Child Support Enforcement System will automatically write off unfunded disbursement balances for obligees who have no open cases anywhere in Colorado and with no financial history activity throughout the State for seven years.

6.809 CHILD SUPPORT INCENTIVE PAYMENTS

A. Child support incentives distributed to counties shall be the total amount of the federal incentives paid to the state, excluding amounts described in paragraph B of this section, plus no less than 50% of the state share of retained collections. However, beginning 01/01/2020 if the Federal Medical Assistance Percentages (FMAP) rate is greater than 50%; then the share of retained collections distributed to the counties will default to the share percentage remaining after the federal government is reimbursed based on the current FMAP rate. Reimbursement pursuant to the FMAP rate might result in counties receiving less than 50% of the retained collections. The share of retained collections paid to the counties shall never exceed 50%. In the event that the share of retained collections to be distributed to the counties is less than 50%, the state division of child support services must issue notice to the counties within 91 days of the determination that the share of retained collections is less than 50%. Child support incentives shall be paid to counties quarterly. The federal and state share incentives shall be calculated separately but using the same formula.

B. Beginning in federal fiscal year 2024, a percentage of the federal incentives received by the state may be retained for the purposes of information technology enhancements to the ACSES, if approved by majority vote by the Policy Advisory Committee.

1. Beginning in federal fiscal year 2024, the State Division of Child Support Services shall annually submit a proposal to the Policy Advisory Committee containing:

a. The dollar amount of federal incentives available to be retained, pursuant to

section 26-13-112.5, C.R.S.;

b. The recommendation of the IV-D Task Force regarding technology enhancements to be funded with federal incentives; and c. A cost estimate of each recommended enhancement. 6.809.1 Incentive Formula The following formula to calculate incentives is used at the federal level to calculate incentives to distribute to states and shall be used in Colorado to calculate incentives to distribute to counties.

A. Two (2) X (collections for current and former IV- A and IV-E cases) + collections for non-PA and non-IV-E cases = “Collections Base”

B. Total “collections base” X the weight for each = County “collections base amount” for each C. Convert each actual performance ratio using the conversion table = “Performance incentive factor” for each E. Each county’s “unadjusted incentive amount” ÷ state total of “unadjusted incentive amounts” = Each county’s percent of the state “unadjusted incentive amount”

F. Each county’s percent of the “unadjusted incentive amount” X the statewide incentive to be distributed for each performance measure = “County incentive” for each performance measure G. Sum of the “county incentive” for each = Total “county quarterly federal incentive payment” or “county quarterly state share incentive payment”

H. Sum of county quarterly federal and state share incentives = Total “county quarterly incentive payment” 6.809.2 Performance Measures Incentives distributed to counties will be based on five (5) performance measures. Each performance measure will be calculated at the end of the quarter for each county.

A. Paternity establishment percentage (PEP) is:

The total number of children born out of wedlock in the IV-D caseload with paternity established as of the end of the present month divided by the total number of children born out of wedlock in the IV-D caseload as of the end of the corresponding month of the previous year.

B. The percent of caseload with support orders is:

The total number of cases with an order for support as of the end of the present month divided by the total number of cases in the caseload as of the end of the present month.

C. The percent of current support paid is:

The total dollar amount of child support payments made to current monthly support obligations from the beginning of the year to the present time divided by the total dollar amount of current monthly support obligations due from the beginning of the year to the present time.

D. The percent of arrears cases with a payment is:

The total number of cases with a payment made to an arrears obligation or current delinquency balance during the previous 12 months divided by the total number of cases with an arrears obligation or current delinquency owed as of the end of the present month.

E. The cost effectiveness ratio is:

The total county combined collections divided by the total county administrative costs.

The paternity establishment percentage, the percent of caseload with orders, and the percent of current support paid shall have a weight of one hundred percent (100%). The percent of arrears cases with a payment and the cost effectiveness ratio shall have a weight of seventy-five percent (75%). 6.809.3 “Statewide Incentive Amount” for Each Performance Measure The total amount of incentives to be distributed shall be the quarterly estimated incentive amount received from the federal government plus the state share incentive, excluding amounts described in

section 6.809.B. 6.809.4 Conversion Tables Each performance measure has a bottom threshold; no incentives will be paid for performance ratios below the bottom threshold. The bottom threshold is fifty percent (50%) for the paternity establishment percentage and the percent of caseload with orders. The bottom threshold of the table is forty percent (40%) for the percent of current support paid and the percent of arrears cases with a payment.

Each performance ratio, except for the cost effectiveness ratio, converts, by means of the following table, to a performance incentive factor.

If the performance ratio is at least But is less than The performance incentive factor equals:

If the performance ratio is at least But is less than The performance incentive factor equals: 80% 100% 59% 60% 69% 79% 80% 98% 58% 59% 68% 78% 79% 96% 57% 58% 67% 77% 78% 94% 56% 57% 66% 76% 77% 92% 55% 56% 65% 75% 76% 90% 54% 55% 64% 74% 75% 88% 53% 54% 63% 73% 74% 86% 52% 53% 62% 72% 73% 84% 51% 52% 61% 71% 72% 82% 50% 51% 60% 70% 71% 80% 49% 50% 59% 69% 70% 79% 48% 49% 58% 68% 69% 78% 47% 48% 57% 67% 68% 77% 46% 47% 56% 66% 67% 76% 45% 46% 55% 65% 66% 75% 44% 45% 54% 64% 65% 74% 43% 44% 53% 63% 64% 73% 42% 43% 52% 62% 63% 72% 41% 42% 51% 61% 62% 71% 40% 41% 50% 60% 61% 70% The cost effectiveness ratio converts, by means of the following table, to a performance incentive factor.

No incentives will be paid for a cost effectiveness ratio under two dollars ($2.00).

If the CER is at least But is less than The performance incentive factor equals: $5.00 -- 100% $4.50 $4.99 90% $4.00 $4.49 80% $3.50 $3.99 70% $3.00 $3.49 60% $2.50 $2.99 50% $2.00 $2.49 40% 6.809.5 Adjustment An annual adjustment will be done at the end of the federal fiscal year, replacing the estimated state incentive with the actual statewide incentive payment received from the federal Office of Child Support Enforcement, excluding amounts described in section 6.809.B. The adjustment is done in the quarter following the date the state office receives the adjustment letter from the federal office. The adjusted amounts are incorporated into the current quarter’s incentive payments. If there are counties that have a negative incentive amount in the adjusted quarter, they will be billed for this amount by the state Division of Accounting. 6.809.6 Reinvestment A. Federal regulations require that all federal incentives received be reinvested into the child support program to ensure continued improvement, adequate resources, and maintenance of a high performance level for the child support services program.

B. When a county’s federal incentives for a calendar year exceed the county thirty-four percent (34%) share of county administrative expenditures, the county shall demonstrate to the state Child Support Services Unit how the excess federal incentives are reinvested in the child support program. Counties shall report this information to the state Child Support Services Unit within two calendar years of receipt of the federal incentives, or if counties are unable or unwilling to reinvest the federal incentives in the child support program, they shall return that amount to the state office.

C. Counties must gain state approval of any plan to reinvest federal incentives that exceed their thirty-four percent (34%) share of county administrative expenditures by presenting to the state Child Support Services Unit a written proposal of their plan. The reinvestment can be made directly into the Child Support Services program or can be made to a program not approved for IV-D federal participation of expenditures, as long as the county can demonstrate to the state office how the proposed program will benefit the Child Support Services program. The cost effectiveness ratio converts, by means of the following table, to a performance incentive factor.

No incentives will be paid for a cost effectiveness ratio under two dollars ($2.00).

6.900 ENFORCEMENT

Child Support Services Unit employees must be certified by the State Division of Child Support Services to perform functions associated with the automated enforcement remedies described in section 6.103.2.

6.901 ENFORCEMENT PROCEDURES

The county Child Support Services Units shall establish procedures to ensure that the full range of enforcement activities are undertaken and completed within the time frames specified. The time frames begin when the obligor is located or on the date the obligor fails to make a payment or when other support related non-compliance occurs. The time frames end when enforcement action is taken. All enforcement activities must be documented in the automated child support system.

6.902 ENFORCEMENT FUNCTIONS 6.902.1

The following functions are the responsibility of the Child Support Services Unit with regard to the enforcement of child support obligations for all CSS cases. 6.902.11 County Procedures Within thirty (30) calendar days of identifying a delinquency or other non-compliance with the order, or location of the obligor, whichever occurs later, the Child Support Services Unit must take appropriate enforcement action. The Child Support Services Unit must assess each enforcement case to determine appropriate enforcement actions pursuant to Section 6.903.11.

A. When an obligor fails to make full payment in the month the payment is due, appropriate enforcement action shall be taken.

B. Income Assignment 1. For support orders subject to the immediate activation of an income assignment, the Notice to Withhold Income for Support must be sent within two (2) business days after receipt of an income source.

2. For support orders not subject to the immediate activation of an income assignment, the Advance Notice of Activation of Income Assignment must be filed with the court and mailed to the obligor within two (2) business days after receipt of an income source. If the obligor does not file an objection to the activation of the income assignment, the Notice to Withhold Income for Support must be sent within two (2) business days of the end of the fourteen (14) day objection period.

3. A copy of the Notice to Withhold Income for Support shall be provided to the obligor by the employer.

4. If an automated income assignment cannot be issued due to an exception, the automated child support system will electronically generate a message to the enforcing county and the county child support services worker shall complete the following within two (2) working days of the date of the receipt of the message:

a. Research the case to determine whether the exception is valid and correct the exception data if possible;

b. Document the findings and the actions taken to correct the exception in the automated child support system;

c. Issue the income assignment to the employer, if appropriate.

C. Service of Process 1. If service of process is necessary, service must be completed and enforcement action taken within sixty (60) calendar days of identifying a delinquency or of locating the obligor, whichever occurs later.

2. Repeated unsuccessful service of process attempts are not a valid reason for not meeting the time frames. If service of process is unsuccessful because of a poor address, the case shall be referred back to the locate function. 6.902.12 Public Assistance Cases In public assistance and foster care cases, the Child Support Services Unit shall enforce court-ordered child support obligations from any person who is legally liable for such support until such obligations are satisfied, including assigned arrearages, unless good cause exemption from referral to the Child Support Services Unit has been determined to exist by the county director or designee. Spousal maintenance must also be enforced if established in the same court action and if the child(ren) is living with the obligee of child support and spousal maintenance. 6.902.13 Non-Public Assistance Cases In non-public assistance cases, the Child Support Services Unit shall enforce court-ordered child support obligations from any person who is legally liable for such support until such obligations are satisfied or services are no longer requested. Spousal maintenance must also be enforced if established in the same court action and if the child(ren) is living with the obligee of child support and spousal maintenance. When the current support order and/or the child support arrears are no longer being enforced, the Child Support Services Unit shall cease enforcement of spousal maintenance. 6.902.14 Arrears Calculation For cases where the date of the order is prior to the date of referral, application, or request from an initiating state/jurisdiction, the Child Support Services Unit shall calculate arrearages from the date the child support order is entered to determine the beginning arrears balance.

A. The Child Support Services Unit shall provide notice of the arrears by providing the arrears calculation and any supporting documentation to the obligor and obligee or initiating state/jurisdiction. Notice is only required when an arrears balance has been determined and there was no existing arrears balance on the ledger.

1. Parties are allowed fourteen (14) days to respond to the calculation.

2. Any determined arrearages may not be added to the case ledger until the fifteenth (15th) day.

3. If the parties disagree with the arrears calculation, the county shall refer the case to the court with jurisdiction for an arrears determination.

a. The county shall collect current support while the court determines the arrears.

b. If the court determines that arrears are owed, the county must amend the income withholding order to include all monthly payments due. 6.902.15 National Medical Support Notice The Child Support Services Unit shall enforce a medical support order when health insurance for the child(ren) is no longer being provided, by issuance of the National Medical Support Notice to the obligor's employer, when such an employer is known, or unless the court or administrative order contains alternative health care coverage. 6.902.16 Notice of Emancipation of a Child The enforcing Child Support Services Unit must respond to the automated child support system's electronic message indicating the automatic generation of the right to request review notice for each party or their attorney of record. The electronic message alerts the worker when a child(ren) has reached the age of emancipation. Within five working days of receiving the electronic message and the generation of the right to request review notices, the worker must read the active order and determine if the child(ren) included in the order is emancipated pursuant to Section 14-10-115, Colorado Revised Statutes. If the child(ren) is emancipated and is not the youngest child on the order, the worker shall mail a right to request review notice to each party or their attorney of record. 6.902.17 Credit Reporting (CRA) 6.902.171 Selection Obligors shall be selected for referral on all of their court orders when the following two conditions exist in the same accounting period on at least one court order: 1) current balance exceeds five hundred dollars ($500) and 2) there is an amount that is at least sixty calendar days past due. The Colorado Department of Human Services, Division of Child Support Services, will generate a report which displays the orders that have been selected for credit reporting. The Child Support Services Units shall take the following actions within thirty calendar days of the generation date of the credit reporting agency notification list:

A. Ensure that the monthly support obligation, monthly amount due, monthly payment due and current balance are correct; and, B. Ensure that the arrears in the inactive ledgers are not a duplication of those in the active ledgers; and, C. Ensure that the Social Security Number is correct; and, D. Clear any financial holds; and, E. Electronically send a request for suppression of the court order to the “SEU CRA” mailbox if selection has been made on an incorrect person.

F. Document in the automated child support system all changes or other actions taken. 6.902.172 Notice The Colorado Department of Human Services, Division of Child Support Services, generates the prereferral notice, thirty calendar days after the case is selected for credit bureau reporting. The obligor has thirty calendar days from the date of the pre-referral notice to pay the past-due obligation, pay a lump sum toward the current balance or submit a written request for an administrative review. If a written request for administrative review is received, the county child support enforcement worker shall follow

Section 6.805.

Once sixty (60) calendar days have lapsed, the child support data will be submitted to the credit reporting agencies. 6.902.173 Disputes If, during the monthly referral to the credit reporting agencies, the obligor contacts the county child support enforcement worker to dispute the information contained in their credit report, the county child support enforcement worker shall:

A. Enter the dispute code in the automated child support system within one working day of contact.

B. Research the case to determine if the information is correct or incorrect. If incorrect, the necessary changes must be made to the child support case. The changes will be reflected in the next monthly update to the credit reporting agencies.

C. Document in the automated child support system all changes or other actions taken.

The county Child Support Services Units shall respond to requests from the Division of Child Support Services within two working days for payoff amounts and status information and within six working days for information needed to complete the investigation of a consumer credit dispute. If the Child Support Services Unit receives a request for information from a lender, credit reporting agency or obligor, it shall follow Section 6.902.174. 6.902.174 Limited Point of Contact The Fair Credit Reporting Act, which governs credit reporting agencies, requires a limited point of contact between credit reporting agencies and users of credit information. When a Child Support Services Unit receives a request for credit status information from a lender, an underwriter, a mortgage company, a credit verifier, an obligor or from a credit reporting agency, the request shall be forwarded to the Colorado Department of Human Services, Division of Child Support Services, which shall respond to the request for information or to the request for confirmation or clarification of information submitted to credit reporting agencies by the Child Support Services program. All requests for credit reporting status letters shall be forwarded to the Colorado Department of Human Services, Division of Child Support Services. 6.902.175 Arrears or Payoff Requests If the Colorado Department of Human Services, Division of Child Support Services, requests arrears or payoff information as referenced in Section 6.902.174, the Child Support Services Unit shall provide the information within two (2) working days, as required at Section 6.902.173.

6.902.2 SELECTION FOR DRIVER'S LICENSE SUSPENSION PROCESS

The obligor's court orders will be selected for the drivers' license suspension process if the monthly support obligation is not paid in full each month.

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the Colorado Department of Revenue, Division of Motor Vehicles. 6.902.21 Reports A. A report is generated by the Colorado Department of Human Services, Division of Child Support Services, indicating any cases that have changed status with regards to driver's license suspension. County Child Support Enforcement workers shall take the following actions within thirty calendar days of the generation date of the EM-008, County License Suspension Action Report:

1. Suppress driver's license suspension action, if appropriate. A suppression may be entered at the court order level by the county child support enforcement worker or the technician may request a suppression at the person level, by electronically sending a request to the “SEU DLS” mailbox.

2. Document in the automated child support system all changes or other actions taken.

B. A report is generated by the Colorado Department of Human Services, Division of Child Support Services, indicating cases that have been suppressed from the driver's license suspension process. County child support enforcement workers shall review the case within thirty calendar days of the generation date of the combined suppression report and take the following actions:

1. If appropriate, remove the court case level suppression or request a release of the suppression at the obligor level, by electronically sending a release request to the “SEU DLS” mailbox.

2. Document in the automated child support system all changes or other actions taken. 6.902.22 Notices The following notices are generated by the state office based on the specifics of each case.

A. The obligor has thirty calendar days from the notice of noncompliance date to meet the paying criteria, pay the past due obligation, negotiate a payment plan or request, in writing, an administrative review. If a written request for an administrative review is received, the county child support enforcement worker shall follow Section 6.805.

B. If a new payment plan is reached with the obligor, the county child support enforcement worker shall enter the new payment plan on the automated child support system pursuant to Section 6.902.3.

C. If the obligor has not paid the past due obligation, negotiated a new payment plan, requested an administrative review or met the paying criteria after the notice of noncompliance is issued, and at least thirty calendar days have lapsed, the automated child support system will electronically send an initial notice of failure to comply to the Colorado Department of Revenue, Division of Motor Vehicles, to suspend the license. A paper copy of the initial notice of failure to comply is sent to the obligor at the same time.

D. If the obligor complies and is sent a notice of compliance after the initial notice of failure to comply and then subsequently fails to meet the paying criteria, the automated child support system will electronically send a subsequent notice of failure to comply to the Colorado Department of Revenue, Division of Motor Vehicles, asking that the license be suspended. A paper copy of the subsequent notice of failure to comply is sent to the obligor at the same time.

E. When a manual notice of compliance is needed to stop a suspension, the county child support services worker shall electronically request a manual notice of compliance from the Colorado Department of Human Services, Division of Child Support Services, which will determine if the request is warranted. If the request is approved, within one working day from the date of the decision, Colorado Department of Human Services, Division of Child Support Services, shall fax a manual notice of compliance to the Colorado Department of Revenue, Division of Motor Vehicles. 6.902.23 Rescission A. Within one working day of the discovery that an erroneous suspension of an obligor's driver’s license has occurred due to a county or state Child Support Services office error only, the county child support services worker shall electronically notify the Colorado Department of Human Services, Division of Child Support Services, via the “SEU DLS” mailbox. The message shall contain the date of the erroneous suspension, the specific error that caused the erroneous suspension, and any other relevant facts.

B. Within two working days from the receipt of the electronic message, the Colorado Department of Human Services, Division of Child Support Services, shall review the case to verify whether an error occurred and whether the error is documented in the automated child support system:

1. If the Colorado Department of Human Services, Division of Child Support Services, determines that the suspension occurred erroneously, the Colorado Department of Revenue, Division of Motor Vehicles, shall be notified that the erroneous suspension must be rescinded.

2. If the Colorado Department of Human Services, Division of Child Support Services, determines that the suspension was not erroneous, the county child support services worker shall be electronically notified within two working days of the determination.

6.902.3 PAYMENT PLAN

The payment plan displays the monthly payment due. The monthly payment due consists of the Monthly Support Obligation (MSO) and Monthly Amount Due (MAD) on the arrears.

A. If the obligor has a court ordered MAD on the arrears balance, the county child support worker must enter this amount and the correct code on the court ordered screen in the automated child support system. The code and amount must be removed when the court ordered MAD is no longer valid.

B. If the obligor has a MAD previously set by a county child support worker, the obligor may request the worker reduce the MAD. Upon a request for a reduction by the obligor, the county child support worker must consider information relevant to the determination of the MAD, including but not limited to, the arrears balance, obligor’s current income, and other child support obligations.

The county child support worker shall document any changes to the MAD in chronology.

When the pay plan amounts change, the county child support worker shall issue an amended order/notice to withhold income for support to reflect the new pay plan amount.

C. If the obligor has a MAD set by the child support system that is not a previously technician set MAD, the county shall review the case and ensure the default MAD amount is appropriate and document findings in chronology.

6.902.4 UNEMPLOYMENT COMPENSATION BENEFITS (UCB)

Automated, electronic income assignments are sent to the Colorado Department of Labor and Employment, Division of Unemployment Benefits (UCB), to attach an obligor’s unemployment compensation benefits.

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the Colorado Department of Labor and Employment, Division of Unemployment Compensation Benefits.

When a case is unable to attach to a valid unemployment compensation claim, the county child support services worker shall take the following actions as appropriate within two working days of being electronically notified:

A. Name mismatch – research the case to determine whether the correct name is entered and make any necessary corrections.

B. Exclusion – research the case to determine whether the exclusion is valid and make any necessary corrections.

C. All changes or other actions taken to resolve the exclusions shall be documented in the automated child support system by the county child support services worker.

6.903 ENFORCEMENT ACTIVITIES 6.903.1

The county department shall assure that the full range of enforcement activities are utilized, as applicable, for all CSS cases pursuant to CSS caseload categorization requirements as contained in these rules and consistent with cost-benefit caseload management. 6.903.11 Enforcement Remedies The following enforcement remedies shall be utilized as appropriate:

A. One of two processes of assignment from any type of income through a Notice to Withhold Income for Support:

1. Immediate income assignment - the process whereby the income assignment is ordered in the original or modified court or administrative order or where the original or modified support order was issued after a certain date and takes effect immediately without any further notice to the obligor;

2. Other income assignment - the process whereby the order for income assignment is not

part of the original order or the original order was issued before a certain date and the obligor is afforded due process through advance notification.

B. Immediate health insurance premium withholding through a National Medical Support Notice (NMSN) - notice of health insurance premium withholding shall be included in the original or modified court or administrative order and take effect immediately without any further notice to the parties. The NMSN shall be issued in accordance with Section 6.240.

C. Judgment for arrearages - the process of filing with the court of record a verified entry of judgment or motion and order for judgment for the amount of arrearages owed by the noncustodial parent. All Verified Entries of Judgement must be provided to all parties in a case.

D. Post Judgment remedies - the execution of legal remedies that are available in state law and procedure that are used to satisfy judgment. Such remedies include, but are not limited to:

1. Garnishment of earnings;

2. Garnishment of assets;

3. Liens upon real property;

4. Liens upon personal property;

5. Forced sale of real or personal property;

6. Liens upon motor vehicles.

E. Intercept Program Participation - the participation in state and federal intercept programs which includes:

- IRS income tax refunds, - State lottery winnings, - Unemployment Compensation Benefits, - State income tax refunds, - Gambling intercepts;

- Federal administrative offset, and - State vendor offset.

F. Billings and delinquency notices - the process of billing noncustodial parents or noticing delinquent noncustodial parents as a reminder of support obligations due and past due.

G. Contempt Actions - the process of demonstrating to the court of record at a court hearing that the noncustodial parent has failed to comply with a court order and therefore should be held in contempt of court;

H. Criminal Non-Support Actions - the process of demonstrating to the court of record at a court hearing that the noncustodial parent should be held criminally liable for the failure to support their family;

I. Payment Guarantee Action - request to the court to order the obligor to post security, bond, or other form of guarantee to secure payment of the child support order;

J. Contact with the noncustodial parent - the process of obtaining a support collection by contacting the noncustodial parent by telephone or in writing;

K. Internal Revenue Service full collection service - levy by Internal Revenue Service against noncustodial parent's income or assets;

L. Denial, Revocation, or Limitation of Passports - certifying to the United States Secretary of Health and Human Services the names of noncustodial parents that have failed to comply with a court order to pay child support and who owe the amount of federally mandated arrears for the purpose of denying, revoking, or limiting their passports;

M. Fraudulent Transfers - a petition to the court to void transfers of property by an noncustodial parent to another party;

N. Refer case for prosecution under the Federal Child Support Recovery Act;

O. Administrative Lien and Attachment - form used to attach noncustodial parent's Department of Corrections inmate accounts.

6.903.2 PRIORITY OF OBLIGATION ENFORCEMENT 6.903.21

The county Child Support Services Units shall utilize enforcement activities based upon the type of obligation and the results to be achieved. The order of effectiveness of obligation enforcement is as follows:

A. Enforcement activities that will result in regular collections to satisfy the monthly support obligation for public assistance and non-public assistance cases.

B. Enforcement activities that will result in the collection of arrearages insofar as such enforcement does not interrupt the regular payment of the monthly support obligation by affecting the noncustodial parent's wages.

C. Enforcement activities that will result in the collection of court-ordered costs due to the county department. 6.903.31 Civil Contempt Actions The county Child Support Services Unit may file civil contempt actions with the local court. The CSS Unit must:

A. Screen the case for information regarding the noncustodial parent’s ability to pay or otherwise comply with the order;

B. Provide the court with such information regarding the noncustodial parent’s ability to pay or otherwise comply with the order, which may assist the court in making a factual determination regarding the noncustodial parent’s ability to pay the purge amount or comply with purge conditions; and C. Provide clear notice to the noncustodial parent that his or her ability to pay constitutes the critical question in the civil contempt action.

6.904 ADMINISTRATIVE LIEN AND ATTACHMENT OF INSURANCE CLAIM PAYMENTS,

AWARDS, AND SETTLEMENTS

The Colorado Department of Human Services, Division of Child Support Services, shall attach the insurance claim payments, awards, or settlements due to an obligor who is responsible for the payment of past-due child support obligations or past-due maintenance or maintenance when combined with child support obligations.

6.904.1 SELECTION

A. The State Child Support Services Unit shall attach claim payments, awards, or settlements or obligors who owe more than $500.00, across all court orders, in past-due child support, past-due maintenance or a combination thereof.

B. Pursuant to Section 26-13-122.7, C.R.S., for purposes of this section 6.904, an insurance claim payment, award, or settlement is defined as an individual’s receipt of moneys in excess of $1,000.00 after making a claim for payment under an insurance policy for:

1. Personal injury under a policy for liability;

2. Wrongful death; or 3. Workers’ compensation.

C. Such insurance claim payment, award, or settlement only includes the portion payable to the obligor or the obligor’s representative, and does not include any monies payable as attorney fees or litigation expenses, documented unpaid medical expenses, or payment for damage or loss to real or personal property.

D. The State Child Support Services Unit shall recover any fees assessed from the monies collected under the administrative lien. If it chooses not to pursue collection under the administrative lien, the county Child Support Services Unit is still responsible for fees assessed by the State Department related to the lien, including a data match fee.

6.904.2 NOTICES

The State Child Support Services Unit shall send a notice of administrative lien and attachment to the insurance company, and send to the obligor a copy of the notice of administrative lien and attachment along with notice of the obligor’s right to request an administrative review. The notices shall be sent via first class mail or electronically, if mutually agreed upon. The obligor has thirty (30) calendar days from the date on the notice to request, in writing, an administrative review. When a written request is timely received, the county Child Support Services worker shall follow section 6.805.

6.904.3 POINT OF CONTACT

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the Child Support Lien Network, or similar program, and the insurance companies.

6.905 PROFESSIONAL OCCUPATIONAL LICENSE SUSPENSION PROCESS – DEPARTMENT OF

REGULATORY AGENCIES

Referral will be made to the appropriate licensing board to suspend the professional or occupational license of obligors who:

A. Meet the selection criteria;

B. Have been sent the required notices; and, C. Have failed to comply with a support order.

6.905.1 SELECTION

Obligors will be selected for the professional occupational license process if they owe more than six months' gross dollar amount of child support and are paying less than fifty percent (50%) of their current, monthly child support obligation.

6.905.12 REPORTS

The reports that are generated by the Colorado Department of Human Services, Division of Child Support Services, and used by county CSS Units to process professional occupational license suspension cases must be worked within thirty (30) days of receipt and all changes or other actions taken must be documented in the automated child support enforcement system.

6.905.13 NOTICES

A. The obligor has thirty calendar days from the notice of noncompliance date to pay the past-due obligation, to negotiate a new payment plan or to request, in writing, an Administrative Review.

When a written request is received, the county child support services worker shall follow Section 6.805.

B. When a new payment plan is negotiated with the obligor, the county child support services worker shall enter the new payment plan into the automated child support system pursuant to Section 6.902.3.

C. If the obligor has not paid the past-due obligation, negotiated a new payment plan, requested an Administrative Review or met the paying criteria after the notice of noncompliance, an initial notice of failure to comply shall be electronically sent to the licensing board asking the licensing board to suspend the license. A paper copy shall be sent to the obligor.

D. If the obligor is issued a notice of compliance after the initial notice of failure to comply, but has again become delinquent, a subsequent notice of failure to comply shall be electronically sent to the licensing board asking the licensing board to suspend the license. A paper copy shall be sent to the obligor.

E. When a notice of compliance is needed in less than twenty-four hours to stop the license suspension, the county child support services worker shall electronically request a manual notice of compliance from the Colorado Department of Human Services, Division of Child Support Services, which will fax a notice of compliance to the licensing agency.

F. All changes or other actions taken shall be documented in the automated child support system by the county child support services worker.

6.905.14 POINT OF CONTACT

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between child support services and the Department of Regulatory Agencies representing the licensing boards. County child support services workers shall contact the Division of Child Support Services for assistance with questions or concerns through the automated child support system. The Division of Child Support Services shall resolve the questions or concerns with the Department of Regulatory Agencies and communicate the resolution to the county child support services worker through the automated child support system.

6.905.2 PROFESSIONAL OCCUPATIONAL LICENSE SUSPENSION PROCESS – DEPARTMENT OF

REVENUE

Referral will be made to the appropriate licensing board to suspend the professional or occupational license of obligors who:

A. Meet the selection criteria;

B. Have been sent the required notices; and, C. Have failed to comply with a support order.

6.905.21 SELECTION

Obligors will be selected for the professional occupational license process if they owe more than six months' gross dollar amount of child support and are paying less than fifty percent (50%) of their current monthly child support obligation and have paid less than 90% in the previous and prior accounting periods.

6.905.22 NOTICE

A. The obligor must pay the past due obligation in full, pay a one-time lump sum amount and negotiate a new payment plan if arrears are due or request, in writing, an administrative review.

When a written request is received, the county child support worker shall follow section 6.803.

B. Upon contact from the obligor regarding the DOR license, the county child support worker shall collect a lump sum payment from the obligor and negotiate a payment plan for any arrears due.

C. If a new payment plan is negotiated with the obligor, the county child support worker shall enter the new payment plan on the automated child support system pursuant to section 6.902.3.

D. All changes or other actions taken shall be documented in the automated child support system by the county child support worker.

6.905.23 POINT OF CONTACT

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between child support services and the Department of Revenue Enforcement representing the licensing boards. County child support services workers shall contact the Division of Child Support Services for assistance with questions or concerns through the automated child support system. The Division of Child Support Services shall resolve the questions or concerns with the Department of Revenue Enforcement and communicate the resolution to the county child support services worker through the automated child support system.

6.906 SELECTION FOR FINANCIAL INSTITUTION DATA MATCH (FIDM)

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the financial institutions.

Obligors shall be selected for Financial Institution Data Match on all of their court orders after they have been advised of their due process rights by the issuance of the annual pre-offset notice and the following selection criteria:

A. Arrears balance is $1,000.00 or greater; and, B. Full monthly support obligation is not paid each month.

The Colorado Department of Human Services, Division of Child Support Services, shall exclude partnership, custodial, and commercial accounts or accounts otherwise precluded by law. Pursuant to

Section 26-13-128, C.R.S., and the “Uniform Transfers to Minors Act” and trust accounts of monies held in trust by a third party shall not be attached, encumbered or surrendered.

6.906.1 REVIEW OF SELECTED CASES

Within seven (7) calendar days of the date the electronic notification is generated from the automated child support system, the county child support services worker shall review the accepted match to ensure that the ledger is accurate and to ensure that issuing a lien and levy against the obligor's financial account is appropriate.

All changes or other actions taken shall be documented in the automated child support system by the county child support services worker.

6.906.2 SUPPRESSION 6.906.21 Temporary Suppression The county Child Support Services worker may, within the allotted seven (7) calendar days, suppress the accepted court order match on a temporary basis by updating the suppression code on the automated 6.906.22 Indefinite Suppression The request for an indefinite suppression shall be submitted to the “SEU FIDM” mailbox electronically by the administrator of the Child Support Services Unit.

6.906.3 CREATION OF THE LIEN AND LEVY

If the court order match has not been suppressed, the automated child support system will create a lien and levy document on the eighth calendar day after the accepted match. The Colorado Department of Human Services, Division of Child Support Services, will submit the lien and levy to the financial institution.

Seven calendar days after the lien and levy document has been sent to the financial institution, the Colorado Department of Human Services, Division of Child Support Services, will notify the obligor and any non-debtor account holders of the lien and levy of the account along with the exception/exemption policy and/or the appeal policy.

6.906.4 EXCEPTION OR EXEMPTION CLAIM

A. Within twenty (20) calendar days from the date of the lien, the obligor may request an exception claim per State policy from the Colorado Department of Human Services, Division of Child Support Services, if there is terminal illness of the obligor or the obligor’s biological or adopted child.

B. Within 20 calendar days from the date of the lien, the obligor may request an exemption claim per State statute from the Colorado Department of Human Services, Division of Child Support Services, if there is:

1. Misidentification; or, 2. A custodial account created pursuant to the “Colorado Uniform Transfers to Minors Act”,

Article 50 of Title 11, C.R.S., or a trust account of moneys held in trust for a third party; or, 3. An account held with a corporate tax identification number; or, 4. An account used to receive deposits of Supplemental Security Income benefits, Social Security survivors benefits, or any combination of these funds, Veterans Administration disability benefits, child support payments, public assistance benefits, or federal or state income tax refunds attributed to an earned income or child tax credit as a refundable tax credit or as a nonrefundable reduction in tax; or, 5. An account used to receive “earnings” as defined in Section 13-54-104, C.R.S. The maximum percentage amount of the account balance that can be seized will be determined based upon the documentation provided by the obligor. Documentation requirements are specified on the notice that the obligor receives.

The obligor is responsible for providing the Colorado Department of Human Services, Division of Child Support Services, documentation in support of the above situations.

The Colorado Department of Human Services, Division of Child Support Services, shall review the claim and document its decision whether to approve or deny the claim. The claim shall be reviewed within three business days of receipt based upon the documentation outlined in the lien and levy exception/exemption policy that is included with the Notice of Lien and Levy. If the claim is approved, the Colorado Department of Human Services, Division of Child Support Services, will issue a release of lien and levy to the financial institution. If the claim is denied, the lien and levy will remain in effect. The Colorado Department of Human Services, Division of Child Support Services, shall notify the obligor and the county child support services worker of the claim decision.

6.906.5 APPEAL PROCESS FOR JOINT ACCOUNTS

The lien placed on any and all types of joint account(s) shall require the financial institution to freeze one hundred percent (100%) of the assets on deposit as of the date of the lien. “Joint accounts” means multiple party accounts as defined in Section 15-15-201(5), C.R.S. The Colorado Department of Human Services, Division of Child Support Services, shall take the following actions:

A. The non-debtor account holders are noticed that they have twenty (20) calendar days from the date of the lien to request an appeal of the frozen funds on the basis that there is proof of contribution of the funds on deposit up to one hundred percent (100%) as of the date of the lien as governed by Section 15-15-211, C.R.S.

B. The request for appeal and the required documentation shall be reviewed by the Division of Child Support Services within three working days of receipt.

1. If the appeal is approved, the Colorado Department of Human Services, Division of Child Support Services, will issue a release of lien and levy to the financial institution releasing the contribution of the non-debtor account holder.

2. If the appeal is denied, the lien and levy will remain in effect as to the amount frozen at the time of the lien.

3. The Colorado Department of Human Services, Division of Child Support Services, shall notify the non-debtor account holder and the county child support services worker of the appeal decision.

6.906.6 ALLOCATION OF FUNDS

The levied funds are sent to the Family Support Registry and are allocated according to the obligor's court orders that were included on the FIDM lien and levy.

6.907 VENDOR OFFSET

This enforcement remedy allows the State Controller’s Office to intercept monies from vendors/contractors who perform work for the State of Colorado and owe child support arrearages.

The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the State Controller's Office.

6.907.1 SELECTION AND REFERRAL TO VENDOR OFFSET

Obligors shall be selected for referral on their court order when the monthly support obligation is not paid in full.

The selection criteria is applied to each court order and subsequent court orders for the obligor. When a match is made between the obligor record and the vendor offset table, the county child support services worker will be notified electronically through the automated child support system. The vendor offset table is maintained by the controller’s office and lists all vendors used by the State of Colorado.

6.907.2 REVIEW OF SELECTED CASES

When the county child support services worker is notified that the case has been selected for vendor offset, the worker shall review the case to ensure that the ledger balances are correct. If the county child support services worker determines that vendor offset is not appropriate for the case, an electronic message must be sent through the automated child support system to the “SEU VO” mailbox to request suppression. The case will remain suppressed until the county child support services worker electronically requests the Colorado Department of Human Services, Division of Child Support Services, lift the suppression.

6.907.3 NOTICE

The Colorado Department of Human Services, Division of Child Support Services, generates a Notice of State Vendor Payment Offset when there is a match with the obligor with the vendor table and the match is not suppressed by the county Child Support Services Unit. The obligor has thirty calendar days from the generation date of the Notice of State Vendor Payment Offset to take one of the following actions to stop the intercept of the vendor payment:

A. Contact the county child support services worker and enter into a payment plan and pay the monthly payment due (MPD). If a payment plan is reached with the obligor, the county child support services worker shall update the payment plan on the automated child support system pursuant to Section 6.902.3 concerning maintenance of the payment plan; or, B. Pay the total amount due on the court order; or, C. Submit a written request for an administrative review. If an administrative review is received, the county Child Support Services worker shall follow Section 6.805.

All changes or other actions taken shall be documented in the automated child support system by the county child support Services worker.

6.908 RECREATIONAL LICENSE SUSPENSION

Referral will be made to the Colorado Department of Natural Resources, Parks and Wildlife, to suspend the recreational license of obligors who:

A. Meet the selection criteria;

B. Have been sent the required notices; and, C. Have failed to comply with a support order.

6.908.1 SELECTION

Obligors will be selected for the recreational license suspension process if they owe more than six months’ gross dollar amount of child support and are paying less than fifty percent of their current monthly child support obligation.

6.908.2 NOTICES

A. The obligor has thirty calendar days from the notice of the noncompliance date to pay the pastdue obligation, to enter into a payment plan and begin paying the required amount within the 30 days or to request, in writing, an administrative review. If a written request is received, the county child support services worker shall follow Section 6.805.

B. If the obligor enters into a payment plan, the county child support services worker must enter the payment plan on the automated child support system pursuant to Section 6.902.3.

C. All changes or other actions taken shall be documented in the automated child support system by the county child support services worker.

D. The automated child support system will electronically send a failure notice to the Department of Natural Resources, Parks and Wildlife to suspend the license privilege and shall send a paper copy to the obligor in the following circumstances:

1. Obligor has not paid the past-due obligation;

2. Obligor entered into a new payment plan but failed to make a payment within 30 days of the pay plan; or, 3. Obligor failed to request an administrative review.

6.908.3 REPORT

The reports that are generated by the Colorado Department of Human Services, Division of Child Support Services, and used by county CSS units to process recreational license suspension cases must be worked within thirty days of receipt and all changes or other action taken must be documented in the automated child support enforcement system.

6.908.4 POINT OF CONTACT

The Colorado Department of Human Services, Division of Child Support Services, is the only point of contact with the Department of Natural Resources, Parks and Wildlife. County child support Services workers shall electronically contact the Colorado Department of Human Services, Division of Child Support Services, with any questions or concerns through the automated child support system. The Colorado Department of Human Services, Division of Child Support Services, shall resolve child support enforcement issues with the Department of Natural Resources, Parks and Wildlife and electronically communicate the resolution to the county child support Services worker through the automated child support system.

6.908.5 MISTAKEN IDENTITY

In cases of mistaken identity, the county child support Services worker shall notify the Colorado Department of Human Services, Division of Child Support Services, through the automated child support system of the error. The county child support Services worker shall not enter the name of the innocent party into the alias screen in the automated child support system. The Colorado Department of Human Services, Division of Child Support Services, shall notify the Colorado Department of Natural Resources, Parks and Wildlife, to resolve the error.

6.909 INCARCERATED OBLIGORS 6.909.1 Confirmation of Sentencing and/or Incarceration of Obligor Upon receipt of information and confirmation that an Obligor has been sentenced to one hundred-eighty (180) days or greater, the delegate County Child Support Services Unit must initiate a review and follow guidance in 6.909.2 and 6.909.3 related to suppression of the driver’s license suspension and professional occupational license suspension enforcement remedies. 6.909.2 Suppression of Driver’s License Suspension Enforcement Remedy for Incarcerated Obligors The delegate County Child Support Services Unit shall review the Obligor's driver's license status. If the Obligor's driver's license is in compliance with child support services, the delegate County Child Support Services Unit shall suppress the driver's license suspension remedy. All actions must be documented in the Automated Child Support Enforcement System. 6.909.3 Suppression of Professional Occupational License Suspension Enforcement Remedy for Incarcerated Obligors The delegate County Child Support Services Unit shall review the Obligor's professional/occupational license status. If the Obligor's professional/occupational license is in compliance with child support services, the delegate County Child Support Services Unit shall suppress the professional/occupational license suspension remedy. All actions must be documented in the Automated Child Support Enforcement System. 6.909.4 Administrative Lien and Attachment of Inmate Bank Accounts The Colorado Department of Human Services, Division of Child Support Services, shall attach the inmate bank account held by the Colorado Department of Corrections for an Obligor who is responsible for the payment of current monthly child support, current maintenance, current maintenance when combined with child support, past due child support, past due maintenance, when combined with child support, child support debt, retroactive child support, or medical support. 6.909.5 Notices A. The delegate County Child Support Services Unit shall generate a right to request notice through the automated system for Obligors who have been sentenced to one hundred-eighty (180) days or greater in a Federal, State, or County Corrections Facility. The confirmation of the sentencing may be through a manual or automated match.

B. This notice sets forth the Obligor’s right to request an administrative review. The Obligor has thirty (30) calendar days from the date on the notice to request, in writing, an administrative review.

When a written request is timely received, the delegate County Child Support Services worker shall follow section 6.805 6.909.6 Reports A monthly report is generated that identifies all Obligors in the Colorado Department of Corrections. The County Child Support Services Unit shall confirm the length of sentence and follow 6.261(k) within 14 days if the obligor is sentenced for 180 days or greater. All actions must be documented in the Automated Child Support Enforcement System. 6.909.7 Point of Contact The Colorado Department of Human Services, Division of Child Support Services, is the single point of contact between Child Support Services and the Colorado Department of Corrections Inmate Banking.

County child support services workers shall contact the State Division of Child Support Services for assistance with questions or concerns with administrative lien and attachment of inmate bank accounts through the automated child support system. _________________________________________________________________________ Editor’s Notes

History Rules B&P, 6.002, 6.210, 6.700, 6.805, 6.901, 6.902, 6.905, 6.906, 6.907, 6.908 eff. 05/01/2007.

Rules 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, 6.903.11 emer. rule eff. 10/01/2007.

Rules 6.002, 6.101.2, 6.201.2, 6.261.3, 6.805, 6.805.2, 6.903.11 eff. 11/30/2007.

Rules 6.905, 6.906 eff. 02/01/2008.

Rules 6.001.1 - 6.002, 6.201.2, 6.201.3, 6.201.6, 6.261.1, 6.700.3, 6.709.4, 6.710.1, 6.803.1 - 6.803.2, 6.903.11 eff. 07/01/2008.

Rules B&P, 6.210.12, 6.210.13, 6.803.45 - 6.804.2, 6.804.5 - 6.804.81 emer. rule eff. 07/11/2008.

Rules B&P, 6.210.12, 6.210.13, 6.803.45 - 6.804.2, 6.804.5 - 6.804.81 eff. 10/01/2008.

Rules B&P, 6.002, 6.201.3 - 6.201.6, 6.240.12 - 6.240.18, 6.250.27, 6.260.54, 6.400.17 - 6.400.19, 6.500 - 6.501, 6.602.2, 6.603.2, 6.700.22 - 6.700.24, 6.700.31, 6.700.35, 6.700.38, 6.702.2, 6.709.1, 6.713.1 - 6.714.2, 6.801.15 - 6.801.18, 6.805, 6.805.2, 6.805.31, 6.805.5, 6.902.1 - 6.902.12, 6.902.14 eff. 10/01/2009.

Rules B&P, 6.102.21, 6.110, 6.201.2, 6.601.32, 6.702.1, 6.902.17, 6.905.2, 6.906.1, 6.906.22, 6.906.4, 6.906.6, 6.907.1, 6.907.2, 6.908.3, 6.908.4 eff. 03/02/2010.

Rules SB&P, 6.207, 6.250.18, 6.250.25 – 6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2 – 6.601.31, 6.601.32. – 6.601.32.B, 6.602.1, 6.603.1, 6.603.3, 6.714 emer. rule eff. 08/10/2011.

Rules SB&P, 6.207, 6.250.18, 6.250.25 – 6.250.26, 6.250.3, 6.260.51, 6.600.11, 6.600.13, 6.601.2 – 6.601.31, 6.601.32 – 6.601.32.B, 6.602.1, 6.603.1, 6.603.3, 6.714 eff. 10/01/2011.

Rules SB&P, 6.101, 6.102.3, 6.130 - 6.140, 6.205.21 - 6.205.22, 6.240, 6.250.18 - 6.250.19, 6.250.2, 6.270, 6.300.2, 6.503 - 6.504, 6.700.33 - 6.700.37, 6.715, 6.801, 6.805.5 - 6.805.7, 6.805.82 eff. 03/01/2012.

Rules SB&P, 6.001.1, 6.002, 6.201.2, 6.201.3, 6.205 - 6.209, 6.230.1, 6.230.11, 6.230.13, 6.230.2 - 6.230.5, 6.260.22 - 6.260.23, 6.260.6 - 6.260.7, 6.400, 6.903.11 eff. 04/01/2012.

Rules SB&P, 6.260.22 – 6.260.23, 6.800 eff. 09/15/2012.

Rules SB&P, 6.102.21, 6.210.13, 6.210.13.J, 6.240 – 6.240.2, 6.261 – 6.261.1, 6.261.3 – 6.6261.8, 6.600 – 6.714, 6.804.4, 6.902.1 – 6.902.175, 6.902.23, 6.902.3, 6.902.3.C, 6.902.4 – 6.903.11, 6.906, 6.906.21 eff. 04/01/2013.

Rules SB&P, 6.250, 6.260.51, 6.806 emer. rules eff. 04/05/2013.

Rules SB&P, 6.250, 6.260.51, 6.806 eff. 07/01/2013.

Rules SB&P, 6.002, 6.205, 6.210.12 – 6.210.6, 6.220, 6.260.23 – 6.260.23.A, 6.260.31, 6.400 – 6.400.1.A, 6.500 – 6.503 eff. 11/01/2013.

Rules 6.240.2, 6.805, 6.904 eff. 01/01/2017.

Rules 6.002, 6.803.1, 6.804.1 eff. 04/01/2017.

Entire rule eff. 12/01/2017.

Entire rule eff. 07/01/2019.

Rules 6.809 A-B emer. rules eff. 06/12/2020.

Rules 6.809 A-B eff. 09/30/2020.

Rules 6.002, 6.260.51 A.2, 6.260.51 N, 6.260.55, 6.261.3 K, 6.261.5, 6.262 B, 6.502.1, 6.502.2, 6.701 E- F, 6.712, 6.903.11 C, 6.906.4 B.4, 6.909 eff. 12/01/2020.

Rules 6.002, 6.201.2 A.1-3, 6.201.2 B.7-9, 6.201.3 C, 6.205 C, 6.260.52 eff. 01/01/2022.

Rules 6.103, 6.706 A, 6.900 eff. 03/01/2022.

Entire rule eff. 07/01/2023.

Rules 6.809 A-B, 6.809.2, 6.809.3, 6.809.5 eff. 10/01/2023.

## **2506** Supplemental Nutrition Assistance Program (SNAP)

##### **10 CCR 2506-1** Rule Manual Volume 4, Snap {#sec-10-ccr-2506-1 omnilex-key=us-co-regs-official--department-9--10 CCR 2506-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 4, SNAP

10 CCR 2506-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 4.000 SNAP 4.000.1 SNAP DEFINITIONS “Able-Bodied Adult Without Dependents (ABAWD)” means an individual aged eighteen (18) through the age of fifty-four (54) without a physical or mental disability who lives in a household with no one under the age of eighteen (18).

“Administrative disqualification hearing (ADH)” means a disqualification hearing against an individual accused of wrongfully obtaining or attempting to obtain SNAP benefits.

“Administrative law judge (ALJ)” means a person that may preside over state-level fair hearings and administrative disqualification hearings.

“Administrative adjudicator” means a person who presides over state-level fair hearings and administrative disqualification hearings.

“Adverse action” means any action taken by a local office that causes a household’s SNAP benefits to be reduced, suspended, terminated, or denied.

“Adverse action period” means the period of time during the certification period prior to the adverse action becoming effective.

“Agency error claim” means that a debt has been established for the household to repay due to an overissuance of SNAP benefits that was issued to the household resulting from an error made by the local “Allotment” means the total amount of SNAP benefits a household is authorized to receive in a particular “Appeal” means a request made by a household to have a decision about its case reviewed by an impartial third party to determine whether the decision was correct. The term appeal includes state level fair hearings and local-level dispute resolution conferences.

“Application” means a request on a state-approved form for public assistance which can include the electronic state-prescribed form.

“Application filing date” means the date an application for public assistance is received by the county “Application for recertification” means an application submitted prior to the last month of the certification period to determine a household’s continued eligibility for the next certification period.

“Application process” means the required process a household must complete for purposes of determining eligibility for SNAP benefits at application or application for recertification.

“Authorized representative” means an individual who has been designated in writing by a responsible member of the household to act on behalf of or assist the household with the application process, obtaining SNAP benefits, and/or in using SNAP benefits at authorized retailers.

“Automated Child Support Enforcement System (ACSES)” means the automated computer system used by the state department’s child support services to record child support payments.

“Basic Categorical Eligibility (BCE)” means the status granted to any household that is not eligible for Expanded Categorical Eligibility and contains only members who receive, or are eligible to receive, benefits from Colorado Works, Supplemental Security Income (SSI), Old Age Pension, Aid to the Needy and Disabled, Aid to the Blind, or a combination of these programs.

“Basic Utility Allowance (BUA)” means a fixed deduction applied to a household that does not pay for heating or cooling and incurs at least two (2) non-heating or non-cooling utility costs, such as electricity, water, sewer, trash, cooking fuel, or telephone.

“Bifurcated appeal” means an appeal that involves more than one benefit program area and where the administrative adjudicator determines to divide the appeal so that a SNAP appeal is reviewed separate from the appeal of a different benefit program area appeal.

“Boarder” means an individual residing with others and paying reasonable compensation to others for lodging and meals.

“Boarding house” means an establishment that is licensed as a commercial enterprise and which offers meals and lodging for compensation, as described in 7 C.F.R 273.1(b)(3)(i), herein incorporated by reference. No later editions or amendments are incorporated. The regulation is available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302 or at https://www.ecfr.gov. This regulation is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.

“Case record” means a combination of the physical case file that contains documents pertinent to a household’s case; similar documents maintained in an electronic database; and information about the household that is contained within the statewide automated system.

“Certification period” means the period of time for which a household has been certified to receive “Civil union” means a legally binding partnership between two individuals without the legal recognition of these individuals as spouses.

“Claim” means a debt resulting from an over-issuance of SNAP benefits that a household is obligated to repay.

“Clear and convincing evidence” means evidence which is stronger than a preponderance of evidence and which is unmistakable and free from serious or substantial doubt.

“Client” means a current or past applicant or a current or past recipient of SNAP.

“Collateral contact” means a verbal or written confirmation of a household's circumstances by a person outside the household who has first-hand knowledge of the information, made either in person, electronically submitted, or by telephone.

“Colorado Department Of Human Services (CDHS)” means the same as defined in section 26-1-105, C.R.S., which is incorporated by reference. No later editions or amendments are incorporated. This

regulation is available for public inspection and copying at The Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.

“Colorado Electronic Benefit Transfer System (CO/EBTS)” means the electronic system that enables SNAP participants or their authorized representatives to redeem their SNAP benefits at point-of-sale terminals.

“Colorado Unemployment Benefits System (CUBS)” means the electronic system by which Unemployment Insurance Benefits (UIB) are determined by the Colorado Department of Labor and Employment.

“Combined appeal” means an appeal that involves both a SNAP appeal and an appeal concerning any other benefit program area (ex. A SNAP appeal plus a Colorado Works appeal that are filed as one appeal). Combined appeals will be bifurcated to allow the SNAP portion of the appeal to move on a faster track to comply with federal SNAP timeliness requirements.

“Communal dining facility” means an establishment approved by FNS that prepares and serves meals for persons aged sixty (60) and older, or for Supplemental Security Income (SSI) recipients, and their spouses. This also includes federally subsidized housing for persons aged sixty (60) and older at which meals are prepared for and served to the residents. It also includes private establishments that contract with an appropriate state or local agency to offer meals at concessional prices to persons aged sixty (60) and older or SSI recipients, and their spouses.

“Compromise” means a local office’s decision to reduce the amount of a claim that is owed by a “Countable month” means a month in which an ABAWD received a full SNAP allotment but did not meet work requirements or have an exemption from those requirements.

“Demand letter”, see “notice of overpayment.”

“Disaster Supplemental Nutrition Assistance Program (D-SNAP)” means the assistance provided to the affected areas when a Presidential disaster declaration for individual assistance is declared and the decision to implement this program after a Presidential declaration shall be at the affected county’s discretion in coordination with the state SNAP office and FNS.

“Dispute Resolution Conference (DRC)” means an informal meeting between a household and the local office to review an action taken on a case and the relevant facts pertaining to such action.

“Disqualification Consent Agreement (DCA)” means the form that allows the individual(s) suspected of Intentional Program Violation/fraud to consent to his/her disqualification in cases of deferred adjudication, as described in 7 C.F.R. 273.169(h), which is herein incorporated by reference. No later editions or amendments are incorporated. The regulation is available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. This regulation is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.

“Disqualified individuals” means any individual who is ineligible to receive SNAP benefits due to having been disqualified for an Intentional Program Violation/fraud, failure to provide or obtain a SSN, ineligible non-citizens, individuals disqualified for failure to cooperate with work requirements, individuals disqualified for failure to cooperate with the state quality assurance division, and ABAWDs who already received three countable months of SNAP within thirty-six (36) months without meeting an exemption or ABAWD work requirements.

“Documentary evidence” means written information used to verify the income, expenses, and other circumstances of a household.

“Documentation” means the collection of documentary evidence, verification, case notes, and other information related to a household’s case upon which eligibility determinations and other decisions are based.

“Drug and Alcohol Treatment Center (DAA)” means any residential facility run by a private, nonprofit organization or institution, or a publicly operated community mental health center, under Part B of Title XIX of the Public Health Service Act (42 U.S.C 300x-1 through 300x-13) that provides rehabilitative treatment to persons participating in a drug or alcohol treatment program.

“Dual participation” means the receipt of SNAP benefits in more than one SNAP household or state in the same calendar month.

“EBT account” means the account linked to the EBT card where the state department deposits SNAP “EBT card” means the card issued to persons authorized to receive SNAP to which the household’s allotment is credited. Used for SNAP purposes to purchase eligible foods at approved retailers.

“Eligibility has been determined” means a required interview was completed and all required verifications were received for a valid SNAP application and a determination of eligibility or ineligibility was made with a resulting notice of action.

“Employment and Training Program” means a program operated by the Department of Human Services consisting of work, training, education, work experience, and/or job search activities designed to help clients obtain gainful employment.

“Employment First (EF)” means Colorado’s Employment and Training Program.

“Energy Electronic Benefit Transfer (E-EBT)” means the fuel assistance payment to eligible SNAP households of at least $20.01 that qualifies those households for the heating and cooling standard utility allowance.

“Evidence” includes but is not limited to an item, document, photograph, video recording, testimony, or other tangible object presented to an administrative adjudicator, administrative law judge, and/or during a dispute resolution conference to make the existence of a fact more or less valid.”

“Excess medical deduction” means a deduction from a household's total gross income applied when a person with a disability or a person aged sixty (60) and older has medical expenses over a specified monthly amount.

“Exempt income” means income that is exempt from consideration when determining eligibility for SNAP.

“Expanded Categorical Eligibility (ECE)” means households that are exempt from having resources considered when determining eligibility for SNAP.

“Expedited service” means the method by which an application for SNAP is processed to ensure that the neediest households have access to benefits no later than the seventh (7th) calendar day following the date of application.

“Fair hearing” or “State-level fair hearing” means a hearing conducted in person or on the telephone by an administrative adjudicator to provide an impartial decision on a household’s appeal of a local office’s decision or action.

“Final agency decision” means a decision issued by the Office of Appeals after reviewing the initial decision issued by an administrative adjudicator.

“Financial criteria” means the set of rules governing gross and net income and resource standards and the proper methods for computing a household’s income and resources.

“Fleeing felon” means an individual who is fleeing to avoid prosecution or custody for a crime, or an attempt to commit a crime, that would be classified as a felony under a state or federal law.

“FNS” means the Food and Nutrition Service of the U.S. Department of Agriculture.

“Fraud” means the same as described in section 26-2-305(1)(a), C.R.S.

“Full-time student” means a person who has a school schedule equivalent to a full-time curriculum as defined by the institution of higher education the person is attending.

“G-845” means the U.S. Citizenship and Immigration Services (USCIS) form submitted by SNAP to the USCIS to request immigration status verification for a SNAP client. Form G-845 was last modified on April 8, 2021 and is incorporated by reference. No later editions or amendments are incorporated. The form is available at no cost at https://www.uscis.gov/g-845. The form is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.

“Good cause” except as defined in 4.308.1, means a waiver granted to a person or household a) excusing them from complying with a specific eligibility requirement because compliance could cause adverse consequences to the person or household, or b) providing the household with more time to comply with a specific eligibility requirement.

“Gross income” means the total of all non-exempt earned and unearned income added together before any deduction or disregard is considered.

“Group Living Arrangement (GLA)” means a public or private non-profit facility certified under Section 1616(e) of the Social Security Act which serves no more than sixteen (16) people.

“Head of Household (HOH)” means the person who is generally regarded as the person with the most knowledge of the household’s circumstances. The head of household is the person to whom the local office addresses correspondence and notices about the household’s case. This person is generally the individual who completes the application process and is responsible for obtaining and using the household’s EBT card.

“Heating/Cooling Utility Allowance (HCUA)” means a fixed deduction applied to any household that incurs a heating or cooling expense.

“Homeless meal provider” means:

1. A public or private nonprofit establishment that feeds persons experiencing homelessness; or, 2. A restaurant which contracts with an appropriate state agency to offer meals at concessional (low or reduced) prices to persons experiencing homelessness.

“Household” means a group of individuals who live together and customarily purchase and prepare food together for home consumption.

“Household income” means all earned and unearned income received or anticipated to be received by the household from all sources, unless specifically exempted for SNAP eligibility purposes.

“Inadvertent Household Error Claim (IHE)” means a debt that has been established for the household to repay due to an over-issuance of benefits that was issued to a household based on a misunderstanding or unintentional error on the part of the household.

“Income and Eligibility Verification System (IEVS)” means a system used to match client’s Social Security Numbers with the Social Security Administration, Internal Revenue Service, and the Department of Labor and Employment to obtain information about household income.

“Indigent non-citizen” means a sponsored non-citizen who, after considering all income and contributions provided by the sponsor and other sources in conjunction with the non-citizen’s own income, is unable to obtain food and shelter amounting to one hundred thirty percent (130%) of the federal poverty level (FPL), as defined in section 4.401.1, for the non-citizen’s household size. When a non-citizen is declared indigent, only the amount provided by the sponsor shall be deemed for the non-citizen. A declaration of indigence may last up to twelve (12) months but may be renewed at the end of such a period, if necessary. The local office must notify the U.S. Attorney General of each indigence determination, including the name of the sponsor and the sponsored non-citizen.

“Initial decision” means a decision issued by an administrative adjudicator after a state-level fair hearing.

“Initial application” means a household’s first application for assistance or an application for assistance that is received after the household has been off the program for any period following the end of a “Initial month of application” means the first month for which the household is certified for participation in the program for those who have not received SNAP benefits in the state previously or following any break after the end of the certification period where the household was not certified for participation. If the household applies for recertification prior to the expiration of its certification period and is found eligible for the first month following the end of the certification period, that month shall not be an initial month.

“Institution of higher education” means institutions that normally require a high school diploma or equivalency certificate for a student to enroll, such as colleges, universities, and vocational or technical schools.

“Intentional” means a false representation of a material fact with knowledge of that falsity or omission of a material fact with knowledge of that omission.

“Intentional Program Violation (IPV)” means when an individual has intentionally made a false or misleading statement or misrepresented, concealed, or withheld facts, or committed or intended to commit any act that constitutes a violation of the federal SNAP program operated under the Food and Nutrition Act of 2008, the federal SNAP regulations, or any state statute relating to the use, presentation, transfer, acquisition, receipt, or possession of SNAP benefits or EBT cards.

“IPV hearing”, see “Administrative disqualification hearing.”

“IPV hearing waiver”, see “Waiver of administrative disqualification hearing.”

“Issuance month” means the calendar month for which a benefit allotment is issued.

“Lawful Permanent Resident” means a non-citizen legally admitted into the United States to reside on a permanent basis.

“Level sanction” means a specified period of ineligibility imposed against an individual who failed to take a required action as part of his or her eligibility for SNAP.

“Liquid resources” means assets such as cash on hand or assets that can be easily converted to cash such as money in checking or savings accounts, saving certificates, or stocks and bonds.

“Live-in attendants” means individuals who reside with a household to provide medical, housekeeping, child-care, or other personal services.

“Local office” means the county Department of Social/Human Services that is responsible for administering SNAP. In those counties that have more than one office that administers SNAP, “local office” shall be inclusive of all local offices within the county that administer the program.

“Local-level dispute resolution conference”, see “Dispute resolution conference.”

“Low-Income Home Energy Assistance Program (LEAP)” means the Colorado program designed to help low-income clients pay a portion of their winter heating costs.

“Management Evaluation (ME) reviews” means state or federal reviews of each county’s administration of SNAP to determine each county’s adherence to federal- and state-mandated requirements. Such reviews are mandated by the Food and Nutrition Service of the USDA.

“Mass update” means a change in data or policy that affects the entire state-wide caseload or a portion of the caseload.

“Material fact” means information to which a reasonable person would attach importance when determining a course of action.

“Migrant farm worker” means a person who travels away from home on a regular basis to follow the flow of seasonal agricultural work.

“Minimum benefit” means the minimum amount of benefits issued to one- and two-person households that are eligible for assistance, but whose issuance calculates to less than the federally prescribed minimum allotment.

“Net income test” means the one hundred percent (100%) federal poverty level (FPL), as defined in

section 4.401.2, under which a household’s income must fall after all allowable deductions are considered in order to be considered eligible. This level is specific to the household size as defined by FNS.

“Non-financial criteria” means the set of rules governing SNAP eligibility elements not related to a household’s gross and net income and resource standards.

“Non-liquid resources” means assets which cannot be easily converted into cash such as vehicles and real property.

“Notice of Action (NOA)” means the state-prescribed form sent to a household every time a local office increases or takes an adverse action impacting a household’s SNAP benefits. This form describes the action taken upon a household’s case and the resulting effect.

“Notice of Overpayment” means a notice sent to a household upon the establishment of a claim against the household for an overpayment of benefits.

“Office of Administrative Courts (OAC)” means the office within The Colorado Department of Personnel and Administration that The Colorado Department of Human Services may designate to hear state-level fair hearings as needed and as agreed to by The Office of Administrative Courts.

“Office of Appeals (OOA)” is an office within The Colorado Department of Human Services that issues final agency decisions on behalf of The Colorado Department of Human Services.

“On-the-job training (OJT)” means training provided to an employee after he or she is hired. Such training is designed for individuals who do not have the necessary work experience required for the job.

“One Utility Allowance (OUA)” means a fixed deduction given to any household that is not eligible to receive the HCUA or BUA and incurs only one (1) non-heating or non-cooling utility expense, such as electricity, water, sewer, trash, or cooking fuel. The OUA is not allowed if the household’s only utility expense is a telephone.

“Outdated” means information that is older than sixty (60) days from the point of eligibility determination or is no longer representative of a household’s circumstances.

“Over-issuance” means the amount of SNAP benefits issued to a household that exceeds the household’s correct allotment.

“PA households” means households that contain only persons who receive TANF/Colorado Works or Adult Financial cash grants.

“Parolee” means a non-citizen allowed into the United States for urgent humanitarian reasons or when the non-citizens entry is determined to be for significant public benefit as described in 8 U.S.C 1182(d)(5) and in 8 C.F.R. 212.5 (2019), herein incorporated by reference. No later editions or amendments are incorporated. The regulation is available at no cost at the U.S. Department of Homeland Security, 3801 Nebraska Avenue NW, Washington D.C., 20016 or at https://www.ecfr.gov. This regulation is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203. Parole does not constitute a formal admission to the United States and confers temporary status only, requiring parolees to leave when the conditions supporting their parole cease to exist.

“Payment Error Rate (PER)” means the sum of the overpayment error rate and the underpayment error rate, which is the value of all over and underpaid allotments expressed as a percentage of all allotments issued to the cases reviewed, excluding those cases processed by Social Security Administration (SSA) personnel or participating in certain demonstration projects designated by FNS.

“Period of ineligibility” means the period of time a person is ineligible to receive SNAP benefits as a result of a failure to cooperate with either a state or federal QA review.

“Periodic Report Form (PRF)” means the report that must be submitted by the household during the twelfth (12th) month of a twenty-four (24) month certification period. The purpose of this form is to allow the household to report any changes that occurred during the first half of the twenty-four (24) month certification period and for the local office to determine the household’s continued eligibility for the remaining twelve (12) months of the household’s certification period.

“Person experiencing homelessness” means an individual who lacks a fixed and regular nighttime residence or whose primary residence is: a supervised shelter designed for temporary accommodations; a halfway house or similar facility that provides temporary residence; a place not designed for or ordinarily used as regular sleeping accommodations for human beings; or a temporary accommodation in the residence of another individual for ninety (90) days or less.

“Person with disabilities” means a person who:

1. Receives Supplemental Security Income (SSI) benefits under Title XVI of the Social Security Act, or the Colorado Supplement, or Aid to the Needy and Disabled- Supplemental Security Income- Colorado Supplement (AND-SSI-CS), or Aid to the Blind- Supplemental Security Income- Colorado Supplement (AB-SSI-CS); or Disability or Blindness Payments under Title I, II, X, or IXV of the Social Security Act;

2. Is a veteran with a service-connected disability rated or paid as a total disability under Title 38 of the United States Code or is a veteran receiving a pension for a non-service connected disability;

3. Is a veteran considered by the Veterans Affairs (VA) to be in need of regular aid and attendance or permanently housebound under Title 38 of the United States Code;

4. Is a surviving spouse of a veteran and considered in need of aid and attendance or permanently housebound or a surviving child of a veteran and considered by the VA to be permanently incapable of self-support under Title 38 of the United States Code;

5. Is a surviving spouse or child of a veteran and considered by the VA to be entitled to compensation for a service-connected death or pension benefits for a non-serviceconnected death under Title 38 of the United States Code and has a disability considered permanent under Section 221(i) of the Social Security Act. “Entitled”, as used in this definition, refers to those veterans’ surviving spouses and children who are receiving the compensation or benefits or have been approved for such benefits but are not yet receiving them;

6. Has a disability considered permanent under Section 221(i) of the Social Security Act and receives a federal, state, or local public disability retirement pension;

7. Receives an annuity for disability from the railroad retirement board who is considered as a disabled person with disabilities by the SSA or who qualifies for Medicare as determined by the railroad retirement board; or 8. Is a recipient of interim assistance benefits pending the receipt of the Supplemental Security Income (SSI), disability-related medical assistance under Title XIX of the Social Security Act, or disability-based state assistance benefits provided that the eligibility to receive these benefits is based on disability or blindness criteria which are at least as stringent as those used under Title XVI of the Social Security Act.

“Post high school education” means colleges, universities, and post-high school level technical and vocational schools.

“Preliminary determination” means an administrative adjudicator has determined in writing and at a hearing that the sole issue is one of federal law or regulation and that the household’s claim that the local office improperly calculated benefits, and/or misinterpreted or misapplied such law or regulation is invalid.

“Preponderance of evidence” means the legal burden of proof to show that the evidence is more likely to be true than not. Preponderance of evidence is a lesser burden of proof than that of clear and convincing evidence.

“Prospective budgeting” means the method of computing a household’s monthly allotment by using current circumstances and reasonably anticipated income for the month in which the allotment will be issued.

“Prudent Person Principle (PPP)” means a technician’s discretion to apply reasonable judgment when determining the proper course of action in specific situations in order to make an eligibility determination.

“Public assistance (PA)” means the same as section 26-2-103(7), C.R.S.

“Quality assurance (QA)” means the division of the Colorado Department of Human Services (CDHS) responsible for reviewing SNAP cases to determine if the proper eligibility determination was made and if the correct allotment was issued to a household in a given month.

“QA active case” means cases where a household was certified prior to or during the sample month and issued SNAP benefits for the sample month.

“QA negative case” means cases where a household was denied certification to receive SNAP benefits in the sample month or which had its participation in the program terminated during a certification period effective for the sample month.

“Qualified non-citizen” means an individual who meets the specific definition of “qualified alien” as defined by the Food and Nutrition Service, United States Department of Agriculture, in 7 C.F.R. 273.4(a)(5), (6)(1)

(2019), and is herein incorporated by reference. No later editions or amendments are incorporated. The

regulation is available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. This regulation is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203. Qualified non-citizen for purposes of SNAP includes lawful permanent residents, asylees, refugees, parolees, individuals granted withholding of deportation or removal, conditional entrants, Cuban or Haitian entrants, battered immigrants and non-citizen victims of a severe form of trafficking. This term is not itself an immigration status, but rather includes a collection of immigration statuses. It is a term used solely for federal SNAP purposes. Qualified non-citizens are not automatically eligible for assistance, but rather must meet all other eligibility requirements.

“Quality control review” means a review conducted by CDHS of a statistically valid sample of active and negative cases to determine the extent to which households are receiving snap allotments to which they are entitled, and to determine the extent to which decisions to deny, suspend, or terminate cases are correct.

“Quest card” means Colorado’s specific version of the EBT card.

“Questionable” means inconsistent or contradictory information, statements, documents, or case documentation that requires verification from the household to determine eligibility.

“Recoupment” means the withholding of a portion of a household’s monthly allotment to pay back an over-issuance.

“Repayment agreement” means the state department form sent to a household upon the establishment of a claim that outlines the household’s responsibility and options for repayment.

“Restoration” means a payment of benefits made to a household who was eligible to receive the amount in a past month but did not receive the payment.

“Roomer” means an individual to whom a household furnishes lodging, but not meals, for compensation.

“Sanction” means a specified period of ineligibility imposed against an individual who failed to take a required action as part of his or her eligibility for either SNAP or Colorado Works.

“Self-employment” means a situation where some or all income is received from a self-operated business or enterprise in which the individual retains control over work or services offered and assumes the necessary business risks and expenses connected with the operation of the business.

“Shelter for battered women and children” means a public or private nonprofit residential facility that serves battered women and their children. If such a facility serves other individuals, a portion of the facility must be set aside on a long-term basis to serve only battered women and children.

“Simplified reporting” means SNAP households are required to report mid-certification changes that cause the household’s combined gross income to rise above one hundred thirty percent (130%) of the federal poverty level (FPL) as defined in section 4.401.1 for the applicable household size, when a member of the household wins substantial lottery or gambling winnings, and if an ABAWD’s work/volunteer hours fall below twenty (20) hours per week.

“SNAP” means Supplemental Nutrition Assistance Program, formerly known as the Food Assistance program, administered by the state department in Colorado.

“SNAP fair hearings unit” means the unit within the Office of Appeals at the Colorado Department of Human Services that may be designated by the Colorado Department of Human Services to hear SNAP appeals, the SNAP portion of a bifurcated appeal, combined appeals, and administrative disqualification hearings. The SNAP fair hearings unit generally operates under the supervision of the chief adjudicator of the Office of Appeals but acts independently and in a fair and impartial manner concerning the fair hearings process and the issuance of initial decisions.

“Sponsor” means any person(s) who executed an affidavit of support (USCIS form I-864A (March 6, 2018)) or another form deemed legally binding by the Department of Homeland Security on behalf of a non-citizen as a condition of the non-citizen’s date of entry or admission into the United States as a permanent resident. These forms are herein incorporated by reference. This rule does not contain any later amendments or editions. These forms are available at no cost from https://www.uscis.gov/forms.

These forms are also available for public inspection and copying at the Colorado Department of Human Services, Director of the Employment and Benefits Division, 1575 Sherman Street, Denver, Colorado, 80203, or at any state publications library during regular business hours.

“Sponsored non-citizen” means those non-citizens lawfully admitted for permanent residence into the United States who have been sponsored by an individual for entry into the country.

“Standard Eligibility (SE)” means the set of rules applicable to households that do not fall under “Expanded Categorical Eligibility” or “Basic Categorical Eligibility.” Households considered under Standard Eligibility rules are subject to resource limits as a condition of eligibility.

“State department” means the office/division within the Colorado Department of Human Services that administers SNAP. Currently, this is the Food and Energy Assistance Division within the Office of Economic Security.

“State-level fair hearing” or “Fair hearing” means a review (hearing) requested by a client which is held before an administrative adjudicator to establish whether an adverse action or eligibility determination taken was correct.

“Striker” or “striking member” means an individual who is involved in a strike or other concerted stoppage of work by employees, including a stoppage by reason of the expiration of a collective bargaining agreement and any concerted slowdown or other concerted interruption of operations by employees.

“Substantial lottery or gambling winnings” is a cash prize won in a single game, before taxes or other amounts are withheld, that is equal to or greater than the resource limit for persons aged sixty (60) and older and persons with disabilities.

“Supplement” means a payment of additional allowable SNAP benefits made for the current issuance “Supplemental Security Income (SSI)” means monthly cash payments made under the authority of: (1)

Title XVI of the Social Security Act, as amended, to the aged, blind and disabled; (2) Section 1616(a) of the Social Security Act; or (3) Section 212(a) of Pub. L. 93-66.

“Systematic Alien Verification for Entitlements (SAVE)” means the system allowing for the validation of immigration statuses of non-citizen clients through access to centralized U.S. Citizenship and Immigration Service (USCIS) data.

“Telephone allowance” means a fixed deduction given to any household not incurring utility expenses other than the expense for a telephone.

“Temporary Assistance for Needy Families (TANF) or Colorado Works (CW)” means the cash assistance program also known as Title IV-a of the Social Security Act.

“Temporary emergency” means an emergency caused by any natural or human-caused disaster, other than a major disaster declared by the President of the United States under the Disaster Relief Act of 1974, which is determined by FNS to have disrupted commercial channels of food distribution.

“Thrifty food plan” means the diet required to feed a family of four (4) persons, as defined by the FNS, as consisting of a man and a woman twenty (20) through fifty (50) years of age, a child six (6) through eight (8) years of age, and a child nine (9) through eleven (11) years of age, determined in accordance with the U.S. Department of Agriculture. The cost of such a diet shall be the basis for uniform allotments for all households regardless of their actual composition.

“Trafficking” means the same as defined in section 26-2-306, C.R.S. and 7 C.F.R. 271.2 (2019), which is incorporated by reference. No later editions or amendments are incorporated. The regulation is available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. This

regulation is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203.

“Unclear information” means unverified information that is known to the agency and requires verification, or information that is verified but the local office needs additional information to determine SNAP eligibility.

“Under-issuance” means the difference between the allotment the household was eligible to receive and the allotment the household received, which was lower than what the household was eligible to receive.

“Valid application” means a state-prescribed public assistance benefits form completed with name, address, and signature.

“Vendor payments” means money payments that are not payable directly to a household but are paid to a third party for a household expense.

“Verification” means confirmation of a household’s statements through written, verbal, or electronic means “Verified upon receipt (VUR)” means information that is provided directly from the primary source and which is not questionable.

“Voluntary quit” means when a SNAP client voluntarily quit a job of 30 or more hours a week or reduced work effort to less than 30 hours a week without good cause.

“Voluntary work registrant” means an individual who chooses to participate in the program and is not mandated to participate by the state or federal regulations.

“Waiver of administrative disqualification hearing” means a waiver sent to individuals suspected of IPV which presents the individual with the option of waiving his or her right to an administrative hearing, accepting the appropriate disqualification without necessarily admitting the violation.

4.100 SNAP INTRODUCTION

This material sets forth rules, policies, and procedures concerned with eligibility determination and certification of persons who apply to participate in SNAP, and, if determined eligible, the requirements concerning the use of SNAP benefits. The rules and regulations herein are promulgated in accordance with Program regulations of the United States Department of Agriculture (USDA), 7 C.F.R. 271–274 (2021), as amended, which are incorporated by reference, and the State Plan of Operation. No later amendments or editions of the regulations are incorporated. Copies of the regulations are available at no cost at the FNS, 3101 Park Center Dr., #906, Alexandria, VA 22302, or at https://www.ecfr.gov. These regulations are also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado.

4.110 USE OF THE SNAP MANUAL

Below is a summary of the information contained in each section:

Section 4.000 contains SNAP specific definitions.

Section 4.100 contains general program information, confidentiality requirements, and complaint procedures (including complaints regarding alleged discrimination).

Section 4.200 sets forth policies and procedures for the application and recertification processes.

Information contained in this section includes the process of filing an application and recertification, interview requirements, timely processing standards, determination of certification periods, and initial month allotment proration.

Section 4.300 outlines the non-financial criteria a household must meet to be eligible for SNAP. Nonfinancial criteria include identity of clients, Social Security Number (SSN) requirement, residency, household composition, citizenship and non-citizenship status, and work program requirements.

Section 4.400 sets forth the financial criteria a household must meet to be eligible for SNAP. Financial criteria include gross and net income standards, resource standards, and deductions from income.

Section 4.500 sets forth policies and procedures regarding the verification and documentation of a household’s circumstances.

Section 4.600 outlines a household’s obligation to report changes during the certification period, and how certain changes are handled by the local office.

Section 4.700 sets forth policies and procedures for issuing SNAP benefits, including restoration and replacement of issuances.

Section 4.800 outlines the rules and processes regarding claims, appeals, and fraud.

Section 4.900 outlines state and county administrative requirements.

4.120 PURPOSE OF SNAP

The purpose of SNAP is expressed by the United States Congress in Section 2 of the Food and Nutrition Act of 2008, Public Law No. 110-246 (codified at 7 USC 2011).

SNAP is designed to promote the general welfare and to safeguard the health and well-being of the nation’s population by raising the levels of nutrition among low-income households.

4.130 USING SNAP BENEFITS

SNAP benefits received by an eligible household may be used at any time by the household or other persons whom the household selects to purchase eligible food for the household. SNAP benefits are issued through an Electronic Benefit Transfer (EBT) system in which benefit allotments are stored on an electronic benefit transfer card and used to purchase authorized items at a point-of-sale (POS) terminal.

EBT cards shall be presented only to retailers authorized by USDA/FNS to accept food benefit payment for food purchases.

SNAP benefits must be used to pay for food currently purchased and cannot be used to pay for foods previously or subsequently secured or to pay back bills owed the grocer. The only exceptions are that SNAP benefits may be used to pay for food items such as milk or bakery goods that are delivered to the home on a regular basis, or for advance payment to a non-profit cooperative food venture when food purchased is to be delivered later.

A. Expungement 1. Upon approval of benefits, SNAP recipients are provided information in writing that any SNAP benefits issued to the EBT card that are unused after nine (9) months (274 days) will be expunged and removed from the account.

2. Upon approval of benefits, SNAP recipients are provided information in writing that if the EBT account goes inactive (no food purchases or returns) after nine (9) months (274 days), the inactive SNAP benefits will be considered expunged and removed from the account.

4.130.1 WHERE HOUSEHOLDS CAN USE SNAP BENEFITS

A. Specified persons may use their SNAP benefits to purchase meals from the following:

1. A meal delivery service approved by the USDA, Food and Nutrition Service (FNS);

2. A communal dining facility for persons aged sixty (60) years and older and/or SSI households;

3. An authorized drug or alcoholic treatment and rehabilitation center;

4. An authorized public or private, nonprofit group living arrangement facility; and 5. A shelter for battered women and children.

B. Households containing persons experiencing homelessness shall be permitted to use their benefits to purchase prepared meals from an authorized public or private nonprofit provider for persons experiencing homelessness. A meal provider for persons experiencing homelessness means a public or private non-profit establishment, including, but not limited to, soup kitchens and temporary shelters which feed persons experiencing homelessness. To be considered a meal provider to persons experiencing homelessness, the meal provider must be approved as such by the USDA, FNS.

Households containing persons experiencing homelessness may also purchase meals from restaurants if the restaurant offers discounts to or serves food to households containing persons experiencing homelessness at concessional (reduced) prices, and the restaurant is authorized by the USDA, FNS as a retailer.

4.130.2 ELIGIBLE FOODS

Households can only purchase eligible foods with SNAP benefits. Eligible foods include:

A. Any food or food product intended for human consumption, except for alcoholic beverages, tobacco, and hot food, including hot food products prepared by the retailer and sold at above room temperature for immediate consumption.

B. Seeds and plants to grow foods for personal consumption by eligible household members.

4.140 CONFIDENTIALITY

A. If there is a written request by a responsible member of the household, the current authorized representative, or a person acting on behalf of the household to review materials contained in the case record, the material and information contained in the case record shall be made available to the requestor.

1. The local office shall withhold confidential information, such as the names of persons who have disclosed information about the household without the household’s knowledge, or the nature or status of pending criminal investigations or prosecutions.

B. Use or disclosure of information obtained from a SNAP household or from any State or Federal agency included in the Income and Eligibility Verification System (IEVS), including the Internal Revenue Service (IRS), Social Security Administration (SSA) and Colorado Department of Labor and Employment (DOLE) exclusively for SNAP, shall be restricted to the following persons, as described in 7 C.F.R 272.1(C)(1). Incorporated by reference in section 4.100:

1. Persons directly connected with the administration or enforcement of the provisions of the Food Stamp Act or regulations, other Federal assistance programs, federally- assisted State programs providing assistance on a means-tested basis to low-income individuals, or general assistance programs which are subject to the joint processing requirements in

section 4.202.1.

2. Employees of the Comptroller General's office of the United States for audit examination authorized by any other provision of law;

3. Local, State or Federal law enforcement officials, upon their written request, for the

purpose of investigating an alleged violation of the Food Stamp Act or regulations. The written request shall include the identity of the individual requesting the information and his/her authority to do so, the violation being investigated, and the identity of the person about whom the information is requested;

Local, State, or Federal law enforcement officers acting in their official capacity, upon written request by such law enforcement officers that includes the name of the household member being sought, for the purpose of obtaining the address, social security number, and, if available, photograph of the household member, if the member is fleeing to avoid prosecution or custody for a crime, or an attempt to commit a crime, that would be classified as a felony (or a high misdemeanor in New Jersey), or is violating a condition of probation or parole imposed under a Federal or State law. The agency shall provide information regarding a household member, upon written request of a law enforcement officer acting in his or her official capacity that includes the name of the person being sought, if the other household member has information necessary for the apprehension or investigation of the other household member who is fleeing to avoid prosecution or custody for a felony or has violated a condition of probation or parole imposed under Federal or State law.

The agency must accept any document that reasonably establishes the identity of the household member being sought by law enforcement authorities. If a law enforcement officer provides documentation indicating that a household member is fleeing to avoid prosecution or custody for a felony, or has violated a condition of probation or parole, the agency shall follow the procedures in 4.304.4 to determine whether the member's eligibility in the SNAP program should be terminated. A determination and request for information that does not comply with the terms and procedures in 4.304.4 is not sufficient to terminate the member's participation. The agency shall disclose only such information as is necessary to comply with a specific written request of a law enforcement agency authorized by this paragraph.

4. Persons connected with the Parent Locator Service. Information made available to the Parent Locator Service must be restricted to the client’s most recent address and place of 5. Persons directly connected with the administration of the Child Support Program under

part D, title IV of the Social Security Act, in order to assist in the administration of their program, and employees of the Secretary of Health and Human Services as necessary to assist in establishing or verifying eligibility or benefits under Titles II and XVI of the Social Security Act;

6. Persons directly connected with the verification of immigration status of non-citizen SNAP clients through the Systematic Alien Verification for Entitlements (SAVE) system, to the extent the information is necessary to identify the individual for verification purposes;

7. School authorities for the purpose of determining which children are from families who participate in SNAP. This information is used to determine eligibility for meals under the National School Lunch or Breakfast Program; and, 8. Persons directly connected with the administration or enforcement of programs included in the Income and Eligibility Verification System (IEVS). Information obtained through the IEVS will be stored and processed so that no unauthorized personnel may acquire or retrieve the information for unauthorized purposes. All persons with access to information obtained pursuant to the IEVS requirements will be advised of the circumstances under which access is permitted and the sanctions imposed for illegal use or disclosure of the information.

C. SNAP is subject to the confidentiality requirements of section 26-1-114, C.R.S. to the extent the provisions of that section are not preempted by Federal law.

4.150 RIGHT AND OPPORTUNITY TO REGISTER TO VOTE

A client for SNAP benefits shall be provided the opportunity to register to vote. The local office shall provide to all clients the prescribed voter registration application.

The local office shall not:

A. Seek to influence the applicant's political preference or party registration.

B. Display any political preference or party allegiance.

C. Make any statement to an applicant or take any action, the purpose or effect of which is to discourage the applicant from registering to vote.

D. Make any statement to an applicant or take any action, the purpose or effect of which is to lead the applicant to believe that a decision to register or not to register has any bearing on the availability of services or benefits. 4.150.1 Transmittal of Voter Registration Records A completed voter registration application shall be transmitted to the county clerk and recorder for the county in which the local office is located not later than ten (10) calendar days after the date of acceptance; except that, if a registration application is accepted within five (5) calendar days before the last day for registration to vote in an election, the application shall be transmitted to the county clerk and recorder for the county not later than five (5) calendar days after the date of acceptance. 4.150.2 Confidentiality of Voter Registration Records Records concerning voter registration and declination to register to vote shall be maintained for two years by the local office, and these records shall not be a part of the SNAP case record and are not subject to subpoena. The local office shall ensure the confidentiality of individuals registering or declining to register to vote. A voter registration application completed at the local office is not to be used for any purpose other than voter registration.

4.160 COMPLAINT REQUIREMENTS

The local office shall be required to comply with complaint-reporting procedures set forth by the State Department. In addition, the local office shall advise any household wishing to file a complaint of the complaint procedure and assist in filing a complaint, as appropriate.

The State Department shall ensure that information concerning the complaint system, including the procedure for filing a complaint at the state or county level, is made available to client and any other interested parties. Such information shall be made available to clients and other interested parties through written materials and posters, including the relevant USDA “And Justice for All” poster. These materials shall be prominently displayed in all certification and issuance offices.

The local office shall make every effort to resolve all complaints, excluding complaints of discrimination, brought to their attention at the local level. All complainants shall be informed they have the right to contact the State Department if they are not satisfied with the action taken at the local level. 4.160.1 State Department and Local Office Responsibility A. The State Department shall maintain records of complaints received. These records shall be obtained via submission from local offices on a frequency set forth by the State Department.

These records will be reviewed on an office-by-office basis at least annually. The local office shall analyze complaint records for any potential or actual patterns of deficiencies and shall include descriptions of those patterns with its submitted materials.

Complaints lodged directly with the State Department shall be triaged by the Department.

Appropriate complaints shall be referred to the relevant local office for resolution.

B. When requested by the State Department, the local office shall be responsible to respond to any complaint no later than the response date specified by the Department in the forwarded complaint. “Respond to” refers not only to acknowledgement of receipt, but also the successful completion of the resolution criteria outlined by the Department in the complaint.

C. The State-level complaint system shall include notification to the complainant, either verbally or in writing, of the action taken in resolving the complaint. Notification to the complainant shall be accomplished within the following time frames:

1. Complaints involving expedited services shall be investigated and a response provided to the complainant no later than three (3) business days following the date the complaint was received by the State Department.

2. All other complaints shall be investigated, and a response provided to the complainant no later than thirty (30) calendar days following the date the complaint was received by the State Department.

D. If a complaint can be resolved through the fair hearing process, the State Department shall advise the complainant of the process for requesting a fair hearing and offer the complainant assistance to request a fair hearing. The State Department may require the local office to provide the same offer of assistance to the complainant. 4.160.2 Non-Discrimination Complaint Requirements State and local offices shall not discriminate against any applicant or participant in any aspect of program administration, including, but not limited to, the certification of households, the issuance of benefits, the conduct of fair hearings, or the conduct of any other program service for reasons of age, race, color, sex, disability, religious creed, national origin, political beliefs, or reprisal or retaliation for prior civil rights activity in any program or activity funded by the USDA. Discrimination in any aspect of program administration is prohibited. Local offices shall ensure that the nondiscrimination poster provided by FNS is prominently displayed. Posters may be obtained through the State Department.

The local office shall explain complaint procedures to each person expressing an interest in filing a discrimination complaint and shall advise the individual of the right to file a complaint under this procedure. Such information shall be made available within ten (10) calendar days from the date of request. 4.160.21 Discrimination Complaint Procedure A. Individuals who believe they have been subject to discrimination may file a written complaint with the USDA, FNS national office, the local office, and/or the State Department. All complaints of alleged discrimination shall be made in writing and shall be submitted to the FNS national office.

If allegations of discrimination are made verbally, and if the complainant is unable or unwilling to put the allegations in writing, the State or county employee to whom the allegation is made shall document the complaint in writing. The person accepting the complaint shall make every effort to secure the information specified in Subsection C, below.

B. The complainant shall be advised that a complaint may be submitted to the State Department, FNS or both, and that a complaint shall not be investigated unless information specified in items C, 2, through C, 4, below, is provided. In addition, the complainant shall be advised that a complaint must be filed no later than one hundred eighty (180) calendar days from the date of the alleged discrimination. The local office shall date stamp or otherwise note the date the complaint is received by the office.

1. Complaints directed to the FNS national office shall be addressed to: U.S. Department of Agriculture, Director, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410; Fax: (202) 690-7442;

Email: program.intake@usda.gov.

2. Complaints directed to the State Department shall be addressed to: Colorado Department of Human Services, SNAP, 1575 Sherman St., Denver, CO 80203.

C. The complaint shall include the following information to facilitate investigations to be considered complete:

1. The name, address, and telephone number or other means of contacting the person alleging discrimination;

2. The location and name of the office which is accused of discriminatory practices;

3. The nature of the incident or action, or the aspect of Program administration that led the person to allege discrimination;

4. The reason for the alleged discrimination;

5. The name(s) and title(s), if appropriate, of person(s) who may have knowledge of the alleged discriminatory act; and 6. The date(s) on which the alleged discriminatory action(s) occurred. 4.160.22 Disposition of Discrimination Complaints When the local office receives a complaint of alleged discrimination and obtains a complete discrimination complaint, it shall transmit a copy of the complaint to the FNS national office and/or the State Department within five (5) working days. The State Department shall file the complaint with the FNS national office on behalf of the complainant if the local office does not file the complaint with the FNS national office.

4.200 APPLICATIONS AND RECERTIFICATIONS

This section specifically discusses processing of initial applications and applications for recertification.

4.201 APPLICATION PROCESSING

A. Local offices shall not apply additional conditions or processing requirements that are beyond those prescribed by State SNAP rules. The application process includes the filing and completion of an application form, being interviewed, and verifying certain information. Signs shall be posted in certification offices that explain the application processing standards and the right to file an application on the day of initial contact. Similar information about same-day filing shall be included in outreach materials and on the application form.

B. The local office shall act promptly on all applications and provide SNAP benefits retroactive to the month of application to those households that have completed the application process and have been determined to be eligible.

C. Applications will be screened as they are filed, or as individuals come in to apply, to determine eligibility for expedited service or for normal processing. Applicants entitled to expedited service shall be informed immediately and given a same-day interview, whenever possible. Those eligible for expedited processing shall be served in accordance with Sections 4.205.1 and 4.205.11 while those eligible for normal processing shall be served in accordance with Section 4.205.2. Local offices shall not conduct any pre-eligibility screening process prior to securing the date of application.

D. The household may voluntarily withdraw its application at any time prior to a determination of eligibility. Once a determination of eligibility is made, the household may voluntarily terminate its participation. Any reason given by the household for withdrawal or termination shall be documented in the case file. A Notice of Action form, indicating voluntary withdrawal of application or voluntary termination of participation, shall be sent to the household within ten (10) calendar days of the decision, to confirm the action taken. The household shall be advised of its right to reapply at any time after withdrawal.

E. No household shall have its SNAP benefits denied solely based on its application to participate in another program being denied or its benefits under another program being terminated, without a separate determination by the local office that a household failed to satisfy a SNAP eligibility requirement.

F. Households denied SNAP that have an SSI application pending shall be informed on the notice of denial of the possibility of categorical eligibility if they become SSI recipients. Residents of public institutions who apply jointly for SSI and SNAP benefits prior to their release from the institution shall not be eligible for SNAP until the individual has been released from the public institution.

G. Local offices shall record in the automated system racial and ethnic data provided by an applicant household. The purpose of obtaining this information is not to affect the eligibility or the level of benefits, but rather to ensure that SNAP benefits are distributed without regard to race, color, or national origin. Households that do not declare race and/or ethnicity information shall not be subject to additional observation or questioning to obtain such information. Under no circumstance should an eligibility technician challenge or change a self-declaration made by a household member.

4.202 FILING AN APPLICATION

A. Regardless of what type of application system is used, the local office must provide a means for applicants to immediately begin the application process. The household shall be advised it may file an incomplete application form if the form contains a name, address, and is signed by a responsible household member or the household's authorized representative. Signatures include handwritten signatures, electronic signature techniques, recorded telephonic signatures, or documented gestured signatures. A valid handwritten signature includes a designation of an X.

Local offices shall accept applications for SNAP during normal business hours and shall not be restricted to a certain day or time of day. The household shall be advised that it need not be interviewed before filing an application. The local office shall inform applicants that receiving SNAP will have no bearing on any other program's time limits that may apply to the household.

B. Persons who request information for SNAP must be advised of expedited service provisions and encouraged to apply so that eligibility processing can begin. County local offices shall encourage the filing of an application form on the same day the household or its representative contacts the local office in person or by telephone and expresses interest in obtaining SNAP, or indicates the household is without food or the means to obtain food.

C. Local offices shall make application forms readily accessible to applicant households, as well as to groups and organizations, and shall also provide an application form to anyone who requests the form. If a household contacting the local office by telephone does not wish to come to the appropriate office to file the application that same day and instead prefers receiving an application through the mail, the local office shall mail an application form to the household on the same day the telephone request is received. An application shall also be mailed on the same day a written request for SNAP is received.

Application forms shall be made available in Spanish, or other appropriate languages for use in those counties where it has been determined in conjunction with the State local office that there are a significant number of households without an adult member fluent in English.

D. The state or local office shall annotate the application form by recording the date the form was received. All valid applications which are paper, transmitted by fax or other electronic transmissions, are acceptable. When an application is submitted through such means outside of business hours, the application filing date shall be recorded as the next business day.

E. Households must file applications by submitting the forms in person, through an authorized representative, by fax or other electronic transmission, by mail, or by completing an online electronic application. The local office must inform the applicant that they can obtain a copy of their application and provide the household with a copy of their completed application upon the request of the client. A copy of a completed application can be a copy of the information provided by the client that was used or will be used to determine a household’s eligibility and benefit allotment. At the option of the household, this may be provided in an electronic format.

F. Applications are valid for a period of sixty (60) calendar days or until eligibility has been determined, whichever is sooner. Once eligibility has been determined, households must submit a new application if the household:

1. Failed to attend an interview in the first thirty (30) days of the application, or 2. Was determined ineligible due to household circumstances.

G. Local offices shall record in the automated system racial and ethnic data provided by an applicant household. The purpose of obtaining this information is not to affect the eligibility or the level of benefits, but rather to ensure that SNAP benefits are distributed without regard to race, color, or national origin. In those instances when the information is not provided voluntarily by the household on the application form, the local office shall use alternative means of collecting the ethnic and racial data on households, such as by observation during the interview. Under no circumstance should an eligibility technician challenge or change a self-declaration made by a household member. 4.202.1 Public Assistance (PA) Applications and Processing A. Households applying for PA shall be notified of their right to apply for SNAP at the same time and shall be allowed to apply for SNAP at the same time they apply for PA benefits.

B. The local office shall provide benefits using the original application and any other pertinent information occurring after that application for any household filing a joint application for SNAP and PA benefits. The original application and relevant subsequent information shall also be used for households that are categorically eligible when they are determined eligible to receive PA after being denied for SNAP. The local office shall not re-interview the household but shall use mail or telephone contact to obtain information about any changes.

C. Households whose PA applications are denied shall not be required to file a new SNAP application. The household shall have its SNAP eligibility determined or continued based on the applications filed jointly for PA and SNAP purposes and any other documented information obtained after the application that may have been used in the PA determination. 4.202.2 Application Filing by Ineligible Individuals The ineligibility of certain individuals for SNAP benefits will not prohibit the remaining household members from applying for and receiving SNAP. Ineligible individuals living in an applicant household shall not be considered eligible household members for SNAP purposes; however, the ineligible individual’s income and resources are considered in the household’s eligibility determination and benefit allotment.

When the eligible members of a household are all unemancipated minors and the only adult is an ineligible individual, the ineligible individual may apply on behalf of the eligible minors without being considered as having applied for themself. However, if there is any other eligible adult in the household, even though they would not normally be considered the head of household, that eligible person should file an application as the head of household. 4.202.3 SSI Households Submitting SNAP Applications to the Social Security Administration (SSA)

A. Whenever a member of a household consisting only of SSI clients transacts business at an SSA office, the member has a right to apply for SNAP at the SSA office or the local office. The SSA office is not required to accept applications for SSI clients who are not members in a household consisting entirely of SSI clients unless a county has out stationed an eligibility technician at the SSA office. The SSA office will refer non-SSI households to the correct local office. An SSI client shall be informed at the SSA office of the availability of SNAP benefits and the availability of the SNAP application at the SSA office. The SSA office shall also complete joint SSI and SNAP applications for residents of public institutions who apply for SSI prior to their release from the institutions. The clients shall be permitted to apply for SNAP while they apply for SSI.

B. The SSA office will accept and complete SNAP applications from SSI households and forward them, within one working day after receipt of a signed application, to the appropriate local office.

The SSA will use the SNAP application. The application will be transmitted to the local office with documentation of verification obtained. When an SSA office sends a SNAP application and supporting documentation to an incorrect local office, the application and documentation shall be sent to the correct office within one working day.

C. The SSA office is required to prescreen all SNAP applications for entitlement to expedited service and shall mark “expedited processing” on the first page of all applications of households that appear to be entitled to such processing. The SSA will inform households which appear to meet the criteria for expedited service that benefits may be issued a few days sooner if the household applies directly at the local office. The household may take the application from the SSA office to a local office for screening, interviewing, and processing of the application. Each local office shall furnish the SSA office(s) serving its geographical area with a street map and/or map defining its boundaries together with the addresses of the local offices in the project area.

D. The local office shall prescreen all applications received from the SSA office for entitlement to expedited service on the day the application is received at the correct local office. All households entitled to expedited service shall be certified in accordance with Sections 4.205.1 and 4.205.11, except that the expedited processing time standard shall begin on the date the application is received at a local office in the correct county. To prevent duplication, the local office shall develop and implement a method to determine if members of SSI households whose applications are forwarded by the SSA office are currently participating in SNAP. 4.202.31 SSI Telephone Applications and Recertifications Completed by the SSA A. If an SSA office takes an SSI application or recertification on the telephone from a household consisting only of SSI clients, a SNAP application shall also be completed during the telephone interview and shall be mailed by the SSA office to the client for signature for return to the SSA office or to the local office. The SSA office shall then forward any SNAP applications it receives to the local office. The local office shall not require the household to be interviewed again. The local office may contact the household further to obtain additional information for the eligibility determination.

B. The SSA office shall mail information of the client’s right to file a SNAP application at the SSA office if all members or their household are SSI clients, or at their local office, and their right to an interview to be performed by the local office.

C. For households consisting entirely of SSI clients who apply for SNAP certification at an SSA office, the application shall be considered filed for normal processing purposes when the application is received by the SSA. 4.202.32 SSI and SNAP Joint Processing A. In those instances where an application has been completed at the SSA office, the local office shall ensure that information required by Section 4.502 is verified prior to certification for households initially applying, and households entitled to expedited certification services shall be processed in accordance with Sections 4.205.1 and 4.205.11. In those cases where the SSI household submits its SNAP application to the local office rather than through the SSA office, all verification, including that pertaining to SSA program benefits, shall be provided by the household, by State Data Exchange (SDX) or Beneficiary Data Exchange (BENDEX), or obtained by the local office rather than being provided by the SSA.

For those cases in which SSI and SNAP are being processed simultaneously, the local office shall question the household and/or use SDX listings to obtain information on SSI determinations.

If the information cannot be obtained through SDX listings and/or questioning the households, a written inquiry may be made to the SSA office to obtain information of the status of SSI determinations. Within ten (10) calendar days of learning of the determination of the SSI application, the local office shall act in accordance with Section 4.604.

B. The expedited processing time standard for clients who filed prior to the release from a public institution will begin on the date that the individual is released from the public institution. The SSA shall notify the local office of the date of release of the client from the institution. Benefits shall be restored back to the date of a client’s release from a public institution if, while in the institution, the client jointly applied for SSI and SNAP, but the local office was not notified on a timely basis of the client’s release. 4.202.33 Out Stationing Eligibility Technicians in SSA Offices If the local office, with the approval of the State Department, chooses to outstation eligibility technicians at SSA offices, with SSA's concurrence, the following actions shall be completed:

A. SSA will provide adequate space for SNAP eligibility technician in SSA offices;

B. The local office shall have at least one out stationed technician on duty at all time periods during which households will be referred for SNAP application processing. In most cases, this would require the availability of an out stationed technician throughout normal SSA business hours;

C. The following households shall be entitled to file SNAP applications with, and be interviewed by, an out stationed eligibility technician:

1. Households containing an SSI client.

2. Households which do not have an SSI client but which contain an applicant for or recipient of benefits under Title II of the Social Security Act, if the county and the SSA have an agreement to allow the processing of such households at SSA offices.

D. Households shall be interviewed for SNAP on the day of application unless there is insufficient time to conduct an interview. The county shall arrange for the out stationed technician to interview clients as soon as possible;

E. The out stationed eligibility technician(s) shall not refuse to provide service to a client because they do not reside in the county or project area in which the SSA office is located, if they reside within the jurisdiction served by the SSA office and the State. The county is not required to process the applications of persons who are not residing within the SSA office’s jurisdiction but who do reside within the county's jurisdiction, other than to forward the forms to the correct local offices;

F. The county may permit the eligibility technician out stationed at the SSA office to determine the eligibility of households, or may require that completed applications be forwarded elsewhere for the eligibility determination;

G. Applications from households entitled to joint processing through an out stationed eligibility technician shall be considered filed on the date they are submitted to that technician. Both the normal and expedited service time standards shall begin on that date; and, H. Households not entitled to joint processing shall be entitled to obtain and submit applications at the SSA office. The out stationed eligibility technician need not process these applications except to forward them to correct local office where they shall be considered filed upon receipt. Both the normal and expedited service time standards shall begin on that date.

4.203 HEAD OF HOUSEHOLD AND AUTHORIZED REPRESENTATIVES

Application for participation shall be made in the name of the household, by the head of the household, the spouse, another household member, or an authorized representative. 4.203.1 Designating a Head of Household A. The local office shall allow a household to select an adult parent of children (of any age) living in the household, or an adult who has parental control over children (under 18 years of age) living in the household, as the head of household provided that all adult members agree to the selection.

The household may make this designation each time the household is certified for participation but may not change the designation during a certification period unless there is a change in the composition of the household.

B. The local office shall not use the head of household designation to impose special requirements on the household, such as requiring that the head of household, rather than another responsible member of the household, appear at the local office to apply for benefits. If the household is not able to select its head of household, or an eligible household does not choose to select its head of household, the local office may make a reasonable determination of the head of household with an understanding that the head of household is usually the household member who has the most knowledge of the household's financial circumstances. If the only adult living in the home is not eligible for SNAP nor required to be included in the household, they can be designated as the head of household and apply on behalf of the unemancipated minors in the home. 4.203.2 Designating Authorized Representatives A. The head of the household, spouse, or any other responsible household member may designate in writing someone to act on behalf of the household to apply, obtain an EBT card, and/or use the EBT card to purchase food for the household. In instances where a household needs an authorized representative but is unable to obtain one, the local office will assist such a household in finding one. The local office will assure that authorized representatives are properly designated; that is, the name of the authorized representative and the justification for appointing a person outside the household shall be maintained as part of the household's permanent case record.

1. Submitting an Application The authorized representative must be a person who is sufficiently aware of relevant household circumstances. Whenever possible, the head of the household or spouse should prepare or review the application even though another household member or an authorized representative is the person interviewed.

The local office shall inform the household that the household will be held liable for any over-issuance which results from erroneous information given by the authorized representative.

2. Obtaining an EBT Card An authorized representative may be designated to obtain an EBT card for the household at the time the household applies for participation. The authorized representative responsible for obtaining an EBT card may be the same individual designated to apply for the household or may be another individual. Even if a household member can apply and obtain an EBT card, the household should be encouraged to name an authorized representative responsible for obtaining an EBT card in case of illness or other circumstances which might result in an inability to obtain SNAP benefits.

3. Using an EBT Card The authorized representative may use the household’s EBT card to purchase food for the household's consumption provided the authorized representative is acting with the full knowledge and consent of the household.

4. Restrictions An authorized representative may act on behalf of more than one household and limits shall not be placed on the number of households an authorized representative may represent, but such an arrangement should be approved only if there is a bona fide need.

In determining such need, consideration shall be given to the proximity of the households to one another, the distance to the certification or issuance office, the availability of transportation, and the health of the household members involved. In the event employers, such as those that employ migrants, are designated as authorized representatives or that a single authorized representative has access to multiple EBT cards, the certification office should make certain that:

a. The household has freely requested the assistance of the authorized representative; b The household's circumstances are correctly stated and the household is receiving the correct amount of benefits; and, c. The authorized representative is properly using the EBT card.

B. In the event the only adult living with a household is classified as a non-household member, that individual may be the authorized representative for the minor household members. 4.203.21 Individuals Who Cannot Be an Authorized Representative The following individuals cannot be an authorized representative unless otherwise stated:

A. Local office employees who are involved in Program eligibility determination and/or issuance processes, or the supervisors of such workers, unless the local office determines that no other representative is available.

B. Employees of FNS-authorized retailers and meal services that are authorized to accept SNAP benefits, unless the local office determines that no other representative is available.

C. An individual disqualified for IPV/fraud shall not be an authorized representative during the period of disqualification unless the individual is the only adult in the household and the office is unable to arrange for another authorized representative. Local offices shall determine whether these disqualified individuals are needed to apply on behalf of the household, to obtain SNAP benefits for the household, and to use the household's SNAP benefits to purchase food.

D. In no event may an authorized meal provider for persons experiencing homeless act as an authorized representative. 4.203.22 Disqualification of an Authorized Representative An authorized or emergency authorized representative (section 4.203.3, below) may be disqualified from representing a household in SNAP for up to one (1) year if the local office has obtained evidence that the representative has misrepresented a household's circumstances and has knowingly provided false information pertaining to the household or has made improper use of SNAP benefits. The local office shall send written notification to the affected household(s) and to the representative thirty (30) calendar days prior to the date of disqualification. The notification shall include the proposed action, the reason for the proposed action, the household's right to request a fair hearing, the telephone number of the office, and, if possible, the name of the person to contact for additional information.

This provision is not applicable in the case of drug and alcohol treatment centers or to the heads of group living arrangements that act as authorized representatives for their residents. However, drug and alcohol treatment centers and the heads of group living arrangements that act as authorized representatives for their residents, and that intentionally misrepresent households' circumstances, may be prosecuted under applicable state fraud statutes for their acts. 4.203.3 Emergency Authorized Representatives The household may designate an emergency authorized representative during the certification period should the need arise. Such a person obtains the EBT Card for the household when neither a household member nor the previously designated authorized representative is able to obtain the EBT Card because of unforeseen circumstances. An emergency authorized representative must be designated in writing by the head of the household, spouse, or other responsible household member.

Local offices shall develop a system by which a household may designate an emergency authorized representative to obtain the household's benefits for a particular month. Households shall not be required to travel to a local office to designate an emergency authorized representative. 4.204 Interviews A. Interview Requirements All applicant households shall undergo a phone or face-to-face interview with a qualified eligibility technician prior to initial certification and at least once every twelve (12) months. The State Department recommends phone interviews as the default option with face-to-face interviews only scheduled upon client request. If an individual does not list a working phone number on the application, then the local office must provide a number for the client to call the local office.

A household certified for twenty-four (24) months is not required to complete an interview at the 12-month Periodic Report Form (PRF) or at twenty-four (24) month recertification, unless the household either requests an interview, is potentially going to be denied for SNAP (24-month households only) or has any outstanding issues or questions about the recertification process.

The applicant may include any person(s) they choose for the interview. The individual interviewed may be the head of the household, spouse, or any other responsible member of the household, or an authorized representative.

A face-to-face interview may be conducted at the local office or a mutually acceptable location, including the household's residence upon household request. If the interview is to be conducted at the residence, it must be scheduled in advance. The interview shall be conducted as an official and confidential discussion of household circumstances. The applicant's right to privacy shall be protected during the interview. Facilities shall be adequate to preserve the privacy and confidentiality of the interview.

The eligibility technician shall not simply review the information entered on the application but shall explore and resolve with the household unclear and incomplete information. Households shall be advised of their rights and responsibilities during the interview, including the appropriate application processing standard and the household's responsibility to report changes. The interviewer must advise households that are applying for other PA programs that any time limits and other requirements for the receipt of other PA do not apply to the receipt of SNAP.

Households may still qualify for SNAP if they have reached a time limit, begun working, or lost benefits from another PA program for another reason.

Upon determination that a person should be referred to an Employment First Unit, the local office shall explain to the applicant the pertinent work requirements, the rights and responsibilities of work-registered household members, and the consequences of failure to comply. The local office shall provide a written statement of these requirements to each work registrant in the household and to each previously exempt or new household member when that person becomes subject to the work registration and at recertification.

B. Scheduling Interviews The local office must schedule an interview for all applicant households who are not interviewed on the same day they apply to the local office. Interviews shall be scheduled for a specific date and time and an appointment letter must be provided to the client at the address on file. All interviews, including the date and time of the interview, shall be documented in the case record.

When scheduling interviews, the interview shall be scheduled as promptly as possible to ensure that eligible applicant households receive an opportunity to participate within SNAP’s processing guidelines, as outlined in Section 4.205. When the interview is scheduled, the client shall be notified that if it a responsible member of the household or its authorized representative fails to attend the interview, the household will be responsible for rescheduling and attending an interview within thirty (30) days from the date of application and that failure to do so shall result in the denial of the application.

If the local office schedules an interview with the household before the thirtieth (30th) day from the application date and no later than the sixtieth (60th) day, the original application can be used, and benefits are issued from the original date of application.

If the household requests an interview date after the thirtieth (30th) day, the local office will deny the application on the thirtieth (30th) day and the household must file a new application.

C. Missed Interviews If the household fails to attend its scheduled interview, the local office shall mail the household a notice of missed interview, informing the household that it missed the scheduled interview and that the household is responsible for rescheduling the interview. If the household does not schedule a subsequent interview for a date within thirty (30) calendar days after the application is filed, the application shall be denied by the local office on the thirtieth (30th) day following the date of application. The application shall not be denied before the thirtieth (30th) day.

If a household misses its first interview, the household forfeits its right to expedited service, unless the second interview is rescheduled for a date within seven (7) days following the date of application.

D. Interviews for PA Households If a household is applying for both PA and SNAP, the local office shall conduct a single interview at initial application for both PA and SNAP purposes. The applicant household shall complete the combined application for PA and SNAP. Following the single interview, the application may be processed by separate workers to determine eligibility and benefit levels for SNAP and PA. A household's eligibility for an out-of-office interview for SNAP purposes does not relieve the household of any responsibility for a face-to-face interview for PA purposes. Except for households which may be eligible under basic categorical eligibility, the household's SNAP eligibility and benefit level shall be based solely on SNAP eligibility criteria, and all households shall be certified in accordance with the noticing, procedural, and timeliness requirements of the SNAP regulations. The PA applicant household shall indicate on the single purpose application if it does not wish to apply for SNAP.

E. Interviews for SSI Households Households in which all members are SSI clients and are applying and being interviewed for SNAP by SSA, will not be required to see a SNAP eligibility technician or otherwise be subjected to an additional certification interview. The local office shall accept SSA documentation and shall not contact the household to obtain additional information for the eligibility determination unless the application is improperly completed, mandatory verification required by Section 4.502 is missing, or the local office determines that certain information on the application is questionable.

In no event shall the client be required to appear at the local office to finalize the eligibility determination. Further contact made in accordance with this paragraph shall not constitute a second SNAP interview. 4.205 Application Processing Standards All newly certified households, except those that are given expedited service, shall be given an opportunity to participate no later than thirty (30) calendar days following the date the application was filed. Households entitled to expedited service shall have benefits available no later than the seventh calendar day following the date of application. For application processing purposes, day “one” (1) is the first calendar day after the application is received by a local office in the correct county.

If the local office does not determine a household’s eligibility and provide an opportunity to participate within thirty (30) calendar days following the date the application was filed, the office shall determine whether the delay was caused by failure to act on the part of the household or on the part of the local office as outlined in Sections 4.205.3 through 4.205.4. 4.205.1 Processing Standards for Expedited Service A. The following households are entitled to expedited service:

1. Migrant or seasonal farm worker households whose liquid resources do not exceed one hundred dollars ($100) and who are destitute of income as defined in Section 4.406.

2. Households whose liquid resources do not exceed one hundred dollars ($100) and who reasonably expect to have less than one hundred fifty dollars ($150) of gross monthly income in the calendar month of application.

3. Eligible households whose combined monthly gross income and liquid resources are less than the household's anticipated monthly rent/mortgage and utilities. The appropriate utility standard, as defined in Section 4.407.31, shall be utilized when determining a household’s utility costs.

B. Households eligible for expedited service shall be able to access EBT benefits no later than the seventh (7 ) calendar day following the date of application.

1. If a household is entitled to expedited service the local office shall conduct the interview, unless the household cannot be reached, and complete the application process within seven (7) calendar days.

2. Households entitled to expedited service shall complete an interview prior to any determination of eligibility. If a household fails to complete the required interview within seven (7) calendar days following the date the application for assistance was filed, the household is no longer entitled to expedited benefits by the seventh (7th) day following the date of application.

C. Households that apply for initial benefits after the fifteenth (15 ) of the month under the expedited service procedures, which have completed the application and provided all verification within the expedited timeframe and have been determined eligible to receive benefits for the initial month and the subsequent month, shall receive the application month’s prorated allotment and the next full month's allotment at the same time.

Households applying for initial benefits after the fifteenth (15 ) of the month for which verification has been postponed shall have the second month's benefits and the prorated allotment available on the seventh (7 ) calendar day. The household must provide all postponed verification before the third month's benefits can be issued.

D. Households not initially screened as requiring expedited service, but subsequently determined to be entitled to such service, shall be entitled to the expedited processing timeframes from the date such a determination was made.

E. If Program benefits are reduced, suspended, or cancelled in accordance with Section 4.904.4, households eligible for expedited service shall receive expedited service in accordance with the following procedures:

1. Those households that receive expedited service in the month(s) in which reductions are in effect and are determined to be eligible shall be issued allotments that are reduced in accordance with the reduction in effect. These reduced allotments shall be made available to the households within the timeframes specified in this section.

2. Those households that receive expedited service in month(s) in which suspensions are in effect and are determined to be eligible shall have benefits issued to them within the timeframes specified in this section. However, if the suspension is still in effect at the time issuance is to be made, the issuance shall be postponed until the suspension is ended.

3. Households eligible to receive expedited processing and who apply for Program benefits during months in which cancellations are in effect shall receive expedited service.

However, the deadline for completing the processing of such cases shall be five (5) calendar days or the end of the month of application, whichever date is later. All other rules pertaining to expedited service contained in this section shall be applicable to these cases. 4.205.11 Special Provisions for Expedite Service A. Households requesting, but not entitled to, expedited service shall have their applications processed according to normal processing standards.

B. The local office shall use the following procedures for expediting service:

1. Prior to certification, the identity of the applicant shall be verified.

2. Prior to certification of expedited benefits, all reasonable efforts shall be made to verify residency, income, or lack thereof, and other factors of eligibility. However, verification shall be postponed if it cannot be obtained in sufficient time to meet the expedited processing standards. If verification is postponed, the household shall be certified for expedited benefits, if determined eligible, for the month of application or, for those households applying after the fifteenth (15 ) of the month, the month of application and the subsequent month.

a. Except for migrant households applying after the fifteenth (15 ) of a month, when a household is certified for expedited benefits for an initial month of application and the subsequent month and verification is postponed, a request for verification form shall be annotated to indicate what verification is required in order for further benefits to be issued.

b. When households that apply for benefits on or before the fifteenth (15 ) of the month provide the required postponed verification, the local office shall issue the second month's benefits within five working days from receipt of the verification or the first of the second month, whichever is later.

Households that apply after the fifteenth (15 ) of the month and provide the postponed verification shall be issued the third month's benefits within five working days from receipt of verification, or the first of the third month, whichever is later.

Except for migrant households needing out-of-state verification, when the postponed verification is not completed within thirty (30) calendar days from the date of application, the local office shall terminate the household's participation on the thirtieth (30 ) calendar day without providing a notice of adverse action.

c. Migrants shall be entitled to a postponement of out-of-state verification only once each season. If a migrant household requesting expedited service has already received this exception during the current season, the local office shall grant a postponement of out-of-state verification only for the initial month's issuance and not for the second (2 nd ) month's issuance. Migrant households eligible for expedited service and applying after the fifteenth (15 ) of a month which are assigned certification periods of longer than one month shall be issued a request for verification notifying them that they shall provide postponed verification from sources within the state before a second month's benefits are issued and shall provide all verification from out-of-state sources before being issued benefits for the third month. The notice shall also advise the household that if verification results in changes in the household's eligibility or level of benefits, such changes shall be acted on without providing an advance notice of adverse action.

C. There is no limit to the number of times a household can be certified under expedited procedures, as long as prior to each expedited certification, the household either completes the verification requirements that were postponed at the last expedited certification or the household was certified under normal processing standards since the last expedited certification. 4.205.2 Normal Processing Standards A. The local office shall process applications as expeditiously as possible and provide eligible households a written notification of their eligibility. The applicant household must receive a Notice of Action form, which will indicate the household's period of eligibility and SNAP allotment.

Eligible households shall be provided an opportunity to obtain benefits as soon as possible, but no later than thirty (30) calendar days following the date the application was filed. An application shall be considered filed the day a local office in the correct county receives a valid application containing the applicant's name, address, and signature.

B. In cases where verification is incomplete, the local office shall provide the household with a statement of required verification on the state-prescribed notice form and offer to assist the household in obtaining the required verification. The office shall allow the household ten (10) calendar days to provide the missing verifications unless the household missed the first appointment. If the household misses the first appointment and the interview cannot otherwise be rescheduled until after the twentieth (20th) day but before the thirtieth (30th) day following the date the application was filed, the household must appear for the interview, bring verification, and register members for work by the thirtieth (30th) day. A household can be found ineligible or eligible for the month of application and for the following month based on one (1) application if sufficient information for such determination is available. The state-prescribed Notice of Action form shall reflect specific months of eligibility and ineligibility. 4.205.3 Delays in Processing Beyond Thirty (30) Days If the local office does not determine a household's eligibility and provide an opportunity to participate within thirty (30) calendar days following the date the application was filed, the office shall determine whether the delay was caused by failure to act on the part of the household or on the part of the local office. The following shall be used to determine causes of delay beyond thirty (30) calendar days in the application process:

A. If a household has failed to complete a SNAP application form even though the local office offered to assist the client in its completion, the household shall be at fault. If the local office failed to assist the household, the local office is at fault. If the local office offered the household assistance in completing the application but the household failed to cooperate or failed to complete the application process, the local office shall document in the case record its attempt to assist the household.

B. If a nonexempt household member failed to register for work even though the local office informed the household of the work requirements, the household shall be at fault unless paragraph D of this section applies. If the local office did not give the client at least ten (10) calendar days to supply information, the local office is at fault.

C. If requested verification is missing even though the local office offered assistance and a written notice of needed verification was provided and the household was allowed ten (10) calendar days to supply necessary verification, the household shall be considered at fault unless paragraph D of this section applies. If the local office did not request necessary verification through a written notice, or assist the client as required by these regulations, or give the client time to provide information, then the local office is at fault.

D. If the household failed to appear for the first (1st) interview, failed to schedule a second (2nd) interview and/or requested to postpone the interview until after the thirtieth (30th) day following the date of application, the delay shall be the household's fault.

E. If the household missed both scheduled interviews and requests another interview, the delay shall be the fault of the household.

F. If the local office failed to notify the household to schedule a second interview or failed to schedule a second interview within the thirty (30) calendar days following the date the application was filed or failed to request verification or other necessary action at the interview, the local office is at fault. 4.205.31 Delays Caused by the Household Any time the household requests a postponement which delays the thirty (30) calendar day processing, it shall be the household’s fault.

If the household provides requested verification after the thirtieth (30 ) day and on or before the sixtieth (60 ) day from the date of application, the local office shall reopen the case without requiring a new application and benefits will be prorated from the date the requested verification is provided. Any changes in the household situation must be considered for determining eligibility. 4.205.32 Delays Caused by the Local Office Delays that are the fault of the local office include, but are not limited to, those cases in which the office has failed to take any of the actions listed in Section 4.205.3. Whenever a delay in the initial thirty (30) day period is the fault of the local office, the local office shall take immediate corrective action to complete the application process. The local office shall not deny the application if the local office caused the delay, but shall instead notify the household if there is any action the household must take to complete the application process.

Benefits retroactive to the month of application and prorated for an initial month of application in accordance with Section 4.207.2 shall be provided to the household if it is found to be eligible during the second thirty (30) day period. If the household is found to be ineligible, the application shall be denied and the household shall be sent a notice of action form when the eligibility determination is made. 4.205.4 Delays in Processing Beyond Sixty (60) Days A. If the local office is at fault for not completing the application process by the end of the second thirty (30) day period, and the case record is otherwise complete, the office shall continue to process the original application until an eligibility determination is made. If the household is found to be eligible, and the local office was also at fault for the delay in the initial thirty (30) days, benefits retroactive to the month of application shall be provided to the household. However, if the delay during the initial thirty days was the household's fault, benefits shall only be provided back to the month following the month of application (see Section 4.207.2).

B. If the local office is at fault for not completing the application by the end of the second thirty (30) day period, but the case record is insufficiently complete to make an eligibility determination, the office shall deny the case and request the household to file a new application, if desired.

C. If the household is at fault for not completing the application process by the end of the second thirty (30) day period, the application shall be denied and a new application required if the household wishes to participate. The household shall not be entitled to any lost benefits even if the delay in the initial thirty day period was the fault of the local office.

4.206 CATEGORIES OF ELIGIBILITY

A. Households applying for SNAP must be determined eligible using one of the following categories of eligibility: Basic Categorical Eligibility (BCE), Expanded Categorical Eligibility (ECE) or Standard Eligibility (SE).

B. SNAP households that are applying for or receiving benefits from other PA programs in addition to SNAP are still required to meet the resource limits and follow the reporting and verification requirements of the other PA program(s). Requests for information and verification to determine eligibility for other PA programs shall not affect or delay the determination of SNAP eligibility.

C. Eligibility 1. Basic Categorical Eligibility (BCE)

a. BCE households are:

1) Households in which all members receive, or are authorized to receive, SSI, Colorado Works (CW), Old Age Pension (OAP), Aid to the Needy Disabled (AND), Aid to the Blind (AB) or a combination of these benefits.

The CW, SSI, OAP, and/or AB program(s) need only to authorize benefits for the household to be considered for BCE. Clients who are authorized to receive a benefit from one or more of these programs, but who are not paid such benefits because the grant is less than a minimum benefit or the benefits are suspended or are being recouped, are still considered eligible under BCE rules.

Households not receiving, or authorized to receive, TANF, Title IV-A or SSI benefits, who are entitled to Medicaid only, shall not be considered SSI or Title IV-A participants.

2) A household in which at least one (1) member receives services from the Family Preservation Program. This determination must be documented in the case record.

b. Households eligible under BCE have been deemed to have met the income and resource requirements of the program that confers eligibility; therefore, no further verification is required beyond that gathered by the program that confers eligibility. However, the local office must collect and verify eligibility factors, if these factors are not already collected and verified by the other program, are considered questionable, or are unavailable to SNAP. This includes:

1) Net income;

2) Gross income;

3) Resources;

4) Residency;

5) Social Security Number; and 6) Sponsored non-citizen information.

c. A household cannot be considered under BCE rules if, at the time of application:

1) Any member is disqualified for a SNAP IPV.

2) Any member has been convicted of a drug-related felony where SNAP benefits were used to purchase drugs. Drug-related felony means the same as in 7 C.F.R. 273.11(m), which is incorporated by reference in

section 4.100, above.

d. Households that are ineligible for SNAP benefits under BCE rules shall have their eligibility determined under ECE or SE rules.

2. Expanded Categorical Eligibility (ECE)

a. ECE households are:

1) Households with a combined gross income at or below two hundred (200%) of the federal poverty level as defined in section 4.401.1; and 2) Households who have been authorized to receive non-cash Temporary Assistance to Needy Families/Maintenance of Effort (TANF/MOE) funded service designed to further TANF Purpose Four (4) by “encouraging the formation and maintenance of two-parent families.” Language regarding the non-cash TANF/MOE funded program shall be provided on the application, application for recertification, periodic report form, and/or the statement of facts.

b. Households eligible under ECE have been deemed to have met the income and resource requirements of the program that confers eligibility; therefore, no further verification is required beyond that gathered by the program that confers eligibility. However, the agency must collect and verify eligibility factors, if these factors are not already collected and verified by the other program, are considered questionable, or are unavailable to SNAP. This includes:

1) Net income;

2) Gross income;

3) Resources;

4) Residency;

5) Social Security Number; and 6) Sponsored non-citizen information c. A household’s eligibility cannot be determined using ECE rules if, at the time of application:

1) Any member is disqualified for a SNAP IPV.

2) Any member has been convicted of a drug-related felony where SNAP benefits were used to purchase drugs. Drug-related felony means the same as in 7 C.F.R. 273.11(m), which is incorporated by reference in

section 4.100, above.

d. Households that are ineligible for SNAP benefits under ECE rules shall have their eligibility determined under SE rules.

3. Standard Eligibility (SE)

a. SE rules shall only be applied to the following households:

1) Households that include a member who is serving a disqualification for an IPV or a fraud conviction;

2) Households that include a member who has been convicted of a drug related felony where SNAP benefits were used to purchase drugs. Drugrelated felony means the same as in 7 C.F.R. 273.11(m), which is incorporated by reference in section 4.100, above;

3) Households that do not meet the criteria to be considered under BCE or ECE rules.

b. Households having their eligibility reviewed under SE rules must meet the following criteria:

1) Households that include a member who is aged sixty (60) and older or a person with a disability must have a combined net income, after all applicable deductions, at or below one hundred percent (100%) of the federal poverty level. The household must have resources below the limit prescribed in Section 4.408; or 2) Households that do not include a member who is aged sixty (60) and older or a person with a disability must have a combined gross income at or below one hundred thirty percent (130%) of the federal poverty level.

After all applicable deductions, the household’s net income must be at or below one hundred percent (100%) of the federal poverty level as defined in section 4.401.2. The household must have resources below the limit prescribed in Section 4.408; or 3) Households must also meet nonfinancial eligibility criteria set out in

Section 4.300.

c. Households, as defined in Section 4.304, that are found ineligible under SE rules shall be considered ineligible for participation in SNAP.

D. If the circumstances which allowed the household to meet the criteria to be considered under BCE or ECE rules change during the certification period or at the time of recertification or periodic report, the household’s eligibility must be re-evaluated according to the appropriate category. If there is insufficient documentation to make an eligibility determination based on the new category of eligibility, the agency shall send the household a request for verification in accordance with Sections 4.604, Action on Reported Changes, and 4.604.1, Verification of Reported Changes.

E. Substantial lottery or gambling winnings from an individual will disqualify the entire SNAP household from eligibility in the month the winnings are received. The next time such a household reapplies and is certified for SNAP after losing eligibility, the household must be considered under Standard Eligibility (SE) guidelines. After receiving SNAP as a SE household, the SNAP household will be re-evaluated for categorical eligibility at the next eligible certification period.

4.207 AUTHORIZING BENEFITS 4.207.1 Newly-Certified and Ongoing Households A. All households shall be placed on an issuance schedule so that they receive their benefits on or about the same date each month. The date on which a household receives its initial allotment after certification need not be the date that the household must receive any subsequent allotments.

B. All newly certified households shall be given an opportunity to participate no later than thirty (30) calendar days following the date the application was filed. Households eligible for expedited service shall be given an opportunity to participate no later than seven (7) calendar days following the date the application was filed. Day one (1) is the first calendar day after the application is received by a local office in the correct county. An opportunity to participate consists of providing households with an active EBT card and PIN, posting benefits to the household’s EBT account, and making benefits available for spending.

Local offices shall utilize a mailing system to mail EBT cards and PINs, if applicable, by the twenty-eighth (28 ) day to ensure that the benefits can be spent by the thirty (30) day standard.

Local offices shall, at a minimum, use first class mail to send EBT cards to households.

C. Households that apply for initial month's benefits after the fifteenth (15 ) day of the month, that fulfill eligibility requirements, and are determined eligible to receive benefits for the initial month of application and the next subsequent month, shall receive their prorated allotment for the initial month of application and their first full month's allotment at the same time. Expedited households applying for initial benefits after the fifteenth (15 ) of the month for which verification has been postponed shall be entitled to a combined first (1 st ) and second (2 nd ) months' benefits in the same timeframes as above. The postponed verification shall be provided prior to the third calendar month or the application shall be denied.

D. An eligible household shall have an opportunity to receive its benefits prior to the end of the period of intended use. The period of intended use is defined as the month in which benefits are issued. For households certified after the twentieth (20 ) of the month, the period of intended use is the balance of the month for which benefits are authorized through the last day of the following 4.207.2 Initial Month Allotment Prorating A. The household benefit level for the initial month of application shall be based on the day of the month it applies for benefits. Benefits for the initial month shall be prorated from the date of application to the end of the month. Applicant households consisting of residents of a public institution who apply jointly for SSI and SNAP prior to release from an institution will have their eligibility determined for the month in which the applicant household was released from the institution. The benefit level for the initial month of certification shall be based on the date of the month the household is released from the institution and the household shall receive benefits from the date of the household's release through the end of the month. Eligible households are entitled to a full month allotment for all months except an initial month of application.

B. The only exception to the proration policy shall be migrant and seasonal farm worker households who are in the job stream and the break in participation does not exceed thirty (30) days. These households are entitled to a full month allotment.

C. The state automated system will utilize the exact number of days in the calendar month to determine the proration of benefits. The following formula shall be used to determine the amount of prorated benefits:

1. Number of days in month plus one;

2. Subtract the date of application;

3. Multiply by the full month's benefits the household is eligible to receive;

4. Divide by the number of days in the application month. 4.207.3 Benefit Allotment A. After eligibility has been established, the monthly SNAP benefit allotment will be determined. The state automated system will compute the household’s allotment. The following formula shall be used to determine a household’s benefit allotment.

1. Multiply the net monthly income by thirty percent (30%)

2. Subtract the result from the maximum benefit allowed for the appropriate household size, as shown in D below.

3. Round the result down to the nearest dollar.

B. If the calculation of benefits for an initial month yields an allotment of less than the federal minimum allotment referenced in 4.207.3(D), no benefits shall be issued to the household for the initial month.

For eligible households that are entitled to no benefits in their initial month of application, but are entitled to benefits in subsequent months, the local office shall certify the household for a certification period beginning with the month of application.

Except for households that are eligible under BCE or ECE, households with three or more members who are entitled to zero benefits shall have their SNAP application denied. This provision does not apply if zero benefits are due to the pro-ration requirements or due to the initial month's allotment being less than the federal minimum allotment referenced in 4.207.3(D).

C. Except for an initial month, if the allotment for a one- or two-person household is less than the federal minimum allotment referenced in 4.207.3 D, round the allotment up to the minimum benefit allowed for a one- or two-person household.

D. The SNAP maximum and minimum monthly benefit allotment tables will be adjusted as announced by the USDA, FNS.

Household Size Maximum Monthly Allotment Effective October 1, 2025 1 $298 2 $546 3 $785 4 $994 5 $1,183 6 $1,421 7 $1,571 8 $1,789 +$218 Household Size Minimum Monthly Allotment Effective October 1, 2025 1-2 $ 24 4.208 CERTIFICATION PERIODS A. Certification periods shall conform to calendar months. Households shall be assigned the longest certification period possible based on the predictability of the household's anticipated income and other circumstances. At the expiration of each certification period, entitlement to SNAP benefits ends. Further eligibility shall only be established on a newly completed application for recertification. Under no circumstances shall benefits be continued beyond the end of a certification period without a new determination of eligibility. The State-prescribed Notice of Action form provided to the applicant household shall indicate the period of certification if the household is determined to be eligible for benefits.

B. Upon approval at the time of recertification, a household need not be assigned the same certification period as formerly but should be assigned a period of time based on a new review of the household’s circumstances.

C. A delinquent PA recertification shall not delay the SNAP recertification beyond the date of the household's SNAP certification period ending date. 4.208.1 Certification Period Guidelines [Rev. eff. 4/1/16]

Households will be assigned a six (6) month, or twenty-four (24) month certification period as follows:

A. Twenty-Four (24) Month Certification Period 1. A twenty-four month (24) certification period shall be assigned to households that contain only members who are aged 60 and older and/or have a disability and have no earned income, as defined in Section 4.403 at the time of certification.

2. Households that are assigned a twenty-four (24) month certification period must complete a periodic report form at the twelfth (12th) month interval to report any changes that have occurred or to report that no changes have occurred since the most recent certification.

The form shall be returned, or the case will be closed following the notice of adverse action period. The notice will state the reason for ending the certification period and that the certification period will end following the adverse action period.

B. Six (6) Month Certification Period 1. A household not assigned a twenty-four month certification period as outlined in subsection A of this section shall be assigned a six month certification period. 4.208.2 Classification of Households as PA or Non-PA A. PA Households PA households are those SNAP households that contain only persons who receive the following:

1. CW Basic Cash Assistance grant or any type of TANF payment or services under the CW Program. The household will be considered a PA household if one (1) member received cash assistance or services, but the entire household benefits from the receipt of this cash or services, such as when one (1) individual in a household is authorized for family preservation; or, 2. A State Grant (OAP-A, OAP-B, AND/AB); or, 3. Colorado Supplement to the SSI Grant B. Non-PA Households All other households are classified as Non-PA households.

County General Assistance (GA), SSI with no Colorado Supplemental payment, and medical-only programs are not considered PA benefits.

4.209 RECERTIFICATION PROCESS REQUIREMENTS

A. In order to enable timely receipt of an application for recertification, the local office shall provide each household with a notice that its certification is about to expire. Benefits will not be continued beyond the end of the certification period unless the household is recertified.

A notice of expiration, as prescribed by the State Department, shall be used by offices to advise households that their certification period is ending and that a new application must be filed.

B. A household shall receive the notice of expiration not less than thirty (30) calendar days and not more than sixty (60) calendar days prior to expiration of its current certification period. If mailed, the notice shall be sent for the same timely receipt, allowing two (2) extra days for delivery delay.

All households that file on or before the fifteenth (15th) of the last month of their certification period will have timely reapplied. Notices which are mailed must specify a date that allows at least two (2) days mail time and still gives the household fifteen (15) calendar days to respond.

Households that submit an application for recertification by the date specified on their notice of expiration shall be considered to have timely reapplied to prevent an interruption in SNAP C. The local office shall conduct an interview with an adult member of the household or its authorized representative a minimum of once every twelve (12) months for households certified for six (6) months or less. The local office may choose not to interview the household at each recertification provided the household has completed an interview within the previous twelve (12) months.

The local office shall schedule the interview so that the household has at least ten (10) calendar days to provide verification before the certification period ends. If an interview is required and the household fails to attend the scheduled interview, the local office must mail the household a notice of missed interview and a notice of denial at the same time.

The local office may schedule an interview prior to the last month of the certification period or prior to the date the application is timely filed, but the household cannot be denied for failing or refusing to appear for such an interview. Rather, the local office shall send notice to the household in order to reschedule an appointment for an interview on or after the date the application is timely filed.

D. The recertification process must elicit from the household sufficient information that, when combined with information in the case record, will ensure an accurate determination of eligibility.

The local office shall provide the household with a notice of required verification and the date by which the verification must be provided. 4.209.1 Recertification Processing Standards and Timeframes A. Timely Applications for Recertification 1. Households that file an application for recertification on or before the fifteenth (15th) of the last month of their certification period will have reapplied timely. A timely application for recertification shall be approved or denied prior to the end of the household's current certification period and shall provide eligible households with an opportunity to obtain their benefits by their normal issuance day of the month following the expiration of their 2. Households which have reapplied timely, but because of local office error are not determined eligible in sufficient time to permit normal issuance to the household in the following month, shall receive an immediate opportunity to participate upon being determined eligible. Such households shall be entitled to participate and receive a full month's allotment for the month following the expiration of the certification period.

B. Untimely Applications for Recertification 1. Households which file an application for recertification anytime between the sixteenth (16th) and the last day of the last month of the certification period shall not be considered as having timely reapplied. For households that have not timely reapplied, but have been found eligible, benefits may be delayed past the household’s normal issuance day. The household shall be notified of approval or denial on a notice of action form within thirty (30) calendar days of when the application for recertification was submitted to the local C. Late Applications for Recertification 1. If a household files an application form within thirty (30) calendar days after the end of the certification period, the application shall be considered and processed as an application for recertification and shall have the allotment for the initial month of application prorated from the day of application to the end of the month, unless the local office was at fault for the delay. For applications received within thirty (30) calendar days after the expiration of the certification period, verification requirements shall remain consistent with the verification requirements for applications that were filed prior to the expiration of the certification period as outlined in Section 4.502, B.

D. If an application for recertification is denied for a failure of the household to take a required action, the local office shall reopen the case if the required action is taken by the end of the certification period and provide benefits for the first month of the new certification period.

If the household takes the required action after the end of the certification period, but within the next thirty (30) calendar days, the local office shall reopen the case and provide benefits retroactive to the date that the action was taken by the household.

E. A household shall lose its right to uninterrupted benefits if one of the following occurs after the fifteenth (15th) day of the last month of the household’s certification period:

1. A household fails to timely apply for recertification in accordance with Section 4.209.1, A;

2. A household timely files an application for recertification but fails to appear for a scheduled interview; or, 3. A household fails to submit all necessary verification by the date specified on the request for such verification. The request for verification shall allow the household no less than ten (10) days to provide the verification to prevent an interruption in benefits.

If the household is eligible after providing such verification(s), the county/district shall provide benefits within thirty (30) calendar days after the application was filed. If the local office is unable to provide benefits within thirty (30) calendar days due to the time allowed for providing verification, the office shall provide benefits within five (5) calendar days after the household supplies the missing verification. Households that refuse to cooperate in providing required information or taking the required actions to determine eligibility shall be denied.

4.210 PERIODIC REPORTING REQUIREMENTS

A. A household consisting solely of members who are persons with a disability and/or members who are aged sixty (60) years and older with no earned income can be certified for twenty-four (24) months. For households certified for twenty-four months, no interview during the certification period shall be required. Households with a twenty-four (24) month certification period are required to report changes at the twelve (12) month interim reporting period.

B. A PRF shall be mailed to the household during the eleventh (11th) month of the certification period for the household to report all changes. If the PRF is not submitted to the local office by the fifth (5th) day of the twelfth (12th) month of the certification period, a reminder notice shall be sent advising the household that it has ten (10) calendar days plus one (1) calendar day for mailing to return the completed report. Households participating in ACP shall be afforded five (5) days mailing time. If the household has not submitted the completed form by the extended due date on the reminder notice, the SNAP case shall be terminated effective the first day of the thirteenth (13th) month and a termination letter shall be mailed to the household. If the household submits a PRF or reports changes for any other PA program within thirty (30) calendar days following the effective date of the termination notice and provides all required verification, benefits shall be issued without proration from the beginning of the thirteenth (13th) month.

C. The local office must act on all changes reported by those households filing a PRF. If the household files a complete PRF that results in a reduction or termination of benefits, the agency shall send an adequate notice. The adequate notice must be mailed at least two (2) business days prior to the date that benefits are normally received by the household. If the household fails to provide sufficient information or verification regarding a deductible expense, the county local office shall not terminate the household but shall instead determine the household’s benefits without allowing the deduction.

D. The household shall report changes in circumstances to the following items on the periodic report:

1. A change of more than $100 in the amount of unearned income.

2. A change in the source of income, including starting a job.

3. All changes in household composition, such as the addition or loss of a household member.

4. Changes in home address and any resulting changes in shelter costs.

5. Acquisition of a licensed vehicle that is not fully excludable.

6. A change in liquid resources, such as cash, stocks, bonds, and bank accounts that reach or exceed the resource limits for elderly or disabled households and for all other households, unless these assets are excluded.

7. Changes in the legal obligation to pay child support.

8. Whenever a member of the household wins substantial lottery or gambling winnings.

E. If allowable medical expenses are reported and verified, the change should be acted upon for the remainder of the certification period but only if the change results in an increase in benefits.

4.300 NON-FINANCIAL ELIGIBILITY CRITERIA

Non-financial criteria for eligibility shall apply to all households (including those receiving PA) and shall be considered prospectively for the issuance month based on the eligibility technician’s anticipation of circumstances at the time of application and when changes are made known to the local office. Nonfinancial criteria shall consist of:

A. Identity of applicant; and B. Residency; and C. Social Security Number; and D. Citizenship and non-citizenship status; and E. Household composition, including student and striker eligibility; and F. Work registration and employment requirements.

4.301 IDENTITY OF APPLICANT

The identity of the person submitting an application shall be verified either through interfaces, collateral contact, or client provided verification. When an authorized representative applies on behalf of a household, the identity of both the authorized representative and the head of household shall be verified.

4.302 SOCIAL SECURITY NUMBER REQUIREMENT

A. General Requirements 1. As a condition of SNAP eligibility, each member of a household participating in or applying for participation in SNAP shall provide a Social Security Number (SSN), or proof that an application for an SSN has been submitted to the SSA. The local office shall not require any household member to submit a Social Security card or other official documents as a means of verifying an SSN. Household members who provide an SSN shall not be denied benefits for failure or inability to present a Social Security card or other official documentation. If individuals have more than one SSN, all numbers shall be required.

2. The local office shall explain that a member is not required to provide an SSN, but the failure to provide one shall result in disqualification of the individual(s) for whom the number is not provided. The member who does not provide an SSN shall still be required to provide other eligibility information such as income and resources that will affect eligibility of other members. The local office shall advise individuals that any SSN that is provided voluntarily will be used in the same manner as SSNs of eligible household members. The SSNs will be matched against federal and state databases to verify information. SSNs will be used for the initial application matching for duplicate participation.

3. If the household member required to provide an SSN either refuses to supply their SSN at the time of application or fails to provide the local office with a form or letter as proof of application for a SSN without good cause, they shall be ineligible to participate in SNAP.

The disqualification applies to the individual(s) who refused to cooperate with the application process to obtain the SSN and not the entire household. The household member(s) disqualified may become eligible by providing the local office with an SSN, or by providing verification that an application for an SSN has been submitted to the SSA.

B. Individuals and Newborns Without an SSN 1. Those household members who do not have the required SSN shall obtain proof of application for an SSN prior to being certified as a member of the household unless the member is a newborn child. The applicant/recipient shall be instructed to obtain from the SSA proof that they have completed an application for an SSN and that the SSA has received that application. A specifically addressed letter from the SSA verifying that application for an SSN has been made is also acceptable proof of application for an SSN.

The applicant/recipient shall be instructed to return the completed form as soon as possible to the eligibility technician. A copy of the form shall be maintained in the case record.

a. If the household is unable to provide proof of application for an SSN for a newborn, the household shall provide the SSN or proof of application at its next recertification within six (6) months following the baby's birth. The local office shall determine if the good cause provisions are applicable at the recertification.

b. If a participating household's benefits are reduced or terminated within the certification period because one or more of its members are required to provide a SSN is disqualified for failure to meet the SSN requirement, the local office shall issue a Notice of Adverse Action form. The notice shall inform the household that the non-cooperating individual(s) without an SSN is being disqualified and show the current eligibility and benefit level of the remaining members, as well as a statement that the disqualified member(s) may end disqualification by providing an SSN.

2. Household members who provide the eligibility technician with a copy of a form or a letter from SSA, or who demonstrate good cause for not providing the proof from SSA (e.g., difficulty in obtaining birth certificates) shall be allowed to continue to participate in SNAP as follows:

a. When an SSA form or letter is received by the local office or good cause for not providing proof is demonstrated, the household member in need of a SSN shall be allowed to participate so long as the household is not at fault for not providing proof of application with the SSA.

b. If the required SSNs are provided by the household, or it is demonstrated that good cause exists for not having applied for a SSN, the household member(s) without an SSN(s) shall remain eligible to participate. If the local office determines that the household is at fault for not having proof of application for the SSN(s), the member(s) without proof of application shall be disqualified and income shall be handled in accordance with Section 4.411.1.

C. Determining Good Cause for Not Providing an SSN 1. In determining good cause, the local office shall consider information received from the household member and/or the SSA. Documentary evidence or collateral information that the household has applied for the number or made every effort to supply the SSA with the necessary information shall be considered good cause. If the household member can show good cause why an application has not been completed in a timely manner, that person shall be allowed to participate until good cause is no longer applicable or until the household’s next recertification. If the household member(s) applying for an SSN has been unable to obtain the documents required by the SSA, the eligibility technician should assist the individual(s) in obtaining these documents.

2. If an individual refuses to provide an SSN based on a sincere religious objection, all members of the household may participate in SNAP, if otherwise eligible. In these situations, the local office may check with the SSA to see if the household members already have SSNs and may use any existing SSNs for verification and matching purposes without further notice to the household.

4.303 RESIDENCY REQUIREMENT

A. Applicants shall live in the county or district in which they make application for the Program unless the local office has made arrangements to allow particular households to file an application in a nearby specified county/district office.

B. Individuals may not participate in more than one (1) household in the same month unless they are a resident of a shelter for battered women and children, nor may a household participate in more than one (1) county or district in any month unless all household members are residents of a shelter for battered women and children.

Households on Indian reservations participating in the Commodity Food Distribution Program for a particular period shall not be allowed to participate in SNAP during the same period.

Participation shall be limited to participation in the Commodity Food Distribution Program or SNAP.

C. Applicants who maintain a residence in the county or district for any purpose other than a vacation, regardless of the length of time they have resided in the county or district, shall be considered eligible for the Program, provided other eligibility requirements are met.

D. Applicants who reside in a county, without residing in a permanent dwelling nor having a fixed mailing address, shall be considered eligible for the Program, provided other eligibility requirements are met. Migrant campsites satisfy the residency requirement, as do shelters for the homeless. Homeless persons satisfy the residency requirement as long as dual participation in any month of eligibility is not allowed.

E. In no instance shall there be a durational residency requirement imposed upon the applicant.

Intent to permanently remain in the state shall not be a condition of eligibility.

F. The application contains spaces for both a physical address and a mailing address. If the household has a mailing address that is different than the household’s physical address, the certification worker should ensure that both addresses are given. For households residing in a permanent dwelling, a mailing address only, such as post office box or rural route, will not be sufficient, as it does not indicate the household resides in the county. In such cases, information should be given that can identify the location of the home. An exception to the requirement for physical location may be granted for residents of shelters for battered women and children and those that lack a permanent dwelling.

4.304 HOUSEHOLD COMPOSITION

A. Determining Household Composition It is possible for more than one SNAP household to live under the same roof, on the same property, or at the same address.

1. A household is a group of individuals who live together and customarily purchase and prepare food together for home consumption.

2. Each household may apply as a separate household if they are not mandatory household members due to their relationships or financial responsibility.

A. Individuals experiencing homelessness can be determined as a separate household under this provision.

3. If the client is currently purchasing and preparing with other individuals but upon approval of SNAP benefits intends to purchase and prepare separately, separate household status can be granted.

4.304.1 MANDATORY HOUSEHOLD MEMBERS

All mandatory household members who live together must be considered in the same household, even if the mandatory individuals declare they do not customarily purchase and prepare their food together for home consumption.

A. Parents and Children 1. A person aged twenty-one (21) years and younger living with their natural or adoptive parent(s) or stepparent(s).

A. If the child lives in the same home with both parents, regardless of marital status or whether or not the parents purchase and prepare their food together, both parents must be included in the SNAP household.

2. A child (other than a foster child) under eighteen (18) years of age who is living with and is under the parental control of a household member other than their parent.

A. A child under eighteen (18) years of age is considered to be under parental control of an individual if the child is financially or otherwise dependent on that individual member of the household unless emancipated as defined by state law.

B. Spouses 1. Spouses refer to:

A. Persons defined as married to each other under state law.

B. Persons living together who are free to marry and are representing themselves as spouses to relatives, friends, neighbors, or the larger community.

2. In situations where a spouse is in an established residence elsewhere but still contributes financially to the household, the value of the financial contribution will be counted as unearned income to the household in determining eligibility. Please refer to section 4.304.4 for more information.

C. Persons aged sixty (60) and older experiencing a disability who live with others whose income exceeds 165% of the Federal Poverty Line (FPL)

1. Persons aged sixty (60) and older who are also experiencing a disability who are unable to purchase and prepare their own meals and are residing with other individuals whose income exceeds 165% of the FPL must be in the same household.

2. When applying the 165% limit test, the spouse of an elderly person with disabilities is not to be considered a member of their household unless the spouse is the person purchasing and preparing meals. If the spouse is not a member of the household, the spouse’s income and resources are excluded in calculating the household’s eligibility. 4.304.2 Children in Shared Custody Arrangements A. In instances when different households apply for the same child, the household that applies for benefits for the child second must establish that it has majority custody and/or provide a majority of the child’s meals.

B. If the second requesting household provides verification that indicates that household possesses majority custody and provides the majority of meals, this constitutes unclear information as to the first household under which the child is currently receiving benefits.

1. A request for contact (RFC) must be initiated on the first case if verification was not previously provided to establish majority custody and/or that the majority of meals are being provided. The confidentiality rules described in Section 4.140 must be followed when making this request.

A. If the two different households applying for the same child cannot agree in which household the child shall receive benefits the household that provides the majority of meals to the child(ren) in question shall include the child(ren) in their household. Depending on the document being used to establish majority custody and majority of meals, the eligibility technician must ensure that they are considering a period of time of sufficient length to accurately capture the custody arrangement, taking into account disruptions to established arrangements such as holidays and school breaks. Eligibility technicians may have to look at a longer period of time than just the last calendar month.

2. If the second requesting household provides verification that conclusively proves it has majority custody of the child and provides majority of meals as of the request to include the child(ren) in its household, the child(ren) should be removed from the first case and added to the second case as detailed in Section 4.604.G to avoid dual participation.

3. If the two households provide an equal number of meals to the child(ren), then the SNAP household currently receiving benefits or who applied first shall receive benefits for the child(ren).

4. If one household fails to provide verification of the percentage of meals they provide to the child(ren), the child(ren) shall remain in the household in which they first began receiving SNAP benefits. 4.304.3 Optional Household Members The following individuals residing with a household shall not be considered household members in determining the household's eligibility or allotment, unless otherwise stated:

A. Persons aged sixty (60) and older experiencing a disability who live with others whose income does not exceed 165% Federal Poverty Level (FPL).

1. Persons aged sixty (60) and older who are also persons with disabilities who are unable to purchase and prepare their own meals and are residing with other individuals whose income does not exceed 165% of the FPL can be in a separate household.

2. When applying the 165% limit test, a person aged sixty (60) and older with disabilities’ spouse is not to be considered a member of the household unless the spouse is the person purchasing and preparing meals. If the spouse is not a member of the household, the spouse’s income and resources are excluded in calculating the household’s eligibility.

B. Foster children 1. If a foster parent chooses not to include a foster child in their SNAP household, the foster child not included will not have their income, resources/assets, or needs included in the eligibility determination for the SNAP household.

2. If the foster parent chooses to include the foster child in their SNAP household, the foster child's income, and resources/assets, as well as their needs, are considered in the eligibility determination.

3. The foster child, including a child and/or spouse of the foster child, may not apply for benefits separately from the foster family unless they are over eighteen (18) and no longer under the parental control of the foster parents.

C. Boarders 1. Boarders are only considered members of a client’s SNAP household if the household requests that they be considered household members.

2. If a boarder is not considered a SNAP household member, the boarder’s income and resources shall not be considered available to the household.

A. The amount of payment that a boarder gives to a household for lodging and meals shall be treated as self-employment income to the SNAP household.

3. If the SNAP household requests to include the boarder as a household member, the boarder's income and resources/assets shall be considered available to the SNAP household and used in determining eligibility and allotment.

4. Persons who only work and provide no monetary compensation in exchange for meals or who make payments to a third party on the household’s behalf in exchange for meals would not be classified as boarders.

5. Boarder status shall not be granted to individuals paying less than a reasonable monthly payment for meals. An individual not paying a reasonable monthly payment for meals will be considered a member of the household which provides the meals and lodging.

A. A reasonable monthly payment is one of the following:

1) Boarders, whose board arrangement is for more than two (2) meals per day, shall pay an amount that equals or exceeds the maximum SNAP allotment for the number of persons in the boarder SNAP household.

2) Boarders, whose board arrangement is for two (2) meals or fewer per day, shall pay an amount that equals or exceeds two-thirds of the maximum allotment for the number of persons in the boarder household.

B. When the boarder's payments for a room are distinguishable from their payments for meals, only the amount paid for meals will be considered in determining if reasonable compensation is being paid for meals. 4.304.31 Non-Household Members The following individuals residing with a household shall not be considered household members in determining the household’s eligibility or allotment unless otherwise stated in 4.304.3:

A. Boarders Boarders are individuals residing with others and paying reasonable compensation for lodging and meals.

Boarders cannot participate in SNAP as separate households.

B. Roomers Roomers are individuals to whom a household furnishes lodging, but not meals, for compensation.

Roomers who are otherwise eligible may participate in SNAP as separate households.

C. Live-in Attendant Live-in attendants are individuals who live with a household to provide medical, housekeeping, childcare, or other similar personal services.

Live-in attendants, who are otherwise eligible may, participate in SNAP as separate households. 4.304.32 Established Residence Separate and Apart Mandatory household members who live together must be included in the same household unless one of the mandatory individuals has established a residence separate and apart from the other mandatory household members.

A residence shall only be considered established as separate and apart from mandatory SNAP household members when the individual pays shelter expenses, supports the maintenance of the other residence, or has provided that separate address to other governmental organizations or an employer as their primary residence. Supporting the maintenance of another residence can be demonstrated through paying rent/mortgage, paying utilities, paying insurance, or other charges necessary to maintain the residence.

When it is determined that a person who would normally be considered a mandatory household member has established a residence separate and apart and is not required to be considered part of the SNAP household, any monies that person provides to the SNAP household should be considered as unearned income.

Examples include, but are not limited to:

A. A truck driver who is away from the household, returns at the end of each trip, and has not established a residence separate and apart must be considered a household member.

B. A spouse in the armed forces may be considered a non-household member if the spouse is away on assignment for a calendar month or longer and has established a residence separate and apart.

C. Oil field workers living on-site while working away from the primary residence may be considered a non-household member if the spouse is away on assignment for a calendar month or longer and has established a residence separate and apart. 4.304.4 Persons Disqualified or Ineligible to Participate in SNAP A. Disqualified individuals shall not be allowed to participate in SNAP as separate households.

“Disqualified individuals” are individuals disqualified for:

1. IPV/fraud;

2. Failure to either provide or obtain an SSN;

3. Being an ineligible non-citizen;

4. Failure to comply with work requirements;

5. Being an ABAWD who has been disqualified after receiving three (3) months of SNAP benefits within a period of thirty-six (36) months; or, 6. Being a person with a felony conviction who is not in compliance with the terms of their sentence and was convicted as an adult for conduct that occurred after February 7, 2014 for any of the following crimes:

a. Aggravated sexual abuse under Section 2241 of Title 18, United States Code;

b. Murder under Section 1111 of Title 18, United States Code;

c. An offense under Chapter 110 of Title 18, United States Code;

d. A federal or state offense involving sexual assault, as defined in Section 40002(a) of the Violence Against Women Act of 1994 (42 U.S.C. 13925(a)); or e. An offense under state law determined by the attorney general to be substantially similar to an offense described in clause (a), (b), or (c).

B. Individuals who are fleeing to avoid prosecution or custody for a crime, or an attempt to commit a crime, that would be classified as a felony shall not be considered eligible household members. If an individual is suspected of being a fleeing felon, either by their own admission or based on a report from law enforcement, the fleeing status must be verified in to determine if the client is eligible for SNAP.

The following four-part test must be used to determine if the individual would be considered a fleeing felon for SNAP:

1. There is an outstanding felony warrant for the individual by a Federal, State, or local law enforcement agency and the underlying cause for the warrant is for committing, or attempting to commit, a crime that is a felony under the law of the place from which the individual is fleeing or is a high misdemeanor under the law of New Jersey; and 2. The individual is aware of, or should reasonably have been able to expect that, the felony warrant has already or would have been issued; and 3 The individual has taken some action to avoid being arrested or jailed; and 4. The Federal, State, or local law enforcement agency is actively seeking the individual as provided in 4.304.4, C, 1.

C. Individuals who are determined to be a parole or probation violator shall not be an eligible household member. To be considered a probation or parole violator, an impartial party, as designated by the agency, must determine that the individual violated a condition of his or her probation or parole imposed under Federal or State law, and that Federal, State, or local law enforcement authorities are actively seeking the individual to enforce the conditions of the probation or parole as outlined below.

1. For the purposes of this provision, actively seeking is defined as follows:

a. A Federal, State, or local law enforcement agency informs the local office that it intends to enforce an outstanding felony warrant or to arrest an individual for a probation or parole violation within twenty (20) days of submitting a request for information about the individual to the local office; or, b. A Federal, State, or local law enforcement agency presents a felony arrest warrant as provided in 4.304.4, B, 1; or, c. A Federal, State, or local law enforcement agency states that it intends to enforce an outstanding felony warrant or to arrest an individual for a probation or parole violation within thirty (30) days of the date of a request from a local office about a specific outstanding felony warrant or probation or parole violation.

D. Residents of commercial and noncommercial boarding houses and institutions are not eligible to participate in the Program unless exempt in Section 4.304.41.

1. The household of the proprietor of a boarding house may participate in the Program separate and apart from the residents of the boarding house if that household meets all eligibility requirements for Program participation.

2. An institution is a place which has not been authorized by FNS to accept SNAP benefits, but which provides its residents with more than fifty percent (50%) of their daily meals as a part of its normal services. Residents of a halfway house for persons with a disability are residents of an institution if they are provided meals as part of their regular service.

3. Students who purchase meal plans through an institution of higher education shall be considered residents of an institution if the meal plan provides the student more than fifty percent (50%) of his/her meals, unless the individual is otherwise exempt from the institution provisions as provided in Section 4.304.41.

4.304.41 EXEMPTIONS FROM THE BOARDING HOUSE AND INSTITUTION PROHIBITIONS

A. An individual who is a resident of federally subsidized housing for persons aged sixty (60) and older under 12 U.S.C. 1701Q or 12 U.S.C. 1715Z-1.

B. Narcotic addicts or alcoholics and their children, who, for purposes of regular participation in a drug or alcoholic treatment and rehabilitation program, reside at a facility or treatment center.

C. Residents of a public or private nonprofit group living arrangement facility, who are blind or a person with disabilities.

D. Women or women and their children who are temporarily residing in a public or private nonprofit shelter for battered women and children.

E. Residents of public or private nonprofit shelters for homeless persons.

4.305 CITIZENSHIP AND NON-CITIZENSHIP STATUS

Citizens of the United States are potentially eligible for participation in SNAP, provided they meet other eligibility requirements. Most non-citizens must be in a qualified non-citizen status and meet one (1) additional condition to be eligible for participation in the Program. Some classes of non-citizens are eligible for participation without having to meet an additional condition.

A. Citizens and Non-Citizen Nationals 1. The following individuals are considered United States citizens:

a. A person born in the United States or in the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands or the Mariana Islands;

b. A person who has become a citizen through the naturalization process;

c. A person born outside of the United States to at least one (1) U.S. citizen parent;

d. A child under eighteen (18) years of age adopted or born outside the U.S. with a parent who is a U. S. citizen, who has been admitted as a lawful permanent resident, and is in the legal and physical custody of a parent who is a U.S. citizen.

2. Although not considered U.S. citizens, non-citizen nationals have the same potential eligibility for SNAP as U.S. citizens. Non-citizen nationals are those individuals born in an outlying possession of the United States (either American Samoa or Swain’s Island) on or after the date the U.S. acquired the possession, or a person whose parents are U.S. noncitizen nationals.

B. Non-Citizens Qualified non-citizens and certain groups of non-citizens who are not qualified are eligible for participation under certain conditions.

Some qualified non-citizens must also meet an additional condition, as outlined in Section 4.305, B, 3, to be eligible for participation. Each of the following categories of qualified non-citizens stands alone for the purposes of determining eligibility. If eligibility expires under one (1) eligible category, the local office shall determine if eligibility exists under another category.

1. Qualified Non-Citizen Status The following classes of non-citizens, based on the immigration status of an individual, are defined as a qualified non-citizen. The non-citizen shall be qualified as listed below at the time the non-citizen applies for, receives, or attempts to receive SNAP benefits.

A non-citizen under the age of eighteen (18) that is in a qualified alien status, as outlined in paragraphs A and B of this subsection, shall be eligible for participation in the program without having to meet an additional requirement. Once the non-citizen turns eighteen (18), the eligibility of the non-citizen shall be reviewed.

a. A non-citizen in one (1) of the following qualified non-citizen statuses is not required to meet an additional condition to be eligible for participation in the Program and is eligible for participation indefinitely from the date the non-citizen obtains qualified non-citizen status or enters the U.S. in a qualifying status.

1) A refugee who is admitted to the United States under 8 U.S.C. 1157.

2) Victims of trafficking, under the Trafficking Victims Protection Act of 2000, as amended, certified by the U.S. Department of Health and Human Services Office of Refugee Resettlement (ORR). This person shall have a certification letter.

a) ORR issues a letter of eligibility for adults and children under the age of eighteen (18). A trafficked minor shall have either an interim assistance letter or an eligibility letter from ORR to be eligible for SNAP. The local office shall accept these letters in place of Department of Homeland Security documentation.

b) Certification letters and eligibility letters do not expire; however, interim assistance letters that are provided to children are valid for ninety (90) calendar days from the effective date of the letter.

ORR may extend the interim eligibility an additional thirty (30) calendar days. Children with an interim assistance letter can only receive SNAP benefits until the expiration of the period established in the interim letter.

c) The local office can verify the status of these individuals through SAVE.

3) Asylees granted asylum under Section 208 of the INA, which is codified throughout Title 8 of the United States Code. The U.S. Code does not include any later amendments to or editions of the incorporated material.

Copies of the federal laws are available for inspection as defined in 4.000.

4) A non-citizen whose deportation is being withheld under 8 U.S.C. 1224(H) as in effect prior to April 1, 1997, or whose removal is withheld under 8 U.S.C. 1231(B)(3).

5) Retroactive to August 22, 1996, Cuban or Haitian entrants under 8 U.S.C. 1522(E).

6) Retroactive to August 22, 1996, Amerasians under 8 U.S.C 1612..

7) Iraqi and Afghan Special Immigrants (SIV)

Special immigrant status under 8 U.S.C. 1101(A)(27) may be granted to Iraqi and Afghan nationals who have worked on behalf of the U.S.

Government in Iraq or Afghanistan. The Department of Defense Appropriations Act of 2010 (DODAA), P.L. 111-118, Section 8120 enacted on December 19, 2009 provides that SIVs are eligible for all benefits to the same extent and the same period as refugees.

b. Non-citizens in one (1) of the following qualified non-citizen statuses are required to meet an additional condition (see Section 4.305, B, 3) to be eligible for participation in the Program.

1) Lawfully Admitted for Permanent Residence (LPRs) under the Immigration and Nationality Act (INA). LPRs are holders of Green Cards.

If a non-citizen is in a qualified non-citizen status as outlined in paragraph a. of this section and later adjusts to LPR status, the noncitizen does not have to meet an additional condition to be eligible for participation and shall remain eligible based on the previous qualified status.

2) Paroled into the United States under 8 U.S.C. 1182(d)(5) for at least one (1) year.

3) Granted conditional entry pursuant to 8 U.S.C. 1153(a)(7) as in effect before April 1, 1980.

4) A non-citizen who has been battered or subjected to extreme cruelty in the U.S. by a family member with whom the non-citizen resides, such as by a spouse, a parent, or a member of the spouse or parent's family.

This qualified alien status also extends to a non-citizen whose child has been battered or subjected to battery or cruelty or to a non-citizen child whose parent has been battered.

To establish eligibility, the local office shall determine that the non-citizen has satisfied three (3) requirements. Spouses and children who have applied for or have been granted protection under the Violence Against Women Act will meet these requirements.

a) The battered non-citizen(s) shall show that he/he has an approved or pending petition which makes a prima facie case for immigration status in one (1) of the following categories:

i) United States Citizenship and Immigration Services (USCIS) Form I-130, last modified July 20, 2021, petition for alien relative, filed by their spouse or the child’s parent, which is incorporated by reference. No later editions or amendments are incorporated. This form is available at no cost from the USCIS at https://www.USCIS.gov/I-130. The form is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado 80203;

ii) Form I-130, as incorporated by reference above, petition as a widow(er) of a U.S. citizen;

iii) Self-petition under the Violence Against Women Act (including those filed by a parent on behalf of an abused child), USCIS Form I-360, last modified June 9, 2020, which is incorporated by reference. No later editions or amendments are incorporated. This form is available at no cost from the USCIS at https://www.USCIS.gov/I-360.

The form is also available for public inspection and copying at the Food and Energy Assistance Division Director, Colorado Department of Human Services, 1575 Sherman Street, 3rd Floor, Denver, Colorado, 80203; or, iv) An application for cancellation of removal or suspension of deportation filed as a victim of domestic violence.

b) There is substantial connection between the battery or extreme cruelty and the need for SNAP benefits; and c) The battered non-citizen, child, or parent no longer resides in the same home as the abuser.

2. Eligible Non-Citizens Not in a Qualified Status:

The following classes of non-citizens are not defined as having a qualified status but are potentially eligible for participation in SNAP without having to meet an additional condition (see Section 4.305, B, 3). All other classes of non-citizens that are not in a qualified status are not eligible for participation in SNAP.

a. Certain American Indians Born Abroad American Indians born abroad in Canada living in the U.S. under Section 289 of the INA or non-citizen members of a federally recognized Indian tribe under

Section 4(e) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450(B)(E) who are recognized as eligible for the special programs and services provided by the U.S. to Indians because of their status as Indians.

This provision was intended to cover Native Americans who are entitled to cross the U.S. border between Canada and/or Mexico. It was intended to include but is not limited to the St. Regis Band of the Mohawk in New York State, the Micmac (also known as Mi’kmaq) in Maine, the Abenaki in Vermont, and the Kickapoo in Texas.

b. Hmong or Highland Laotian Tribal Members An individual lawfully residing in the U.S. who was a member of a Hmong or Highland Laotian tribe that rendered assistance to U.S. personnel by taking part in a military or rescue operation during the Vietnam era (August 5, 1964 – May 7, 1975). This category includes:

1) Spouse or surviving spouse of a deceased Hmong or Highland Laotian Tribal Member who is not remarried; and/or, 2) Unmarried dependent child of Hmong or Highland Laotian Tribal Member who is: under the age of eighteen (18) or a full-time student under the age of twenty-two (22);

3) Unmarried child under the age of eighteen (18) or a full-time student under the age of twenty-two (22) of a deceased Hmong or Highland Laotian Tribal Member, provided the child was dependent upon them at the time of the Hmong or Highland Laotian tribal member’s death; or, 4) Unmarried child with disabilities age eighteen (18) or older if the child with disabilities had a disability and was dependent on the person prior to the child's eighteenth (18th) birthday.

A) For purposes of this paragraph, “child” means the legally adopted or biological child of the person described in this section as a Hmong or Highland Laotian Tribal Member.

3. Additional Conditions Non-citizens in a qualified status as outlined in subsection 4.305, B, 1, are required to meet one additional condition to be eligible for participation in the Program. At the time the non-citizen applies for SNAP, they need only satisfy one of the following conditions to be eligible:

a. Five (5) Years of Residence The non-citizen has lived in the U.S. in a qualified non-citizen status for five (5) years. The five (5) year waiting period begins on the date the non-citizen obtains status as a qualified non-citizen or enters the U.S. in a qualifying status.

b. Forty (40) Qualifying Work Quarters A person shall have satisfied this additional condition if they are lawfully admitted for permanent residence while already possessing credit for forty (40) qualifying work quarters as defined under Title II of the Social Security Act. In some cases, an applicant may have work from employment that is not covered by Title II of the Social Security Act, but which is countable toward the forty (40) quarters test, and there are also cases in which SSA records do not show current year’s earnings. Such quarters are still countable for the forty (40) quarter test, but the individual non-citizen shall be responsible for providing evidence needed to verify the quarters.

1) The sum of work quarters can include:

a) Quarters the non-citizen worked;

b) Quarters credited from the work of a parent of such a non-citizen while the non-citizen was under eighteen (18), which includes quarters worked before the non-citizen was born or adopted; or c) Quarters credited from the work of the non-citizen’s spouse.

Quarters are only creditable to the non-citizen for work performed by his or her spouse if the couple is still legally married, or if the spouse becomes deceased while married to the non-citizen, and the work being credited to the non-citizen was performed after the marriage began.

If a couple divorces prior to determination of SNAP eligibility, a spouse may not get credit for quarters of their spouse. However, if the local office determines eligibility of a non-citizen based on the quarters of the spouse, and then the couple divorces, the non-citizen's eligibility continues until the next re-certification. At that time, the local office shall determine the non-citizen's eligibility without crediting the non-citizen with the former spouse's quarters of coverage.

2) The sum of work quarters cannot include:

a) Quarters in which not enough income was earned to qualify, or, b) Quarters earned after December 31, 1996, cannot be counted if the non-citizen, during the quarter, received SNAP or any other federal means-tested public benefits, such as Medicaid, SSI, TANF, or state Children’s Health Insurance Program.

c. Children Under Eighteen (18)

A non-citizen under eighteen (18) years of age in a qualified non-citizen status who lawfully resides in the U.S. When the non-citizen turns eighteen (18), noncitizen eligibility shall be reviewed.

d. Blind or Person with Disabilities A non-citizen who is blind or a person with a disability if the non-citizen is receiving benefits or assistance for their condition regardless of entry date.

e. Born on or before August 22, 1931 who lawfully resided in the U.S. on August 22, 1996.

f. Military Connection 1) Qualified non-citizens with a military connection, including an individual who is lawfully residing in a state and is on active duty, other than training, in the military, excluding national guard; or, 2) An honorably discharged veteran, as defined in Section 101 of Title 38, U.S.C, whose discharge is not because of immigration status, who fulfills the minimum active-duty service requirements. This includes an individual who died in active military duty, naval or air service. This provision extends to the spouse, un-remarried surviving spouse, and unmarried dependent children. A discharge “under honorable conditions,” which is not the same as an honorable discharge, does not meet this requirement.

3) The definition of “veteran” shall also include:

a. An individual who served before July 1, 1946, in the organized military forces of the Commonwealth of the Philippines while such forces were in the service of the Armed Forces of the U.S. or in the Philippine Scouts; or, b. An individual who is on active duty (other than active duty for training) in the Armed Forces of the United States, or the spouse of such a person; or, c. The spouse of a veteran who served at least twenty-four (24) months in the Armed Forces. This includes the spouse of a deceased veteran, provided the marriage fulfilled the requirements of 38 U.S.C. 1304, and the spouse has not remarried; or d. An unmarried dependent child of a veteran who is under the age of eighteen (18) or, if a full-time student, under the age of twentytwo (22); or, e. Unmarried dependent child of a deceased veteran provided such child was dependent upon the veteran at the time of the veteran's death; or an unmarried child with disabilities age eighteen (18) or older if the child with disabilities was disabled and dependent upon the deceased veteran prior to the child's eighteenth (18th) birthday.

1. For purposes of this provision, “child” means the legally adopted or biological child of the veteran. 4.305.1 Non-Citizens Ineligible for Participation in SNAP The following non-citizens are not eligible to participate in SNAP as a member of any household.

A. Non-citizens who are lawfully present in the U.S. but not in a qualified status, such as students and H-1B Visa workers;

B. Undocumented non-citizens (e.g., individuals who entered the country as temporary residents and overstayed their visas or who entered without a visa);

C. Non-citizen visitors;

D. Tourists;

E. Diplomats;

F. Students who enter the U.S. temporarily with no intention of abandoning their residence in a foreign country;

G. Individuals granted temporary protection status (TPS), unless in some other qualifying status;

H. Citizens of nations under Compact of Free Association agreements (Palau, Micronesia, and the Marshall Islands) who have been admitted under those agreements are not qualified non-citizens.

These individuals may otherwise reside, work, and study in the U.S.; and, I. Individuals with U Visas, including minor children under the age of eighteen (18), are ineligible as they have temporary status and are not considered qualified non-citizens. However, if the individual adjusts to qualified non-citizen status, such as LPR or battered immigrant status, then the individual’s non-citizen eligibility shall be reviewed under the new status. 4.305.2 Households Containing a Sponsored Non-Citizen Member A. The provisions of this section apply only to those non-citizens for whom a sponsor has executed an affidavit of support (INS Form I-864 or I-864A) on behalf of the non-citizen pursuant to Section 213A of the Immigration and Nationality Act (INA) on or after December 19, 1997. Prior to this time, affidavits of supports, known as I-134s, were not legally binding; therefore, the sponsor could not be legally compelled to support the non-citizen based on an affidavit of support signed prior to December 19, 1997.

B. Definition of a Sponsor 1. Sponsored non-citizens are those non-citizens lawfully admitted for permanent residence into the United States who have been sponsored by an individual for entry into the country.

2. A sponsor is a person who executed an affidavit(s) of support (INS Form I-864 or I-864A) or another form deemed legally binding by the Department of Homeland Security on behalf of a non-citizen as a condition of the non-citizen's entry or admission to the United States as a permanent resident. Date of entry or admission means the date established by the Immigration and Naturalization Service (INS) as the date the sponsored noncitizen was admitted for permanent residence.

C. Only when a sponsored non-citizen is an eligible non-citizen will the local office consider the income and resources of the sponsor and sponsor's spouse available to the household. For purposes of determining eligibility and benefit level of a household of which an eligible sponsored non-citizen is a member, the local office shall deem the income and resources of the sponsor and the sponsor's spouse, if they have executed USCIS Form I-864 or I-864A, as the unearned income and resources of the sponsored non-citizen.

D. Calculating Sponsor Income 1. The total gross income and resources of a sponsor and sponsor's spouse shall be considered as unearned income and resources of a sponsored non-citizen for a period until the person’s citizenship is obtained; or until the non-citizen has worked or can receive credit for forty (40) work quarters under Title II of the Social Security Act; or the sponsor dies.

The spouse's income and resources shall be counted even if the sponsor and spouse were married after the signing of the agreement.

2. The monthly income of the sponsor and the sponsor's spouse to be considered toward the non-citizen shall be the total monthly earned and unearned income of the sponsor and spouse at the time the household containing the sponsored non-citizen member applies for or is recertified for Program participation and shall be calculated as follows:

a. Reduced by an amount equal to twenty percent (20%) of the earned income of the sponsor and the sponsor's spouse; and, b. An amount equal to the SNAP monthly gross income eligibility limit for a household equal in size to the sponsor, the sponsor's spouse, and any other person who is claimed or could be claimed by the sponsor or the sponsor's spouse as a dependent for federal income tax purposes; and, c. If a sponsored non-citizen can demonstrate to the local office's satisfaction that his or her sponsor is the sponsor of other non-citizens, the local office shall divide the deemed income and resources of the sponsor and the sponsor's spouse by the number of such sponsored non-citizens.

3. If the sponsored non-citizen has already reported gross income information on his/her sponsor in compliance with the sponsored non-citizen rules of another state assistance program, and the local office is aware of the amounts that income amount shall be used for SNAP deeming purposes. However, the local office shall limit allowable reductions to the total gross income of the sponsor and the sponsor's spouse prior to attributing an income amount to the non-citizen. The only reduction will be twenty percent (20%) earned income amount for that portion of the income determined as earned income of the sponsor and the sponsor's spouse and an amount equal to the SNAP monthly gross income eligibility limit for a household equal in size to the sponsor, the sponsor's spouse, and any other person who is claimed or could be claimed by the sponsor or the sponsor's spouse as a dependent for federal income tax purposes.

4. Actual money paid to the non-citizen by the sponsor or the sponsor's spouse shall not be considered as income to the non-citizen unless the amount paid exceeds the amount already considered as income as above. Only the portion that exceeds the income already considered shall be added to that income.

5. If the non-citizen changes sponsors during the certification period, a change shall be processed to consider the new sponsor's income and resources toward the non-citizen as soon as possible after the information is verified. The previous sponsor's income and resources shall be used until such determination; however, should any present sponsor become deceased, that sponsor's income and resources shall not be attributed to the non-citizen.

6. Total resources of the sponsor and the sponsor's spouse shall be considered as resources to the non-citizen reduced by one thousand five hundred dollars ($1,500).

E. The counting of a sponsor’s income and resource provisions do not apply to a non-citizen who is:

1. A member of his or her sponsor's SNAP household;

2. Sponsored by an organization or group as opposed to an individual;

3. Not required to have a sponsor under the Immigration and Nationality Act (INA), such as a refugee, a parolee, an asylee, or a Cuban or Haitian entrant;

4. Considered as an “indigent” non-citizen;

An indigent non-citizen is a non-citizen who has been determined to be unable to obtain food and shelter which totals to an amount exceeding one hundred thirty percent (130%) of the federal poverty level, as defined in section 4.401.1. A non-citizen who is receiving in-kind benefits that exceed the gross income level for the household size shall not be considered indigent. The noncitizen's own income plus any cash, food, housing, or other assistance provided by other individuals, including the sponsor, will be counted in making this determination.

For purposes of this provision, the sum of the eligible sponsored non-citizen household's own income, the cash contributions of the sponsor and others, and the value of any inkind assistance from the sponsor and others, shall not exceed one hundred thirty percent (130%) of the poverty income guideline for the household's size. The local office shall determine the amount of income and other assistance provided in the month of application. If the non-citizen is below one hundred thirty percent (130%) of the federal poverty level, the only amount that the local office shall consider deemed to such a noncitizen will be the amount provided by the sponsor for a period beginning on the date of such determination and ending twelve (12) months after such date. Each determination is renewable for additional twelve (12) month periods. The local office shall notify the U.S. attorney general of each such determination, including the names of the sponsor and the sponsored non-citizen involved.

5. A child of a battered parent is exempt from the provision of sponsorship. A battered noncitizen spouse, non-citizen parent of a battered child, or child of a battered non-citizen will not have sponsor's income and resources counted during a twelve (12) month period after the local office determines that the battering is substantially connected to the need for benefits, and the battered individual does not live with the batterer. After twelve (12) months, the local office shall not deem the batterer's income and resources if the battery is recognized by a court or the INS and has a substantial connection to the need for benefits, and the non-citizen does not live with the batterer;

6. Had been sponsored but has since obtained citizenship;

7. A person whose sponsor has died; or, 8. Who has worked or can receive credit for a total of forty (40) work quarters under Title II of the Social Security Act.

F. Verification Requirements The local office shall verify the following information at the time of initial application and recertification:

1. The income and resources of the non-citizen's sponsor and the sponsor's spouse (if the spouse is living with the sponsor) at the time of the non-citizen's application for SNAP.

2. The names (and alien registration numbers) of other non-citizens for whom the sponsor has signed an affidavit of support or similar agreement.

3. The number of dependents who are eligible to be claimed for federal income tax purposes by the sponsor and the sponsor's spouse.

4. The name, address, and phone number of the non-citizen's sponsor.

G. Awaiting Verification 1. Until the non-citizen provides information or verification necessary to determine eligibility, the sponsored non-citizen shall be ineligible. When such verification is provided, the local office shall act on the information as a reported change in household circumstances. The eligibility of any remaining household members shall be determined. The income and resources of the ineligible non-citizen (excluding the attributed income and resources of the non-citizen's sponsor and sponsor's spouse) shall be treated in the same manner as a disqualified member as set forth in Section 4.411.1 and considered available in determining the eligibility and benefit level of the remaining household members.

2. If the sponsored non-citizen refuses to cooperate in providing and/or verifying needed information, other adult members of the non-citizen's household shall be responsible for providing and/or verifying the information. If the information or verification is subsequently received, the local office shall act on the information as a reported change. If the same sponsor is responsible for the entire household, the entire household is ineligible until such time as the needed information is provided and/or verified. The local office shall assist the non-citizen in obtaining verification provided the household is cooperating with the local office.

H. Sponsored Non-Citizen’s Responsibility 1. During the period the sponsored non-citizen is subject to deeming, the eligible sponsored non-citizen shall be responsible for obtaining the cooperation of their sponsor, for providing the local office, at the time of application and/or recertification, the information and/or documentation necessary to calculate income and resources attributable to the non-citizen's household. The eligible sponsored non-citizen shall be responsible for providing the names (or other identifying factors) of other non-citizens for whom the noncitizen's sponsor has signed an agreement to support. The local office shall attribute the entire amount of income and resources to the eligible sponsored non-citizen until they provide the information required.

2. The local office will determine how many of such non-citizens are SNAP applicants or participants and initiate appropriate proration. The eligible sponsored non-citizen shall also be responsible for reporting the required information about the sponsor and sponsor's spouse should the non-citizen obtain a different sponsor during the certification period. The eligible sponsored non-citizen shall report changes in income should the sponsor or sponsor's spouse change or lose employment or become deceased during the certification period. The local office shall act on the information as a reported change in household circumstances as set forth in Section 4.604. 4.305.3 Reporting Undocumented Non-Citizens A. The local office shall immediately inform the local USCIS office whenever personnel responsible for the certification or recertification of households determine that any member of a household is ineligible to receive SNAP because the member is present in the United States in violation of immigration laws.

B. In determining whether the member is present in the United States in violation of immigration laws, caution shall be exercised to ensure that the determination is not made merely on the noncitizen's inability or unwillingness to provide documentation of non-citizen status. When a person indicates an inability or unwillingness to provide documentation of non-citizen status, the local office shall not continue efforts to obtain documentation other than that necessary to obtain information on the income and resources to be made available to remaining members of the C. Because many non-citizens who are legally present in the United States are not eligible for SNAP, eligibility technicians are cautioned that a determination that a person is an ineligible noncitizen is not equivalent to a determination that a person is a non-citizen present in the United States in violation of immigration laws.

D. When and if a SNAP eligibility technician is able, based on information that becomes available to him/her in the process of reviewing a household's eligibility for SNAP, to determine that a member or members of that household are in fact non-citizens present in the United States in violation of the immigration laws, the eligibility technician will report the determination to their supervisor. The report to USCIS, if made, shall be in writing.

This rule does not permit the reporting to USCIS on mere suspicion or prejudice. Firm evidence that a household is illegally in the U.S. would be required. A person known to be a non-citizen in the United States in violation of the Immigration and Nationality Act is only known to have such status when they are found in this country and are known to have a final order of deportation outstanding against them. An outstanding order of deportation is final when it is not subject to appeal because the relevant statutory appeal period of ten (10) days has expired or because there are no lawful grounds upon which an appeal may be based or because the available administrative and/or judicial appeals have been exhausted, and the order is not subject to review under the limited standards of reopening for consideration.

E. The failure to report a non-citizen illegally present in the United States in violation of immigration laws to USCIS will not be considered a quality assurance error or assessed as an administrative deficiency.

4.306 STUDENT ELIGIBILITY

A. Any person who is age eighteen (18) through forty-nine (49) and enrolled at least half time in an institution of higher education shall not be eligible to participate in the SNAP unless the person meets one of the exemption criteria outlined at 4.306.1.

B. The following individuals are not considered under student eligibility criteria:

1. Persons aged seventeen (17) or under;

2. Persons aged fifty (50) or over;

3. Persons enrolled less than half time;

4. Persons enrolled full time in schools and training programs that are not institutions of higher education;

5. Persons attending high school;

6. Persons participating in an on-the-job training program. On-the-job training is defined as training in an employment environment and does not include an internship, field work, or practical experience associated with a course of higher education.

C. The enrollment status of a student shall begin on the first day of the school term of the institution of higher education. Once a student enrolls in an institution of higher education, such enrollment shall be deemed continuous through normal periods of class attendance, vacation, and recess unless the student graduates, is suspended or expelled, drops out or does not intend to register for the next normal school term (excluding summer session). It is possible for a student to enroll prior to the beginning of the school term. However, for eligibility purposes, enrollment starts when the student starts classes. 4.306.1 Student Exemption Criteria To be eligible to participate in SNAP, a student must meet at least one (1) of the following exemptions:

A. Be physically or mentally unfit for employment (including students participating through or in a vocational rehabilitation program).

If mental or physical unfitness for employment is claimed and the unfitness is not evident to the local office, verification may be required. Appropriate verification may consist of receipt of temporary or permanent disability benefits or a statement from a physician or licensed psychologist.

B. The student is employed for an average of twenty (20) hours per week and is paid for such employment. The student shall be employed an average of twenty (20) hours each week, regardless of wages received.

If the student is self-employed, the student shall work an average of twenty (20) hours a week and have earnings after allowable business expenses are deducted equal to at least the federal minimum wage multiplied by twenty (20) hours.

The weekly employment of twenty (20) hours may be based on an average number of hours worked per month, so long as the student is employed for eighty (80) hours per month.

C. The student is participating in a state or federally financed work-study program. The student shall be approved for a work-study program at the time of application for SNAP. The work-study shall be approved for the school term and the student shall anticipate working during that time. The student qualifies for this exemption the month the school term in which the work-study will occur begins or the month work-study is approved, whichever is later. The exemption will continue until the end of the school term or until it becomes known that the student has refused an assignment.

The exemption shall not continue between terms when there is a break of one (1) full month or longer unless the student is participating in work-study during the break.

D. The student is responsible for more than half of the physical care of a dependent household member under the age of six (6), or a full-time student who is a single parent with responsibility for the care of a dependent child under age twelve (12). The single parent provision applies in those situations where only one natural, adoptive, or stepparent regardless of marital status is in the same SNAP household as the child. A full-time student in the same SNAP household with a child who is under their parental control may qualify if they do not reside with their spouse.

E. The student is responsible for more than half of the physical care of a dependent household member who has reached the age of six (6) but is under the age of twelve (12) where the local office has determined that adequate childcare is not available to enable the individual to attend class and satisfy the requirement of item B or item C, above.

F. The student is receiving a Title IV-A TANF cash grant. The student’s needs shall be included in the grant to be eligible under this provision. Family Preservation is not considered a TANF cash grant.

G. The student is assigned to or placed in an institution of higher education through a program under the Workforce Innovation and Opportunity Act (WIOA), Employment First (EF), a program under

Section 236 of the Trade Act of 1974 (19 U.S.C. 2296), another program for the purpose of employment and training operated by the state or local government (program shall have at least one (1) component equivalent to the SNAP EF Program), or as a result of participating in the JOBS program under Title IV of the Social Security Act.

Self-initiated placement during the period the person is enrolled in one of these employment and training programs shall comply with the requirements of the employment and training program in which the person is enrolled. This placement is considered in compliance provided that the Employment and Training program has a component for enrollment in an institution of higher education and that the Employment and Training program accepts the placement. Persons who voluntarily participate in one of these employment and training programs and are placed in an institution of higher education through or in compliance with the requirements of the Employment and Training program shall also qualify for the exemption.

H. The student is participating in an on-the-job training program. A person is participating in an onthe-job training program only during the period the person is being trained by an employer.

4.307 STRIKER ELIGIBILITY

A. Households containing a striking member, as defined in section 4.000.1, shall not be eligible for SNAP unless the household was eligible for the Program the day before the strike and are otherwise eligible at time of the strike. Households where the striking member was exempt from work registration the day before the strike shall not be subject to these provisions and shall be certified if otherwise eligible unless the exemption was based on the employment.

B. Pre-strike eligibility is determined by considering the day prior to the strike as the day of application and assuming the strike was not occurring. Eligibility at the time of application shall be determined by comparing the striking member's income as of the day before the strike to the striking member's current income and adding the higher of the two (2) to the current income of the non-striking household members during the month of application. The higher income will be used in determining benefits. 4.307.1 Households Not Affected by the Striker Provisions A. Employees whose work place is closed by an employer (i.e., lockout), B. Employees unable to work as a result of other striking employees (e.g., a paper strike closes operations at a printing company; therefore, pressmen are out of work), C. Employees not wanting to cross a picket line due to fear of personal injury or death (this does not include persons sympathetic to the strike who refuse to cross the picket line), D. Persons who were exempt from work registration the day before the strike such as the caretaker of a child under six (6) years of age (other than those exempt solely on the ground that they were employed).

4.308 VOLUNTARY QUIT

A. No individual who quit his or her most recent job without good cause or reduces work effort and, after the reduction, is working less than thirty (30) hours each week, without good cause, or earning less than the federal minimum wage multiplied by thirty (30) hours, shall be eligible for participation in SNAP. At the time of application, the eligibility technician shall explain to the applicant the potential penalties if a household member quits his or her job or reduced hours or wages without good cause or if another member joins the household if that individual has voluntarily quit employment.

B. When a household files an application, or when a participating household reports the loss of a source of income or reduction in hours, the local office shall determine whether any household member voluntarily quit or reduced his or her hours or income. Benefits shall not be delayed pending the outcome of this determination. A sanction shall be imposed if the quit or reduction in hours or wages occurred within sixty (60) calendar days prior to the date of application or anytime thereafter, and the quit or reduction was without good cause. An employee of the federal government, or of a state or local government who participates in a strike against such government and is dismissed from his or her job because of participation in the strike, shall be considered to have voluntarily quit his or her job without good cause. If an individual quits a job, secures new employment at comparable wages or hours, and, through no fault of his or her own loses the new job, the earlier quit shall not be a basis for disqualification.

C. In the case of an applicant household, the local office shall determine whether any currently unemployed household member who is required to register for work or was exempt from registration for being employed has voluntarily quit his or her most recent job within the last sixty (60) days. If the local office learns that a household has lost a source of income after the date of application but before the household is certified, the local office shall determine whether a voluntary quit occurred.

The nonexempt individual who quit or reduced work hours will be ineligible to participate for the sanction period if the household is determined eligible for SNAP. The individual will be required to comply with EF following the sanction period unless the individual becomes exempt from work requirements.

D. In the case of the participating household, the local office shall determine whether any household member voluntarily quit his or her job while participating in the Program. If a household is already participating when a quit that occurred prior to certification is discovered, the household shall be regarded as a participating household.

E. Upon a determination that the individual voluntarily quit employment, reduced work hours below thirty (30) hours, or reduced wages to the point at which the person is earning less than the federal minimum wage multiplied by thirty (30) hours, the local office shall determine if the voluntary quit was with good cause.

If an individual voluntarily quits or reduces work hours/wages without good cause, the individual will be disqualified in the same manner as individuals failing to comply with work registration or EF requirements.

F. If the local office determines that the individual voluntarily quit his or her job or reduced his or her work hours without good cause while participating in SNAP, the local office shall provide the household with a Notice of Adverse Action within ten (10) calendar days after the determination of a voluntary quit is made. The notice shall contain the act of noncompliance, the proposed period of disqualification, the action to be taken at the end of the disqualification and shall specify that the individual may be included in the household after the disqualification period if the individual meets other work requirements.

G. Individuals have the right to a fair hearing to appeal a disqualification due to a determination that the individual quit his or her job without good cause or reduced his or her work hours without good cause. If a participating household requests a fair hearing and the local office determination is upheld, the disqualification period shall begin the first of the month after the hearing decision is rendered. 4.308.1 Good Cause for Quitting or Reducing Work Hours Upon a determination that the individual voluntarily quit employment, the local office shall determine if there was good cause which shall include, but not be limited to, any of the following:

A. Discrimination by an employer based on age, race, sex, color, handicap, religious beliefs, national origin, or political beliefs;

B. Work demands or conditions that render continued employment unreasonable such as working without being paid on schedule;

C. Acceptance by the individual of employment; or enrollment of at least half-time in any recognized school, training program, or institution of higher education, that requires the individual to leave D. Acceptance by any other household member of employment or enrollment at least half-time in any recognized school, training program, or institution of higher education in another county or political sub-division which requires the household to move and thereby requires the individual to leave employment;

E. Resignations by persons under the age of sixty (60) that are recognized by the employer as retirement;

F. Resignation from employment that does not meet suitable criteria specified in Section 4.310.7;

G. Because of circumstances beyond the control of the individual, accepted full time employment subsequently either does not materialize or results in employment of less than thirty (30) hours a week or weekly earnings of less than the federal minimum wage multiplied by thirty (30) hours;

H. Leaving a job in connection with patterns of employment in which workers frequently move from one employer to another, such as migrant farm labor or construction work, even though employment at the new site has not actually begun;

I. Illness of the head of household;

J. Illness of another household member requiring the presence of the head of household;

K. A household emergency;

L. The unavailability of transportation; or, M. Employer demands a reduction in participant's work effort or salary through no fault of the employee.

N. Lack of adequate child care for children who have reached age 6 but are under age 12.

4.309 HOUSEHOLDS WITH SPECIAL CIRCUMSTANCES

The following sections explain the application of SNAP criteria and certification procedures to the eligibility determinations for households with special circumstances pertaining to:

A. Dining Facilities and Homeless Meal Providers;

B. Shelters for Battered Women and Children;

C. Drug and Alcohol Treatment and Rehabilitation Centers;

D. Residents of Group Living Arrangements. 4.309.1 Dining Facilities and Homeless Meal Providers Households with special circumstances, such as a person with disabilities, persons aged sixty (60) and older, or group living arrangements, may be authorized to use SNAP benefits to buy food from authorized communal dining facilities, meals on wheels, drug and alcohol treatment and rehabilitation centers, and shelters for battered women and children.

Households experiencing homelessness may also use SNAP benefits to purchase prepared meals from approved restaurants. SNAP households experiencing homelessness may use food benefits for meals prepared for and served by an authorized provider (for example, a soup kitchen or temporary shelter) that feeds persons experiencing homelessness. 4.309.2 Shelters for Battered Women and Children There are no restrictions on how long a center shall be in operation or on the number of residents served by the shelter. The local office shall determine a shelter's status as a shelter for battered women and children and shall document the basis for their determination. The rules within this subsection apply specifically to centers which provide meals to their residents. Centers which do not provide meals are not to be considered institutions and their residents' eligibility will be determined using the standard rules for eligibility. 4.309.21 Residents of Shelters for Battered Women and Children Women or women with their children who are temporarily residing in a shelter for battered women and children (which serves over fifty percent (50%) of their meals) shall be considered exempt from the prohibition against residents of institutions.

A. They shall be allowed to apply and be considered for eligibility as individual (parent/child) units, rather than considered as part of a household consisting of all shelter residents.

B. In many instances battered women and their children who were previously certified in the household of an abuser may not have access to their allotment. Therefore, these individuals shall be allowed to participate in one (1) additional project area and/or household so long as one of the two households with which they are participating contains the individual who abused them. These persons may receive an additional allotment only once in a month.

C. The local office should act promptly to reflect the changes in household composition and shall act on the change to reduce or terminate benefits to the applicant's former household as appropriate.

D. Shelter residents who apply as separate households shall be certified solely on the basis of their income and resources and the expenses for which they are responsible. They shall be certified without regard to the income, resources, and/or expenses of their former household. Jointly held resources shall be considered inaccessible to the household if access to such resources is dependent upon the agreement of a joint owner who still resides in the former household. 4.309.3 Drug and Alcohol Treatment and Rehabilitation Centers (Center)

A. Residents of publicly operated community mental health centers or private non-profit organizations or institutions, operating a residential drug or alcohol treatment or rehabilitation program, are eligible to participate in SNAP. Applications shall be made through an authorized representative who is employed by the drug or alcohol treatment or rehabilitation facility and designated by the facility for that purpose. Individuals residing in a for-profit facility are considered residents of an institution per Section 4.304.4(E), above.

B. The center shall be approved by the Colorado Department of Human Services (CDHS), Office of Behavioral Health (OBH) before its residents are eligible for SNAP participation. The OBH will ensure that the center is providing treatment that can lead to the rehabilitation of drug or alcohol addiction.

Before the certification of residents can be accomplished, the local office shall verify that the center has been approved by FNS as a retailer and is certified by the OBH. Proof of OBH certification may be provided in the form of a license or an approval letter issued to the center by that agency, or proof that the center is funded under Part B of Title XIX of the Public Health Service Act (42 U.S.C. 300x-1 through 300x-13).

C. Residents and their children residing in a certified center must voluntarily elect to participate in SNAP. Residents shall have their eligibility determined as one-person households unless children are residing with them at the center. Children of the residents in a center who live with their parents in the treatment center will qualify for SNAP. Meals served to the children are eligible for purchase with SNAP benefits. The local office shall certify residents of centers by using the same provisions that apply to other applicant households.

D. Residents of centers may be receiving public assistance or SSI benefits or may be destitute of income and resources and eligible for expedited service. Residents who qualify for expedited service shall have benefits available for spending no later than seven (7) calendar days following the date the application was filed.

E. Any applicant household containing a member who regularly participates in a drug and alcohol treatment program on a non-resident basis shall include this member when having its eligibility determined. The household must complete the application process through the head of household or through an authorized representative and shall meet all financial and non-financial criteria unless specifically exempt. Such households may use any part of their SNAP benefits to purchase food prepared for or served to the individual during the program, provided the program has been authorized by FNS for such purposes. 4.309.31 Responsibilities of the Center Drug or alcohol treatment and rehabilitation centers will be responsible for the following:

A. The drug or alcohol treatment center employee designated to serve as an authorized representative shall be responsible for obtaining their own Electronic Benefit Transfer (EBT) card and Personal Identification Number (PIN) with which to access benefits from the resident’s account while the resident remains a resident of the facility.

The resident’s EBT card shall be stored in a secure area while the resident receives treatment at the facility. The drug or alcohol treatment center shall not have access to, or knowledge of, the PIN for the resident’s own EBT card.

B. Each treatment and rehabilitation center shall provide the certification office with a certified list of currently participating residents and their children residing with them in the center. The certification office shall require the list on a monthly or semimonthly basis. In addition, the certification office shall conduct periodic, random, onsite visits to the center to ensure the accuracy of the listings and that the local office's records are consistent and up-to-date. The frequency of periodic visits is left to the discretion of the local office but once each year is recommended.

C. The center shall also report when the resident leaves the center. The center shall return to the issuing office any benefits received after the household has left the center.

The center shall provide the residents with their EBT card when the household leaves the treatment and rehabilitation program. Once the household leaves the center, the center is no longer allowed to act as that household's authorized representative. The departing resident shall receive his/her full allotment if already issued and if no benefits have been spent on his/her If benefits have been issued and any portion has been spent on his/her behalf and the resident leaves prior to the sixteenth (16th) of the month, the center shall provide the resident with one half of his/her monthly allotment; on or after the sixteenth (16th), if benefits have already been used, the resident shall not receive any benefits.

Under no circumstances shall the center pull benefits from an EBT card after the resident has left the facility. The center shall return the authorized representative EBT card, and the resident’s card if it was left behind, to the issuing office within five (5) calendar days of the resident’s departure.

The center shall provide the household with a change report form as soon as it has knowledge the household plans to leave the facility and advise the household to return the form to the local office within ten (10) days of any change the household is required to report.

D. The center shall be responsible for any misrepresentation or fraud, which it knowingly commits in the certification of center residents. The organization or institution shall be knowledgeable about household circumstances when serving as an authorized representative. The organization or institution should carefully review those circumstances with residents prior to applying on their E. The center may be penalized or disqualified if it is determined administratively or judicially that benefits were misappropriated or used for purchases that did not contribute to a certified household's meals. The local office shall promptly notify the state department when it has reason to believe that a center is misusing SNAP benefits in its possession. However, no action shall be taken against the center prior to an FNS investigation. The local office shall establish a claim for over-issuance of SNAP benefits held on behalf of center residents if any over-issuances are discovered because of an FNS investigation or hearing. If FNS disqualifies a center as an authorized drug and alcohol rehabilitation and treatment center, the local office shall suspend its authorized representative status for the same period. 4.309.4 Residents of Group Living Arrangements A. Group living arrangements are residential settings that are considered alternatives to institutional living. Institutional settings are not included in this provision. To be eligible as residents of a group living arrangement, the person must be a person with disabilities. In addition, the local office shall verify that the group living arrangement is a public or private nonprofit facility with no more than sixteen (16) residents and is certified as a group living arrangement by the Colorado Department of Public Health and Environment and the state department under Section 1616(e) of the Social Security Act (codified at 42 U.S.C. 1382e(e)). FNS may also certify under standards determined by the USDA that are comparable to standards implemented by the state under 1616(e) of the Social Security Act. Individuals residing in a for-profit facility are considered residents of an institution per Section 4.304.4(E).

B. Residents of group living arrangements must voluntarily elect to participate in SNAP.

Residents shall either apply and be certified through an authorized representative, who is employed and designated by the group living arrangement or apply and be certified on their own behalf or through an authorized representative of their own choice. The group living arrangement shall determine if any resident may apply for SNAP on his/her own behalf; the determination shall be based on the resident's physical and mental capability to handle his/her own affairs.

1. If residents apply using the group living facility's authorized representative, eligibility shall be determined as a one-person household. The group living arrangement may either:

a) Receive and spend the allotment on food prepared by and/or served to the eligible resident, or b) Allow the eligible resident to use all or any portion of the allotment on his/her own 2. The group living facility employee designated to serve as an authorized representative shall be responsible for obtaining their own Electronic Benefit Transfer (EBT) card and Personal Identification Number (PIN) with which to access benefits from the resident’s account while the resident remains a resident of the facility.

3. The resident’s EBT card shall be stored in a secure area while the resident resides in the group living facility. The group living facility shall not have access to, or knowledge of, the PIN for the resident’s personal EBT card.

4. If the residents apply on their own behalf, the applications shall be accepted for any individual applying as a one-person household or for any grouping of residents applying as a household. If residents are certified on their own behalf, the allotment may be returned to the facility to be used to purchase food for meals served either communally or individually to eligible residents, used by eligible residents to purchase and prepare food for their own consumption, and/or to purchase meals prepared and served by the group living arrangement.

C. Applications for residents of group living arrangements shall be processed using the same standards that apply to all other SNAP households including that residents entitled to expedited service shall have benefits available for spending no later than seven (7) calendar days following the date the application was filed. Required verification shall be obtained prior to further benefits being issued.

D. The local office shall process changes in household circumstances and recertifications by using the same standards that apply to all other SNAP households, and resident households shall be afforded the same rights all other SNAP households enjoy, including the right to notices of adverse action, fair hearings, and entitlement to lost benefits. 4.309.41 Responsibilities of Group Living Arrangements A. Each group living arrangement shall provide the local office with a list of currently participating residents. The local office shall require the list on either a monthly or semimonthly basis and the list shall be signed by a responsible center official attesting to the validity of the list. In addition, the local office shall conduct periodic random onsite visits to ensure the accuracy of the list and that the local office's records are consistent and up to date.

B. If the resident has applied on his/her own behalf, the household is responsible for reporting changes to the local office in accordance with Section 4.603. If the group living arrangement is acting in the capacity of an authorized representative, the group living arrangement shall notify the local office of changes in the household's income or other household circumstances and when the individual leaves the group living arrangement.

C. When the household leaves the group living facility, the group living arrangement, either acting as an authorized representative or retaining use of the benefits on behalf of the residents (regardless of the method of application), shall provide residents with their EBT card. The household, not the group living arrangement, shall be allowed to receive his/her authorized issuance. Also, the departing household shall receive its full allotment if no benefits have been spent on behalf of that individual household. These procedures are applicable any time during the month.

However, if the benefits have already been issued and any portion spent on behalf of the individual and the household leaves the group living arrangement prior to the sixteenth (16th) of the month, the facility shall provide the resident with one half of his/her monthly allotment. If the household leaves on or after the sixteenth (16th) of the month and the benefits have already been issued and used, the household does not receive any benefits.

Once the resident leaves, the group living arrangement no longer acts as his/her authorized representative. Under no circumstances shall the group living arrangement pull benefits from an EBT card after the resident or group of residents have left the group living facility. The facility shall return the authorized representative EBT card, and the resident’s card if it was left behind, to the issuing office within five (5) calendar days of the resident’s departure.

The group living arrangement shall provide the household with a change report form as soon as it has knowledge of the household plan to leave the facility and advise the household to return the form to the local office within ten (10) days of any change the household is required to report.

D. When acting as the authorized representative, a group living arrangement shall be responsible for any misrepresentation or fraud, which it knowingly commits in the certification of group living facility residents. The facility shall be knowledgeable about household circumstances as an authorized representative and should carefully review those circumstances with residents prior to applying on their behalf. The facility shall be strictly liable for all losses or misuse of benefits held on behalf of resident households and for all over-issuances that occur while the households are residents of the group living facility. However, the resident applying on his/her own behalf shall be responsible for over-issuance as would any other household.

E. The group living arrangement may purchase and prepare food to be consumed by eligible residents on a group basis if residents normally obtain their meals at a central location as part of the group living arrangement services, or if meals are prepared at a central location for delivery to the individual residents. If residents purchase and/or prepare food for individual consumption, as opposed to communal dining, the group living arrangement shall ensure that each resident’s SNAP benefits are used for meals intended for that resident. If the resident retains use of their own allotment, they may either use the benefits to purchase meals prepared for them by the facility or to purchase food to prepare meals for their own consumption. 4.309.42 Disqualification of the Group Living Arrangements A group living arrangement facility authorized by FNS may be penalized or disqualified if it is determined administratively or judicially that benefits were misappropriated or used for purchases that did not contribute to a certified household's meals. The local office shall promptly notify the state department when it has reason to believe that a facility is misusing benefits. However, the local office shall take no action prior to FNS action against the facility. The local office shall establish a claim for over-issuances of SNAP benefits held on behalf of resident clients if any over-issuances are discovered during an investigation or hearing procedure for redemption violations.

If the group living facility loses its authorization from FNS to accept SNAP benefits or is no longer certified by the Colorado Department of Public Health and Environment as a group living arrangement, residents using the facility as an authorized representative shall no longer be able to participate. The residents are not entitled to a Notice of Adverse Action but shall receive a written notice explaining the termination and when it shall become effective.

Residents applying on their own behalf shall still be able to participate, if otherwise eligible.

4.310 GENERAL WORK REQUIREMENTS

As a condition of eligibility for SNAP, each household member not determined to be exempt must comply with the following work requirements:

A. Register for work at the time of initial application and at every recertification by signing the application for assistance or recertification. The application must be signed by the member required to register, an authorized representative, or by another adult household member; and B. Provide the eligibility techncian with sufficient information regarding employment status or availability for work; and C. Cannot commit an act of voluntary quit; and D. Accept an offer of suitable employment; and E. Report to an employer if referred by the local office if the potential employment is suitable employment. 4.310.1 Work Requirements and Verification Client statements are considered acceptable verification unless questionable.

If verification is requested from the client because client statement is considered questionable, case documentation must thoroughly explain why the original client statement was considered questionable.

A. Examples of verification that can be obtained to resolve questionable information can include but is not limited to:

1. Receipt of temporary or permanent disability benefits issued by government or private sources; or 2. Persons may provide a statement from a physician, physician’s assistance, nurse, nurse practitioner, designated representative of the physician’s office, or a licensed or certified psychologist. A county agency may determine other licensed medical personnel appropriate to provide verification that a work registrant is physically or mentally unfit for employment; or 3. A statement from a licensed social worker or a social worker employed by or acting on behalf of a 501(C)(3) non-profit organization or government entity. 4.310.2 Informing the Household of General Work Requirements At the point of initial application and recertification, when an interview is required, SNAP households must receive from the eligibility technician a written notice and a verbal explanation of:

A. The SNAP general work requirements;

B. The rights and responsibilities of household members subject to work requirements;

C. The consequences of failure to comply with these work requirements; and D. The availability of additional employment and training programs and services, outside of Employment First (EF), within their community.

When an interview is not required at recertification, the written statement of these requirements to the work registrants in the household is sufficient. 4.310.3 General Work Requirement Exemptions At all determinations of eligibility including initial, ongoing, and recertification, eligibility technicians must explore if the household member meets an exemption rather than placing the burden solely on the household member to self-report.

General work requirement exemptions include:

A. A person 15 years of age or younger or a person 60 years of age or older;

1. A person age 16 or 17 who is not the head of a household, or who is attending school, or is enrolled in an employment training program, on at least a half-time basis, is also exempt.

B. A parent or other household member responsible for the care of a dependent child under 6 or an incapacitated person;

C. A person physically or mentally unfit for employment;

Examples of being physically or mentally unfit for employment can include but are not limited to:

1. Persons experiencing homelessness, as defined in 4.000.1 2. Recently released from an institution 3. Person with disabilities as defined in 4.100 and includes but is not limited to:

a. Persons with self-declared temporary conditions that would prevent successful participation in work activities b. Persons receiving temporary or permanent disability benefits issued by government or private sources c. Persons participating in vocational rehabilitation d. Persons applying for and/or appealing SSI benefits 4. Persons unable to maintain employment 5. Persons impacted by domestic violence D. A student enrolled at least half-time, as defined by the educational facility, in any accredited school, training program, or institution of higher education;

1. A student who is enrolled in an institute of higher education must meet student eligibility requirements to receive SNAP.

2. Students who are eligible for SNAP remain exempt from work requirements during normal periods of class attendance and school breaks.

3. Persons who are not enrolled at least half-time or who experience a break in their enrollment status due to graduation, expulsion, suspension, or who drop out or otherwise do not intend to register for the next normal school term (other than summer), shall not be eligible for this exemption.

E. Employed or self-employed individuals who are working a minimum of thirty (30) hours per week or receiving weekly earnings at least equal to the federal minimum wage multiplied by thirty (30) hours;

1. This shall include migrant and seasonal farm workers who are under contract or similar agreement with an employer or crew chief to begin employment within thirty (30) days.

2. Persons working in action programs, including VISTA, are exempt from work requirements if they work at least thirty (30) hours per week even if the compensation is not consistent with prevailing community wage, since an employer-employee relationship can be documented.

F. A person applying for or receiving Unemployment Insurance Benefits (UIB). The local office shall verify application for or receipt of UIB, if questionable. A person who has been denied UIB and who is appealing the decision is exempt;

G. A regular participant in drug or alcohol treatment or rehabilitation program;

H. A person subject to and complying with CW or the Colorado Refugee Services Program (CRSP) work programs. 4.310.4 Changes in Exemption Status Individuals exempt from work requirements are not required to report changes in their exemption status during their certification period. At recertification, all individuals subject to work requirements will be reassessed for work requirement exemptions.

If an individual loses their exemption status during their certification period, they shall retain their original work requirement exemption through their certification period unless they are considered an ABAWD. 4.310.5 Voluntary Quit A. When a household files an initial application or recertification, the local office must determine if any household member who is not exempt from work requirements voluntarily quit his or her job of 30 or more hours a week or reduced his or her work effort to be less than 30 hours a week without good cause. Benefits must not be delayed beyond the normal processing times pending the determination of voluntary quit.

B. A level sanction as described in section 4.3108, below, will be imposed if voluntary quit occurred within sixty (60) calendar days prior to the date of application or after the date of application but prior to eligibility determination and the voluntary quit was without good cause as defined in

section 4.308.1.

1. Individuals who voluntary quit are ineligible to participate in SNAP and shall be treated as a disqualified member. If the disqualified member joins another household, the ABAWD disqualification period for that individual shall continue until the ABAWD disqualification period is completed.

C. An employee of the federal, state, or local government who participates in a strike against such a government and is dismissed from his or her job because of participation in the strike, will be considered to have voluntarily quit his or her job without good cause.

If an individual quits a job, secures new employment at comparable wages or hours, and, through no fault of his or her own loses the new job, the prior voluntary quit will not be a basis for 4.310.6 Suitable Employment Employment will be considered suitable, unless any of the following apply:

A. The wages offered are less than the higher of:

1. The applicable federal or state minimum wage.

2. Eighty percent (80%) of the federal minimum wage if neither the federal or state minimum wage is applicable.

B. The employment offered is on a piece-rate and the average hourly yield the employee can reasonably be expected to earn is less than the applicable hourly wage specified above.

C. The household member, as a condition of employment, is required to join, resign from, or refrain from joining any legitimate labor organization.

D. The work offered is at a site subject to a strike or lockout at the time of the offer unless the strike has been enjoined under the Labor Management Relations or the Railway Labor Act.

E. The household member that can demonstrate or the local office becomes aware that:

1. The degree of risk to the health and safety is unreasonable.

2. The client is physically or mentally unfit to perform the employment as established by documentary medical evidence or reliable information obtained from other sources.

3. The employment offered is not in his/her major field experience unless, after a period of thirty (30) calendar days from registration, job opportunities in his/her major field have not been offered.

4. The distance from the member’s home to the place of employment is unreasonable considering the expected wage and the time and cost of commuting.

5. The daily commuting time exceeds two (2) hours per day, not including the transporting of a child or children to and from a child care facility.

6. The distance to the place of employment prohibits walking and neither public nor private transportation is available to transport the member to the job site.

7. The working hours or nature of the employment interferes with the member’s religious observances, convictions, or beliefs. 4.310.7 Good Cause for Voluntary Quit and Suitable Employment The local office is responsible for determining good cause when a non-exempt individual appears to have voluntarily quit or failed to accept an offer of suitable employment. Good cause and/or lack of good cause must be clearly documented in the case file.

Good cause for voluntary quit includes circumstances beyond the household member’s control, such as, but not limited to:

A. Discrimination by an employer based on age, race, sex, color, handicap, religious beliefs, national origin or political beliefs;

B. Work demands or conditions that render continued employment unreasonable, such as working without being paid on schedule;

C. Acceptance by the individual of employment; or enrollment of at least half-time in any recognized school, training program, or institution of higher education, that requires the individual to leave D. Acceptance by any other household member of employment or enrollment at least half-time in any recognized school, training program, or institution of higher education in another county or political subdivision which requires the household to move and thereby requires the individual to leave employment;

E. Resignations by persons under the age of sixty (60) that are recognized by the employer as retirement;

F. Resignation from employment that does not meet suitable employment;

G. Because of circumstances beyond the control of the individual, accepted full time employment subsequently either does not materialize or results in employment of less than thirty (30) hours a week or weekly earning of less than the federal minimum wage multiplied by thirty (30) hours;

H. Leaving a job in connection with patterns of employment in which workers frequently move from one employer to another, such as migrant farm labor or construction work, even though employment at the new site has not actually begun;

I. Illness of the individual;

J. Illness of another household member requiring the presence of the individual;

K. A household emergency;

L. Unavailability of transportation;

M. Employer demands a reduction in participant’s work effort or salary through no fault of the employee; and N. Lack of adequate child care for children who have reached age 6 but are under age 12. 4.310.8 Level Sanction Periods A. If the local office determines that an individual has voluntarily quit or failed to accept suitable employment without good cause, that individual shall be ineligible to participate in SNAP and shall be treated as a disqualified member. If the disqualified member joins another household, the disqualification period for that individual shall continue until the disqualification period is completed.

1. The first (1st) time, the individual shall be disqualified for a period of one (1) month after the date the individual became ineligible.

2. The second (2nd) time an individual fails without good cause to comply with work requirements, the individual shall be disqualified for a period of three (3) months after the date the individual became ineligible.

3. The third (3rd) or subsequent time an individual fails without good cause to comply with work requirements, the individual shall be disqualified for a period of six (6) months after the date the individual became ineligible.

B. The disqualification period shall begin the month following the expiration of the Notice of Adverse Action unless a fair hearing is requested.

C. If the level sanction disqualified individual is the sole member of the SNAP household and then becomes exempt, the newly exempt individual can reapply for benefits. The newly exempt individual will be eligible based on the date of the application or if in the case of reinstatement, the date exemption information was provided to the local office.

D. If the level sanction disqualified individual is in a SNAP household with other eligible members and then becomes exempt, the newly exempt individual will be eligible based on the date exemption information was provided to the local office.

4.311 ABAWD WORK REQUIREMENTS

ABAWDs must fulfill an ABAWD work requirement in addition to the general work requirements. For the remainder of this section, client statement is considered acceptable verification unless questionable. If verification is requested from the client, case documentation must thoroughly explain why the original client statement was considered questionable.

A. The following individuals are not considered ABAWDs and are therefore not subject to the ABAWD work requirement:

1. Aged seventeen (17) or younger.

2. Aged fifty-five (55) or older.

3. Determined to be medically certified as physically or mentally unfit for employment. An individual is medically certified as physically or mentally unfit for employment if they:

A. Are receiving temporary or permanent disability benefits issued by governmental or private sources;

B. Are obviously mentally or physically unfit for employment as determined by the local office; or C. Provide a statement from a physician, physician’s assistant, nurse, nurse practitioner, designated representative of the physician’s office, a licensed or certified psychologist, a social worker, or any other qualified health professional as defined in 12-200-101 through 12-315-126, C.R.S., that the client is physically or mentally unfit for employment.

4. Residing in the same physical household with an individual who is under the age of eighteen (18). The minor individual does not have to be included in the same SNAP household for this exclusion to apply.

B. To fulfill the ABAWD work requirement, the ABAWD must be:

1. Working 20 hours per week or averaged monthly for a total of 80 hours a month; or a. Working includes:

i. Work completed in exchange for money (compensated work); or ii. Work completed in exchange for goods or services (in-kind work); or iii. Unpaid work verified by the provider of the unpaid work; or iv. Any combination of compensated work, unpaid work, or in-kind work.

2. Participating in and complying with the requirements of a work program 20 hours per week or averaged monthly for a total of 80 hours a month; or a. A work program includes:

i. A program of employment and training operated or supervised by the CDHS program other than a job search program or a job search training program;

ii. A program under the Workforce Innovation and Opportunity Act (WIOA);

iii. A program under Section 236 of the Trade Act of 1974 (19 USC 2296, “Trade Adjustment Assistance”).

3. In any combination of working and participating in a work program for a total of 20 hours per week or averaged monthly for a total of 80 hours a month; or 4. Participating in and complying with the Colorado Workfare program.

Failure to meet the ABAWD work requirement will result in the ABAWD losing eligibility if they accrue three countable months within a thirty-six (36) calendar month period. 4.311.1 ABAWD Exemptions Any individual who meets the definition of an ABAWD can be exempt from the ABAWD work requirement by meeting one of the follow exemptions:

A. Exempt from the general work requirements;

B. Pregnancy;

C. A person experiencing homelessness, as defined in Section 4.000.1;

D. Veterans;

E. Aged twenty-four (24) years and younger and in Foster Care on their eighteenth (18th) birthday;

F. Exempt under a waiver approved by the USDA, FNS; or G. Exempt using Colorado defined state exemptions as identified in the current SNAP Employment and Training State Plan. 4.311.2 Changes in ABAWD Exemption Status ABAWDs are not required to report changes in their exemption status during a certification period.

However, if the ABAWD loses their exemption status during a certification period, the months the ABAWD was not exempt will count toward their three countable months in a thirty-six (36) calendar month period.

Any remaining months of benefits received during that certification period are not considered overissuances and claims will not be established. 4.311.3 ABAWD Time Limits ABAWDs are not eligible to participate in SNAP if they have received SNAP benefits for more than three countable months during a thirty-six (36) month period.

However, ABAWDs may be eligible for up to three additional consecutive months after regaining eligibility in accordance with paragraph (C) of this section.

A. Countable months 1. Countable months are accrued when an ABAWD received SNAP benefits for the full benefit month but did not:

A. Meet an exemption; or B. Fulfill their work requirements.

2. When an individual turns eighteen years old (18) and enters ABAWD status, they do not accrue a countable month in the month they turn eighteen (18). If they do not meet an ABAWD exemption, they will begin to accrue countable months in the month after the month in which they turn eighteen (18).

B. Good cause for countable months If an ABAWD would have worked an average of twenty (20) hours per week but missed some work for good cause, the ABAWD shall be considered to have me the work requirement if the absence from work is temporary and the individual retains work.

Good cause for countable months shall include circumstances beyond the individual’s control, such as, but not limited to, illness, illness of another household member requiring the presence of the member, a household emergency, or the unavailability of transportation.

C. The ABAWD time limit clock:

1. Counts accrued countable months for all ABAWDs who are not in compliance with work requirements and do not have an exemption; and 2. Resets accrued countable months and ABAWD disqualifications, regardless of start date, for all ABAWDs every thirty-six (36) calendar months starting July 1, 2023.

D. Regaining Eligibility 1. An individual who is denied eligibility under this provision can regain eligibility if in a thirty (30) calendar day period, the individual:

a. Worked eighty (80) or more hours;

b. Participates in and complies with the requirements of a work program for eighty (80) or more hours;

c. Participates and complies with the Workfare Program as described in section 4.313; or d. Becomes exempt.

2. The individual will be reinstated if otherwise eligible and will continue to be eligible if the individual continues to meet the work requirement or is exempt.

3. If an individual regains eligibility but then fails to continue meeting these requirements, the individual shall remain eligible for a consecutive three-month period after the individual notifies the local office. The individual can only have this provision applied for a single three-month period in the thirty-six (36) calendar month period. 4.312 Employment First (EF)

In Colorado, the Employment and Training program is called EF. The purpose of the program is to assist members of households participating in SNAP in gaining skills, training, work, or experience that will increase their ability to obtain employment.

CDHS must submit an annual Employment and Training State Plan for approval by the USDA, Food and Nutrition Service. A copy of the CDHS Employment and Training plan is available at https://cdhs.colorado.gov/benefits-assistance/employment-assistance/colorado-employment-first.

The EF program is a voluntary work program for SNAP applicants and recipients. Failure to participate with the EF program will not result in a work requirement disqualification. 4.312.1 County Administration Requirements for EF Local offices choosing to administer an EF program shall submit a county plan as prescribed by CDHS and shall operate their EF program in alignment with the CDHS Employment and Training plan. Failure to adhere to the requirements as described in the CDHS Employment and Training plan will result in a Corrective Action Plan (CAP).

Local offices may enter into a contractual agreement for all or any part of the EF program service delivery.

These contractual agreements shall be reviewed by CDHS for adherence to the program requirements before implementation.

A. Every EF program must monitor ABAWDs who choose to use EF to meet their ABAWD work requirement to ensure they are meeting ABAWD work requirements. This monitoring may include obtaining employment or volunteer working hours information and/or ensuring the ABAWD is participating in an allowable Employment First component as set forth in the annual CDHS Employment and Training plan and the specific county EF plan.

B. The EF provider shall:

1. Deliver case management services as prescribed in the CDHS EF State Plan;

2. Compile data and submit required reports within prescribed timeframes;

3. Coordinate program operations with the state EF staff, in accordance with the annual CDHS Employment and Training plan as well as the specific county EF plan;

4. Ensure that participants receive the appropriate reimbursement for participation, such as actual costs of transportation or other costs as outlined in the CDHS Employment and Training plan;

5. Utilize required forms as prescribed or approved by the state;

6. Attend scheduled EF program meetings and training as required;

7. Ensure that all funds expended are allowable program costs per the annual CDHS Employment and Training plan;

8. Ensure program services are not suspended for longer than fourteen (14) consecutive days for any reason;

9. Ensure that any exemptions discovered through working with participants are communicated to county eligibility 4.313 Colorado Workfare Program In Colorado, the Section 20 Workfare Program of the Food and Nutrition Act of 20018 (codified at 7 USC 2029) is called the Colorado Workfare Program.

CDHS must submit an annual Section 20 Workfare State Plan for approval by the USDA, FNS. A copy of the CDHS Section 20 Workfare plan is available at https://cdhs.colorado.gov/benefitsassistance/employment-assistance/colorado-employment-first. 4.313.1 County Administration Requirements for Workfare Local offices choosing to administer a Colorado Workfare program shall submit a county plan as prescribed by CDHS and shall operate their Workfare program in alignment with the CDHS Section 20 Workfare plan. Failure to adhere to the requirements as described in the CDHS Section 20 Workfare plan will result in a Correct Action Plan (CAP).

4.400 FINANCIAL ELIGIBILITY CRITERIA

Income shall be considered prospectively for the issuance month based on the eligibility technician’s determination of the household's reasonably anticipated monthly income, and for households eligible under Standard Eligibility as outlined in Section 4.206, the value of its resources is considered. 4.401 Income Eligibility Standards A. Income eligibility is determined based on the composition of the household. A household shall meet the gross and net monthly income eligibility standards as outlined in this section. See

section 4.401.1 and 4.401.2 for the gross and net percentages of the Federal Poverty Levels.

1. ECE households must have gross income below two hundred percent (200%) of the federal poverty level.

2. BCE households shall be deemed as having met gross and net income limits.

3. Households that are not considered ECE or BCE and are instead subject to SE rules shall meet income eligibility standards as follows:

a. Households that do not include a member who is aged sixty (60) and older or a person with a disability shall have gross income at or below one hundred thirty percent (130%) of the federal poverty level and have a net income at or below one hundred percent (100%) of the federal poverty level.

b. Households that include a member who is aged sixty (60) and older or a person with a disability shall have a net income at or below one hundred percent (100%) of the federal poverty level.

4. For household members who are persons that are aged sixty (60) and older and/or have a disability, who are unable to purchase and prepare meals because they suffer from a disability considered permanent under the Social Security Act, or a non-disease related, severe, permanent disability, may be considered, together with his or her spouse if the spouse is living in the same home, a separate household from the others with whom the individual lives. The combined income of the others with whom the individual who is aged sixty (60) and older and a person with disabilities resides (excluding the income of the individual who is aged sixty (60) and older and a person with disabilities and his or her spouse) must not exceed one hundred sixty-five percent (165%) of the poverty level.

B. Ineligible students and household members who are ineligible due to citizenship status, intentional program violation, failure to cooperate with work programs, or failure to provide or apply for a Social Security Number, shall be excluded when determining the household size and the appropriate income eligibility maximum and/or level of benefits. 4.401.1 Gross Income Limits Effective October 1, 2025, the gross income levels for one hundred thirty percent (130%), two hundred percent (200%), and one hundred sixty-five percent (165%) of the federal poverty level for the corresponding household size are as follows:

Household Size 130% Gross Income 200% Gross Income 165% Gross Income 1 $1,696 $2,610 $2,152 2 $2,292 $3,526 $2,909 3 $2,888 $4,442 $3,665 4 $3,483 $5,360 $4,421 5 $4,079 $6,276 $5,177 6 $4,675 $7,192 $5,934 7 $5,271 $8,110 $6,690 8 $5,867 $9,026 $7,446 +$596 +$918 +$757 4.401.2 Net Income Levels Effective October 1, 2025, the net income level of one hundred percent (100%) of the federal poverty level for the corresponding household size is as follows:

Household Size 100% Net Income Level 1 $1,305 2 $1,763 3 $2,221 4 $2,680 5 $3,138 6 $3,596 7 $4,055 8 $4,513 +$459 4.402 HOUSEHOLD INCOME ELIGIBILITY A. Determining Income 1. Income eligibility shall be determined prospectively based on the eligibility technician’s anticipation of income at the time of application and when changes are made known to the local office.

2. When determining if a household is eligible under gross and/or net income limits, households shall have income converted to a monthly amount by using a conversion as specified below. When a full month's income is anticipated any cents in the gross weekly or biweekly earnings shall be used in converting income to a monthly amount.

Pay Frequency Conversion Weekly Multiply Weekly Average by 4.3.

Bi-Weekly (Every Two Weeks) Multiply Bi-Weekly Average by 2.15.

Semi-Monthly (Twice a Month) Multiply Semi-Monthly Average by 2.

Every Other Month Multiply Average by 0.5.

Quarterly Multiply Average by 0.333333.

Twice a Year Multiply Average by 0.166666.

Annual Multiply Average by .083.

3. Household income shall mean all earned and unearned income received or anticipated to be received by household members from whatever source, unless specifically exempted for Food Assistance eligibility and budgeting purposes, per Section 4.405. Income of household members, including the amount of the disqualified person's income attributed to the household, shall be counted as income in the month received or the month it becomes available, unless the income is averaged over the certification period.

B. Variations in Date of Pay 1. Regular ongoing earned income that is received early or late by a household due to a holiday, a weekend, or pay dates being changed will have income counted based on the regular pay schedule instead of the actual date of pay.

2. Households receiving monthly benefits such as public assistance or social security payments shall not have their monthly income varied merely because mailing cycles resulted in two (2) payments in one month and none in the next month.

3. Households containing a member of the Armed Services of the United States shall not have their monthly income varied merely because the first day of the month falls on a holiday or weekend which resulted in two (2) payments in the month and none in the subsequent month.

C. Wage Data 1. With respect to income or resource information originating with the Internal Revenue Service (IRS) and provided through the income and eligibility verification system (IEVS), as well as wage data obtained through the DOLE or IEVS, the local office must verify such information from another source and must verify applicant/participant access to that income/resource. The local office may not take adverse action on such information until independent verification is obtained, or until the applicant has been found to have failed to cooperate in providing the required verification. The information must also be verified prior to establishing a claim for an over-issuance of benefits. 4.402.1 Prospective Budgeting A. Prospective budgeting is the process of computing a household's allotment based on anticipated income and circumstances during the issuance month. All SNAP households and all situations require prospective budgeting determinations, including Public Assistance (PA) households under the TANF /Colorado Works Program.

B. If the date of receipt or the amount of any anticipated income is uncertain, such as a new job or a PA application, that portion of income shall not be considered. Only the portion of income which can be anticipated with reasonable certainty concerning the amount and month in which monies will be received shall be counted as income.

C. Income received within the past thirty (30) days may be used as an indication of the income that will be received in the issuance month unless changes in income have occurred or can be anticipated which require proper adjustment. Income used to determine prospective eligibility shall be representative of the household’s current circumstances.

If the verified income does not provide an accurate indication of anticipated income, a longer period of past time may be used if it will provide a more accurate indication of anticipated income.

If a household's income fluctuates seasonally, it may be appropriate to use the last season rather than the last thirty (30) days, although precaution must be taken to account for possible fluctuations or new circumstances. Except for eligible strikers, no household shall have the amount of any past income automatically attributed to it. 4.402.2 Averaging Income To obtain a household's average monthly income, income intended to cover a specific period of time is divided by the number of months the income is intended to cover.

A. Income shall be averaged for:

1. Households who derive their annual income from self-employment. These households shall have their income annualized over a twelve (12) month period even if the income is received within a shorter period of time.

2. Households who derive their annual income from contract income shall have that income averaged over a twelve (12) month period. (This requirement is not applied to income from a contract received on an hourly or piecework basis.)

3. Households receiving educational income as defined in Section 4.404, D. The income is prorated over the period of time it was intended to cover.

4. Other households not previously mentioned, such as migrant or seasonal workers, may elect to have their fluctuating income averaged over the period of time the income is intended to cover.

Self-employment income, contract income, and fluctuating income intended to cover a specific period of time shall not be averaged or annualized for migrant households that are destitute of income as defined in Section 4.406.

B. The types of households listed above shall have their self-employment income, contract income, or educational monies annualized or prorated, and added to other household income to determine monthly income for SNAP.

C. To average income prospectively, the eligibility technician shall use the household's anticipation of income, considering fluctuations, to obtain a monthly average amount for the period of certification. The number of months used to arrive at the average income need not be the same as the number of months in the certification period, such as the known income from two (2) previous months may be averaged and projected for each month of a certification period that is longer than two (2) months. Refer to Section 4.403.11 for more information on computing selfemployment income.

Fluctuating income that has been averaged may be adjusted if verification of a change in circumstances is received.

4.403 COUNTABLE EARNED INCOME

The following shall be considered as earned income:

A. Wages and Salaries 1. All payments for services as an employee, including garnishments, or money payments legally obligated to the employee and diverted to a third party for the employee's household expenses. Countable income from employment received by students in institutions of higher education while participating in state work-study programs or a fellowship with a work requirement shall not be considered earned income.

2. Earned income includes government payments from Agricultural Stabilization and Conservation Service and wages of AmeriCorps Volunteers in Service to America (VISTA) workers. VISTA payments are excluded if the client was receiving SNAP benefits when they joined VISTA. If the client was not receiving SNAP benefits when they joined VISTA, the VISTA payments shall count as earned income. Temporary interruptions in SNAP participation shall not alter the exclusion once an initial determination has been made (see Section 4.405.2, A, 3). Temporary interruptions shall be defined as a period where a household or individual missed a full month of benefits, excluding instances where the lapse in benefits is due to the local office not taking timely action in accordance with the processing standards outlined in Sections 4.604, 4.205, or 4.209.1.

3. Wages held at the request of the employee shall be considered income to the household in the month the wages would otherwise have been paid by the employer. Advances on wages shall count as income in the month received, if reasonably anticipated. However, wages held by the employer as a general practice shall not be counted as income unless the household anticipates that it will receive income from such wages previously withheld by the employer.

When an advance on wages is subsequently repaid from current wages, only the wages received is considered as income. The amount of repayment is disregarded, even if the wage-earner was not a SNAP participant at the time of the advance.

4. Payment for sick leave, vacation pay, and bonus pay shall be considered as earned income, if the person was still employed while receiving the pay.

B. Training Allowances 1. Payments from vocational and rehabilitation programs recognized by federal, state, or local governments, such as the Job Opportunities and Basic Skills (JOBS) Program, to the extent they are not a reimbursement, except for allowances paid under the Workforce Innovation and Opportunity Act (WIOA).

2. Earned income will include earnings to individuals who are participating in the on-the-job training under Section 204(5), Title II, of the Workforce Innovation and Opportunity Act (WIOA). This provision does not apply to household members under nineteen (19) years of age who are under the parental control of another adult member. Earnings include monies paid by the Workforce Innovation and Opportunity Act (WIOA) and monies paid by an employer.

C. Title I Monies Payments received under Title I (VISTA-University Year of Action) of the Domestic Volunteer Service Act of 1973 shall be considered earned income and subject to the earned income deduction, excluding payments made to those households specified in Section 4.405.2.

D. Income of Strikers Pre-strike eligibility is determined by considering the day prior to the strike as the day of application and assuming the strike was not occurring. Eligibility at the time of application shall be determined by comparing the striking member's income as of the day before the strike to the striking member's current income and adding the higher of the two to the current income of the non-striking household members during the month of application.

E. Self-Employment The method of ascertaining the self-employment income to be considered for SNAP purposes is often difficult and the guidelines set forth in Sections 4.403.1–4.403.12 are meant to clarify and aid the process.

In determining gross self-employment income, all income received by the self-employment household must be considered. Self-employment income includes:

1. Monies received from rental or lease of self-employment property. Rental property shall be considered a self-employment enterprise. However, the income will be considered as earned income only if the household member (or disqualified person) actively manages the property at least an average of twenty (20) hours per week.

2. Monies received from the sale of capital goods, services, and property connected to the self-employment enterprise. Proceeds of sales from capital goods or equipment are to be treated as income rather than as capital gains.

The term “capital gains”, as used by the Internal Revenue Service (IRS), describes the handling of the profit from the sale of capital assets such as, but not limited to, computers and other electronic devices, office furniture, vehicles, and equipment used in a selfemployment enterprise; or securities, real estate, or other real property held as an investment for a set time period. For SNAP purposes, the total amount received from the sale of capital goods shall be counted as income to the household.

F. Owners of Limited Liability Corporations (LLC) and S-Corporations For SNAP purposes, owners of LLCs or S-Corporations are considered employees of the corporation and, therefore, cannot be considered self-employed. The income from these types of corporations should be treated as regular earned income, not self-employment income.

If the owner of the LLC or S-Corporation takes a draw, the total business income minus all expenses will count as earned income for the client. If the owner receives a salary, we count all payments for services as an employee as regular earned income. There are situations where the owner of an LLC or S-Corporation may receive a salary and a draw, so both sources of income must be counted.

Client statement of LLC and S-Corporation income is acceptable, unless questionable. If the income meets the SNAP definition of questionable, verification can be provided in the form of pay stubs, bank records, the LLC or S-Corporation owner’s individual form 1040, or any other document that sufficiently establishes countable earned income for the owner.

G. Boarder Income The income of boarders shall include all direct payments to the household for room and meals, including contributions to the household for shelter expenses. Shelter expenses paid directly by boarders to someone outside of the household shall not be counted as income to the household.

See Section 4.403.2 regarding calculating income from a boarder. 4.403.1 Self-Employment See Section 4.403, E, for a description of what is considered self-employment income.

A. Self-employment is defined as a situation where some or all income is received from a selfoperated business or enterprise in which the individual retains control over work or services offered, and assumes the necessary business risks and expenses connected with the operation of the business.

Households in which one or more members are engaged in an enterprise for gain either as an independent contractor, franchise holder, or owner-operator must be considered as selfemployed, provided that the members are actively engaged in the enterprise on a day-to-day

basis. In instances where the members hire or contract for another person or firm to handle the day-to-day activities of such enterprise, the members will have self-employment income but will not be considered as self-employed for purposes of work registration. The self-employed individual need not own one hundred percent (100%) of the company to be considered selfemployed.

B. The receipt of income from self-employment, which may constitute all or only a portion of the income of the household, does not automatically exempt the members from the work registration requirement. This determination will be made based on the assessment of the eligibility technician and the household’s declaration that the self-employment enterprise requires thirty (30) hours of work per week or averages annually thirty (30) hours per week. 4.403.11 Determining Monthly Income from Self-Employment The amount of income considered from self-employment in the month of application shall be the gross amount of anticipated income plus capital gains less anticipated costs of doing business.

A. To determine average income from self-employment, the worker first must determine the gross amount of income, actual or anticipated, including capital gains, for the period of time over which the self-employment income is being considered. The allowable costs of producing the selfemployment income are excluded and the net income divided by the number of months over which the income is intended to cover. For federal income tax purposes, only fifty percent (50%) of the proceeds from the sale of capital goods is taxed. Therefore, if income tax forms are used to determine household income, the eligibility technician must be aware that the full amount of the capital gains is counted as income.

B. Allowable costs of doing business include, but are not limited to: identifiable costs of labor; stock; raw materials; seed; fertilizer; payments on the principal of the purchase price of income producing real estate; capital assets, equipment, machinery and other durable goods; interest paid to purchase income-producing property; insurance premiums; taxes paid on incomeproducing property; and, other similar items that are necessary costs of doing business.

C. The following shall not be allowed as a deduction for business costs:

1. Any amount that exceeds the payment a household receives from a boarder for lodging and meals is not allowable as a cost of doing business.

2. Any amount claimed as a net loss sustained in any prior period.

3. Federal, state, and local income taxes, money set aside for retirement purposes, and other work-related personal expenses (such as meals). These expenses are accounted for by the earned income deduction. However, any taxes paid by the business for employees (such as the business share of social security taxes) are allowed as a business deduction.

D. Anticipating Capital Gains and Other Self-Employment Income When self-employment income is calculated on an anticipated basis, any capital gains that the household anticipates receiving in the next twelve (12) months, beginning with the date the application is filed, are added, and divided by twelve (12). This amount is used in successive certification periods over the next twelve months unless a change occurs. A new average monthly amount must be calculated over this twelve-month period if the anticipated amount of capital gains changes. The anticipated monthly amount of capital gains and the anticipated monthly selfemployment income then are added and the anticipated cost of producing the income deducted.

The cost is calculated by anticipating the monthly allowable costs of producing the selfemployment income.

The monthly net self-employment income will be added to any other earned and unearned income received by the household to determine eligibility of self-employed SNAP applicants.

For those households with self-employment income, which is not annualized, the eligibility technician shall anticipate income. Any anticipated proceeds from the sale of capital gains shall be used as income in the month the proceeds are anticipated to be received. 4.403.12 Averaging Self-Employment Income Self-employment income must be averaged over the period for which the income is intended to cover, as outlined below:

A. Self-Employment as Primary Annual Support When a household receives its annual support from self-employment income, such income is to be averaged over twelve (12) months to determine the household's average monthly income from this source. This policy applies even if the income is received in only a short period of time or the household receives income from other sources in addition to the self-employment income.

However, if the averaged, annualized amount does not accurately reflect the household's actual circumstances because the household has experienced a substantial increase or decrease in business, the worker must calculate the self-employment income on anticipated earnings and not on the basis of prior income.

B. Self-Employment as Partial Support Households may receive income from self-employment that represents only a part of their annual income. Such self-employment income must be averaged over the self-employment months rather than over a twelve (12) month period.

C. Self-Employment Income Received Monthly Self-employment income received on a monthly basis and representing a household's annual support normally will be averaged over twelve (12) months. If the monthly average does not accurately reflect the household's actual financial situation because of a substantial increase or decrease in business, the worker must calculate self-employment income based on the household's anticipated earnings.

D. Self-Employment Income from a New Source Income from a self-employment enterprise that has been in business less than a year is to be averaged over the period of time the business has been in operation and the monthly amount projected for the coming year.

E. Self-Employment Income of a Farmer 1. If after deducting all allowable business expenses from gross income received from selfemployment as a farmer, the costs of producing the income exceed the income derived, such losses shall be offset against other income received by the household. Steps to take in offsetting the loss shall be as noted below. The net losses shall be prorated over the period intended and the monthly prorated amount deducted from other monthly income.

2. For purposes of applying this rule, an individual shall be considered a self-employed farmer if they receive or expect to receive gross annual income of one thousand dollars ($1,000) or more from the farm enterprise. In addition, the following steps shall be taken when determining eligibility and benefits levels of the self-employed farmer.

a. The monthly prorated loss shall be deducted first from any other “selfemployment” income.

b. Any remaining loss will then be deducted from other earned income into the household. This total shall be the figure from which the earned income deduction shall be calculated.

c. Finally, any other income shall be added, and this total shall be the amount used to compare the household's gross income to income eligibility standards for the appropriate-sized household. 4.403.2 Boarder Income Persons paying a reasonable amount for room and board shall be excluded from the household when determining the household's eligibility and benefit level. The income of households owning and operating a commercial boarding house shall be handled as described in Section 4.403.11. For all other households, payments from the boarder shall be treated as self-employment income and the household's eligibility determined as follows:

A. The income from boarders shall include all direct payments to the household for room and meals, including contributions to the household for shelter expenses. Shelter expenses paid directly by boarders to someone outside of the household shall not be counted as income to the household.

B. After determining the income received from the boarders, the local office shall exclude that portion of the boarder payment which is the cost of doing business. The cost of doing business shall be equal to either of the following costs, provided that the amount allowed as a cost of doing business shall not exceed the payment the household received from the boarder for lodging and meals.

1. The value of the maximum allotment for the household size that is equal to the number of boarders;

2. The actual documented cost of providing room and meals if the actual cost exceeds the appropriate maximum allotment. If actual costs are used, only separate and identifiable costs of providing room and meals to boarders shall be allowed as a cost of doing business; or, 3. If the boarder income received is from foster care payments, the entire amount of the payment will be disregarded as a cost of doing business.

C. The monthly net income (after subtracting costs of doing business) from self-employment shall be added to other monthly earned income and the twenty percent (20%) earned income deduction shall be applied to the total dollar amount.

D. Shelter costs the household actually incurs, even if the boarder contributes to the household for

part of the household's shelter expenses, shall be computed to determine if the household will receive a shelter deduction. However, the shelter costs shall not include any shelter expenses paid directly by the boarder to a third party, such as to the landlord or the utility company. 4.403.3 School Employee Income The provisions of this section are intended to apply primarily to teachers and other school employees.

A. Households with members who receive income other than that which is paid on an hourly piecework basis from employment under a contract which is renewable on an annual basis will have such income averaged over a twelve (12) month period to determine household eligibility.

B. Such members will be considered to be receiving compensation for an entire year, even though predetermined non-work periods are involved or actual compensation is scheduled for payment during work periods only. The renewal process may involve a signing of a new contract each year, be automatically renewable, or, as in cases of school tenure, rehire rights may be implied and thus preclude the use of a written contract altogether. The fact that such a contract is in effect for an entire year does not necessarily mean that the contract will stipulate work every month of the year. Rather, there may be certain predictable non-work periods or vacations, such as the summer break between school years.

C. Income from such a contract will be considered as compensation for a full year, regardless of the frequency of compensation as stipulated in the terms of the contract, as determined at the convenience of the employer, or as determined at the wish of the employee.

D. The annual income household members receive from contractual employment described above shall be averaged over a twelve (12) month period to determine the member's average monthly income. To determine household eligibility all other monthly income from other household members will be added to this average monthly income. 4.404 Countable Unearned Income Unearned income shall include, but not be limited to, the following:

A. Assistance Payments Payment from federal or federally aided public assistance programs, such as Supplemental Security Income (SSI), or Colorado Works/Temporary Assistance to Needy Families (TANF)/Title IV-A, or other assistance programs based on need, including payments from programs which require, as a condition of eligibility, the actual performance of work without compensation other than the assistance payments themselves.

B. Retirement and Disability Payments Payments from annuities; pensions; retirement; veterans or disability benefits; workmen's or unemployment compensation; old age, survivors, or Social Security benefits; and strike benefits.

C. Support and Alimony Payments Support and alimony payments made directly to the household from non-household members for normal living expenses.

D. Rental Income Rental income is total income, less the cost of doing business, from rental property in which a household member (or disqualified individual) is not actively managing the property an average of at least twenty (20) hours a week.

E. Income of Non-Citizen Sponsors Income of non-citizen sponsors shall be considered as unearned income to households containing sponsored non-citizens.

F. Vacation Pay, Sick Pay, and Bonus Pay If vacation pay, sick pay, or bonus pay is received in installment payments after a person has terminated employment, it is considered unearned income. If the pay is received in a lump sum, it shall be considered as a resource in the month received.

G. Gifts Gifts from nonprofit organizations that exceed three hundred dollars ($300) in a quarter or gifts from other sources of any amount, if they can be anticipated.

H. Other Gain or Benefits Dividends, interest, royalties, and all other nonexempt direct money payments from any source that can be construed to be a gain or benefit.

Monies withdrawn from trust funds are income in the month received. Dividends that the household has the option of either receiving as income or reinvesting in the trust must be considered as income in the month they are available to the household.

I. Substantial Lottery or Gambling Winnings Substantial lottery or gambling winnings as defined in section 4.000.1 will be counted as unearned income in the month received. If multiple individuals shared in the purchase of a ticket, hand, or similar bet, then only the portion of the winnings allocated to the member of the SNAP household would be counted in the eligibility determination. 4.405 Exempt Income Income from certain sources will be excluded for SNAP eligibility purposes under mandate of law. Only the following will not be considered as income:

A. Irregular Income Any income in the certification period that is received too infrequently or irregularly to be reasonably anticipated, but not in excess of thirty dollars ($30) in three (3) months.

B. Monies Intended for Non-Household Members Monies received and used for the care and maintenance of a third-party beneficiary who is not a household member. If the intended beneficiaries of a single payment are both household and non-household members, any identifiable portion of the payment intended and used for the care and maintenance of the non-household member shall be excluded. If the non-household member's portion cannot be readily identified, the payment shall be evenly prorated among the intended beneficiaries and the exclusion applied to the non-household member's pro rata share or the amount actually used for the non-household member's care and maintenance, whichever is less.

C. Earnings of Children The earned income of children who are under eighteen (18) years of age, who live with their natural parent, adoptive parent, stepparent, or are under the parental control of another household member other than a parent and are students at least half-time in elementary school, high school, or classes to obtain a General Equivalency Diploma (GED), will be considered exempt income.

If the student becomes eighteen (18) years of age in the month of application, the income shall be excluded for the month of application and counted the following month. If the student turns eighteen (18) during the certification period, their income shall be excluded until the month following the month in which the student turns eighteen (18).

D. Recoupments The following recoupments or repayments from any nonexempt income source shall be exempt as income as follows:

1. Monies withheld from an assistance payment, earned income, or monies received from any nonexempt income source that is voluntarily or involuntarily returned to repay a prior overpayment received from that income source. Only the net income received from these sources shall be considered countable income. However, monies withheld from a federal, state, or local means-tested program (such as Title IV-A, State Old Age Pension), for purposes of recouping an overpayment which resulted from the household's intentional failure to comply with that program's requirements, shall not be exempted as income, and the gross income received from these sources shall be considered countable income.

See Section 4.705 for specific instructions.

2. Child support payments received by Title IV-A participants that the household must transfer to the agency administering Title IV-D of the Social Security Act, in order to maintain their Title IV-A eligibility.

E. Non-recurring Lump Sum Payments Money received in the form of non-recurring lump sum payments, includes, but is not limited to, income tax refunds, rebates, or credits; retroactive lump-sum Social Security, SSI, public assistance, railroad retirement benefits or other payments; or retroactive lump-sum insurance settlements; or any money an inmate receives upon release from prison, including earnings from work performed while incarcerated and accumulated over the length of the incarceration.

State and county diversion payments under Colorado Works shall be excluded as a non-recurring lump sum payment if the payment does not cover more than ninety (90) days of expenses and is not expected to occur again in a twelve (12) month period.

Non-recurring lump sum payments shall be counted as resources in the month received, unless specifically excluded from consideration as a resource by other federal laws. Any funds remaining in subsequent months shall be considered a resource.

F. Loans 1. All loans from private individuals as well as commercial institutions shall not be considered as income, including educational loans.

2. Monies received from a Reverse Annuity Mortgage (RAM) loan program should be treated as a loan and excluded from income. These loans meet the accepted definition of a loan since there is a verifiable agreement to repay with interest.

G. In-Kind Benefits An in-kind benefit is any gain or benefit received by the household that is not in the form of money such as meals, clothing, public housing, or produce from a garden.

H. Vendor Payments A payment made on behalf of a household shall be considered a vendor payment whenever a person or organization outside of the household uses its own funds to make a direct payment to either the household's creditors or a person or organization providing a service to the household.

Vendor payments are excludable as follows:

1. Such payments include subsidies paid to the households and legally obligated to the landlord, rent or mortgage payments made directly to landlords or mortgagees by the Department of Housing and Urban Development (HUD), or payments by a government agency to a child-care institution to provide day care for a household member are also excluded as vendor payments.

2. Monies that are legally obligated and otherwise payable to the household, but which are diverted by the provider of the payment to a third party for household expense, shall be counted as income and not excluded as a vendor payment. The distinction is whether the person or organization making the payment on behalf of a household is using funds that otherwise would need to be paid to the household.

3. Any emergency Public Assistance (PA) or General Assistance (GA) payment that is provided to a third party on behalf of the migrant or seasonal farm worker household, while the household is in the job stream, shall be excluded as income and considered as a vendor payment. These payments would normally be considered as income since the payment is legally obligated to the household.

4. Wages earned by a household member that are garnished or diverted by an employer and paid to a third party for a household's expenses, such as rent, shall be considered as income. However, if the employer pays a household's rent directly to the landlord in addition to paying the household its regular wages, this rent payment shall be excluded as a vendor payment. In addition, if the employer provides housing to an employee, the value of the housing shall not be counted as income.

5. Assistance provided to a third party on behalf of a household by the state or local program shall be considered money payable directly to the household if the assistance is provided in lieu of:

a. A regular benefit payable to the household for living expenses under a program funded under Part A of the Social Security Act; or, b. A benefit payable to the household for housing expenses under a state or local general assistance program or other assistance program comparable to general assistance.

6. Assistance payments made to a third party for medical, child-care, or emergency/special assistance would be excluded as a vendor payment. Assistance payments provided by a state or local housing authority would also be excluded as income.

7. Energy assistance payments, other than for the Low-Income Energy Assistance Program (LEAP) or a one-time payment under federal or state law for weatherization or to repair/replace an inoperative furnace or other heating or cooling device, that are made under a state or local program shall be counted as income. The exclusion will still apply if a down payment is made and is followed by a final payment upon completion of work. If a state law prohibits the household from receiving a cash payment under state or local general assistance (or comparable program), the assistance would be excluded. This applies to either an energy assistance payment or other type of payment.

Energy assistance payments for an expense paid on behalf of the household under a state law shall be considered an out-of-pocket expense incurred and paid by the household. Energy assistance payments made under Part A of Title IV of the Social Security Act (42 U.S.C. 601 through 42 U.S.C. 619) are included as income.

8. Vendor payments which would normally be excluded as income but are converted in whole or in part to a direct cash payment under the approval of a federally authorized demonstration project (including demonstration projects created by a waiver of the provisions of federal law) shall be excluded from income.

9. Monies from alimony or a court-ordered child support payment which are required by a court order (or other legally binding agreement) to be paid to a third party rather than to the household shall be excluded from income as a vendor payment, even if the household agrees to the arrangement.

10. Payments more than the amount specified in a court order (or other legally binding agreement) which are paid to a third party in addition to a court-ordered vendor payment shall also be treated as a vendor payment.

I. Reimbursements 1. Reimbursement for past or future expenses, to the extent they do not exceed actual expenses, and do not represent a gain or benefit to the household shall not be considered income.

To be excluded, the reimbursement must be provided specifically and used for an identified expense, other than normal living expenses, and used for the purpose intended. When a reimbursement, including a flat allowance, covers multiple expenses, each expense does not have to be separately identified as long as none of the reimbursement covers normal living expenses. Reimbursements for normal household living expenses such as rent or mortgage, personal clothing, or food eaten at home are a gain or benefit and, therefore, are not exempt.

2. No portion of benefits provided under Title IV-A of the Social Security Act, to the extent such benefit is attributed to an adjustment for work related or child care expenses, except for payment or reimbursement for such expenses made under an education, employment, or training program initiated under such Title after September 18, 1988, shall be considered exempt under this provision.

3. The amount by which a reimbursement exceeds the actual incurred expense shall be counted as income. However, reimbursements shall not be considered to exceed actual expenses unless the provider or the household indicates the amount is excessive.

4. Types of reimbursement for expenses include:

a. Reimbursement or flat allowances for job or training related expenses, such as travel, per diem, uniforms, and transportation to and from the job or training site including migrant travel.

b. Reimbursements for out of pocket expenses of volunteers incurred in the course of their work.

c. Medical or dependent care reimbursements.

d. Reimbursements received by households to pay for services provided by Title XX of the Social Security Act.

e. Reimbursements made to the household for expenses necessary for participation in an education component under the Employment First program.

J. Verification Documentation of exempt income may explain a household's ability to maintain itself. Verification of exempt income is necessary only if the income is questionable. For example, when it is questionable that money received is a loan, a simple statement signed by both parties must be obtained which states that the money is a loan and that a repayment is being made or will be made.

If the household receives payments on a regular basis from the same source but claims that payments are loans, it may be required that the provider of the loan sign an affidavit stating that repayments are being made or will be made in accordance with an established repayment schedule. 4.405.1 Loans and Reimbursements to Students All education assistance including grants, scholarships, fellowships, work-study, veteran's educational benefits, and any other money received specifically for educational expenses are exempt from consideration as income. 4.405.2 Income Excluded by Other Federal Statutes The following government payments are received for a specific purpose and are excluded as income.

A. General 1. P.L. No. 89-642, Section 11(b) of the Child Nutrition Act of 1966, as amended, excludes the value of assistance to children under this Act.

2. Reimbursement from the Uniform Relocation Assistance and Real Property Acquisition Policy Act of 1970, as amended, (P.L. No. 91-646, Section 216).

3. Any payment to volunteers under Title II (RSVP, Foster Grandparents and others) of the Domestic Volunteer Services Act of 1972, as amended, (P.L. No. 93-113).

Payments under Title I (AmeriCorps Volunteers in the Service of America/VISTA including University Year for Action and Urban Crime Prevention Program) to volunteers shall be excluded for those individuals receiving SNAP or PA at the time they joined the Title I Program, except that households which are receiving an income exclusion for a VISTA or other Title I Subsistence Allowance at the time of conversion to the Food Assistance Act of 1977 shall continue to receive an income exclusion for VISTA for the length of their volunteer contract in effect at the time of conversion. Temporary interruptions in SNAP participation shall not alter the exclusion once an initial determination has been made. New applicants who are not receiving PA or SNAP at the time they joined VISTA shall have these volunteer payments included as earned income.

4. P.L. No. 101-610, Section 17(d), 11/16/90, National and Community Service Act (NCSA) of 1990, as amended, provides that Section 142(b) of the Job Training Partnership Act (JTPA) applies to projects conducted under Title I of the NCSA as if such projects were conducted under the JTPA. Title I includes three Acts:

a. Serve-America: the Community Service, Schools and Service-Learning Act of 1990, as amended.

b. American Conservation and Youth Service Corps Act of 1990, as amended.

c. NCSA, as amended.

There are approximately forty-seven (47) different NCSA programs and they vary by state. Most of the payments are made as a weekly stipend or for educational assistance.

The Higher Education Service-Learning program and the AmeriCorps umbrella program come under this title. The National Civilian Community Corps (NCCC) is a federally managed AmeriCorps program. The Summer for Safety program is an AmeriCorps program under which participants earn a stipend and a one thousand dollar ($1,000) post-service educational award. The National and Community Service Trust Act of 1993 (P.L. No. 103-82) amended the NCSA but did not change the exclusion.

P.L. No. 93-288, Section 312(d), the Disaster Relief Act of 1974, as amended by P.L. No. 100-707, Section 105(i), the Disaster Relief and Emergency Assistance Amendments of 1988. Payments precipitated by an emergency or major disaster as defined in this Act, as amended, are not counted as income for SNAP purposes. This exclusion applies to Federal assistance provided to persons directly affected and to comparable disaster assistance provided by states, local governments, and disaster assistance organizations.

A major disaster is any natural catastrophe such as a hurricane or drought, or, regardless of cause, any fire, flood, or explosion, which the President determines causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement the efforts and available resources of states, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby.

An emergency is any occasion or instance for which the President determines that Federal assistance is needed to supplant state and local efforts and capabilities to save lives and to protect property and public health and safety, or to lessen or avert the threat of a catastrophe.

Payments made to homeless people with funds from Federal Emergency Management Assistance (FEMA) to pay for rent, mortgage, food, and utility assistance when there is no major disaster or emergency are not excluded under this provision.

6. Payments, allowances and earnings under the Workforce Innovation and Opportunity Act (WIOA) are excluded as income. Earnings paid for on-the-job training are still counted for SNAP. On-the-job training payments for members under nineteen (19) years of age who are participating in WIOA Programs and are under the parental control of an adult member of the household shall be excluded as income. The exclusion shall apply regardless of school attendance and/or enrollment as outlined in Section 4.405, C. Onthe-job training payments under the Summer Youth Employment and Training Program are excluded from income.

7. P.L. No. 99-425, Section(e), the Low-Income Home Energy Assistance Act, 1986.

Payments or allowances made under any federal laws for the purpose of energy assistance. P.L. No. 104-193 states that any payment or allowances made for the

purpose of providing energy assistance under a federal law other than Part A of Title IV of the Social Security Act (42 U.S.C. 601 through 42 U.S.C. 619), or a one-time payment, or allowance made under federal or state law for the cost of weatherization, or emergency repair or replacement of an unsafe or inoperative furnace or other heating or cooling device is excluded from income.

8. Payments received from the Youth Incentive Entitlement Pilot Projects, the Youth Community Conservation and Improvement Projects, and under the Title IV of the Comprehensive Employment and Training Act Amendments of 1978 (P.L. No. 95-524).

9. P.L. No. 100-175, Section 166, Older Americans Act. Funds received by persons fiftyfive (55) years of age and older under the Senior Community Service Employment Program under Title V of the Older Americans Act are excluded from income. State agencies and eight organizations receive funding under Title V. The eight organizations are: Green Thumb, National Council on Aging, National Council of Senior Citizens, American Association of Retired Persons, U.S. Forest Service, National Association for Spanish Speaking Elderly, National Urban League, National Council on Black Aging.

10. Payments in cash donations, based upon need, from one or more private, nonprofit charitable organizations, but not exceeding three hundred dollars ($300) in the aggregate, per fiscal quarter (P.L. No. 100-232).

11. The portion of a military retirement payment, which goes to an ex-spouse under a divorce decree property settlement, is not counted as income to the retiree. (P.L. No. 97-252, Uniform Service Former Spouse Protection Act.) These payments are excluded as vendor payments.

12. Military combat payments received by a member of the United States Armed Forces deployed to a designated combat zone shall be excluded from the household income for the duration of the member’s deployment as long as the additional payment was not received immediately prior to serving in a combat zone.

13. Mandatory deductions from military pay for education purposes while the individual is enlisted. (P.L. No. 99-576, Veterans' Benefits Improvement and Health-Care Authorization Act of 1986, Section 303(a) (1)). Section 216 of P.L. No. 99-576 authorizes stipends for participation in study of Vietnam-Era veterans' psychological problems which are not excluded from income.

14. Payments to U.S. citizens of Japanese ancestry and resident Japanese non-citizens of up to twenty thousand dollars ($20,000) each and payments to certain eligible Aleuts of up to twelve thousand dollars ($12,000) each (P.L. No. 100-383, Civil Liberties Act of 1988).

15. Emergency assistance payments made by a state or local agency for migrants or seasonal farm-workers in the job stream (P.L. No. 100-387).

16. Benefits received from the special supplemental food program for women, infants and children (WIC), including benefits that can be exchanged for food at farmers' markets or

part of a WIC demonstration project (P.L. No. 92-443). This payment is excluded as an in-kind benefit (P.L. No. 100-435, Section 501, amended, Child Nutrition Act).

17. P.L. No. 100-485, Section 301, the Family Support Act, 10/31/88 which amended Section 402(g)(1)(E) of the Social Security Act. The value of any child-care payments made under Title IV-A of the Social Security Act, including transitional child-care payments, are excluded from income.

18. Payments made from the Agent Orange Settlement Fund (P.L. No. 101-201). All payments from the Agent Orange Settlement fund or any other fund established pursuant to the settlement in the Agent Orange product liability litigation are excluded from income retroactive to January 1, 1989.

The veteran with disabilities will receive yearly payments. Survivors of deceased veterans with disabilities will receive a lump-sum payment. These payments were disbursed by the AETNA insurance company.

P.L. No. 102-4, Agent Orange Act of 1991, 2/6/91, authorized veterans' benefits to some veterans with service-connected disabilities resulting from exposure to Agent Orange.

These VA payments are not excluded by law.

19. P.L. No. 101-508, Section 5801, which amended Section 402(i) of the Social Security Act, 11/5/90. At-risk block grant child care payments made under section 5801 are excluded from being counted as income for SNAP purposes and no deduction may be allowed for any expense covered by such payments.

20. P.L. No. 101-508, the Omnibus Budget Reconciliation Act of 1990, Title XI Revenue Provisions, Section 11111, Modifications of Earned Income Tax Credit, subsection (b) provides that any earned income tax credit shall not be treated as income. This provision is effective with taxable years beginning after December 31, 1990.

21. Any payment made to an Employment First participant for costs that are reasonably necessary and directly related to participation in the Employment First Program. These costs include, but are not limited to, dependent care costs, transportation, other expenses related to work, training or education, such as uniforms, personal safety items, or other necessary equipment, and books or training manuals. These costs shall not include the cost of meals away from home. Also, the value of any dependent care services provided for or arranged by the Employment First Unit is excluded.

22. Amounts necessary for the fulfillment of a Plan for Achieving Self-Support (PASS) under Title XVI of the Social Security Act (P.L. No. 102-237). This money may be spent in accordance with an approved PASS or deposited into a PASS savings account for future use.

23. Any money received from the Radiation Exposure Compensation Trust Fund pursuant to P.L. No. 101-426 as amended by P.L. No. 101-510.

24. P.L. No. 102-586, Section 8, amended the Child Care and Development Block Grant Act Amendments of 1992 by adding a new Section 658S to exclude the value of any childcare provided or arranged, or any amount received as payment for such care or reimbursement for costs incurred for such care from income for purposes of any other federal or federally assisted program that bases eligibility, or the amount of benefits, on need.

25. P.L. No. 101-625, Section 22(i), Cranston-Gonzales National Affordable Housing Act, (42 U.S.C.S. 1437t(i)), provides that no service provided to a public housing resident under this section (Family Investment Centers) may be treated as income for purposes of any other program or provision of state or federal law.

This exclusion applies to services such as child-care employment training and counseling, literacy training, computer skills training, assistance in the attainment of certificates of high school equivalency, and other services. The exclusion does not apply to wages or stipends.

P.L. No. 101-625, Section 522(i)(4), excludes most increases in the earned income of a family residing in certain housing while participating in HUD demonstration projects authorized by P.L. No. 101-625. Demonstration projects are authorized by P.L. No. 101- 625 for Chicago, Illinois, and three other locations. The affected offices will be contacted individually regarding these projects.

26. P.L. No. 103-286, Section 1(a), Section 1(a), provides in part that payments made to individuals because of their status as victims of Nazi persecution shall be disregarded in determining eligibility for and the amount of benefits or services to be provided under any federal or federally assisted program which provides benefits or services based, in whole or in part, on need.

27. Amendments to Section 1403 of the Crime Act of 1984 (42 U.S.C. 10602) provides in

part that, notwithstanding any other law, if the compensation paid by an eligible crime victim compensation program would cover costs that a federal program or a federally financed state or local program would otherwise pay:

a. Such crime victim compensation program shall not pay that compensation.

b. The other program shall make its payments without regard to the existence of the crime victim compensation program.

Based on this language, payments received under this Program must be excluded from income for SNAP purposes.

28. P.L. No. 104-204, requires that allowances paid under this law to children of Vietnam veterans who were born with spina bifida be excluded from income.

B. American Indian or Alaska Native Usually a law will specify payments to members of a tribe or band, and the law will apply to the members enrolled in the tribe or band wherever they live. The individuals should have documentation showing where the payments originate.

1. P.L. No. 92-203, section 29, dated 1/2/76, the Alaska Native Claims Settlement Act, and

Section 15 of P.L. No. 100-241, 2/3/88, the Alaska Native Claims Settlement Act Amendments of 1987 - All compensation, including cash, stock, partnership interest, land, interest in land, and other benefits, received under this Act are excluded.

2. P.L. No. 93-134, the Judgment Award Authorization Act, as amended by P.L. No. No. 97- 458, Section 1407, 11/12/83 and P.L. No. 98-64, 8/2/83, the Per Capita Distribution Act.

P.L. No. 97-458 required the exclusion of per capita Payments under the Indian Judgment Fund Act (judgment awards) of two thousand dollars ($2,000) or less from income. The exclusion applies to each payment made to each individual. P.L. No. 98-64 extended the exclusion to cover per capita payments from funds which are held in trust by the Secretary of Interior (trust fund distributions).

P.L. No. 93-134, the Indian Tribal Judgment Fund Use or Distribution Act, Section 8, 10/19/73, as amended by P.L. No. 103-66, Section 13736, 10/7/93, provides that interest of individual Indians in trust or restricted lands up to two thousand dollars ($2,000) per year received by individual Indians that is derived from such interests shall not be considered income in determining eligibility for assistance under the Social Security Act or any other federal or federally assisted program. The two thousand dollar ($2,000) limit is based on calendar years from January through December.

3. P.L. No. 93-531, section 22 - Relocation assistance payments to members of the Navajo and Hopi Tribes are excluded from income and resources.

4. P.L. No. 94-114, section 6, 10/17/75 - Income derived from certain sub-marginal land held in trust for certain Indian tribes is excluded from income. The tribes that shall benefit are:

a. Bad River Band of the Lake Superior Tribe of Chippewa b. Indians of Wisconsin c. Blackfeet Tribe d. Cherokee Nation of Oklahoma e. Cheyenne River Sioux Tribe f. Crow Creek Sioux Tribe g. Lower Brule Sioux Tribe h. Devils Lake Sioux Tribe i. Fort Belknap Indian Community j. Assiniboine and Sioux Tribes k. Lac Courte Oreilles Band of Lake Superior Chippewa Indians l. Keweenaw Bay Indian Community m. Minnesota Chippewa Tribe n. Navajo Tribe o. Oglala Sioux Tribe p. Rosebud Sioux Tribe q. Shoshone-Bannock Tribes r. Standing Rock Sioux Tribe 5. P.L. No. 94-189, Section 6, 12/31/75 - Funds distributed per capita to the Sac and Fox Indians or held in trust are excluded from income. The funds are divided between members of the Sac and Fox Tribe of Oklahoma and the Sac and Fox Tribe of the Mississippi in Iowa. The judgments were awarded in Indian Claims Commission dockets numbered 219, 153, 135, 158, 231, 83, and 95.

6. P.L. No. 94-540 - Payments from the disposition of funds to the Grand River Band of Ottawa Indians are excluded from income.

7. P.L. No. 95-433, section 2 - Indian Claims Commission payments made pursuant to this Public Law to the Confederated Tribes and Bands of the Yakima Indian Nation and the Apache Tribe of the Mescalero Reservation are excluded from income.

8. P.L. No. 96-420, section 9(c), 10/10/80, Maine Indian Claims Settlement Act of 1980 - Payments made to the Passamaquoddy Tribe, the Penobscot Nation, and the Houlton Band of Maliseet are excluded from income.

9. P.L. No. 97-403 - Payments to the Turtle Mountain Band of Chippewas, Arizona, are excluded from income.

10. P.L. No. 97-408 - Payments to the Blackfeet, Grosventre, and Assiniboine tribes, Montana, and the Papago, Arizona, are excluded from income.

11. P.L. No. 98-123, Section 3, 10/13/83 - Funds distributed to members of the Red Lake Band of Chippewa Indians are excluded from income. Funds were awarded in docket number 15-72 of the United States Court of Claims.

12. P.L. No. 98-124, Section 5 - Per capita and interest payments made to members of the Assiniboine Tribe of the Fort Belknap Indian Community, Montana, and the Assiniboine Tribe of the Fort Peck Indian Reservation, Montana, under this Act are excluded from income. Funds were awarded in docket 10-81L.

13. P.L. No. 98-500, Section 8, Old Age Assistance Claims Settlement Act, provides that funds made to heirs of deceased Indians under this Act shall not be considered as income nor otherwise used to reduce or deny SNAP benefits except for per capita shares more than two thousand dollars ($2,000). The first two thousand dollars ($2,000) of each payment is excluded.

14. P.L. No. 99-146, Section 6(b), 11/11/85 - Funds distributed per capita or held in trust for members of the Chippewas of Lake Superior are excluded from income. Judgments were awarded in Dockets Numbered 18-S, 18-U, 18-C, and 18-T.

a. Dockets 18-S and 18-U are divided among the following reservations:

1) Wisconsin 2) Bad River Reservation 3) Lac du Flambeau Reservation 4) Lac Courte Oreilles Reservation 5) Sokaogon Chippewa Community 6) Red Cliff Reservation 7) St. Croix Reservation 8) Michigan 9) Keweenaw Bay Indian Community (L'Anse, Lac Vieux Desert, and Ontonagon Bands)

10) Minnesota 11) Fond du Lac Reservation 12) Grand Portage Reservation 13) Nett Lake Reservation (including Vermillion Lake and Deer Creek)

14) White Earth Reservation b. Under dockets 18-C and 18-T funds are given to the Lac Courte Oreilles Band of the Lake Superior Bands of Chippewa Indians of the Lac Courte Oreilles Reservation of Wisconsin, the Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, the Sokaogon Chippewa Community of the Mole Lake Band of Chippewa Indians, and the St. Croix Chippewa Indians of Wisconsin.

15. P.L. No. 99-264, White Earth Reservation Land Settlement Act of 1985, 3/24/86, Section 16 excludes moneys paid from income. This exclusion involves members of the White Earth Band of Chippewa Indians in Minnesota.

16. P.L. No. 99-346, Section 6(b) (2) - Payments to the Saginaw Chippewa Indian Tribe of Michigan are excluded from income.

17. P.L. No. 99-377, Section 4(b), 8/8/86, - Funds distributed per capita to the Chippewas of the Mississippi or held in trust under this Act are excluded from income. The judgments were awarded in Docket Number 18-S. The funds are divided by reservation affiliation for the Mille Lac Reservation, Minnesota; White Earth Reservation, Minnesota; and Leech Lake Reservation, Minnesota.

18. P.L. No. 101-41, 6/21/89, the Puyallup Tribe of Indians Settlement Act of 1989, Section 10 (b) provides that nothing in this Act shall affect the eligibility of the Tribe or any of its members for any Federal program. Section 10(c) provides that none of the funds, assets, or income from the trust fund established in section 6(b) shall at any time be used as a

basis for denying or reducing funds to the tribe or its members under any Federal, State, or local program. (The Puyallup Tribe is located in the State of Washington.)

19. P.L. No. 101-277, 4/30/90, funds appropriated in satisfaction of judgments awarded to the Seminole Indians in dockets 73, 151, and 73-A of the Indian Claims Commission are excluded from income except for per capita payments in excess of two thousand dollars ($2,000). Payments were allocated to the Seminole Nation of Oklahoma, the Seminole Tribe of Florida, the Miccosukee Tribe of Indians of Florida, and the independent Seminole Indians of Florida.

20. P.L. No. 101-503, Section 8(b), Seneca Nation Settlement Act of 1990, dated November 3, 1990, provides that none of the payments, funds, or distributions authorized, established, or directed by this Act, and none of the income derived therefrom shall affect the eligibility of the Seneca Nation or its members for, or be used as a basis for denying or reducing funds under, any federal program.

21. P.L. No. 103-436, 11/2/94, Confederated Tribes of the Colville Reservation Grand Coulee Dam Settlement Act, Section 7(b) provides that payments made pursuant to the Act are totally excluded from income.

4.406 HOUSEHOLDS DESTITUTE OF INCOME

Migrant or seasonal farm worker households may be considered destitute of income upon initial certification or recertification, but only for the first month of each certification period.

A. Migrant or seasonal farm worker households may have little or no income at the time of application even though they receive income at some time during the month of application. Such households will be considered destitute and thereby entitled to expedited application processing if their only income is from a terminated and/or new source under the following circumstances:

1. The household's only income for the month of application was received from a terminated source prior to the date of application.

a. Income is considered to be from a terminated source if it is normally received on a monthly or more frequent basis and is not expected to be received again from the same source during either the remainder of the month of application or the month following (i.e., migrant work ended with one grower).

b. Income that is normally received less often than monthly is considered to be from a terminated source if it is not anticipated to be received during the month in which it would normally be received (i.e., quarterly income not received in the normal third month).

2. The household's only income for the month of application is more than twenty-five dollars ($25) from a new source and it will not be received by the tenth (10th) calendar day after the filing date of an application for initial certification, or by the tenth calendar day after the household's normal issuance cycle if the application is for recertification.

a. Income is considered to be from a new source if the income of more than twentyfive dollars ($25) is normally received on a monthly or more frequent basis but has not been received from that source within thirty (30) calendar days prior to the filing date of application.

b. Income is considered to be from a new source if the income of more than twentyfive dollars ($25) is normally received less often than monthly but was not received within the last normal interval between payments.

3. The household's only income is a combination of that received from a terminated source prior to date of application and income of more than twenty-five dollars ($25) received in the month of application from a new source, which will not be received by the tenth (10th) calendar day after the date of initial application, or by the tenth (10th) calendar day after the household's normal issuance cycle if application is for recertification.

B. A migrant farm worker's source of income shall be considered to be the particular grower, and not the crew chief. A migrant who moves from one grower to another shall be considered to have moved from a terminated source to a new source.

C. There is no limit on the number of times a household can be considered destitute of income provided that before each subsequent expedited certification, the household either has completed the verification requirements that were postponed at the last expedited certification or the household was certified under normal processing standards since the last expedited certification. 4.406.1 Income Calculation When Destitute of Income A. Destitute households shall have their eligibility and level of benefits calculated for the month of application by considering only that income received between the first of the month and the date of application. It if is an initial month application, the first application or an application received after the household's last certification period expired, the allotment for the initial month shall be prorated to cover days from date of application to the end of the month.

B. If income of more than twenty-five dollars ($25) from a new source has not been received or is not anticipated within ten (10) calendar days from the date of initial application or within ten (10) calendar days after the household's normal issuance cycle if applying for recertification, it shall be disregarded.

C. Travel advances provided by an employer to reimburse travel costs of relocation of a new employee is exempt income and does not affect the destitute status of a household. If the travel advance is, by written contract, an advance of wages that will be subtracted from wages later earned by the employee, the money is considered as income but shall not affect the determination of whether subsequent payments from the employer are from a new source of income nor whether the household shall be considered destitute.

4.407 DEDUCTIONS AND EXCLUSIONS FROM INCOME

A. Allowable deductions are subtracted from total monthly gross income to determine the household's monthly net SNAP income.

Allowable expenses will not be deductible if covered by vendor payments such as HUD, or reimbursements, such as insurance. An expense which is covered by an excluded vendor payment that has been converted to a direct cash payment under a federally authorized demonstration project shall not be deductible.

B. Households may elect to have fluctuating monthly expenses averaged over the certification period. Also, households have the option of having expenses that are billed less often than monthly averaged over the period the expense is intended to cover. Households may elect to have medical expenses averaged as described in Sections 4.407.6 and 4.407.61. Expenses that have been averaged are subject to the reporting requirements contained in Section 4.603.

C. Actual or averaged expenses that result in deductions for medical, dependent care, and shelter costs shall be anticipated. Households who expect changes cannot have their expenses averaged solely on the basis of the last several bills. Expenses that are billed on a weekly or biweekly basis shall be converted to a monthly figure utilizing the conversion outlined in Section 4.402.

D. Legally obligated child support is considered an income exclusion.

E. The following subsections contain the only deductions allowed from a household's monthly income. The deductions are as follows:

1. Standard deduction 2. Earned income deduction 3. Excess shelter deduction 4. Dependent care deduction 5. Excess medical deduction 4.407.1 Standard Deduction A standard deduction of 8.31% of the federal poverty income guidelines for the household size as described in Section 4.401.2 will be used to calculate the amount that is allowed to all households. The established standard amount will be adjusted annually as announced by FNS, USDA. The calculation of 8.31% of the federal poverty income guidelines for eligible members will be used for all households up to the household size of six (6). All households with six (6) or more eligible members will use the six (6) person standard deduction.

Standard Deduction Amount Household Size 1-3 4 5 6+ Effective October 1, 2025 $209 $223 $261 $299 4.407.2 Earned Income Deduction A. A household with earned income shall receive a deduction of twenty percent (20%) of its gross nonexempt earned income. The twenty percent (20%) deduction shall also apply to prorated income earned by the disqualified member and attributed to the household.

B. The earned income deduction will not be applied to any portion of income earned under a work supplementation or work support program that is attributable to a federal, state, or local public assistance program.

An Inadvertent Household Error (IHE) claim that is due to earned income being reported in an untimely manner will be calculated without allowing the twenty percent (20%) earned income deduction 4.407.3 Excess Shelter Deduction A. Households shall receive a deduction for the allowable monthly shelter costs that are in excess of fifty percent (50%) of the household's income after all other deductions. Shelter expenses are allowed as billed to a household member or as paid or billed to a disqualified individual. Shelter costs that are paid by or billed to a person disqualified for fraud shall be allowed as a deduction for eligible members in their entirety. Shelter costs, paid or billed to a person disqualified for being an ineligible non-citizen or for failure to provide a Social Security Number shall be divided evenly among all household members and the disqualified individual. All except the disqualified person's pro rata share is counted as a shelter cost of the household.

B. A shelter deduction cap, as specified below, applies to households that do not contain a person who is aged sixty (60) and older or a person with a disability as defined in Section 4.000.1. Those households containing a person who is aged sixty (60) and older and/or a person with a disability shall receive an excess shelter deduction for the monthly cost of shelter that exceeds fifty percent (50%) of the household's monthly income after all other applicable deductions.

Shelter Deduction Cap Effective October 1, 2025 $744 C. Households in which all individuals are experiencing homelessness and are not receiving free shelter throughout the calendar month shall be entitled to use a standard estimate of shelter expenses.

The FNS, USDA, provides an update of this estimated figure annually when the shelter cap for other households is adjusted. The Homeless Shelter Deduction is as follows:

Homeless Shelter Deduction Effective October 1, 2025 $198.99 All households experiencing homelessness that incur, or reasonably expect to incur, shelter costs during a month shall be eligible for the estimate, unless higher shelter costs are verified, at which point the household may use actual shelter costs rather than the estimate.

Households experiencing homelessness that incur no shelter costs during the month shall not be eligible for the homeless shelter deduction.

If a household experiencing homelessness has difficulty in obtaining traditional types of verification of shelter costs, the eligibility technician shall use the prudent person principle in determining if verification obtained is adequate.

D. A household may claim both the costs of its actual residence and those for a home that is not occupied by the household because of: employment or training away from home; illness; or abandonment caused by a natural disaster or casualty loss.

For costs of a home vacated by the household to be included in the household's shelter costs, the household must intend to return to the home; the current occupants of the home, if any, must not be claiming the shelter costs for SNAP purposes; and the home must not be leased or rented during the absence of the household.

E. Allowable shelter costs shall include only the following:

1. Continuing charges for the shelter, including rent, mortgages, condo, and association fees or other continuing charges leading to the ownership of the shelter such as loan repayments for the purchase of a mobile home, including interest on such payments.

a. If a homeowner has drawn money down in a reverse mortgage and now wants to make monthly payments to repay some of the amount drawn, the repayment shall be considered a charge leading to the ownership of a home, such as a loan repayment. To be deductible, the charge must be continuing. If the household expects to make monthly payments, the client’s charges are considered to be continuing, and the repayments shall be allowed as a shelter cost. If the repayment is not continuing, it does not meet the requirement and the payments shall not be allowed as a shelter deduction.

b. Payments on loans secured by a lien placed on the property by the lending institution, such as a second mortgage or home equity loan, shall be considered a continuing charge for shelter. Payments on unsecured loans or personal loans are not considered shelter costs.

c. Expenses incurred to keep a pet that are billed separately from the household’s rent are not allowable as shelter deductions.

2. Property taxes, state and local assessments, and insurance on the structure itself, but not separate costs for insuring furniture or personal belongings.

3. Charges to repair or rebuild a home substantially damaged or destroyed due to a natural disaster such as a fire or flood. Allowable expenses are those that have not been, and will not be, reimbursed by private or public relief agencies, insurance companies, or any other source.

4. Utility costs which include charges for heating and cooking fuel; water and sewer; well installation and maintenance; septic tank installation and maintenance; garbage and trash collection fees; and, fees charged by the utility provider for initial installation of the utility.

5. A telephone allowance for one telephone or the cost of telephone service that is associated with a specific device, which includes land-line service or cellular service, including disposable cell phones, and voice over internet protocol (VOIP). Households are not allowed to deduct the cost of pay phones and of phone cards that are not associated with a specific device. One-time deposits shall not be included as shelter costs. With regard to VOIP, only the cost of VOIP is deductible; other charges such as Internet connectivity fees and monthly cable/internet fees are not deductible. 4.407.31 Four-Tiered Mandatory Standard Utility Allowance Effective October 1, 2008, a four-tiered mandatory standard utility allowance deduction was implemented in determining a household’s excess shelter deduction. Households cannot claim actual utility expenses and are only entitled to one (1) of the four (4) utility allowances. The four (4) utility allowances shall be reviewed annually and adjusted each year, based on federal approval, to reflect Colorado's cost of utilities. No utility expenses can be allowed as an income exclusion for self-employed households when a mandatory utility allowance is given to the household.

When determining expedited eligibility, the appropriate utility allowance shall be applied when establishing the household’s shelter costs.

The four (4) allowances are as follows:

A. Heating and Cooling Utility Allowance (HCUA)

1. “Cooling costs” are defined as utility costs relating to the operation of air conditioning systems, room air conditioners, swamp coolers, or evaporative coolers. Fans are not an allowable cooling cost. A heating and cooling utility allowance (HCUA) is available only to households that:

a. Incur or anticipate heating or cooling costs separate and apart from their rent or mortgage;

b. Received a Low-Income Energy Assistance Program (LEAP) or an Energy Electronic Benefit Transfer (E-EBT) payment within the previous twelve (12) month period, regardless of whether the individual is still residing at the address for which they received the LEAP or E-EBT payment;

c. Live in private rental housing and are billed by their landlords on the basis of individual usage or charged a flat rate separately from their rent for heating and cooling;

d. Share a residence and incur at least a portion of the heating or cooling cost, in which case each household will be entitled to the full HCUA; or, e. Live in public housing and are responsible for excess heating and/or cooling costs.

2. A SNAP household, which incurs or anticipates heating or cooling costs on an irregular

basis, may continue to receive the HCUA between billing periods.

3. The operation of a space heater, electric blanket, heat lamp, cooking stove, and similar appliances, as a supplemental heating source, are allowable costs when determining eligibility for the basic utility allowance (BUA), but do not qualify a household for the HCUA.

4. The HCUA standard is as follows:

HCUA Standard Effective October 1, 2025 $594 B. Basic Utility Allowance (BUA)

1. The Basic Utility Allowance (BUA) is mandated for any households that are not entitled to the HCUA and that incur at least two (2) non-heating or non-cooling utility costs, such as electricity, water, sewer, trash, cooking fuel, or telephone.

2. If more than one SNAP household shares in paying non-heating or non-cooling utility costs of the dwelling, the full BUA will be allowed for each SNAP household sharing in the utility costs.

3. The BUA standard is as follows:

BUA Standard Effective October 1, 2025 $377 C. One Utility Allowance (OUA)

1. The OUA is mandated for any household that is not entitled to the HCUA or BUA but is responsible for only one (1) non-heating or one (1) non-cooling utility expense. The OUA is not allowed if the household’s only utility expense is a telephone.

2. If more than one (1) SNAP household shares in paying one (1) non-heating or one (1) non-cooling utility cost of the dwelling, the full OUA will be allowed for each SNAP household sharing in the utility cost.

3. The OUA standard is as follows:

OUA Standard Effective October 1, 2025 $71 D. Telephone allowance 1. The telephone allowance is available to households whose only utility cost is for a telephone. If more than one SNAP household shares in paying the telephone costs, and that is the only utility cost of the dwelling, the full phone standard will be allowed for each SNAP household sharing in the telephone costs.

2. The telephone allowance is as follows:

Telephone Standard Effective October 1, 2025 $97 4.407.4 Dependent Care Deduction Refer to Section 4.407.6 if the attendant care is for a household member who is age sixty (60) or older or who receives SSI or Social Security disability payments. The attendant costs, including meals provided, shall be considered as a medical expense.

A. Dependent care expenses, as billed to a household member or as paid by or billed to a person disqualified for being an ineligible non-citizen or failure to provide or apply for a SSN, for the care of a child or dependent with disabilities shall be considered when the dependent care expenses are necessary for a household member to accept or continue employment, seek employment, or attend training or pursue education which is preparatory to employment. Dependent care expenses that are paid by or billed to the disqualified person shall be divided equally among all household members and the disqualified person. All except the disqualified member's pro rata share is considered for a deduction.

The dependent care deduction that is paid by or billed to individuals disqualified for intentional Program violation/fraud will be allowed in its entirety.

Allowable dependent care costs include:

1. The cost of care given by an individual care provider or care facility;

2. Transportation costs to and from the care facility. Mileage expenses must be calculated based on the prevailing Internal Revenue Service (IRS) business rate published annually at https://www.irs.gov/tax-professionals/standard-mileage-rates; and 3. Activity or other fees associated with the care provided to the dependent that are necessary for the household to participate in the care.

B. The total dollar amount that the household is responsible to pay for dependent care expenses is deductible.

C. Only direct monetary payments to an agency or a person outside of the household will be allowable. The value of in-kind benefits paid to an attendant, such as meals, is not considered for a dependent care deduction.

D. A child care expense which is reimbursed or paid for by the JOBS program under Title IV-F of the Social Security Act or the Transitional Child Care (TCC) program shall not be a deductible expense. 4.407.5 Child Support Expense Exclusion A. A household shall receive an exclusion from income for legally binding child support payments made to or for non-household members. The child support exclusion will be made from the household's total countable gross income and prior to any gross income test to determine eligibility. The court-ordered amount and the most recent amounts that have been paid must be verified by the household. Legally obligated child support paid by a household member under the age of eighteen (18) shall be an allowable exclusion, even if the income of the child is considered exempt under Section 4.405, C.

B. If the noncustodial parent makes child support payments to a third party non-household member (e.g., a landlord, utility company, or health insurance organization) in accordance with the support order, the payment shall be included in the child support exclusion.

C. A deduction for amounts paid toward arrearage will be allowed. Alimony payments will not be allowed as an exclusion.

D. Households with a history of three (3) or more months of paying child support shall have the support payments averaged taking into account any anticipated changes in the legal obligation and shall use that average as the household's support exclusion.

E. For households with less than a three (3) month record, the local office shall estimate the anticipated payments and use that estimate as the household's support exclusion.

F. If the household does not report and verify its monthly child support payment or a change in its legal obligation, the child support exclusion shall not be allowed. 4.407.6 Excess Medical Deduction A household shall receive a deduction for total medical expenses more than thirty-five dollars ($35) per month, incurred by any household member(s) who is aged sixty (60) and older or a person with disabilities. Other household members who are not aged sixty (60) and older or a person with disabilities, including spouses and dependents, cannot claim costs of their medical treatment and services.

A. The following medical costs, less the cost of reimbursements from another source, are allowable:

1. Medical and dental care including psychotherapy and rehabilitation services provided by a licensed practitioner or other qualified health professional as defined in 12-200-101 through 12-315-126, C.R.S.

2. Hospitalization or outpatient treatment, nursing care, and nursing home care including payments by the household for an individual who was a household member immediately prior to entering a hospital or nursing home provided by a facility recognized by the Colorado Department of Public Health and Environment.

3. Prescription drugs when prescribed by a licensed practitioner authorized under state law and other over-the-counter medication (including insulin) when approved by a licensed practitioner or other qualified health professional. Costs of medical supplies, sickroom equipment (including rental), or other prescribed equipment may also be allowable.

4. Health and hospitalization insurance policy premiums, Medicare premiums, and any costsharing expenses incurred by medical recipients.

5. Dentures, hearing aids, prosthetics, and eyeglasses prescribed by a physician skilled in eye disease or by an optometrist.

6. Securing and maintaining a service animal, such as a seeing eye or hearing dog, including cost of food and veterinarian fees. The costs of caring for these animals may be deducted only when the animal has received special training to provide a service to the client.

7. Reasonable transportation and lodging to obtain medical treatment or services. Mileage expenses shall be calculated based on the prevailing Internal Revenue Service (IRS) commercial mileage rate.

8. Wages to an attendant, homemaker, home health aide, child-care services, or a housekeeper necessary due to age, infirmity, or illness. In addition, an amount equal to the maximum allotment for one (1) person is allowed if the household furnishes the majority of the attendant's meals. The allotment shall be the one in effect at the time of certification with an appropriate adjustment at the next certification.

If attendant care costs qualify under both medical and dependent care deduction, the costs shall be allowed as a medical expense.

In cases when the household claims a deduction for billed medical expenses and the household is unable to verify whether any reimbursement will be received, no medical expense deduction shall be allowed until the household either receives reimbursement for all or part of the expense or is able to verify that reimbursement will not be provided.

When such reimbursement is received and/or verified, the non-reimbursed portion of the claimed medical expense is allowed.

B. Non-allowable medical costs include, but are not limited to:

1. Special diet expenses;

2. Premiums for health and accident policies, such as those payable in lump sum settlements for death or dismemberment, or policies for income maintenance such as those that continue mortgage or loan payments while the beneficiary is a person with disabilities;

3. Medical expenses that are reimbursable by insurance or other public or private sources;

4. Medical marijuana;

5. Vitamins and supplements unless prescribed by a physician; and 6. Medical expenses carried forward from past billing periods unless one (1) of the following conditions is met:

a. The amount is being carried forward pending reimbursement information; or, b. The household has arranged to make monthly installments on the past due bills.

The past due amount must be due to missed payments under a previous repayment agreement with the medical provider, and the payment plan is now being renegotiated with the provider. The negotiation of a payment plan with a collection agency will not be accepted as a renegotiated payment plan; or, c. Households that become categorically eligible for SNAP by reason of becoming a pure SSI household shall be entitled to excess medical expenses for the period for which they are authorized to receive SSI or from the date of the SNAP application, whichever is later. Restored benefits shall be issued if appropriate;

d. Medical expenses that occur after the application filing date and reported at the subsequent application for recertification or periodic report shall be considered if the medical expense has not previously been reported and allowed as a medical deduction. If at recertification the household provides previously unreported medical expenses that occurred prior to the last certification period that are past due, the local office shall review the medical expenses under provisions a through c of this subsection. 4.407.61 Determining Monthly Medical Expenses A. A household that contains a member who is eligible for a medical expense deduction is eligible for a deduction using either the Standard Medical Expense Deduction (SMED) or using actual medical expenses. Beginning October 1, 2016, the SMED is one hundred sixty-five dollars ($165).

The SMED is used if the total verified medical expenses are greater than thirty-five dollars ($35) and less than or equal to the SMED. The household may claim actual expenses if the total verified expenses, after deducting the first thirty-five dollars ($35), exceed the SMED.

At ... Then allow ... And verify ...

Application, if the household has medical expenses greater than $35 and less than or equal to the SMED, The SMED, The household has medical expenses greater than $35.verification must be received to allow the SMED.

Application, if the household has monthly medical expenses greater than the SMED after subtracting the first $35, Actual medical expenses, The actual monthly medical expense(s). If the household chooses not to provide verification of expenses exceeding the SMED, then allow the SMED instead of actual expenses.

Verification of expenses exceeding $35 must be received to allow the SMED.

Recertification, if:

• The household already has actual medical expenses greater than $35 and less than or equal to the SMED, • There is no change, or there is a change in the amount but the monthly medical expense is still greater than $35 and is less than or equal to the SMED, The SMED, No verification is required unless the household’s declaration is questionable.

Recertification, if the household does not already have the SMED allowed and the household states an eligible member has medical expenses greater than $35 and less than or equal to the SMED, The SMED, The household has medical expenses greater than $35. Verification must be received to allow the SMED.

Recertification, if the household does not already have actual medical expenses budgeted and the household states an eligible member has medical expenses greater than the SMED after subtracting the first $35, Actual medical expenses, The actual monthly medical expense(s). If the household chooses not to provide verification of expenses exceeding the SMED, then allow the SMED instead of actual expenses. The household must provide proof of expenses exceeding $35 to receive the SMED.

Recertification, if:

• The household has actual medical expenses greater than the SMED already allowed, and • There is a change in the monthly amount of more than twenty-five dollars ($25), • The SMED if the new total is greater than $35 and less than or equal to the SMED, or • Actual medical expenses if the new total exceeds the SMED after deducting the first $35 The change in medical expenses.

B. Expenses incurred weekly or biweekly shall be converted to a monthly amount using exact dollars and cents and the conversion method outlined in Section 4.402, A. The excess over thirty-five dollars ($35) per month is allowed as a monthly deduction.

C. At the time of application and recertification, the household may elect to have one-time-only costs deducted in one month as a lump sum or averaged over the certification period to obtain a monthly amount. If the household elects to average the expenses over the certification period, the thirty-five dollar ($35) deduction shall be taken for each month of the certification period.

When a one-time-only medical expense is reported during a certification period, the amount may be deducted in a lump sum or averaged over the remainder of the certification period. Averaging would begin the month the change would be effective. If the household elects to average the expenses over the remainder of the certification period, the thirty-five dollar ($35) deduction shall be taken for each remaining month of the certification period.

When averaging the medical expenses, the SMED is allowed for each month of the certification period, as long as the household’s allowable averaged monthly medical expense is greater than $35. If the expense recurs monthly or more often, and the medical expense exceeds $35 and is less than or equal to the SMED each month, the SMED is allowed for each month of the certification period. When allowable medical expenses for the household exceed the SMED after deducting the first $35, the actual medical expenses are budgeted. The following chart is used to determine when to allow the SMED or actual medical expenses.

If the expense ... THEN ALLOW THE ... averaged for each month is less than or equal to $35, Actual amount of verified actual medical expense in the month billed, or use the SMED in the month billed if the medical expense is greater than $35 and less than or equal to the SMED. averaged for each month is greater than $35 and less than or equal to the SMED each month, SMED for each month of the certification period. averaged for each month is greater than the SMED, Averaged amount of actual verified medical expenses for each month. Allow the SMED only if the household chooses to use the SMED or fails to provide enough verification to qualify for actual medical expenses. the certification period is less than or equal to $35 a month, Actual amount of verified medical expenses in the month billed, or use the SMED in the month billed if the medical expense is greater than $35 and is less than or equal to the SMED. the certification period is greater than $35 and less than or equal to the SMED each month, SMED for each month of the certification period. the certification period is greater than the SMED each month, Averaged amount of the actual medical expenses for each month. Allow the SMED only if the household chooses to use the SMED or fails to provide enough verification to qualify for actual medical expenses.

4.408 RESOURCE ELIGIBILITY STANDARDS

A. The local office shall consider households eligible under either expanded or basic categorical eligibility exempt from the resource eligibility criteria of this section.

B. Households that do not meet expanded or basic categorical eligibility criteria shall have their nonexempt resources, as anticipated to be available in the issuance month, used to determine household eligibility.

The resources of a sponsor and spouse considered toward a non-citizen household shall be the sponsor's total resources less two thousand dollars ($2,000).

C. The value of liquid resources, as declared by the household, shall be utilized in the determination of expedited eligibility for all applicant households.

D. As a result of the Food, Conservation and Energy Act of 2008, adjustments to the SNAP resource limit will be subject to change annually according to the Consumer Price Index. There are currently two (2) resource limits:

1. One established for households that do contain a member who is aged sixty (60) and older and/or a person with a disability; and, 2. Another established for households that do not contain a member who is aged sixty (60) and older and/or a person with a disability.

E. The resource limits are as follows:

Effective October 1, 2024, the resource limit for households that include a member who is aged sixty (60) and older and/or a person with a disability is four thousand and five hundred dollars ($4,500). The resource limit for households that do not include a member who is aged sixty (60) and older and/or a person with a disability is three thousand dollars ($3,000). 4.408.1 Determining the Value of Resources The value of nonexempt household resources at the application filing date must be determined from applicant statements, documents, and/or from collateral contacts when household assessment is uncertain or questionable.

A. Valuation of Liquid Resources The value of liquid resources is the current redemption rate less encumbrances.

B. Valuation of Non-Liquid Resources Except for real property, non-exempt non-liquid resources shall have a fair market value as determined from the best source available (such as, but not limited to, blue book, local dealer, or equivalent verifiable Internet web site) less verified encumbrances. If warranted, the eligibility technician worker should adjust the market value for poor or unusable condition of the property before assigning a resource value. The eligibility technician worker shall annotate the case record to show source and computation used to determine resource value.

The value of real property, such as buildings, land, or vacation property, unless exempt as income producing, may be obtained by using the actual value reported by a county assessor or, if not reported, the current assessed valuation, accomplished in accordance with state law, and dividing the value by the appropriate percentage rate of assessment for real property to derive fair market value and subtracting the amount the household currently owes on the property. 4.408.2 Transfer of Resources At the time of application, households not eligible under expanded or basic categorical eligibility rules shall be asked to provide information regarding any resources which any household member, ineligible non-citizen, or disqualified person whose resources are being considered available to the household has transferred within the three (3) month period immediately preceding the date of application. Households that have transferred resources knowingly for the purpose of qualifying or attempting to qualify for SNAP benefits shall be disqualified from participation in the program for up to one (1) year from the date of discovery of the transfer. This disqualification period shall be applied if the resources are transferred knowingly in the three (3) month period prior to application, or if they are transferred knowingly after the household is determined eligible for benefits.

A. Eligibility for the program shall not be affected by the following transfers:

1. Resources that would not otherwise affect eligibility, such as resources consisting of excluded person property such as furniture, or of money that when added to other household resources, totaled less at the time of the transfer than the allowable resource limits.

2. Resources that are sold or traded at, or near, fair market value.

3. Resources that are transferred between members of the same household including ineligible non-citizens or disqualified individuals whose resources are being considered available to the household.

4. Resources that are transferred for reasons other than qualifying or attempting to qualify for SNAP benefits, for example a parent placing funds into an educational trust fund.

B. In the event the local office establishes that an applicant household knowingly transferred resources for the purpose of qualifying or attempting to qualify for SNAP, the household shall be sent a notice of denial explaining the reason for and length of disqualification. The period of disqualification shall begin in the month of application. If the household is participating at the time of the discovery of the transfer, a notice of adverse action explaining the reason for and the length of disqualification shall be sent. The period of disqualification shall be made effective with the first allotment to be issued after the notice of adverse action has expired unless the household has requested a fair hearing and continued benefits.

The length of the disqualification period shall be based on the amount by which nonexempt transferred resources, when added to other countable resources, exceed the allowable resource limits.

C. The following chart shall be used to determine the period of disqualification for transfer of resources.

Amount in Excess of the Resource Limit Period of Disqualification $1 to $249 1 month $250 to $999 3 months $1,000 to $2,999 6 months $3,000 to $4,999 9 months $5,000 12 months 4.409 COUNTABLE RESOURCES A. Liquid Resources Liquid resources are assets such as cash on hand, money in checking or savings accounts, saving certificates stocks or bonds, or lump sum payments as specified in Section 4.405, F.

B. Non-Liquid Resources A non-liquid resource is any tangible real property such as buildings, land, and vacation homes.

The value of non-liquid resources, unless exempt under Section 4.410 or specified under Section 4.408.1 shall be the equity value. The equity value is the fair market value minus the verified amount owed.

C. Jointly Owned Resources Nonexempt liquid and non-liquid resources owned jointly by separate households shall be considered available in their entirety to each household, unless it can be demonstrated by the applicant household that it does not have access to such resources. If only a portion of the resource is accessible, that portion which is available to the household is considered as a resource. The resource shall be considered totally inaccessible to the household if the resource cannot practically be subdivided and the household's access to the value of the resource is dependent on the agreement of a joint owner who refuses to comply. For the purpose of this provision, ineligible non-citizens or disqualified individuals residing with the household shall be considered household members.

D. Co-Mingled Resources Exempt monies that are kept in a separate account and that are not commingled in an account with non-excluded funds shall retain their resource exclusion for an unlimited period of time.

Those excluded shall retain their exemption for six (6) months from the date they are commingled. After six (6) months from the date of commingling, all funds in the commingled account shall be counted as a resource.

4.410 EXEMPT RESOURCES

In determining the resources for a household, the following shall be excluded from consideration.

A. Vehicles All of a household's licensed and unlicensed automobiles, motorcycles and vehicles, including recreational vehicles and seasonal vehicles, shall be totally exempt as a resource.

B. Home and Property The home and surrounding property, which is not separate from the home by intervening property owned by others, will be an exempt resource. Public rights of way, such as roads that run through the surrounding property and separate it from the home, will not affect the exemption of the property. The home and surrounding property shall remain exempt when temporarily unoccupied for reasons of employment, training for future employment, illness, or not habitable as a result of casualty or natural disaster, if the household intends to return. The property owned or being purchased by households that currently do not own a home and on which the household intends to build or is building a permanent home shall be exempt.

C. Prorated Income Monies that have been prorated and considered as income for eligibility purposes will be an exempt resource. Prorated student and self-employment income is exempt as a resource as long as a portion is still being counted as income.

D. Household Goods, Personal Effects, and Retirement Accounts 1. Household goods, personal effects, including one burial plot per household member, the cash value of life insurance policies, and livestock not excluded as income producing property are exempt resources.

2. All retirement accounts with Federal tax preferred retirement status are exempt resources. The following retirement accounts are exempt:

a. Pension or traditional defined benefit plan;

b. 401(K) plan and simple 401(K);

c. 501C(18);

d. 403(A) and 403(B) plans;

e. 408 plans including traditional individual retirement accounts (Roth IRA, SIMPLE IRA, and myRA), traditional Individual Retirement Annuities f. 457 plan;

g. Federal employee thrift savings plan;

h. Keogh plan;

i. 529A funds including funds in a qualified ABLE program j. Simplified employer plan;

k. Profit sharing plan; and, l. Cash balance plans.

3. All tax deferred education accounts are exempt resources. The two types of tax deferred education savings accounts are:

a. Section 529 qualified tuition programs, which allow owners to prepay a student’s education expenses or to contribute to an account to pay those expenses.

b. Coverdell education savings accounts and IRA type of account designed to pay a student’s education expense.

4. One bona fide pre-purchased funeral agreement per household member, which may include one burial plot per household member, shall be excluded provided that the agreement does not exceed one thousand five hundred dollars ($1,500) in equity value; the equity value over one thousand five hundred dollars ($1,500) is counted as a resource. If a burial plot is included in the agreement, the burial plot portion will be exempted prior to determining the equity value of the funeral agreement.

E. Income-Producing Property, Including Vehicles 1. Any property that is producing an annual income consistent with its fair market value in the community, even if it is used only on a seasonal basis, shall be an exempt resource.

Such property includes farmland and rental homes, or work- related equipment, such as the tools of a tradesman or the machinery of a farmer, and vehicles which are essential to the employment or self-employment of a household member such as semi-tractor/trailer, boat, motor home, utility trailer, or seasonal or recreation vehicles used for incomeproducing purposes. Such property also includes livestock.

2. Installment contracts for the sale of land or buildings if the contract or agreement is producing income consistent with its fair market value shall be an exempt resource. The exclusion shall also apply to the value of the property sold under the installment contract or held as security in exchange for a purchase price consistent with the fair market value of that property retained by the seller.

3. Income-producing vehicles such as, but not limited to, a taxi, tractor, fishing boat, a vehicle used for deliveries, motor home, snowmobile, or camper is an exempt resource if it annually produces income consistent with its fair market value, even if only used on a seasonal basis. The exemption will apply when the vehicle is not in use because of temporary unemployment. This exemption also applies to ineligible non-citizens or disqualified persons whose resources are being considered available to the household.

4. Property essential to the self-employment of a household member engaged in farming (including land, machinery, equipment, and supplies) shall be excluded for one (1) year from the date the household member terminates his or her self-employment from farming.

F. Inaccessible Resources 1. Resources having a cash value which is not accessible to the household include, but are not limited to, irrevocable trust funds, property in probate, or property prohibited from sale by a creditor holding a lien, and real property which the household is making a good faith effort to sell at a reasonable price, and which has not been sold. In such cases, the local office shall establish that the property is for sale and that the household will accept a reasonable offer.

2. Non-exempt, non-liquid resource, as defined in Section 4.408.1, B, that would have a net return of one thousand five hundred dollars ($1,500) or less if sold, shall be considered an inaccessible resource. The equity value shall be used to determine this amount. The equity value is fair market value less verified encumbrances (amount owed).

3. Any funds in a trust or transferred to a trust, and the income produced by that trust shall be considered inaccessible to the household if:

a. The trust arrangement will not likely cease during the certification period, and no household member has the power to revoke the trust arrangement or change the name of the beneficiary during the certification period; or b. The trustee administering the funds is either a court, an institution, corporation, or organization which is not under the direction or leadership of any household member; or an individual appointed by the court who has court-imposed limitation placed on his/her use of funds which meet requirements of this section; or c. The trust investments made on behalf of the trust do not directly involve or assist any business or corporation under the control, direction, or influence of a household member; or d. The funds held in irrevocable trust are either established from household's own funds and are used solely to make investments on behalf of the trust or to pay educational or medical expenses of persons named by the household creating the trust; or established from non-household funds by a non-household member; or e. Monies which are withdrawn from trust and dividends that are or could be received by the household shall be considered as income.

G. Resources with No Significant Return Resources that, as a practical matter, the household is unlikely to be able to sell for any significant return because the household's interest is relatively slight or because the cost of selling the household's interest would be relatively great and shall be considered inaccessible. A resource shall be so identified if its sale or other disposition is unlikely to produce any significant amount of funds for the support of the household. Verification of the value of a resource to be excluded shall not be required unless the eligibility worker determines that the information provided by the household is insufficient to permit a determination of the resource value or the technician believes that the information is questionable.

This provision regarding no significant return does not apply to negotiable financial instruments (as defined in C.R.S section 4-3-104). A significant return or a significant amount of funds shall be any return/funds after estimated costs of sale or disposition and considering the ownership interest of the household. A significant return or a significant amount of funds is an amount that is estimated to be more than one thousand five hundred dollars ($1,500).

H. Resources of Battered Women in Shelters Residents of shelters for battered women and children may not have been able to retain access to all the resources of their former household. Therefore, in cases where access to a resource, such as jointly held bank accounts requiring both signatures, vehicles, and property, is dependent upon the agreement of a person who still resides in the household where the woman was abused, the resource shall be considered inaccessible to the applicant.

I. Resources Used by Household Members Where an exclusion applies because of use of a resource by or for a household member, the exclusion shall also apply when the resource is being used by or for an ineligible non-citizen or disqualified person whose resources are being counted as part of the household's resources.

J. Government Payments The following government payments are received for a specific purpose or services and shall be excluded as a resource for SNAP eligibility.

1. P.L. No. 89-642. Section (11b) of the Child Nutrition Act of 1966 excludes the value of assistance to children under this Act from resources for SNAP purposes.

2. Payments received from the youth incentive entitlement pilot projects, the youth community conservation and improvement projects, and the youth employment and training programs under Youth Employment and Demonstration Act of 1977 (P.L. No. 95- 93) and extended under Title IV of the Comprehensive Employment and Training Amendments of 1978 (P.L. No. 95-524). (Note: Does not include other payments under the Comprehensive Employment and Training Act (CETA) or payments under the Youth Adults Conservation Corps.)

3. Any governmental payments which are designated for the restoration of a home damaged in a disaster, if the household is subject to a legal sanction if the funds are not used as intended: for example, payments made by the Department of Housing and Urban Development through the individual and family grant program or disaster loans or grants made by the Small Business Administration, Section 312(d) of Disaster Relief Act of 1974.

The Disaster Relief Act of 1974. P.L. No 93-288 as amended by P.L. No. 100-707,

Section 105(i). the Disaster Relief and Emergency Assistance Amendments of 1988.

Payments precipitated by an emergency or major disaster as defined in this Act, as amended, are not counted as income or resources for SNAP purposes. This exclusion applies to Federal assistance provided to persons directly affected and to comparable disaster assistance provided by states, local governments, and disaster assistance organizations.

4. Reimbursements from the Uniform Relocation Assistance and Real Property Acquisition Policy Act of 1970 (P.L. No. 91-646. section 216).

5. Benefits received from the special supplemental food program for women, infants and children (WIC) (P.L. No. 92-443). This payment is excluded as an in-kind benefit.

6. Payments or allowances made under any federal laws for the purpose of energy assistance, other than Part A of Title IV of the Social Security Act (42 U.S.C. 601 through 42 U.S.C. 619), or a one-time payment or allowance made under federal or state law for the cost of weatherization or emergency repair or replacement of an unsafe or inoperative furnace or other heating or cooling device is exempt as a resource.

7. HUD rental refund payments made pursuant to settlement of a series of class action lawsuits such as Underwood v. Harris, originally brought in the District of Columbia Federal District Court, are excluded in the month received and the following month.

8. Mandatory deductions from military pay for educational purposes while the participant is enlisted. (P.L. No. 99-576, Veterans' Benefits Improvement and Health-Care Authorization Act of 1986, Section 303(a) (1)) Section 216 of P.L. No. 99-576 authorizes stipends for participation in study of Vietnam-Era veterans’ psychological problems that are not excluded from income.

9. Payments to U.S. citizens of Japanese ancestry and resident Japanese non-citizens for up to twenty thousand dollars ($20,000) each and payments to certain eligible Aleuts of up to twelve thousand dollars ($12,000) each. P.L. No. 100-383. Section 105(f)(2) Civil Liberties Act of 1988.

10. P.L. No. 100-435, Section 501, amended Child Nutrition Act to allow under WIC demonstration projects, benefits that may be exchanged for food at farmers' markets.

11. Payments made from the Agent Orange Settlement Fund (P.L. No. 101-201). All payments from the Agent Orange Settlement fund or any other fund established pursuant to the settlement in the Agent Orange product liability litigation are excluded from income retroactive to January 1, 1989. The veteran with disabilities will receive yearly payments.

Survivors of deceased veterans with disabilities will receive a lump-sum payment. These payments were disbursed by the AETNA insurance company.

12. A federal earned income tax credit received either as a lump sum or as payments under

Section 3507 of the Internal Revenue code for the month of receipt and the following month for the individual and that individual's spouse (P.L. No. 101-508).

A federal, state, or local Earned Income Tax Credit (EITC) would be exempted for twelve (12) months from receipt for any household member if the individual receiving the EITC was participating in SNAP when the EITC was received and participation continues for twelve (12) months. Temporary non-participation due to administrative reasons, such as a delayed recertification, shall not affect the twelfth (12th) month participation requirement (P.L. No. 103-66, Mickey Leland Childhood Hunger Relief Act of 1993).

13. Any money received from the Radiation Exposure Compensation Trust Fund, pursuant to P.L. No. 101-426 as amended by P.L. No. 101-510.

14. P.L. No. 103-286, Section 1(a) provides, in part, that payments made to individuals because of their status as victims of Nazi persecution shall be disregarded in determining eligibility for, and the amount of, benefits or services to be provided under any federal or federally assisted program which provides benefits or services based, in whole or in part, on need.

15. Amendments to Section 1403 of the Crime Act of 1984 (42 U.S.C. 10602) provide in part that, notwithstanding any other law, if the compensation paid by an eligible crime victim compensation program would cover costs that a federal program or a federally financed state or local program would otherwise pay:

a. Such crime victim compensation program shall not pay that compensation;

b. The other program shall make its payments without regard to the existence of the crime victim compensation program.

Based on this language, payments received under this program must be excluded from income for SNAP purposes.

16. P.L. No. 104-204 requires that allowances paid under this law to children of Vietnam veterans who were born with spina bifida be excluded from resources.

17. P.L. No. 111-312 and The American Taxpayer Relief Act of 2012 requires that Federal income tax refunds received beginning January 1, 2010 must be disregarded as a resource for twelve (12) months from the date of receipt by the client.

4.411 TREATMENT OF INCOME AND RESOURCES OF DISQUALIFIED, SANCTIONED, AND NON-

HOUSEHOLD MEMBERS 4.411.1 Treatment of Income and Resources of Disqualified and/or Sanctioned Members A. Individual household members may be disqualified for being ineligible non-citizens, for failure or refusal to obtain or provide a Social Security Number (SSN), for Intentional Program Violation (IPV)/fraud, for being a fleeing felon, for failing to comply with a work requirement, or for being a sanctioned ABAWD (Able Bodied Adult Without Dependents) who has received three (3) months of SNAP benefits within a thirty-six (36) month period.

B. During the period in which a household member is disqualified, the eligibility and benefit level of any remaining members shall be determined as follows:

1. Households containing members disqualified for IPV or fraud, or a work requirement sanction, or classified as a fleeing felon:

a. Income, Resources, and Deductible Expenses The income and resources of the disqualified household member(s) shall be counted in their entirety. Resources shall only be considered if the household is required to meet the resource standard. The allowable earned income, standard, medical, dependent care, and shelter deductions shall be allowed in their entirety.

b. Eligibility and Benefit Level The disqualified member shall not be included when determining the household's size for purposes of assigning a benefit level to the household. The disqualified household member will not be included when determining the household size for comparison against any eligibility standard; this includes the gross income and net income eligibility limits, or the resource eligibility limits.

2. Households containing members disqualified for being an ineligible non-citizen, for failure or refusal to obtain or provide a SSN, or sanctioned as an ABAWD who has received three (3) months of SNAP benefits in a thirty-six (36) month period:

a. Resources The resources of the disqualified and/or sanctioned member(s) shall be counted in their entirety to the remaining household members if the household is required to meet the resource standard.

b. Income A pro rata share of the nonexempt income of the disqualified and/or sanctioned member(s) shall be counted as income to the remaining members. This pro rata share is calculated by dividing the income evenly among the household members, including the disqualified member. All but the disqualified member's share is counted as income to the remaining household members. If an ineligible non-citizen is also an ineligible student and purchases and prepares food with the household, the individual’s income shall be prorated under the ineligible noncitizen provisions.

c. Deductible Expenses The earned income deduction shall apply to the prorated income earned by the disqualified and/or sanctioned member that is attributed to the household. That portion of the household's allowable shelter and dependent care expenses which are either paid by or billed to the disqualified member shall be divided evenly among the household members, including the disqualified member. Legally obligated child support payments are deducted before prorating income. The shelter expense will be prorated except for the standard utility allowance (SUA).

The full SUA will be added to the other prorated shelter components if the household qualifies for the SUA. All but the disqualified member's share is counted as a deductible expense for the remaining household members.

d. Eligibility and Benefit Level The disqualified and/or sanctioned member shall not be included when determining the household's size for purposes of assigning a benefit level to the household. The disqualified or sanctioned household member will not be included when determining the household size for comparison against any eligibility standard, which includes the gross income, the net income eligibility limits, and the resource eligibility limits. 4.411.2 Treatment of Income and Resources of Other Non-Household Members A. For those non-household members that have not been disqualified, such as live-in attendants and ineligible students, the income and resources of the non-household member shall not be considered available to the household. Cash payments from the non-household member to the household will be considered as income to the household. Vendor payments, as defined in Sections 4.405, H and 4.405, I, shall be excluded as income. Except for the mandatory telephone allowance, if the household shares deductible expenses with the non-household member, only the amount actually paid or contributed by the household shall be deducted as a household expense. If the payments or contributions cannot be differentiated, the expenses shall be prorated evenly among persons actually paying or contributing to the expenses and only the household's pro rata share deducted.

If an ineligible non-citizen is also an ineligible student and purchases and prepares food with the household, the individual’s income shall be prorated under the ineligible non-citizen provisions.

B. When the earned income of one or more household members and the earned income of a nonhousehold member are combined into one wage, the income of the household members shall be determined as follows:

1. If the household's share can be identified, the local office shall count that portion due to the household as earned income.

2. If the household's share cannot be identified, the local office shall prorate the earned income among all those whom it was intended to cover and count that prorated portion to the household.

C. A person who is an ineligible student for SNAP purposes shall be treated as a non-household member. The other members of a household containing the ineligible student may be certified.

The income and resources of the ineligible student shall not be considered available to the other household members for determining the household's income resources and deductions nor shall the student be considered in determining the household's allotment.

4.500 VERIFICATION AND DOCUMENTATION

A. Verification is the use of documentary evidence or a contact with a third party to confirm information and to establish the accuracy of statements provided by the household.

B. The case record shall consist of statements and documentation regarding the sources and results of verification used to determine a household’s eligibility. Such statements must be sufficiently detailed to support the determination of eligibility or ineligibility and to permit a reviewer to determine the reasonableness of the eligibility technician’s determination. When ineligibility is determined, the case record must clearly indicate the reason for denial or termination of SNAP benefits and the verification used in making the decision. If information is considered questionable or if an alternate source of verification was requested, the reason for additional verification shall be documented in the case record.

The case record shall also contain all correspondence pertaining to fair hearings and administrative disqualification hearings (ADH).

Information to retain in the case record for fair hearings shall include, at a minimum, the household’s request for a fair hearing, the scheduling notice with the hearing date and time, all decisions pertaining to the fair hearing, an any formal objections to the court’s ruling (known as exceptions) filed by the local office or the household.

Information to retain in the case record for an ADH shall include, at a minimum, the notice to the individual of the alleged intentional program violation (IPV)/fraud, any notice given to the household waiving the household’s right to an ADH, the scheduling notice of the ADH if the waiver is not signed and returned, all decisions issued regarding the outcome of the ADH hearing, and the disqualification notice sent to the household notifying the individual of the disqualification period.

C. The local office shall provide each household at the time of application for initial certification, recertification, and periodic report form with a notice that informs the household of verification requirements that the household must meet as part of the application, recertification, or periodic report process. The notice will inform the household that the local office will assist the household in obtaining verification, provided the household is cooperating with the office. The notice shall be written in clear and simple language and shall meet bilingual requirements.

D. The household has the primary responsibility for providing documentary evidence for required verification and to resolve questionable information. The local office shall assist the household to obtain the necessary documentation provided the household is cooperating with the local office.

E. The household shall also be determined ineligible if it refused to cooperate in any subsequent review of its eligibility, including reviews generated by reported changes, recertifications, or as

part of a quality control review. 4.501 Prudent Person Principle The rules contained herein are intended to be sufficiently flexible to allow the eligibility technician to exercise reasonable judgment, also known as PPP, in executing his/her responsibilities when determining SNAP eligibility.

In making an eligibility decision, the eligibility technician should consider whether their judgment is reasonable, based on their experience with and knowledge of SNAP.

4.502 VERIFICATION REQUIREMENTS AT APPLICATION, RECERTIFICATION, AND PERIODIC

REPORT

A. Verification Requirements at Application 1. Expedited Service Requirements Only verification of the identity of the head of household is required. When an authorized representative applies on behalf of a household, the identity of both the authorized representative and the head of household shall be verified. No requirement for a specific document may be imposed. Client declaration of Social Security Number(s) (SSNS) and residency shall be accepted. Client declaration of other household circumstances shall be accepted when determining eligibility for expedited service, and verification of any clientdeclared information shall be postponed and verified prior to certification.

2. The following information shall be verified prior to certification:

a. Identity of the head of household;

b. Household's gross nonexempt income;

c. Information available through IEVS, including SSNs for all household members;

d. Non-citizen status of persons identified as non-citizens on the application;

e. Residency, except for homeless households, or households newly arrived in the state or county for whom third-party verification cannot reasonably be obtained.

3. The household shall be given a reasonable opportunity to submit verification of certain expenses to receive expense deductions and exclusions.

If a deductible expense must be verified and obtaining verification may delay the household's certification, the local office shall advise the household that the household's eligibility and benefit level will be determined without providing a deduction or exclusion for the claimed but unverified expense.

If the expense cannot be verified within thirty (30) calendar days of the date of application, the local office shall determine the household's eligibility and benefit level without providing a deduction or exclusion for the unverified expense. These expenses are:

a. Allowable medical expenses less reimbursement;

b. Legally obligated child support payments;

c. Dependet care expenses; and, d. Shelter expenses, if questionable and verification has been requested.

4. For households eligible under basic or expanded categorical eligibility rules, verification of resources, gross and net income, SSN information, sponsored non-citizen information, and residency beyond that gathered by the Public Assistance (PA) program that confers eligibility shall not be required unless these eligibility factors are not already collected and verified by the other PA program, are considered questionable, or are unavailable to SNAP. The local office shall verify that each member receives benefits or services from the program that confers basic or expanded categorical eligibility.

5. For households subject to an asset test, the household's written declaration of resources that declares more than the resource limit is an acceptable form of verification.

B. Verification Requirements at Recertification 1. Eligibility factors not verified by the Income and Eligibility Verification System (IEVS) should be verified at recertification only if they are incomplete, inaccurate, questionable, inconsistent, or outdated and would affect a household's eligibility or benefit level.

Unchanged information shall not be verified unless the information is outdated. 2 A change in total monthly income of fifty ($50) or more for each member must be verified at recertification. If the source of income has not changed and if the amount is unchanged or has changed by fifty dollars ($50) or less, verification is not required unless the information is unclear, questionable, or outdated.

3. At recertification, all households shall verify the following information if the source has changed, or the amount has changed by more than twenty-five dollars ($25) since the last time they were verified:

a. Dependent care expenses; and b. Allowable medical expenses; and c. Legally obligated child support.

4. A reported SSN not verified at initial certification and newly obtained SSNs shall be verified through the IEVS or State On-Line Query Internet (SOLQ-I).

5. For households subject to an asset test, the household's written declaration of resources that declares more than the resource limit is an acceptable form of verification.

6. If there has been a change in a deductible expense that must be verified and obtaining verification delays the household's redetermination processing, the local office shall advise the household that the household's eligibility and benefit level will be determined without providing a deduction for the claimed but unverified expense.

C. Verification Requirements at Periodic Report 1. The household shall verify the following changes in circumstances at the time of periodic report:

a. A change of more than $100 in the amount of unearned income.

b. A change in the source of income, including starting a job.

c. Acquisition of a licensed vehicle that is not fully excludable, if resource limits apply.

d. A change in liquid resources, unless excluded, if resource limits apply.

e. Changes in the legal obligation to pay child support.

f. If a member of the household won substantial lottery or gambling winnings.

g. Allowable medical expenses to receive an increase in the allowed expense or add a medical expense.

2. Previously reported medical and shelter expenses used to establish the twenty-four (24) month certification should continue through the end of twenty-four (24) month certification period unless:

a. An increase in medical expenses is verified, or b. An increase in shelter expenses is reported. 4.503 Case Documentation The case record shall consist of statements and documentation regarding the sources and results of verification used to determine eligibility and ineligibility. Such statements shall be entered into a physical case file and/or the statewide automated system. Such statements must be sufficiently detailed to support the determination of eligibility or ineligibility and to permit a reviewer to determine the reasonableness of the eligibility technician’s determination. When ineligibility is determined, the case record must clearly indicate the reason for denial or termination and the verification used in making the decision. If information is considered questionable or if an alternate source of verification was requested, the reason for additional verification shall be documented in the case record.

The case record shall show the names of the employers and others contacted; the dates and amounts of wage stubs and statements; the figures used to arrive at monthly gross income; the household’s responsibility to pay utilities; and the method of verifying other information, including non-citizen status, if applicable.

A notation shall be made to indicate which household members completed work registration forms and the date completed. 4.504 Sources of Verification The local office shall accept any pertinent documentary evidence provided by the household and shall be primarily concerned with how adequately the verification proves the statements on the application, during recertification, in the PRF, or in any reported changes. Local offices shall accept the minimum verification requirements outlined throughout this document, unless questionable. If written verification cannot be obtained, the eligibility technician shall substitute an acceptable collateral contact. 4.504.1 Documentary Evidence Documentary evidence consists of written confirmation of a household’s circumstances. Households may supply documentary evidence in person, through the mail, by facsimile or other electronic device, or through an authorized representative. The local office shall not require the household to present verification in person at the office. 4.504.2 Collateral Contacts A. A collateral contact is a verbal confirmation of a household's circumstances by a person outside the household, made either in person, in writing, or by telephone. Acceptable collateral contacts include, but are not limited to: employers, landlords, social/migrant service agencies, and neighbors of the household who can be expected to provide accurate third-party verification. The name of the individual contacted, the individual’s contact information, and the information provided shall be documented in the case record.

B. Confidentiality shall be maintained when talking with collateral contacts. The local office shall disclose only the information that is necessary to get information being sought. When talking with collateral contacts, the local office must not state that an individual or household has applied for SNAP.

C. If the household fails to provide a collateral contact or provides a contact that is unacceptable to the eligibility technician, the technician may select a collateral contact that can provide information that is needed.

D. The local office shall not determine the household to be ineligible when a person outside the household fails to cooperate with a request for verification. Household members who are disqualified or in an ineligible status shall not be considered individuals outside the household.

E. In cases in which the information from another source contradicts statements made by the household, the household shall be afforded a reasonable opportunity to resolve the discrepancy prior to an eligibility determination. 4.504.3 Home Visits For the purposes of determining eligibility, home visits shall be used as verification only if documentary evidence cannot be obtained and the visit is scheduled in advance with the household. Home visits are to be used on a case-by-case basis where the supplied documentation or verification is insufficient. 4.504.4 Systematic Alien Verification Entitlement (SAVE)

The U.S. Citizenship and Immigration Service (USCIS), Systematic Alien Verification for Entitlement (SAVE) system will verify the alien status of applicant non-citizens. The use of SAVE shall be documented in the case record. The record will contain the date the primary or secondary request was submitted, along with a copy of the Form G-845 when applicable, and any response to the request for verification. 4.504.5 Colorado Income Eligibility Verification System (IEVS)

A. The Colorado Income and Eligibility Verification System (IEVS) provides for the exchange of information on SNAP clients with the Social Security Administration (SSA), Internal Revenue Service (IRS), and the Colorado Department of Labor and Employment (DOLE).

B. At initial certification and recertification, all applicants for SNAP shall be notified through a written statement provided on or with the application form that contains the following information:

1. Information available through the IEVS will be requested and verified through collateral sources when discrepancies are found by the local office.

2. Information available through the IEVS shall be used and that such information will be used and may affect the household’s eligibility and level of benefits.

C. With respect to all household members, including any excluded household members for whom a Social Security Number (SSN) is available, the agency shall be responsible for requesting verification through the IEVS or directly from locally accessed automated information. All such information shall be requested at the first available opportunity after the date of application.

D. The local office shall at a minimum, prior to approval of benefits at initial application, recertification, and periodic report, verify potential earnings or unemployment benefits through the DOLE for all applicants.

E. Determination of a household's eligibility and benefit level shall not be delayed past the application processing time standards if verification of information is not available nor shall determination be delayed awaiting verification from the IEVS.

F. The local office is required to act upon information received from IEVS within forty-five (45) calendar days of the receipt of that information, except for UIB information received from the DOLE, which must be acted upon in accordance with Section 4.604.

G. Some information received through the IEVS is not considered verified and is subject to independent verification by the local office. Benefits shall not be delayed pending receipt of verification from a collateral source, such as an employer, when independently verifying information received from the IEVS. Such verification of IEVS information may include contacting the household in writing informing them of the information received from the IEVS data source and requesting a response within ten (10) calendar days, or by appropriate collateral contact. The following Information received through the IEVS shall be treated as not verified and subject to independent verification by the local office:

1. Wage data from the Colorado Department of Labor and Employment.

2. Internal Revenue Service unearned income information.

H. Through the IEVS, participant SSNs will be matched with source agency records on a regular

basis to identify potential earned and unearned income and resources and assets from the following sources:

1. Social Security Administration (SSA)

Information received from the Social Security Administration includes:

a. Wages, payments of retirement income, Title II Social Security benefits, Title XVI Social Security benefits, pensions, and federal employee earnings maintained by the SSA.

b. Federal retirement, survivors disability, SSI, and related information available from SSA through BENDEX (Beneficiary Data Exchange) and SDX (State Data Exchange).

2. State Data Exchange (SDX) and Beneficiary Data Exchange (BENDEX)

Death information, SSI benefit amounts, and social security benefit information may be obtained verified through SDX AND BENDEX. See Section 4.504.6, E, for what information from SSA is considered verified upon receipt.

3. Colorado Department of Labor and Employment (DOLE)

a. Information received from the DOLE includes wage and unemployment insurance benefits (UIB). Wage data received from the DOLE shall not be considered as verified upon receipt and shall be subject to independent verification. Unemployment information reported through the IEVS shall be verified through the DOLE or by the household. Verification of unemployment compensation insurance benefits, including beginning dates, duration of payments and amount of payments can be obtained from the Colorado Department of Labor and Employment.

b. The local office shall at a minimum, prior to approval of benefits at initial application, recertification, and periodic report, verify potential earnings or unemployment benefits through the DOLE for all applicants, including ineligible and disqualified members’ SSNs. With respect to all members of a participant household, the local office shall use UIB information received through the Income and Eligibility Verification System (IEVS). Participant SSNs will be matched at least monthly with the DOLE, UIB records.

4. Internal Revenue Service (IRS)

Unearned income information received from the IRS includes, but is not limited to, interest on checking and savings accounts, dividends, royalties, winnings from betting establishments, and capital gains. Unearned income information from the IRS that is reported through the IEVS shall not be considered as verified upon receipt and shall be subject to independent verification. 4.504.6 Information Considered Verified Upon Receipt A. Verified upon receipt (VUR) is a term given to a state-prescribed list of specific information that comes directly from the primary source of the information and is free from question.

B. Information that is considered VUR shall be acted upon for all households. Information considered VUR shall be acted on at the time of application, recertification, periodic report, and during a household’s certification period if the information causes a change in the SNAP benefit amount. A household shall not be convicted of fraud for not reporting a change in the information it is not required to report.

C. Information considered VUR shall be considered verified unless the office has reason to believe that the information may be inaccurate. Advance notice of adverse action shall be given when acting on information that is considered VUR, except as noted in Section 4.608.1.

D. The local office shall consider only the following information as VUR:

1. Social Security and SSI benefit amounts obtained from SSA.

SSI and benefit amounts obtained from the SSA are considered reported and verified on the day the information is first known to the agency, either through the IEVS, SDX, BENDEX or another automated interface of information, whichever is sooner.

2. Death information received from the Burial Assistance program.

Death information received from the Burial Assistance program is considered reported and verified on the day the information is first known to the agency.

3. Unemployment insurance benefits (UIB) that are reported through the IEVS and obtained through the Department of Labor and Employment (DOLE).

The UIB information shall be considered reported and verified on the date of the IEVS notification. Advance notice of adverse action shall be given when acting on the change in information.

4. PA benefit amounts (Colorado Works, Aid to the Needy Disabled (AND) program consisting of AND-State Only (AND-SO) and AND-Colorado Supplement (AND-CS), Home Care Allowance (HCA), and Old Age Pension (OAP), obtained from the State Department.

5. Information that is reported and verified to a PA program which results in a change to the PA benefit amount and that meets SNAP verification requirements.

Such information shall be considered reported and verified on the day the PA program processes the change and authorizes the new PA benefit amount.

6. Child support income and expense amounts obtained through the ACSES.

Such information is considered reported and verified on the day the information is reported through an automated interface with ACSES.

7. Non-compliance information obtained from EF agencies of the failure of an ABAWD to meet work requirements.

8. Colorado IPVs.

9. Information obtained from the SAVE system regarding non-citizen status.

10. Changes in household composition that are reported and verified and result in one (1) or more members being removed from one (1) SNAP household and added to a new or existing SNAP household.

Duplicate benefits shall not be issued for a particular individual when removing that individual from one SNAP household and adding them to a new SNAP household.

11. Changes in household composition that are reported and verified by child welfare agencies and result in a child being removed from one SNAP household and added to a new or existing SNAP household.

12. The disqualification of a household member who is determined to be a fleeing felon. 4.504.61 Information Not Considered Verified Upon Receipt (VUR)

A. Some information received from sources other than the household are not considered VUR. Such information shall be subject to independent verification prior to taking adverse action against a household’s SNAP benefits during the certification period.

B. The following sources of information shall not be considered as VUR:

1. Death information received from a source other than the Burial Assistance program.

2. Veterans Assistance (VA) benefit amounts obtained through the IEVS.

3. Wage data obtained through the IEVS and the DOLE.

4. IRS income and asset information obtained through the IEVS.

5. Information regarding railroad retirement benefits obtained through the IEVS.

6. Information received from the Public Assistance Reporting and Information System (PARIS).

7. Prisoner information received during the certification period.

8. Information received from the National Directory of New Hires (NDNH).

9. Social Security benefit amounts reported via an award letter given by the household.

10. IPV/disqualification data from another state as reported through the disqualified recipient database.

4.505 VERIFICATION OF NON-FINANCIAL INFORMATION

A. Some information received from sources other than the household are not considered verified.

Such information shall be subject to independent verification prior to taking adverse action against a household’s SNAP benefits during the certification period. 4.505.1 Verification of Identity A. The identity of the person making an application shall be verified. When an authorized representative applies on behalf of a household, the identity of both the authorized representative and the head of household shall be verified.

B. Identity may be verified through readily available documentary evidence, or if this is unavailable, through a collateral contact or through electronic information received from the Colorado Department of Revenue, Division of Motor Vehicles (DMV). Acceptable documentary evidence that the applicant may provide includes, but is not limited to, a driver's license, a work or school ID, an ID for health benefits or for another assistance or social services program, a voter registration card, wage stubs, or a birth certificate. No requirement for a specific type of document, such as a birth certificate or picture ID, may be imposed.

C. When obtaining an Electronic Benefit Transfer (EBT) card, a household shall not be required to provide verification beyond what was utilized to establish identity when determining SNAP eligibility. This includes verification through a collateral contact. 4.505.2 Verification of Social Security Numbers (SSN)

A. All SSNs provided by the household, including multiple SSNs issued by the Social Security Administration (SSA), shall be verified through the SSA in accordance with the Income and Eligibility Verification System (IEVS) procedures established by the State Department. The State On-Line Query Internet (SOLQ-I) may also be utilized to verify an SSN. Certification of an otherwise eligible household member shall not be delayed verifying the SSN provided by the client. Household members who provide an SSN shall not be denied benefits for failure or inability to present a social security card or other official documentation. Eligibility determinations and benefits will not be delayed to otherwise eligible households while awaiting a response from the IEVS. For basic categorically eligible clients, the local office shall accept SSNs as verified by the categorically eligible programs.

B. When the local office receives notification through the IEVS that a participant's SSN cannot be verified or is otherwise discrepant, such as the name or number does not match SSA records, the local office shall:

1. Conduct a case record review to confirm that the SSN in the case record matches the SSN submitted to the SSA for verification. If an error occurred in the original submittal, such as digits transposed or an incorrect name submitted, the local office shall correct the error and the SSN will be resubmitted through the IEVS for verification.

2. If no error is identified as outlined in 1, above, the local office shall advise the household in writing that a member's SSN could not be verified and instruct the household to contact the local office to resolve the discrepancy. This notice shall not constitute advance notice of adverse action.

3. The local office shall make every effort to assist the household in resolving the discrepancy, including referral to the appropriate SSA office and assisting the household in obtaining documents available to the local office which may be required by the SSA.

4. Should the household or participant fail or refuse to cooperate in resolving the discrepancy, the individual whose SSN cannot be verified may be disqualified as having failed to provide an SSN until such time as the household/participant cooperates, unless good cause exists. Disqualification shall be effective the month following the expiration of the notice of adverse action. 4.505.3 Verification of Residency A. Except for basic categorically eligible households, residency shall be verified prior to certification, except in unusual cases when verification cannot reasonably be accomplished, such as for homeless households, some migrant farm worker households, or households newly arrived to an area. Verification of residency should be accomplished to the extent possible when verifying other information, such as identity or income. Any documents or collateral contacts which reasonably establish the applicant’s residency must be accepted and no requirement for a specific type of verification may be imposed.

A. If the eligibility technician and client have made reasonable efforts to verify residency and it has proved impossible, the household may be certified, if otherwise eligible. If an individual’s county residency cannot be verified, but the individual’s Colorado residency is not questionable, then the individual shall be certified if otherwise eligible and not participating in another SNAP household.

C. The client may supply the verification through driver's license, rent receipt, utility or other recently received bill, voter registration, or similar means. If the client is unable to supply documentary evidence, information may be obtained from a telephone or city directory or detailed area map. If documentary evidence is not available, a collateral contact, such as a landlord or neighbor, may provide verification. In the absence of documentary evidence or collateral contact, a scheduled home visit may be feasible. 4.505.4 Verification of Household Composition A. Local offices shall accept the household’s statement, without requiring verification, regarding household composition unless the statement is questionable or there is unclear information, as defined in section 4.000.1.

B. Persons aged sixty (60) and older experiencing a disability as described in Section 4.304.3.A, declaring separate household status from others in the household shall be responsible for providing necessary income information of other household members and medical statements that the individual(s) cannot purchase and prepare their own meals if questionable and requested by the local office.

C. A household that requests benefits for a child that is already receiving benefits in another household is responsible for verifying that they provide the child with the majority of his or her meals prior to receiving benefits for that child as described in Section 4.304.1.B. 4.505.5 Verification of U.S. Citizenship A. If questionable, U.S. citizenship may be verified by one of the following:

1. A U.S. birth certificate;

2. Possession of a U.S. passport;

3. A certificate of U.S. citizenship (INS form N-560 or N-561);

4. A certificate of naturalization (INS form N-550 or N-570);

5. A certificate of birth abroad of a citizen of the United States (Department of State forms FS-545 or DS-1350);

6. Identification Cards for U.S. citizens (INS-I- 179 or INS-I- 197); or, 7. Information obtained through the Colorado Vital Information System (COVIS).

B. If the above forms of verification cannot be obtained and the household can provide a reasonable explanation as to why verification is not available, the local office shall accept a signed statement from a third party having personal knowledge of the person's status and who declares, under penalty of perjury, that the member in question is a U.S. citizen. The signed statement shall contain a warning of the penalties for helping someone commit fraud. 4.505.51 Verification of Questionable Citizenship A. The following guidelines shall be used in considering whether a client’s statement of citizenship is questionable:

1. The claim of citizenship is inconsistent with statements made by the client.

2. The claim of citizenship is inconsistent with information received from another source.

B. Application of the above criteria by the eligibility technician must not result in discrimination based on race, religion, ethnic background or national origin, and groups such as migrant farm workers or American Indians shall not be targeted for special verification. The eligibility technician shall not rely on a surname, accent or appearance that seems foreign to find a claim to citizenship questionable. Nor shall the eligibility technician rely on a lack of English speaking, reading, or writing ability as grounds to question a claim to citizenship.

C. The member whose citizenship is in question shall be ineligible to participate until proof of citizenship is obtained, except as provided in Section 4.505.6, E. Until proof of citizenship is obtained, the member whose citizenship is in question shall have his or her income, less a prorated share, and all of his or her resources considered available to any remaining household members.

D. The method used to document verification of citizenship and the result of the verification shall be included in the case record. 4.505.6 Verification of Non-citizen Status A. All SNAP clients shall be notified on the application form that the non-citizen status of any household member will be subject to verification by the U.S. Citizenship and Immigration Service (USCIS) through the submission of information from the application to the USCIS. The information received from the USCIS may affect the household's eligibility and level of benefits.

The application shall contain a statement signed by an adult representative from each household which attests, under penalty of perjury, to citizenship or non-citizen status of each member.

B. The local office shall verify the eligibility status of non-citizens by submitting the noncitizen registration number through the USCIS Systematic Alien Verification for Entitlement (SAVE) system. The office shall use the information from USCIS SAVE to determine eligibility for benefits.

The use of SAVE shall be documented in the case record. If a non-citizen does not wish the office to verify his or her immigration status, the local office shall give the household the option of withdrawing its application or participating without that member.

C. The SAVE system will verify the alien status of non-citizens. The use of SAVE shall be documented in the case record. The record will contain the date that the primary or secondary request was submitted, along with a copy of the Form G-845, as incorporated by reference in

section 4.000.1, when applicable, and any response to the request for verification.

1. If the non-citizen status is not verified in the primary SAVE verification process, a USCIS Form G-845 will be submitted with a photocopy of the non-citizen's document to the Colorado Refugee Service Program (CRSP).

2. If the proper USCIS documentation is not available, the non-citizen may state the reason and submit other conclusive verification. The local office shall accept other forms of documentation or corroboration from the USCIS that the non-citizen is classified pursuant to Section 207 (8 U.S.C. 1157), Section 208 (8 U.S.C. 1158), or Section 243(h) (8 U.S.C. 1253(h)) of the Immigration and Nationality Act, or other conclusive evidence such as a court order stating that deportation has been withheld pursuant to Section 243(h) of the Immigration and Nationality Act.

D. If a non-citizen is unable to provide any USCIS document, such as an INS form I-94, the local office has no authority or responsibility to contact the USCIS.

E. The local office shall provide an applicant non-citizen up to the thirtieth (30th) calendar day following the date of application to submit acceptable documentation of their non-citizen status or at least ten (10) calendar days from the date of the local office's request for an acceptable document.

F. A non-citizen who has been given a reasonable opportunity to submit acceptable documentation and has not done so within the normal processing time shall not be certified for benefits until acceptable documentation is available, except as provided below. However, when the local office fails to provide a non-citizen applicant with a reasonable opportunity as of the thirtieth (30th) calendar day following the date of application, the local office must provide the household with benefits back to the date of application, provided the household is otherwise eligible. A noncitizen is ineligible to participate until acceptable documentation is provided, except as provided below:

1. The local office has submitted a copy of a document provided by the household to the USCIS or other federal agency for verification that bears on the individual’s eligible alien status. In such instances, the local office must certify the individual for up to six (6) months from the date of the original request for verification pending the results of the investigation. Pending such verification, the individual's benefits will not be delayed, denied, reduced or terminated based on the individual's immigration status while awaiting a response to the request for verification.

2. The local office has submitted a request to the SSA for information regarding the number of quarters of work that can be credited to the individual; or SSA has responded that the individual has fewer than forty (40) quarters, and the individual provides documentation from the SSA that the SSA is conducting an investigation to determine if more quarters can be credited. If the SSA indicated that the number of qualifying quarters that can be credited is under investigation, the local office shall certify the individual, pending the results of the investigation, for up to six (6) months from the date of the original determination of insufficient quarters.

G. If the office determines that the documentation presented by the household is questionable or the documents that are used to determine eligibility are not issued by the USCIS, the office will use a secondary SAVE process. The secondary verification process will also be used when primary verification is not available through SAVE.

The secondary verification process will consist of submitting a photocopy of the documentary evidence presented, with form G-845, to the U.S. Citizenship and Immigration Service.

H. If the local office determines, after complying with the requirements of this section, that the noncitizen is not in an eligible alien status, the office shall take action, including sending proper notices to the household, to terminate, deny or reduce benefits. The household will have the opportunity to request a fair hearing prior to any adverse action taking effect.

I. If verification of eligible non-citizen status is not provided on a timely basis, the household has the option of withdrawing its application or requesting that the eligibility of the remaining household members be determined. The income and resources of the individual whose non-citizen status is unverified shall be considered available in determining the eligibility of the remaining household members. If verification of eligible non-citizen status is subsequently received the local office shall act on the information as a reported change in household membership in accordance with timeliness standards. The non-citizen shall not be entitled to retroactive benefits.

J. When any person in a household indicates inability or unwillingness to provide documentary evidence of non-citizen status, either for themselves or any other household member, the household has the option of withdrawing its application or participating with the member in question classified as an ineligible non-citizen. In such cases the local office shall not continue efforts to obtain that documentary evidence. 4.505.61 Verification of SSA Forty (40) Work Quarters The SSA Quarters of Coverage History System (QCHS) is available for purposes of verifying whether a lawful permanent resident has earned or can receive credit for forty (40) qualifying quarters. If the individual does not have documentation, they cannot participate until verification of forty (40) quarters of work is received from either the SSA or the individual.

If the SSA determines that its existing records do not verify that an individual claiming forty (40) credits or quarters has the forty (40) credits or quarters and the individual believes the SSA records are not correct, the SSA will work with the individual to determine whether the additional credits or quarters can be established. The individual should be advised that they have the option of working with the SSA and that if they exercise this option and obtain a statement from the SSA indicating that the number of credits or quarters is under review, they can continue to receive SNAP benefits for up to six (6) additional months from the date of the original determination of insufficient quarters.

A. No such qualifying quarter of coverage that is creditable under Title II of the Social Security Act for any period beginning after December 31, 1996, may be credited to a non-citizen if the noncitizen, parent of the non-citizen, or spouse of such non-citizen received any federal meanstested public benefit during the period for which such qualifying quarter of coverage is so credited.

B. The local office must evaluate quarters of coverage and receipt of federal means-tested public benefits on a calendar year basis. The local office must first determine the number of quarters creditable in a calendar year, then identify those quarters in which the non-citizen (or the parent(s) or spouse of the non-citizen) received federal means-tested public benefits and then remove those quarters from the number of quarters of coverage earned or credited to the noncitizen in that calendar year. However, if the non-citizen earns the fortieth (40th) quarter of coverage prior to applying for SNAP or any other federal means-tested public benefit in that same quarter, the local office must allow that quarter toward the forty (40) qualifying quarters total.

C. Receipt of federal means-tested public benefit shall not include the following:

1. Medical assistance under Title XIX of the Social Security Act (or any successor program to such Title) for care and services that are necessary for the treatment of an emergency medical condition (as defined in Section 1903(v)(3) of such Act) of the non-citizen involved and are not related to an organ transplant procedure, if the non-citizen involved otherwise meets the eligibility requirement for medical assistance under the State Plan approved under such Title (other than the requirement of the receipt of aid or assistance under Title IV of such Act, supplemental security income benefits under Title XVI of such Act, or a state supplementary payment)

2. Short-term non-cash, in-kind emergency disaster relief.

3. Assistance or benefits under the National School Lunch Act.

4. Assistance or benefits under the Child Nutrition Act of 1966.

5. Public health assistance (not including any assistance under Title XIX of the Social Security Act) for immunizations with respect to immunizable diseases and for testing and treatment of symptoms of communicable diseases whether or not such symptoms are caused by a communicable disease.

6. Payments for foster care and adoption assistance under Parts B and E of Title IV of the Social Security Act for a parent or a child who would, in the absence of Subsection (q), be eligible to have such payments made on the child's behalf under such part, but only if the foster or adoptive parent (or parents) of such child is a qualified alien (as defined in

Section 431 of the Social Security Act).

7. Programs, services, or assistance (such as soup kitchens, crises counseling and intervention, and short-term shelter) specified by the U.S. Attorney General, in the Attorney General's sole and unreviewable discretion after consultation with appropriate federal agencies and departments, that:

a. Deliver in-kind services at the community level, including through public or private nonprofit agencies, b. Do not condition the provision of assistance, the amount of assistance provided, or the cost of assistance provided on the individual recipient's income or resources, and, c. Are necessary for the protection of life or safety.

8. Programs of student assistance under Titles IV, V, IX, and X of the Higher Education Act of 1965.

9. Means-tested programs under the Elementary and Secondary Education Act of 1965.

10. Benefits under the Head Start Act.

11. Benefits under the Workforce Investment Act. 4.505.7 Verification of Non-citizen Sponsorship A. The local office shall verify the following information at the time of initial application and recertification:

1. The income and resources of the non-citizen’s sponsor and the sponsor's spouse (if living with the sponsor) at the time of the non-citizen’s application for SNAP.

2. The names and alien registration numbers of other non-citizens for whom the sponsor has signed an affidavit of support or similar agreement.

3. The number of dependents who are claimed or who could be claimed for federal income tax purposes of the sponsor and the sponsor's spouse.

4. The name, address, and phone number of the non-citizen’s sponsor.

B. Until the non-citizen provides information or verification necessary to determine eligibility, the sponsored non-citizen shall be ineligible. When such verification is provided, the local office shall act on the information as a reported change in household circumstances.

C. The eligibility of any remaining household members shall be determined. The income and resources of the ineligible non-citizen, excluding the attributed income and resources of the noncitizen’s sponsor and sponsor's spouse, shall be considered available in determining the eligibility and benefit level of the remaining household members.

If the sponsored non-citizen refuses to cooperate in providing and/or verifying needed information, other adult members of the non-citizen’s household shall be responsible for providing and/or verifying the information. If the information or verification is subsequently received, the local office shall act on the information as a reported change. If the same sponsor is responsible for the entire household, the entire household is ineligible until such time as the needed information is verified. The local office must assist the non-citizen in obtaining verification provided the household is cooperating with the local office. 4.505.8 Verification of Disqualified Member Data At the time of application and when adding a new member to a SNAP household, the office shall verify data with the national IPV/disqualification database for all household members aged eighteen (18) or older to determine if any members have an active IPV / disqualification from another state which requires a portion, or the entirety of, the disqualification period to be served in Colorado. Application processing shall not be delayed while awaiting verification from another state.

The local office shall ensure that:

A. Disqualifications from another state due to a drug-related felony, as defined in 7 C.F.R. 273.11(m), which is incorporated by reference in section 4.100, above, or any other disqualification that is not pursued in Colorado due to a waiver or state statute shall not be acted upon;

B. IPVs/disqualifications from another state must be independently verified with the originating state prior to taking any adverse action against a household’s SNAP benefits, if the client is unable to attest to the accuracy of the disqualification;

C. States shall be given twenty (20) calendar days to respond to a request for verification. If verification cannot be provided by the other state, then the disqualification shall not be acted upon. Local offices shall be given twenty (20) calendar days to respond to another state’s request of obtaining verification of a Colorado IPV. If the local office cannot provide verification, then steps shall be taken to remove the IPV from the national database.

D. Once independent verification is received, advance notice of adverse action shall be granted prior to benefits being reduced, suspended, denied, or terminated; and, E. The disqualified individual shall be provided an opportunity to appeal any adverse action.

If benefits are issued by the local office to an individual while awaiting verification of an IPV disqualification, the benefits issued while awaiting such verification may be reclaimed by the local office if it is determined that the individual was disqualified from the program at the time the benefits were issued.

4.506 VERIFICATION OF INCOME

Monthly, gross nonexempt income shall be verified prior to initial certification, unless the household is entitled to expedited service and postponed verification for one month. Income is also verified at recertification when a household reports that the amount of income has changed more than fifty dollars ($50), or the source of income has changed.

A. Responsibility 1. Clients are primarily responsible for furnishing income verification documents, a collateral contact, or the authorization needed to secure sufficient information to allow written or verbal verification by the eligibility technician. For PA recipients, the PA case record will normally be used as the source of verification.

2. Means of income verification include pension award letters, check stubs, employer letters, and collateral contacts with employers, agencies, or other persons having knowledge of the household’s circumstances.

3. When a collateral contact designated by the household cannot be expected to provide accurate third-party verification, the local office shall ask the household to designate an acceptable collateral contact, provide an alternative form of verification, or substitute a home visit.

4. In some instances, however, all attempts to verify income may be unsuccessful because the person or organization has failed to cooperate with the household. A cooperating client shall not be denied solely because a third-party refuses to provide verification. The eligibility technician shall, in consultation with the client or other sources, arrive at a figure to be used for certification purposes and annotate the household’s case record with information used to make an eligibility determination.

B. Continuing Employment When the client has continuing employment, the previous month's income is the best indication and source of verification of the amount of income the household may expect to receive. If information, such as probable salary raise, overtime pay, or layoff supplied by the household or collateral contact reveals that future income will differ substantially from the previous month's income, a reasonable estimate of income shall be made based on information obtained from the household members and/or collateral contacts. The method of determining and computing income shall be fully annotated in the case record.

C. Self-Employment A household’s statement of self-employment income shall be accepted unless questionable.

Should verification be requested, no specific verification shall be required. Self-employment verification may consist of tax documents, self-employment ledgers maintained by the household, receipts, or other documents used for verifying and documenting the household’s selfemployment income and expenses. If at the time of initial certification, a household is recently self-employed or does not have adequate documentation of the household’s self-employment income and expenses, the eligibility technician shall use the best information available to determine the household’s monthly income. The household shall be encouraged to keep records of income and expenses for subsequent certifications.

D. Educational Assistance All educational income and financial aid are considered exempt income and does not require verification to determine a household’s monthly income.

E. Verification of Terminated Employment 1. If information regarding the termination of employment is questionable, verification is necessary. The primary responsibility for providing verification rests with the household. If it is difficult or impossible for the household to obtain documentary evidence in a timely manner, the local office shall offer assistance. 2 Acceptable sources of verification include, but are not limited to, the previous employer, employee associations, union representatives and grievance committees, and the Colorado Department of Labor and Employment (DOLE). Whenever documentary evidence is not available, a collateral contact shall be used.

3. If the household and the local office are unable to obtain verification for a questionable claim of resignation from employment due to discrimination practices or unreasonable demands by an employer because an employer cannot be located, the household shall not be denied.

F. Cases of No Reported Income The existence of resources, unpaid bills, and/or credit might be an explanation of how the household exists with no income or income so low as to place them at the maximum benefit level without consideration of deductible expenses. The client’s statement of no income is acceptable, unless otherwise questionable.

4.507 VERIFICATION OF EXPENSES

A. Verification of Dependent Care Verification of dependent and child care expenses is required to grant a deduction.

B. Verification of Shelter and Utility Costs 1. A household’s declaration of its responsibility to pay shelter and utility costs, as well as the amount the household is responsible to pay, shall be considered an acceptable source of verification, unless questionable, to grant the household a deduction for the amount the household declares it is responsible for paying.

2. Households that wish to claim shelter costs for a home that is unoccupied because of employment or training away from the home, illness or abandonment caused by a natural disaster or casualty loss must provide verification of actual utility costs if the costs would result in a deduction. These households are also responsible for providing verification of any other shelter costs if the cost is questionable and it would result in a deduction. The local office is not required to assist households in obtaining verification of this expense if the verification needs to be obtained from a source outside the county.

3. If shelter expense is questionable and verification cannot be verified within thirty (30) calendar days from the date of application, the local office shall determine the household's eligibility and benefit level without providing a deduction for the unverified expense.

4. If the household subsequently provides the missing verification for questionable shelter costs, the information will be handled as a reported change. The household shall be entitled to restoration of any lost benefits as a result of the disallowance of the expense which could not be verified within the thirty (30) day period, only if the client was not given at least ten (10) calendar days to provide verification or less than ten (10) calendar days if a necessary second interview could only be scheduled between the twentieth (20th) and thirtieth (30th) day of the processing period.

C. Verification of Medical Expenses 1. The amount of medical bills and the portion that is reimbursable shall be verified prior to initial certification. At recertification, total medical expenses shall be verified if the source has changed or the total amount has changed more than twenty-five dollars ($25) since the last time they were verified, or the information is incomplete, inaccurate, inconsistent, or outdated.

2. The household's monthly medical deduction for the certification period shall be based on the information reported and verified by the household, any anticipated changes in the household's medical expenses that can be reasonably expected to occur during the certification period based on available information about the recipient's medical condition public or private insurance coverage and current verified medical expenses. If the change cannot be reasonably anticipated, the household shall have the non-reimbursable portion of the medical expense considered at the time the amount of the expense or reimbursement is reported and verified.

3. If the household reports a change in its medical expenses, the local office shall verify the change and act on the change during the certification period if it will result in an increase to the household’s benefit allotment. The household shall not be contacted to verify a change discovered through another source.

4. Households certified for twenty-four (24) months that incurred a one-time medical expense during the first twelve (12) months shall have the option of deducting the expense for one month, averaging the expense over the remainder of the first twelve (12) months of the certification period, or averaging the expense over the remainder of the certification period. One-time expenses reported after the twelfth (12th) month of the certification period will be deducted as a one-time monthly expense or averaged over the remaining months in the certification period, at the household's option.

D. Verification of Child Support Expenses 1. The local office shall accept any document that verifies the household's legal obligation to pay child support, such as a court or administrative order or legally enforceable separation agreement.

2. The local office shall accept documentation verifying a household's actual payment of child support including, but not limited to, cancelled checks, wage withholding statements, verification of withholding from unemployment compensation and statements from the custodial parent regarding direct payments or third party payments that the noncustodial parent pays or expects to pay on behalf of the custodial parent.

3. Documents that are accepted as verification of the household's legal obligation to pay child support shall not be accepted as verification of the household's actual monthly child support payments.

4. In addition to requiring verification from the household, the local office shall be responsible for obtaining verification of the household's child support payments if the payments are made to the child support services agency. The local office shall give the household an opportunity to resolve any discrepancy between household verification and the verification received from the child support services agency.

5. At recertification or periodic report, the local office shall require the household to re-verify the amount of legally obligated child support that a household member pays to a nonhousehold member and the actual monthly child support payments made.

4.601 GENERAL REQUIREMENTS FOR REPORTING CHANGES

A. Households are only required to report and verify if the household’s combined gross income exceeds one hundred thirty percent (130%) of the Federal Poverty Level (FPL) for its household size.

B. Households shall be required to report any increase in income no later than ten (10) calendar days from the end of the calendar month in which the change occurred.

C. The household shall be allowed to report changes in person, by telephone, in writing, or through the online system.

4.602 WHEN CHANGES ARE CONSIDERED REPORTED

A. A change shall be considered to be reported as of the date the local office is notified of the change, if the required verification is received within ten (10) calendar days from the date the change is considered reported.

If verification is obtained after the ten (10) calendar day timeframe, or during the adverse action period, the office shall consider the change reported on the day the verification is received.

4.603 HOUSEHOLD RESPONSIBILITY TO REPORT CHANGES

A. Households shall report all changes related to their SNAP eligibility and benefits at the certification interview, including any changes that occurred between the date an application is submitted and the date of the interview. If a change is reported in an initial month and the application has not yet been processed, the local office shall act on the most current information.

B. Households are required to report all changes in household circumstances when filing a recertification and periodic report.

C. Able-Bodied Adults Without Dependents (ABAWD), as defined in Section 4.100, that do not meet an exemption, as outlined in Section 4.310.3, are required to report any changes in work hours that bring the individual below twenty (20) hours per week, averaged monthly.

D. Households who have no gross income threshold or who are eligible to be certified with a gross income level of up to two hundred percent (200%) of the federal poverty level, as applicable to the household size, who are initially certified with income above one hundred thirty percent (130%) FPL shall not be required to report increases in the household’s combined gross income during the certification period.

E. Households who have no gross income threshold or who are eligible to be certified with a gross income level of up to two hundred percent (200%) of the FPL, as applicable to the household size, who are initially certified with income below 130% FPL are required to report when the household’s combined gross income exceeds one hundred thirty percent (130%) FPL applicable to the household size. After the household reports its first increase in income above one hundred thirty percent (130%) FPL, the household shall not be required to report further increases in the household’s combined gross income for the remainder of the certification period.

F. When a household submits a recertification or periodic report form and an interview is not conducted because one has been completed in the previous twelve month period, any changes that occur after the recertification or periodic report form was submitted are not required to be reported unless the change causes the household to exceed one hundred thirty percent (130%)

FPL applicable to the household size. If an interview is scheduled with the household, then the household is required to report any changes that occur between the time the household submitted the recertification application or periodic report form and the date of the interview.

G. Upon benefit approval at initial application, recertification and periodic change report, the household shall be provided with a notice of the gross income level that applies to its household size.

H. All applicant and ongoing SNAP households are responsible to report whenever a member of the SNAP household wins substantial lottery or gambling winnings.

4.604 ACTION ON REPORTED CHANGES

Changes shall be acted on in accordance with the following guidelines:

A. General Requirements Changes to a household’s circumstances shall be acted on prospectively and processed within ten (10) calendar days from the date the change is reported. Changes reported by households shall be documented in the SNAP case record to indicate the change and the date that the change was reported. If the reported change causes a change to the household’s allotment, a notice of action form shall be issued to inform the household of a new basis of issuance and/or a supplemental allotment. If a supplemental allotment is to be issued, the amount of the supplemental allotment shall be the difference between the allotment the household is eligible to receive, due to the reported change, and the allotment the household received for the current month. The household's total monthly allotment shall be increased for all subsequent months of the certification period that are affected by the change.

B. Changes Reported at Recertification and Periodic Report The local office shall act on all changes reported by households filing a recertification or periodic report. When a household reports information during the certification period that it was not required to report, the local office shall document the information in the case record. If the information is not acted upon because it would cause a reduction in benefits, and it does not meet the criteria outlined in D below, the local office shall review the information at the time of the household’s subsequent certification, or at the twelve (12) month periodic report for those households certified for twenty-four (24) months, to determine if the change should be acted upon when processing the recertification or periodic report.

C. Changes Resulting In an Increase 1. The local office shall act on any change reported by the household that will increase benefits. The increased allotment shall be made no later than the first allotment issued ten (10) or more calendar days after the change is reported. Any increase in benefits resulting from a change shall take effect the month following the month the change is considered reported. Therefore, if such a change is reported after the twentieth (20th) of a month, and it is not possible to adjust the following month's allotment before the household's next normal issuance day, a supplemental allotment (in addition to the previously authorized monthly allotment) must be issued within ten (10) calendar days from the date the change was reported. A supplemental allotment shall not be issued for the month in which the change occurred.

2. Changes that result in increased SNAP benefits for a household must be verified by the household within ten (10) calendar days from the date the change is reported. If the household fails to provide verification, benefits shall remain at the original level until verification is obtained. Changes that result in increased SNAP benefits for a household must be verified prior to adjusting the household’s allotment.

D. Changes Resulting in Allotment Decreases Changes that result in a decreased allotment shall be processed within ten (10) calendar days from the date the change is considered reported and made effective on the last day of the month in which the advance Notice of Adverse Action (NOAA) expires. The NOAA expires eleven (11) calendar days from the date it is issued or fifteen (15) calendar days for households participating in the address confidentiality program (ACP).

The county local office shall not act on changes during the certification period that would decrease benefits, unless:

1. The head of household requests that their case be closed;

2. The head of household requests that any member be removed;

3. An adult member requests to be removed from the case;

4. An adult member requests themselves and their children be removed from the case;

5. The agency has information about the household’s circumstances considered verified upon receipt;

6. There has been a change in the household’s public assistance grant;

7. The agency is acting on a mass change;

8. A household who has no gross income threshold or who is eligible to be certified with a gross income level up to two hundred percent (200%) FPL as applicable to the household size, which is initially certified with income below one hundred thirty percent (130%) FPL has a change in income that causes the household’s combined gross monthly income during the certification period to exceed one hundred thirty percent (130%) FPL; or 9. The agency has received information from the Prisoner Verification System or the Deceased Matching System that a household member is no longer residing in the home and the household has failed to respond to the notice of match, provided insufficient evidence to the contrary, or has confirmed the match.

E. Changes Resulting in Ineligibility Changes that result in the household becoming ineligible shall be processed within ten (10) calendar days from the date the change is considered reported unless the change does not require adverse action. Changes resulting in ineligibility shall be made effective on the last day of the month in which the Notice of Adverse Action expires.

F. Changes in Categorical Eligibility When a household reports a change during the certification period that results in it no longer meeting the criteria of the categorical eligibility tier for which it was originally certified, the household’s eligibility must be re-evaluated using the next appropriate category. If the reported change has not been verified, or is considered questionable, and it cannot be determined whether basic categorical eligibility, expanded categorical eligibility, or standard eligibility criteria should be used, a request for verification shall be initiated.

G. Changes in Household Composition 1. Changes in household composition shall be acted on prospectively for the following month when the local office is able to affect the change prior to the determination of the household’s allotment for that month. Anticipated income, deductions and other financial and non-financial criteria of the new member shall be considered in the prospective determination. The anticipated income, deductions, and other financial and non-financial criteria of a removed member shall no longer be considered when determining the household’s eligibility.

2. Individuals Disqualified During the Certification Period When an individual is disqualified during the household's certification period, the local office shall determine the eligibility or ineligibility of the remaining household members based on information contained in the case record. If information in the case record is insufficient, additional information shall be obtained as needed.

a. If a household's benefits are reduced or terminated within the certification period because one or more of its members was disqualified for intentional program violation/fraud, the local office shall notify the remaining members of their eligibility and benefit level at the same time the disqualified member(s) is notified of his or her disqualification.

b. If a household's benefits are reduced or terminated within the certification period because one or more of its members is disqualified for being an ineligible noncitizen, noncompliance with a work requirement, or for failure or refusal to obtain or provide a Social Security Number, the local office shall send a Notice of Adverse Action which informs the household of the disqualification, the reason for the disqualification, the eligibility and benefit level of the remaining members, and the actions the disqualified member must take to end the disqualification.

H. Changes Reported During the Certification Period That the Household Is Not Required To Report When a household reports information during the certification period that it was not required to report, the local office shall document the information in the case record. If the information is not acted upon because it would cause a reduction in a household’s benefit allotment and it does not meet the criteria outlined in D above, the local office shall review the information at the time of the household’s subsequent certification, or at the twelve (12) month periodic report for those households certified for twenty-four (24) months to determine if the change should be acted upon at that time. 4.604.1 Verification of Reported Changes Before action is taken on reported changes and to determine the effect on benefits, additional verification is required in the following instances:

A. Unclear Information 1. If the local office receives information about changes in a household's circumstances but cannot determine if or how the change will affect the household's benefits and the unclear information is:

a. Fewer than sixty (60) days old relative to the current month of participation; and b. Was required to have been reported per simplified reporting rules; or c. Appears to present significantly conflicting information about the household’s circumstances from that used by the local office at the time of certification, including changes to the household’s categorical eligibility tier, then:

The local office shall send a verification request notice requesting the household to provide the specific information or verification within ten (10) calendar days plus one (1) additional calendar day for mailing. Households participating in the Address Confidentiality Program (ACP) shall receive five (5) additional calendar days for mailing time. The local office shall assist the client in obtaining the verification if the household cannot obtain the information.

If the household fails or refuses to provide the verification or to request assistance with obtaining the verification within the ten (10) calendar days plus one (1) additional calendar day for mailing timeframe, or five (5) additional calendar days mailing time for ACP households, the process for closing the case shall be initiated. The Notice of Action Form shall advise the household that a change occurred that could not be acted upon, that the case is being closed, and that the household must provide the needed verification if it wishes to continue participation in the program. The household may be required to reapply if the household takes the required action after a break in benefits of more than thirty (30) calendar days.

2. If the information is more than sixty (60) days old relative to the current month of participation, was not required to be reported, or does not present significantly conflicting information from that used by the agency at the time of certification, the local office shall not act on this information or require the household to provide the information until the household’s next recertification or periodic report.

3. Changes which result in increased SNAP benefits for a household shall be verified prior to adjusting the household’s allotment. If the household fails to provide verification, benefits shall remain at the original level until verification is obtained.

B. Computer Matches Not Considered Verified Upon Receipt When information is received from a Prisoner Verification System indicating an individual is currently being held in a federal, state, or local detention or correctional institution for more than thirty (30) days or information is received from a Deceased Matching System indicating a household member has recently died, a notice of match shall be sent to the affected household prior to taking action to adjust or terminate the household’s benefits.

The notice of match shall explain what information is needed to challenge the match and the consequences of failing to respond. The notice shall provide the household with ten (10) calendar days plus one (1) additional calendar day for mailing time to respond. Households participating in the ACP shall be provided five (5) additional calendar days for mailing time.

If the household substantiates the match, fails to respond to the notice, or fails to provide sufficient verification to challenge the match results, the local office shall remove the subject individual from the SNAP household and adjust benefits accordingly following the procedures outlined in Section 4.604.

If the household provides sufficient verification that the match is invalid, no further action shall be taken to remove the subject individual or adjust the household’s benefits. The case record shall be documented accordingly.

4.605 FAILURE TO REPORT CHANGES

If SNAP benefits are over-issued because a household fails to timely report changes as required, a claim shall be established. Upon the establishment of a claim, a notice of overpayment, a detailed explanation of why the claim was established, and a repayment agreement will be mailed to the household. If the discovery is made within the certification period, the household must be given advance notice of adverse action if its benefits are to be reduced.

4.606 PUBLIC ASSISTANCE (PA) HOUSEHOLD CHANGES

A. Households that receive PA benefits which report a change in circumstances to the PA technician shall be considered to have reported the change for SNAP purposes. Information that is reported and verified to a PA program which results in a change to the PA benefit amount and that meets the SNAP rules for verification shall be considered VUR. The date the change is considered reported and verified is the date the PA program processes the change and authorizes the new PA benefit amount. When acting on information considered verified upon receipt (VUR), advance Notice of Adverse Action is required, except as noted in Section 4.608.1.

B. When there is a change in a PA case and the local office has sufficient information to make the corresponding SNAP adjustment, the local office shall follow the guidelines listed below.

1. If the change in household circumstances requires a reduction or termination of both PA and SNAP, the following action will be required:

a. Send Notices of Action for both programs simultaneously with both notices bearing the same effective date.

b. If a household requests a fair hearing any time prior to the effective date of the Notice of Adverse Action, and its certification period has not expired, the household's participation in the program shall be continued on the basis authorized immediately prior to the Notice of Adverse Action, unless the household specifically waives continuation of benefits. Continued benefits shall not be issued for a period beyond the end of the current certification period.

c. If the household appeals only a PA adverse action and is granted interim relief, SNAP benefits authorized prior to the adverse action shall continue or be restored. However, the household must reapply if the SNAP certification period expires before the hearing process is completed.

d. If the household does not appeal the adverse action to decrease the PA or SNAP benefits within the adverse action period, the changes shall be made in accordance with timeframes outlined in Section 4.603.

2. If the change requires a reduction or termination of PA benefits and/or increases in SNAP benefits, the following action will be required:

a. A PA Notice of Adverse Action shall be issued to the household and SNAP benefits shall not be increased until the adverse action period expires. If the household does not appeal, the increase shall be effective in accordance with

Section 4.604. The time limit for taking the action to increase SNAP benefits shall be calculated from the date the PA Notice of Adverse Action expires. The Notice of Adverse Action expires eleven (11) calendar days from the date it is issued or fifteen (15) calendar days for households participating in the address confidentiality program (ACP).

b. If the household requests a PA appeal and is granted interim relief, the household is entitled only to SNAP benefits that were authorized immediately prior to the PA adverse action and action must be taken to correct the current

basis of issuance. A SNAP claim must be made against the household if there was an over-issuance for the period pending the appeal decision.

3. When there is a change in a PA case which results in a termination of PA but there is insufficient information to determine SNAP eligibility, the local office shall follow the guidelines listed below:

a. The PA Advance Notice of Adverse Action and a verification request notice are issued simultaneously. The PA notice makes the action effective on the last day of the month the notice is sent (or the last day of the following month, as appropriate, to allow for the required advance notice period). The routine extension on SNAP notices allows the household time to reapply for benefits at the appropriate local office.

The verification request notice shall advise the household of the information that needs to be verified for the household to continue to receive SNAP benefits. The eligibility technician shall not take any further action until the PA Notice of Adverse Action period expires or until the household requests an appeal. If the household does not appeal the PA action and request a continuation of benefits, the agency may resume action on the reported change.

Depending on the response or non-response to the verification request, the eligibility technician shall adjust the household's benefits if the verification of the household circumstances is received, or issue a Notice of Adverse Action to close the household's case if the household does not respond or refuses to provide information.

b. Households requesting a SNAP appeal may be entitled to continued benefits.

c. If the household requests only a PA state appeal and is granted interim relief, SNAP benefits authorized immediately prior to the adverse action will continue or be restored.

4. If the situation does not require a PA Notice of Adverse Action, the local office shall act based on the normal change reporting processing time frames and provide proper noticing as described in this section.

C. Local offices shall ensure that there is no increase in SNAP benefits to households as the result of a penalty being imposed for an IPV or failure to comply with program requirements for a federal, state, or local means-tested program that distributes publicly funded benefits.

The local office shall calculate the SNAP allotment using the benefit amount that would be issued by the federal, state, or local means-tested program if no penalty had been imposed to reduce the benefit amount. A situation where benefits of the other program are being frozen at the current level shall not constitute a penalty subject to these provisions. Changes in household circumstances that are not related to the penalty and result in an increase in SNAP benefits shall also not be affected by these provisions.

4.607 MASS CHANGES

There are certain changes that occur which are not caused by the household, and which affect a mass portion of the SNAP caseload simultaneously. Such adjustments go into effect for all households at a specific point in time, and the local office will have full prior knowledge of the change. Such changes are generally initiated because of a change in state or federal regulations. When such changes occur, the local office shall be responsible for making the appropriate adjustments in the household's eligibility or allotment as directed by the State Department and noticing the client as outlined below:

A. Federal adjustments to eligibility standards, allotments, and deductions; state adjustments to the Standard Utility Allowance; and any federal reduction, cancellation, or suspension of SNAP These mass changes shall not require Advance Notice of Adverse Action to affected households; however, households shall be notified of such changes through the news media; posters in certification or issuance offices, or other locations frequented by participating households; or general notices mailed to participating households. Adjustments to federal standards and state adjustments to utility standards shall be implemented prospectively.

B. Mass changes in PA grants, such as state-only OAP and AND; and Cost of Living Adjustments (COLA), increases in federal Retirement, Survivors, and Disability Insurance (RSDI), SSI benefits (Title XVI), and amendments to the Social Security Act (Title II).

These mass changes shall require a Notice of Adverse Action when SNAP benefits are decreased or terminated. Such Notice for these mass changes shall be provided to the household as much before the household's scheduled issuance date as reasonably possible, although the Notice need not be given any earlier than the time required for advance Notice of Adverse Action, per Section 4.608. Mass changes shall be processed prospectively for all households.

1. At a minimum, affected households shall be informed of:

a. The general nature of the change;

b. Examples of the change's effect on household's allotments;

c. The month in which the change will take effect;

d. The household's right to a fair hearing;

e. The household's right to receive a continuation of benefits if the following criteria are met:

1. The household has not specifically waived its right to a continuation of benefits;

2. The household requests a fair and the request for a hearing is based upon improper computation of SNAP eligibility or benefits, or upon misapplication or misinterpretation of state rules, or federal law or

regulation.

f. The household's liability for any over-issued benefits if the hearing decision is adverse to the household g. General information on whom to contact for additional information.

2. Processing Mass Changes in PA PA grant cost-of-living increases and Social Security Act/SSI cost-of-living increases are treated as mass changes in SNAP. Mass changes shall be processed prospectively for all households. SNAP benefits shall be recalculated, and the change shall be effective in the same month as the change in the PA grant. If the local office has at least thirty (30) calendar days’ advance knowledge of the amount of the PA adjustment, the SNAP benefits shall be recalculated, and the change shall be effective in the same month as the change in the PA grant. In cases where the local office does not have thirty (30) calendar days’ advance notice, the SNAP change shall be made effective no later than the month following the month in which the PA grant was changed.

4.608 ADVANCE NOTICE OF ADVERSE ACTION

A. The local office shall notify a household of any change from its prior benefit level, the reason for the action and the date the action becomes effective on the Notice of Action form except as specified in Section 4.608.1. The Notice of Overpayment form is used as the Notice of Adverse Action for claims and the resulting recoupment for failure to respond.

B. Households shall receive advance Notice of Adverse Action, giving at least ten (10) calendar days advance notice, plus one additional calendar day for mailing time, before any adverse action, such as a benefit reduction, suspension, termination or denial, becomes effective during the certification period, except as specified in Section 4.608.1. Households participating in the address confidentiality program (ACP) shall receive five (5) additional calendar days for mailing time.

When acting on a change, if the ten (10) calendar day advance notice period, plus the additional calendar day(s) for mailing time, can be given in the month the Notice of Adverse Action is sent, the notice shall be effective on the last day of the month the notice is sent.

If the ten (10) calendar day advance notice period, plus the additional calendar day(s) for mailing, extends into the following month, the notice shall be effective on the last day of the month the notice expires. The notice of adverse action expires eleven (11) calendar days from the date it is issued or fifteen (15) calendar days for households participating in the ACP. The notice shall explain the reason for the proposed action and the date the action becomes effective.

If the advance notice period ends on a weekend or holiday and a request for a fair hearing and continuation of benefits are received the business day after the weekend or holiday, the request shall be considered timely received.

For changes that result in a decreased allotment or ineligibility, the local office shall issue a notice of adverse action within ten (10) calendar days of the date the change is considered reported, which will affect the next regularly scheduled allotment after the month in which the advance Notice of Adverse Action period expires.

C. Prior to the effective date of the Notice of Adverse Action, a participant household may request a conference with the staff of the certification office responsible for the decision to take the adverse action, or the household may file an appeal of such action.

D. The participant household may also, prior to the effective date of the Notice of Adverse Action, either before or after the conference, appeal the proposed action. Households that timely request a hearing may be entitled to continued benefits. The eligibility technician shall explain to the household that a demand will be made for any benefits determined by the hearing officer to have been over-issued. 4.608.1 Changes Not Requiring Advance Notice of Adverse Action Advance Notice of Adverse Action may be given, but is not required in the following situations:

A. The state department initiates mass changes outlined in Section 4.607, A. Such changes must be publicized in advance. Announcements may be handed out or mailed to affected participant households.

B. The local office determines based on reliable information that meets verification requirements that all members of a household have died.

C. The local office determines based on reliable information that meets verification requirements that the household has moved from the project area.

D. The household has been receiving an increased allotment to restore lost benefits, the restoration is complete, and the household was previously notified in writing of when the increased allotment would terminate.

E. The household's allotment varies from month to month within the certification period to consider changes that were anticipated at the time of certification, and the household was notified at the time of certification.

F. The household applied for PA and SNAP jointly and has been receiving SNAP benefits pending the approval of the PA grant and was notified at the time of certification that SNAP benefits would be reduced upon approval of the PA grant.

G. The certification office has elected to assign a longer certification period to a household certified on an expedited basis and for whom verification was postponed provided the household has received prior written notice that verification may result in a reduction in benefits.

H. As a result of the facility's loss of state or USDA/FNS authorization, the local office terminates eligibility of those residents in a drug or alcohol treatment center or group living arrangement, who are certified with the facility acting as authorized representative.

I. A household member is disqualified for an IPV/fraud or the benefits of the remaining household members are reduced or terminated to reflect the disqualification of that household member.

J. Converting a household from cash and/or SNAP repayment for claims to allotment reduction because of a failure to make agreed-on repayments.

K. The household was issued a repayment agreement for a claim and failed to respond. For households participating in the program that do not respond to the repayment agreement, benefit recoupment will be initiated.

L. A change that is reported at recertification for a household certified for six (6) months, or at periodic report for a household certified for twenty-four (24) months, which results in a decrease to the household’s SNAP allotment.

4.609 TRANSITIONAL SNAP (T-SNAP)

4.609.1 GENERAL ELIGIBILITY GUIDELINES

A. Households that receive SNAP and Colorado Works (CW) basic cash assistance that become ineligible for continued receipt of CW basic cash assistance because of changes in household income are eligible to receive T-SNAP, as provided for within this section. CW diversion payments are not considered basic cash assistance. CW basic cash assistance is defined in CDHS regulations at 9 CCR 2503-6.

B. Households that are eligible to receive T-SNAP will have the SNAP allotment continued for five (5) months. The household’s SNAP allotment will be continued in an amount based on what the household received prior to when the household’s income made them ineligible for CW basic cash assistance. Only the following four (4) changes will be acted upon when determining the SNAP allotment that is to be continued.

1. The loss of the CW cash grant;

2. Changes in household composition that result in a household member leaving and applying for SNAP in another household;

3. Updates to the SNAP eligibility standards that change each October 1 because of the annual cost-of-living adjustments (see Section 4.607); and, 4. Imposing an IPV disqualification.

C. When the SNAP allotment is continued, the household’s existing certification period shall end, and the household shall be assigned a new five (5) month certification period. The recertification requirements that would normally apply when the household's certification period ends must be postponed until the end of the five (5) month transitional certification period.

D. Households who are denied or not eligible for T-SNAP must have continued eligibility and benefit level determined in accordance with Section 4.604.

E. The following households are not eligible to receive T-SNAP:

1. Households leaving the CW program due to a CW sanction; or, 2. Households that are ineligible to receive SNAP because all individuals in the household meet one of the following criteria:

a. Disqualified for IPV;

b. Ineligible for failure to comply with a work requirement;

c. Ineligible student;

d. Ineligible non-citizen;

e. Disqualified for failing to provide information necessary for making a determination of eligibility or for completing any subsequent review of its eligibility;

f. Disqualified for receiving SNAP benefits in more than one household in the same month;

g. Disqualified for being a fleeing felon; or h. ABAWDs who fail to comply with the requirements of Section 4.310. 4.609.2 HOUSEHOLD CHANGES DURING THE TRANSITIONAL PERIOD [Rev. eff. 2/1/16]

A. The household is not required to report any changes during the five (5) month transitional period, including changes that put the household over one hundred thirty percent (130%) of the Federal Poverty Level (FPL). 4.609.3 CLOSING THE TRANSITIONAL PERIOD [Rev. eff. 2/1/16]

In the final month of the transitional period, the household must undergo the recertification process to determine the household’s continued eligibility and benefit amount.

4.609.4 HOUSEHOLDS WHO RETURN TO COLORADO WORKS (CW) DURING THE TRANSITIONAL

PERIOD

If a household receiving T-SNAP returns to CW during the transitional period, the local office shall complete the recertification process for SNAP to determine the household’s continued eligibility and benefit amount. If the household remains eligible for SNAP, the household shall be assigned a new 4.609.5 HOUSEHOLDS WHO REAPPLY FOR SNAP DURING THE TRANSITIONAL PERIOD [Rev. eff. 2/1/16]

A. At any time during the transitional period, the household may apply for recertification to determine if the household is eligible for a higher SNAP allotment. In determining if the household is eligible for a higher allotment, all changes in household circumstances shall be acted upon.

1. If the household is determined eligible for a benefit lower than its transitional benefit, the local office shall encourage the household to withdraw its application for recertification and continue to receive transitional benefits. If the household chooses not to withdraw its application, the local office shall deny the application and allow the transitional period to run its course.

2. If the household is eligible for benefits higher than its transitional benefit amount, the increased benefits shall take effect with the first day of the month following the month in which the reapplication was received. The transitional certification period shall be ended, and the household shall be assigned a new certification period that begins with the first day of the month following the month in which the household submitted the application for recertification.

B. If a household applies for recertification during its transitional period, the local office shall observe the following procedures:

1. The local office must schedule and complete an interview if one has not been completed within the previous 12 months.

2. The local office must provide the household with a notice of required verification and provide the household a minimum of ten (10) calendar days to provide the required verification.

3. Households shall be notified of their eligibility or ineligibility as soon as possible, but no later than thirty (30) calendar days following the date the application was filed.

a. If the local office does not determine a household's eligibility within thirty (30) calendar days following the application date, then the local office shall continue processing the application while continuing the household's transitional benefits.

b. If the application process cannot be completed because the household failed to take a required action, the local office may deny the application at that time or at the end of the thirty (30) calendar days.

c. If the household is determined to be ineligible, the local office shall deny the household's application for recertification and continue the household's transitional benefits to the end of the transitional benefit period, at which time the local office shall recertify the household in accordance with Section 4.209.

4.609.6 TRANSITIONAL NOTICE REQUIREMENTS

When a household is approved for T-SNAP, the household shall be notified of the following information:

A. A statement informing the household that it will be receiving transitional benefits and the length of its transitional period;

B. A statement informing the household that it has the option of applying for recertification at any time during the transitional period. The household must be informed that if it does not apply for recertification during the transitional period, then at the end of the transitional period the household must undergo the recertification process;

C. A statement that if the household returns to CW during its T-SNAP period, the household must undergo the recertification process to determine the household’s continued eligibility and new SNAP allotment;

D. A statement explaining any changes in the household's benefit amount due to the loss of Colorado Works basic cash assistance or due to changes outlined in Section 4.609.1, B and C;

E. A statement informing the household that it is not required to report and provide verification for any changes in household circumstances until the household completes the recertification process; and, F. A statement informing the household that the local office will not act on changes that the household reports during the transitional period and that if the household experiences a decrease in income or an increase in expenses or household size prior to that deadline, the household should apply for recertification.

4.610 REINSTATEMENT OF BENEFITS

A household may be eligible for a reinstatement of benefits, without filing a new application, during the remaining month(s) of the certification period if the reason for the original closure has been resolved and eligibility may be reestablished.

The local office may reinstate the household if the household reports and verifies a reported change in circumstances that reestablishes the household’s eligibility within 30 calendar days following the date of ineligibility. Within standard processing timeframes, the local office will review the case to determine if the household continues to meet all other eligibility requirements.

If eligible for reinstatement, the local office will prorate SNAP benefits from the date the household took all required action(s) to reestablish eligibility.

If the certification period has already ended or will end during the month the household is attempting to reestablish eligibility, a new application is needed.

4.700 SNAP BENEFIT ISSUANCE

CO/EBTS will allow electronic debiting of benefits onto an EBT card for certified eligible households.

Every household must be informed of the issuance accommodations that are available.

Local offices must provide an adequate number of issuance locations and hours of operation to allow all eligible households to receive their EBT) cards.

As SNAP is a national program, benefits issued to eligible households may be used for the purchase of eligible food in every state.

4.701 PROVIDING BENEFITS TO PARTICIPANTS

A. Local offices are responsible for the timely and accurate issuance of benefits to certified eligible households. All newly certified households, except those that are given expedited service, shall be given an opportunity to participate no later than thirty (30) calendar days following the date the application was filed. Day one (1) is the first calendar day after the application is received by a local office in the household’s county of residence. An opportunity to participate consists of providing households with an active EBT card and Personal Identification Number (PIN), posting benefits to the household’s EBT account, and having benefits available for spending. Local offices utilizing a mailing system must mail EBT cards and pins, if applicable, in time to assure that the benefits can be spent after they are received but before the thirty (30) day standard if the EBT card or pin is mailed on the twenty-ninth (29th) or thirtieth (30th) day. For households entitled to expedited service, the local office shall make benefits available to the household not later than the seventh (7th) calendar day following the date of application, and for mail card issuance, the EBT card shall be mailed no later than the end of the fifth (5TH) calendar day. Local offices that issue EBT cards by mail shall, at a minimum, use first-class mail and sturdy nonforwarding envelopes or packages to send EBT cards to households, and the EBT card and PIN must be mailed separately from one another.

B. Those households composed of persons who are: aged sixty (60) and older; or persons with a disability who have difficulty reaching issuance offices, as described in section 4.707, D; households which do not reside in a permanent dwelling or have a fixed mailing address; and those in remote, rural areas shall be given assistance in obtaining their EBT card. The local office shall assist these households by arranging for the mail issuance of EBT cards to them, by assisting them in finding authorized representatives who can act on their behalf, or by using other appropriate means.

C. The eligibility technician shall be sufficiently familiar with issuance operations to answer any questions the household may have about when, where, and how to access one’s benefits from the EBT card. 4.701.2 EBT Cards A. Certification units of local offices shall issue a Colorado Electronic Benefits Transfer System (CO/EBTS) debit card to each certified household. All cards shall be issued under the Social Security Number or client ID number of the household member or authorized representative who is authorized to receive the household's issuance as designated by the household.

B. The household, or the authorized representative, shall present the household's Colorado Electronic Benefits Transfer System (CO/EBTS) debit card at issuance points, retail outlets, or meal services in order to transact the allotment authorization or when exchanging benefits for eligible food.

C. The EBT card shall contain a space for the name and signature of the household member to whom the allotment is to be issued or for any authorized representatives designated by the D. The local office shall limit issuance of EBT cards to the time of initial certification, with replacements made only in instances when the EBT card is lost, mutilated, destroyed, or if there are changes in the person authorized to obtain benefits, or when the local office determines that a new EBT card is needed. Whenever possible, the local office shall collect the EBT card that it is replacing. The issuance unit must be notified of a replacement EBT card to assure that only the most recently issued EBT card is used for benefit issuance.

E. EBT cards can be used in the following circumstances:

1. Eligible household members sixty (60) years of age or over or members who are housebound, physically handicapped, or otherwise a person with disabilities to the extent that they are unable to adequately prepare all their meals, and their spouses, may use benefits to purchase meals prepared for and delivered to them by a nonprofit meal delivery service authorized by USDA/FNS.

2. Eligible household members sixty (60) years of age or over and their spouses may use benefits issued to them to purchase meals prepared especially for them at communal dining facilities authorized by USDA/FNS for that purpose.

F. EBT cards shall be kept in secure storage with access limited to authorized personnel only.

4.702 RESTORATION OF LOST BENEFITS 4.702.1 Eligibility for Restoration of Lost Benefits A. To be eligible for restored benefits, the household must have had its SNAP benefits wrongfully delayed, denied, or terminated. Delay shall mean that an eligibility determination was not accomplished within processing timeframe standards.

B. A restoration of benefits is warranted when a household has received fewer benefits than it was eligible to receive due to:

1. An error by the local office;

2. A court decision overturning or reversing a disqualification for IPV; or 3. A determination by a court that the household should have received more benefits than it received during a given issuance period.

C. In the event that a restoration is warranted, benefits shall be restored for not more than twelve (12) months prior to whichever of the following occurred first:

1. The date the local office was notified, in writing or orally, by the household or by another person or agency that a household received fewer benefits than it was eligible to receive;

2. The date the local office discovers through the normal course of business that an error occurred which lead to the loss of benefits for a specific household; or, 3. The date the household requested a fair hearing to contest the adverse action that resulted in the loss.

When determining the months for which a household may be entitled to restorations, month one (1) shall be the month prior to the month in which the error was discovered.

D. If the restoration is the result of a judicial action, the amount to be restored shall be determined as follows:

1. If the judicial action is the first action the household has taken to obtain a restoration of lost benefits, then benefits shall be restored for a period of not more than twelve (12) months prior to the date the court action was initiated.

2. If the judicial action is a review of an action taken by the local office, the benefits shall be restored for a period of no more than twelve (12) months prior to the first of either:

a. The date the local office was notified by the household or by another person or agency in writing, or orally, of the possible loss to the household, or, b. The date the household requested a fair hearing.

E. In no case shall benefits be restored for more than twelve (12) months prior to the date the local office is notified of, or discovers, the loss. Benefits shall be restored even if the household is currently ineligible.

F. In the event that the State orders a reduction or cancellation of benefits, those households whose allotments are reduced or cancelled as a result of the enactment of those procedures are not entitled to restoration of lost benefits. If the Secretary of Agriculture directs the State to restore reduced or cancelled benefits, the local office shall work promptly to issue such benefits. 4.702.2 Disputed Benefits A. If a household does not agree with any action taken by the local office to restore lost benefits or the amount of benefits determined to have been lost, the household may request a fair hearing within ninety (90) calendar days of the notice to the household of entitlement to a restoration. If such a request is made before or during the time period for which lost benefits are being restored, the local office will continue to issue the under-issued benefits pending the decision of the fair hearing. Once a final decision is reached, the local office shall restore benefits in accordance with the decision.

B. If the household requests a fair hearing to dispute the local office’s determination that the household is not eligible for restored benefits, restored benefits for the period in question shall not be issued to the household while awaiting the final agency decision. 4.702.3 Lost Benefits Due to Fraud Reversal Individuals disqualified for intentional Program violation/fraud are not entitled to a restoration of any benefits lost during the months they were disqualified unless the decision which resulted in disqualification is subsequently reversed. For each month the individual was disqualified, not to exceed twelve (12) months, the amount to be restored, if any, shall be determined by comparing the allotment the household received with the allotment the household would have received had the disqualified member been allowed to participate. If the household received a smaller allotment than it should have received, the difference equals the amount to be restored.

Participation in an administrative disqualification hearing (state or local) or referral for prosecution in which a person contests the local office's assertion that the individual committed an intentional program violation/fraud will be considered a request for restored benefits. If such a person is found to have committed intentional program violation by the State Department final agency decision and this decision is subsequently overturned by a court of law, the restoration of benefits shall be calculated for a period not to exceed twelve (12) months prior to the date of the original administrative hearing. 4.702.4 Errors by the SSA Office The local office shall restore to the household any benefits lost as the result of an error by the local office or by the SSA through joint processing.

Benefits shall be restored back to the date of a client’s release from a public institution if, while in the institution, the client jointly applied for SSI and SNAP, but the local office was not notified on a timely

basis of the client’s release.

4.703 CALCULATING LOST BENEFITS

After correcting the loss for future months and excluding those months which occurred prior to the twelve (12) month restriction, the following method will be used to calculate the amount of benefits to be restored:

A. If the household was eligible but received an incorrect allotment, the loss of benefits shall be calculated only for those months the household participated. If the loss was caused by an incorrect delay, denial, or termination of benefits, the month the loss initially occurred will be calculated as follows:

1. If an eligible household's application was erroneously denied, the month the loss initially occurred shall be the month of application or for an eligible household filing a timely reapplication, the first month of the new certification period.

2. If an eligible household's application was delayed, the months for which benefits may be lost shall be calculated.

3. If a household's benefits were erroneously terminated, the month the loss initially occurred shall be the first month benefits were not received as a result of the erroneous action.

B. After computing the date the loss initially occurred, the loss shall be calculated for each month subsequent to that date until either the first month the error is corrected or the first month the household is found ineligible, not to exceed twelve (12) months prior to the date the loss was discovered.

4.704 METHOD OF RESTORATION

A. Regardless of whether a household is currently eligible or ineligible, the local office shall restore lost benefits to a household by issuing an allotment equal to the amount of benefits that were lost.

The amount restored shall be issued in addition to the allotment currently eligible households are entitled to receive for the next month.

B. Whenever lost benefits are due to a household and the household's membership has changed, the local office shall restore the lost benefits to the household containing a majority of the individuals who were household members at the time the loss occurred. If the local office cannot locate or determine the household which contains a majority of household members, the local office shall restore the lost benefits to the household containing the person who was the head of the household at the time the loss occurred.

C. Each local office shall be responsible for maintaining an accounting system for documenting a household's entitlement to the restoration of lost benefits and for recording the balance of lost benefits that must be restored to the household. Each local office shall, at minimum, document how the amount to be restored was calculated and the reason lost benefits must be restored. The accounting system shall be designed to readily identify those situations where a claim against a household can be used to offset the amount to be restored.

4.705 WHEN AN INCREASE TO SNAP BENEFITS SHOULD NOT BE ISSUED

A. Local offices shall ensure that there is no increase in SNAP benefits to households as the result of a penalty being imposed for an IPV, or for failure to comply with work requirements, or for failure to comply with another program requirement for a federal, state, or local means-tested program that distributes publicly funded benefits.

B. To determine the SNAP allotment when there is such a decrease, the local office shall calculate the allotment using the benefit amount which would be issued by that program if no penalty had been imposed to reduce the benefit amount. A situation where benefits of the other program are being frozen at the current level shall not constitute a penalty subject to these provisions.

Changes in household circumstances that are not related to the penalty and result in an increase in SNAP benefits shall also not be affected by these provisions.

4.706 REPLACEMENT ISSUANCES TO HOUSEHOLDS DUE TO MISFORTUNE

A. A household may request a replacement issuance if food purchased with program benefits was destroyed in a household misfortune, such as, but not limited to, fire or flood. Replacement issuances shall be provided in the amount of the loss to the household, not to exceed one month's allotment, unless the issuance includes restored benefits that shall be replaced up to their full value. To qualify for a replacement, the household shall report the destruction to the local office within ten (10) calendar days of the incident.

The household shall sign and return a statement or an Affidavit for Food Destroyed in Misfortune to the local office within ten (10) calendar days of the date of the report, or benefits shall not be replaced. If the tenth (10th) day falls on a weekend or holiday, and the statement or Affidavit for Food Destroyed in Misfortune is received the day after the weekend or holiday, the local office shall consider the statement or affidavit timely received.

The statement or affidavit shall:

1. Attest to the destruction of the food purchased with the household's SNAP benefits;

2. State that the household is aware of the penalties for intentional misrepresentation of the facts.

B. Upon receiving a request for replacement of SNAP benefits for food reported as destroyed in an individual household misfortune, the local office shall:

1. Verify the disaster through either a collateral contact, documentation from a community agency including, but not limited to, the fire department or the Red Cross, or a home visit;

2. Issue replacement benefits within ten (10) calendar days of the report of loss, provided a signed statement of loss or an Affidavit for Food Destroyed in Misfortune is received. If the statement of loss is received on the ninth (9th) or tenth (10th) day after the report of loss, the issuance must be replaced within two (2) business days; and, 3. Document in the case record the date and reason that a replacement has been provided.

This provision shall apply in cases of an individual household misfortune, such as a fire, as well as in natural disasters affecting more than one (1) household. No limit on the number of replacements shall be placed on food purchased with SNAP benefits that were subsequently destroyed in a household misfortune. 4.706.1 Disaster and Replacement Allotments Where USDA/FNS has issued a disaster declaration of individual assistance, individuals in a household who are eligible for emergency SNAP benefits shall not receive both the disaster allotment and a replacement allotment. 4.706.2 Replacement of EBT Cards Lost in the Mail or Stolen Prior to Receipt by the Household Local offices shall comply with the following procedures in replacing EBT cards reported lost in the mail or stolen from the mail prior to receipt by the household.

A. Determine if the EBT card was mailed, if sufficient time has elapsed for delivery, or if the card was returned in the mail to the local office.

B. Issue a replacement EBT card and new PIN.

C. Take other action, such as correcting the address on the master issuance file by updating the households mailing and/or home address within the automated system. 4.706.3 Request for Replacement Issuances after Receipt of EBT Card Households cannot receive a replacement allotment of SNAP benefits that have been reported as stolen and used from the EBT card by someone without the household’s knowledge and consent. An EBT card received by a household and subsequently mutilated or found to be improperly manufactured shall be replaced. 4.706.4 Authorized Number of Replacement Issuances No limit on the number of replacements shall be placed on the replacement of benefits if the food purchased with SNAP benefits was destroyed in a household misfortune.

The local office shall deny or delay replacement issuances in cases in which available documentation indicates that the household's request for replacement appears to be fraudulent.

When a local office intends to deny or delay a replacement of SNAP benefits for any reason, the local office shall notify the household of the delay or denial through use of a Notice of Action form. The household shall be informed of its right to a county dispute resolution conference or state-level fair hearing to contest the denial or delay of a replacement issuance. Replacement shall not be made while the denial or delay is being appealed.

Replacement issuances shall be provided to households within ten (10) calendar days after report of loss (fifteen (15) days if issuance was by certified or registered mail) or within two (2) working days of receiving the signed household statement, whichever date is later.

When a request for replacement is made late in an issuance month, the replacement will be issued in the month after the month in which the original allotment was issued. All replacements shall be posted and reconciled to the month of issuance of the replacement.

4.707 SNAP ISSUANCE AND ACCOUNTABILITY

A. Local offices shall establish issuance and accountability systems to comply with these rules and to ensure that: only certified eligible households receive benefits; EBT cards are accepted, stored, and protected after delivery to receiving points; benefits are timely distributed in the correct amounts; and that benefit issuance and reconciliation are properly conducted and accurately reported.

B. Electronic benefit issuance shall be handled through the state department, and at designated contractor sites through the Colorado Electronic Benefit Transfer System (CO/EBTS).

C. Local offices shall assure a separation of certification functions from issuance functions and thereby provide for internal controls and prevention of fraud. Certification functions include determining eligibility for a household and ensuring that the eligibility is current and accurate.

Eligibility shall be updated and maintained in the automated system. It shall be the responsibility of the certification unit to complete all necessary actions in the automated system to authorize the issuance of benefits. Data entry of case information may be completed by either the certification unit or a separate data entry unit, but not by the issuance unit.

D. Issuance offices are responsible for the timely and accurate issuance of SNAP benefits to eligible participant households. An approved accountability and benefit issuance delivery system shall be established to ensure that eligibility information is data entered, that the automated system has an issuance available, and only certified households receive benefits. 4.707.1 Security Procedures The electronic benefit issuance area shall be physically separated, such as, but not limited to, the cage, counter, and railing, from both clients and other employees of the office who are not responsible for benefit issuance and accountability. Persons not specifically responsible for benefit issuance accountability shall also be barred from the electronic benefit card storage area.

Local offices, including contract issuers, shall take all precautions necessary to avoid acceptance, transfer, negotiation, or use of counterfeit SNAP benefits and to avoid any unauthorized use, transfer, acquisition, alteration, or possession of SNAP benefits. EBT cards shall be safeguarded from theft, embezzlement, loss, damage, or destruction.

Issuance supervisors shall give each cashier a daily supply of blank EBT cards from the bulk card inventory. On high volume issuance days, the cashier's supply may need to be replenished during issuance hours from an office vault. The vault containing bulk card inventory shall remain locked unless opened to withdraw cards. Keys and lock combinations shall be controlled and restricted to as few individuals as possible. Combinations and locks should be changed whenever an individual who has received them leaves the employ of the office.

EBT cards must be removed from public view and reach. It is required that each cashier operate from a card drawer rather than from sources on top of the counter. The EBT cards must be locked in the drawer whenever the cashier leaves the issuance area for any reason. In small offices where it is not possible for each cashier to have a separate supply of EBT cards, the number of EBT cards shall be counted whenever one cashier assumes duties of another cashier at the issuance counter, and transferred to that cashier's responsibility.

The office shall never be left unattended during hours of issuance, such as during breaks or lunch, unless the building is secured as it would be after business hours. 4.707.2 Security Program and Types of Prevention of Theft The goal of a security program is to safeguard issuance personnel, EBT cards, and other valuables. In the event of a robbery, a planned security program will prevent panic that could endanger the lives of the people in the office.

A major element in an effective security program is the designation of a security officer who would continually review office facilities and procedures to improve office security and deter loss. She/he shall acquaint fellow employees with the security measures including precautions during issuance, night security, and safety of persons and EBT cards while they are in transit between the issuance office and bulk storage area.

In addition to a security officer, each office shall distribute written instructions to all employees concerning appropriate behavior in the event of a robbery attempt and procedures for reporting the theft to law enforcement authorities and the state department.

A. Burglary Bulk EBT supplies shall be stored in a secure facility, preferably a bank or courthouse vault. If possible, all EBT cards should be returned daily to the secure storage facility. If EBT cards must be kept in the issuance office overnight, the amount shall be strictly limited to a one- or two-day supply.

If EBT cards are being stored in the office overnight, doors and windows that could afford access to the building shall be secured. Doors shall be equipped with double-cylinder dead bolt locks or locks of equivalent security. Any glass in doors and windows shall be barred or otherwise protected against breakage. Doors connecting with other offices or buildings shall be locked as securely as exterior doors. All doors and windows shall be checked to make certain they are locked before closing the office.

Issuance office EBT supplies shall be kept in a safe rather than a desk or file cabinet. The safe shall be immovable and in a part of the office not visible to the outside.

B. Robbery To minimize the temptation for robbery, the amount of EBT cards in the issuance office shall be limited to a one- or two-day supply. The cashier's supply shall be out of public view and issued from a cashier's drawer out of reach of clients.

The county social services director or office supervisor will inform local law enforcement officials of the issuing office operation and advise them of the maximum amounts of EBT cards handled.

If EBT cards are returned to the bank at the end of the day and/or EBT card mailings are delivered to the post office by issuance personnel, an escort shall be provided. EBT card deliveries shall not be made by only one person, especially at night.

Offices that use itinerant issuance points shall take additional precautions to protect EBT cards in transit and during issuance. An escort shall be provided to and from the itinerant point and shall be present during issuance hours.

C. Embezzlement To prevent embezzlement, there shall be a division of issuance responsibilities. The supervisor must verify issuance records and resolve or document any discrepancies in daily reconciliation.

At a minimum, supervisory personnel must take a monthly physical count of all EBT cards in the bulk EBT card storage points and EBT cards in each cashier's working stock. The end-of-themonth physical inventory must be accomplished after the close of business on the last issuance day of the reporting month or prior to the opening of business on the first issuance day of the following month. The actual inventory count is reported on Form FNS-250 (EBT Card Accountability Report). The supervisor must verify the accuracy of the FNS-250 report. 4.707.21 Reporting a Robbery or Burglary The local law enforcement agency shall be notified immediately by one of the persons at the issuance office who have been designated to carry out the reporting of a robbery or burglary. The state department shall also be notified immediately and will be responsible for informing USDA/FNS.

The office shall be protected to ensure that evidence is not destroyed. Any articles touched by the robbers (papers, furniture, counter tops) should not be touched by employees or other persons until law enforcement officers arrive.

The names of persons other than employees in the office at the time of the robbery shall be obtained if they insist on leaving prior to the arrival of law enforcement officers.

Each employee shall write down all pertinent information about the robbery. They should be told it is important to record their own impressions and observations prior to any discussion of them with other employees.

After law enforcement officers have made their examinations and with their approval, an immediate reconciliation of EBT cards shall be made to determine the amount of any loss. Stolen EBT cards will be identified by serial numbers. 4.707.3 EBT Requisition Issuance offices shall maintain EBT card inventory at proper levels as determined by volume of issuance, availability of adequate storage facilities and insurance coverage. EBT card inventory levels shall not exceed a six-month supply, including EBT cards on hand and those on order.

The security of issuance offices shall be continually monitored to ensure that adequate safeguards and insurance coverage are provided for the EBT card inventory on hand.

Arrangements have been made for issuance offices with sufficient issuance volume to receive shipments of EBT cards directly from USDA/FNS. Offices with low issuance volume will receive EBT card shipments from the state department storage vault by fully insured registered mail.

It is advised that issuance offices that receive direct shipments should check EBT cards after monthly reconciliation and order EBT cards according to USDA/FNS instructions. USDA/FNS will assess the reasonableness of EBT card requisitions based on prior inventory change. The requisitioning issuance office will be notified prior to any adjustment made to requisitions.

Those issuance offices which receive their EBT card supply from the state department storage vault shall requisition EBT cards in accordance with the instructions from the state department. The instructions will advise of procedures for ordering from the contractual EBT card provider. 4.707.4 Designated Personnel and Receiving Locations A. Local offices ordering EBT cards shall designate at least two persons who are authorized to receive EBT cards (receiving agent). The state department shall be notified by letter of the following:

1. Names of authorized personnel;

2. Complete address of EBT card receiving location; and 3. Hours in which EBT card delivery will be accepted.

B. Verification of Shipments Issuance offices and bulk storage points shall promptly verify and acknowledge, in writing, the contents of EBT card shipments received, and shall be responsive for the control and storage of EBT cards. Cartons of blank EBT cards are usually numbered consecutively, and serial numbers should be verified upon receipt of shipment. The receiving agent shall ensure that the indicated number of cartons is received before signing the receipt form.

C. Receipt of EBT Cards from USDA, FNS When a shipment of EBT cards is received from USDA/FNS, an original and three (3) copies of Form FNS 261 (Advice of Shipment) are mailed to the receiving agent. If the shipment is in order, the receiving agent shall complete Form FNS 261. If the shipment is not in order, immediately notify the State Department. The receiving agent will then be instructed to annotate Form FNS- 261, describing the EBT card discrepancy or damaged condition of the EBT cards. Form FNS 261 must be signed, dated, and submitted in the normal manner.

D. Receipt of EBT Cards from the State Department When a shipment is received from the State Department, Form FNS-300 (Advice of Transfer) is mailed to the receiving agent in the original and three (3) copies. If the shipment is in order, the original and all copies of Form FNS-300 are signed and dated by the receiving agent. If the shipment is not in order, immediately notify the state department. 4.707.5 Inventory Records A. Shortage/Overage of EBT Cards in Shipment Prior to issuance, each carton and box of EBT cards shall be examined. When there is a shortage or overage of EBT cards, Form FNS-471 must be completed and signed by two witnesses. In the case of a shortage, show the amount of shortage on Line 13 of Form FNS-250 as credits. In the case of an overage, show the amount on Line 9 of Form FNS-250 (Shipments Received from USDA/FCS) regardless of where shipment originated.

B. Improperly Manufactured or Mutilated EBT Cards in Shipment If EBT cards are improperly manufactured or mutilated, Form FNS-471 shall be completed. The EBT cards are cancelled immediately and destroyed at the end of the month in accordance with

Section 4.708.5.

If one or more boxes of EBT cards were improperly manufactured, local offices shall contact the state department, who will contact USDA/FNS on the instructions for disposition of the destructible EBT cards. EBT cards must be destroyed within thirty (30) calendar days from the close of the month in which the EBT cards were received. For disposition of mutilated EBT cards returned by participants, refer to Section 4.708.5.

C. Out-of-Sequence EBT Card Serial Numbers There will be occasional instances where an EBT card will be substituted for an EBT card damaged in manufacturing. Out-of-sequence serial numbered EBT cards in the box present no problem as long as the correct number of EBT cards are contained in the box, and shall be issued in the normal manner. 4.707.6 Benefit Issuance Locations and Storage Facilities A. Issuance locations shall be established by every local office to accomplish the issuance of EBT cards to certified SNAP households.

B. The state department shall be notified of all issuance locations and EBT card shipment receiving points that are created, changed, or terminated at least thirty (30) calendar days prior to THE effective date of action.

C. Whenever an issuance office or bulk storage point is terminated, the state department will complete a closeout accountability audit within thirty (30) calendar days of the termination. The findings of the audit shall be forwarded to USDA/FNS immediately. The state department shall perform a count of EBT cards on hand and transfer the inventory to another issuance office or bulk storage point preferably within the same project area. The actual inventory and transfer shall be properly documented and reported on Form FNS-250.

D. At least thirty (30) calendar days prior to closure of an issuance location, SNAP participants shall be notified of the impending closure. Notification shall include alternative issuance locations and information concerning available public transportation. A notice of closure shall also be prominently displayed in the issuance office. All necessary action shall be taken to maintain participant service without interruption.

E. The transfer of EBT cards between project areas is allowed only in emergency situations and only when authorized by the state department. The transferring office initiates Form FNS-300, retains copy 4, and forwards all other parts to the receiving office with the EBT card shipment. On verification of shipment, Form FNS-300 is dated and signed by the receiving office and copy 3 is returned to the transferring office. The counties involved in “transferring out” and “transferring in'' must properly document the transaction on Form FNS-250, which is submitted at the end of the 4.707.61 Contracting or Delegating Issuance Responsibilities Local assistance offices may legally contract with other parties such as banks, savings and loan associations, the U.S. Postal Service, community action and migrant service agencies, and other commercial businesses, the responsibility of issuance and storage of EBT cards. Contractors may be permitted to subcontract assigned issuance responsibilities with the approval of the local office.

Any delegation of issuance and EBT card security must clearly delineate the responsibilities of both parties. Local offices remain responsible regardless of any agreements to the contrary for ensuring that assigned duties are carried out in accordance with the regulations. Local offices are still liable to USDA/FNS for all losses of EBT cards regardless of the actual responsibility for duties.

If an issuance office/agent or bulk storage point is being closed for noncompliance with contractual agreements, the local assistance office shall perform weekly reconciliation until alternative issuance or storage points are obtained. 4.707.7 Monitoring of EBT Card Issuers The state department shall conduct an onsite review of each EBT issuance office and bulk storage point at least once every three (3) years. All offices or units of an EBT issuance office are subject to this review requirement. The state department shall base each review on the specific activities performed by each EBT card issuer or bulk storage point. A physical inventory of EBT cards shall be taken at each location, and count compared with perpetual inventory records and the monthly reports of the EBT card issuer or bulk storage point. This review may be conducted at branch sites as well as the main offices of each issuer and bulk storage point that operates in more than one office. 4.707.8 Division of Issuance Responsibilities Over the counter and mail issuance responsibilities shall be divided between a cashier and another issuance employee.

A. It is not always feasible for the duties of the cashier to be performed by separate employees because of a low issuance volume at an issuance office. Therefore, any local office that can justify deviation from the requirement, and is willing to assume the additional risk, may obtain permission for one-person issuance through written request to the state department (refer to

Section 4.707).

B. If mail issuance functions are performed by only one person, a second-party review shall be necessary to verify EBT card inventory each day and reconcile the number of certified households who were issued EBT cards and the number of mailings prepared on a biweekly

basis.

C. Cashier Responsibility 1. The cashier requests Form FS-5 (Identification Card) from the over-the-counter participant and compares the names on EBT card with the household names or authorized representative. For mail issuance the participant does not present an ID card for comparison.

2. When satisfied with the identification of the participant (not necessary for mail issuance) the cashier shall issue the EBT card and, enter the issuance information and authorized allotment on the issuance log. The cashier shall also post Form FS-52 (Daily Issuance Log) or Form FS-11 (Daily Tally Sheet of Individual Transactions) if either is used by the issuance office to record household participation.

3. The cashier may enter any remarks, (such as serial numbers) concerning EBT cards to be issued on either Form FS-52 or Form FS-11. For the over-the-counter issuances the cashier shall also obtain the participant's signature on Form FS-52 (Daily Issuance Log) and compare the signature with that on the ID card to assure that the signatures agree.

For mail issuance, there is no participant signature required. The cashier shall enter the date that the EBT card is mailed on Form FS-52 or Form FS-11. 4.707.81 Issuance of EBT Cards The cashier shall use Form FS-10 (Daily Report of Books Issued) each issuance day to record his/her beginning EBT card inventory to show the amount of EBT cards received to replenish the cashier's card stock supply, to show returns to inventory, and to enter total amount of EBT cards on hand by physical count at the end of the issuance-day. The cashier's actual issuance totals must be reconciled with Form FS-52, Form FS-11 or other authorizing documents each issuance day. 4.707.82 Issuance Reconciliation EBT cards shall be maintained in a secure location with access limited to authorized personnel. The issuance supervisor shall establish proper tracking and accounting methods to replenish each cashier's EBT card stock supply as needed.

In all issuance systems, EBT card issuers shall reconcile their issuance daily using daily tally sheets, cashiers' daily reports, tapes or printouts.

The daily total of issuances is recorded for printouts by the automated system, and shall also be reconciled with the cashiers' daily total of actual issuance of EBT cards determined by physical count.

Any unresolved discrepancy must be verified daily and on the cashiers' Form FS-10. 4.707.83 Issuance Record Retention and Forms Security The local office shall maintain issuance and reconciliation records for a period of three (3) years from the month of origination. This period may be extended with the written approval of USDA/FNS. Issuance and reconciliation records shall include, at a minimum, reports regarding Notices of Action, Notices of Change, and inventory record. Forms FNS-250, FNS-259, FNS-46 and substantiating documents, cashiers' daily reports, cashiers' daily tally sheets, master issuance files, the records for issuance for each month and any rosters or lists produced by the automated system. In lieu of the records themselves, easily retrievable microfilm, microfiche, or computer tapes that contain the required information may be maintained. 4.707.84 Control of Issuance Documents Local offices shall control all issuance documents that establish household eligibility while the documents are transferred and processed within the local office. The local office shall use numbers, batching, inventory control logs, or similar controls from the point of initial receipt through the issuance and reconciliation process. Access to all Notices of Action that initiate or terminate the master issuance file and blank EBT cards shall be limited to authorized personnel. 4.707.9 Issuance Methods The issuance office shall mail EBT cards to all eligible households if the household does not utilize any available in person pick up option. Certified households must be issued EBT cards by the end of the month except when benefits are suspended, cancelled, or reduced.

If benefits have been suspended, and the local office receives a directive to resume issuance of benefits, the issuance of mailed or over the counter EBT cards will be staggered through the end of the month or over a five-day period following the resumption of issuance. This could result in benefits being issued after the end of the month in which the suspension occurred. 4.707.91 Mail Issuance A. Prevention of Mail Issuance Losses All EBT cards shall be mailed as first-class mail, in sturdy non-forwarding envelopes.

B. Liability for EBT Cards Lost in the Mail USDA/FCS will assume financial liability for all properly issued EBT cards lost in the mail except losses in excess of three tenths of a percent (0.3%) of the state total quarterly mail issuance loss.

Each local office that has a mail loss during a quarter will be assessed a percentage of the state total penalty when a penalty is assessed against the state by the USDA/FNS.

C. SNAP Mail Issuance Report Form FNS-259 reports shall be submitted by local offices for each unit using a mail issuance system. Local offices shall submit Form FNS-259 reports so that they are received by the fifteenth (15th) day of the next month.

4.708 INVENTORY VERIFICATION

The issuance supervisor is responsible for taking a physical count of EBT cards on hand after the last issuance day of the month. There must be an actual count of all EBT cards in bulk storage facilities and in each cashier's working card stock in order to validate EBT card inventories reported on Form FS-13 and Form FNS-250. 4.708.1 EBT Card Responsibility and Liability Local offices shall be liable to USDA/FNS for the face value of EBT card loss that occurs because of thefts, embezzlements, and cashier error, unless the investigation was reported directly to USDA/FNS prior to the loss and unexplained causes. The local offices shall not be liable for the value of EBT cards issued for those duplicate issuances in the correct amount that are the result of authorized replacement issuances. 4.708.2 Inventory Reporting to The State Department Form FNS-250 (EBT Card Accountability Report), as incorporated by reference in section 4.707.6, C, above, shall be executed monthly by EBT card issuers and bulk storage points. The FNS-250 shall be signed by the EBT card issuer or appropriate official, certifying that the information is true and correct to the best of that person's knowledge and belief.

FNS-250 is an automated report available through an automated system and needs to be data entered by the 15th of the month. Supporting documentation to Form FNS-250 shall be submitted to the state department which will verify the monthly report. Documentation shall consist of documents supporting EBT card shipments (FNS-261, as incorporated by reference in section 4.707.4, C, above), EBT card transfers (FNS-300, as incorporated by reference in section 4.707.4, D, above), and destruction of EBT cards (FNS-135 and FNS-471, as incorporated by reference in section 4.707.5, A, above). 4.708.3 State Monthly EBT Card Accountability The state department shall establish an accounting system to review Form FNS-250, as incorporated by reference in section 4.707.66, C, above, completed by all local offices and determine the propriety and reasonableness of EBT card inventories, issuance activities, and reconciliation records. All records of EBT card requisition, EBT card receipt, returned mail EBT card issuances, replacements of EBT cards lost in the mail or improperly manufactured, or mutilated as well as the supporting remarks and documentation for monthly over-issuance and under-issuance shall be used to assure the accuracy of monthly reports. 4.708.4 Issuance Reconciliation Reporting Form FNS-46 (Issuance Reconciliation Report) shall be submitted by each local office operating an issuance system. The report shall be prepared at the level where the actual reconciliation of the record for issuance and master file occurs.

Local offices shall identify and report the number and value of all issuances that do not reconcile with the record-for-issuance and master issuance file.

In addition to the above requirement, local offices will continue to reconcile inventory levels against issuances each month on Form FNS-250 (SNAP Accountability Report, as incorporated by reference in

section 4.707.6, C, above) and attach Form FNS259 (SNAP Mail Issuance Report, as incorporated by reference in section 4.707.91, E, above) for reconciliation. 4.708.5 Destruction of Unusable EBT Cards Returned by Households Unusable EBT cards shall be destroyed by the local office provided that the destruction is accomplished by burning, shredding, or tearing and two (2) persons witness the EBT card destruction.

Form FNS-471 (EBT Card and Destruction Report, as incorporated by reference in section 4.707.5, A, above) shall be completed and signed by the required witnesses and mailed to the state department.

Form FNS-135 (Affidavit for Return or Exchange of EBT Cards, as incorporated by reference in section 4.708.2, above) completed for the return of unusable EBT cards by clients or for claims payments and Form FNS-471 completed on destruction of unusable EBT cards improperly manufactured or mutilated in shipments are supporting documents for necessary EBT card destruction.

Local offices must report the destruction of improperly manufactured or mutilated EBT cards on Form FNS-471 and submit it with Form FNS-250, as incorporated by reference in section 4.707.6, C, above, for the appropriate month. For EBT cards received from recipients, the original copy of Form FNS-135 must be attached to a copy of Form FNS-471 and retained in the office for future review and audit purposes.

The destruction of EBT cards received from claims collections that are the result of payment of household claims must be reported on Form FNS-471.

Form FNS-135 will act as a receipt on exchange of unusable EBT cards returned by clients or returned for claim payments. 4.708.6 Undeliverable or Returned EBT Cards Local offices shall exercise the following security and controls for EBT cards that are undeliverable or returned during the valid issuance period. Forms FNS-471, as incorporated by reference in section 4.707.5, A, above, and FNS-135, as incorporated by reference in section 4.708.2, above, shall be completed by the local office as appropriate.

EBT cards shall be returned to inventory and noted as such on the issuance log and Form FNS-250, as incorporated by reference in section 4.707.6, C, above. 4.708.7 EBT Cards Returned Because of Involuntary Termination or Death EBT Cards will be accounted for on Form FNS-135 (Affidavit for Return or Exchange of Food Coupons) and destroyed under procedures pertaining to Form FNS-471 (EBT Card and Destruction Report). A copy of Form FNS-135 will be retained in the household's case file for audit purposes. 4.708.8 State EBT Card Issuance and Participation Reporting The state department shall make estimations with data from the automated system on Benefit Issuance and Participation Estimates.

4.709 COLORADO ELECTRONIC BENEFIT TRANSFER SYSTEM (CO/EBTS) AND PROCESSING

CO/EBTS shall maintain a composite of data for all certified households and provide complete information on participating households for review sampling purposes, statistical summary, and reporting requirements. The automated system is a direct-access system that allows online issuance access to the master issuance file. The automated system provides for an online issuance system.

CO/EBTS will provide access to SNAP benefits by issuing a plastic debit card to clients receiving SNAP and/or PA benefits. The overall rules for CO/EBTS are in the Colorado Department of Human Services Special Projects rule manual at 12 CCR 2512-2.

Eligibility determinations in the automated system will be processed nightly to make SNAP benefits available the following day for initial certification. Ongoing cases will have benefits posted during a ten (10) calendar day cycle with the Social Security Number (SSN) as the basis. The ending number of the SSN will indicate the date for the posting of benefits. An SSN ending with one (1) will be posted on the first day of the month, two (2) on the second day of the month, etc. AN SSN ending with zero (0) will be posted on the tenth (10th) day of the month. 4.709.1 Card/PIN Issuance Accountability A. Local offices will establish procedures for issuance of CO/EBTS debit cards and Personal Identification Numbers (PINs). The household will be issued a debit card within seven (7) calendar days from the date of application for expedited cases and within thirty (30) calendar days for non-expedited cases.

B. Local offices shall maintain debit cards on site at its primary location and satellite offices. The EBTS contractor will provide counties with an initial supply of sequentially numbered cards with pre-embossed primary account numbers. Local offices must reorder cards to always ensure an adequate supply. The cards will be secured and accounted for through appropriate inventory and distribution forms.

C. The household PIN will be issued through encryption devices supplied by the state department. 4.709.2 EBT Card Replacement A. CO/EBTS debit cards for eligible recipients will be replaced when reported lost, stolen, or nonfunctioning. Replacement of cards will occur within three (3) business days of notification by the recipient.

B. Local offices may have replacement cards over the counter or through a transmission to the CO/EBTS contractor requesting mail issuance. Local offices shall not charge a fee if the replacement is issued by mail or the original card is inoperable due to no fault of the client. Local offices shall not charge a fee if the client is being recertified, and if, during the period of nonparticipation, the client has destroyed, lost, or damaged the original card.

C. Local offices shall not collect replacement fees by debiting a recipient's SNAP account.

4.800 CLAIMS, APPEAL PROCESS, AND FRAUD

Pursuant to Section 15(d) of the Food Stamp Act, benefits are an obligation of the United States within the meaning of 18 United States Code (USC), Chapter 15. The provisions of Title 18 of the United States Code, “Crimes and Criminal Procedure, Relative to Counterfeiting, Misuse and Alteration of Obligations of the United States” are applicable to SNAP benefits.

Any unauthorized issuance, use, transfer, acquisition, alteration, possession, or presentation of SNAP benefits may subject an individual, partnership, corporation, or other legal entity to prosecution under federal law and/or section 26-2-305, C.R.S. and accompanying Colorado criminal statutes.

4.801 CLAIMS AGAINST HOUSEHOLDS

A claim shall be established when a household is over-issued benefits. An over-issuance means the amount by which SNAP benefits issued to a household exceeds the SNAP allotment. 4.801.1 Classification of Claims Claims shall be classified as follows:

A. “Agency Error Claims” - A claim shall be handled as an agency error claim if the over-issuance is caused by an error on the part of the local office. Instances that may result in an agency error claim include, but are not limited to, the following:

1. The local office failed to take prompt action on a change reported by the household;

2. The local office incorrectly computed the household's income or deductions, or otherwise assigned an incorrect allotment;

3. The local office continued to provide a household SNAP benefits after its certification period expired without a recertification of eligibility.

4. The local office failed to provide a household a reduced level of SNAP benefits when its PA grant changed.

B. “Inadvertent Household Error Claims” - A claim shall be handled as an inadvertent household error claim if the over-issuance was caused by a misunderstanding or unintentional error on the

part of the household. Instances that may result in an inadvertent household error claim include, but are not limited to, the following:

1. The household unintentionally failed to provide the local office with correct or complete information.

2. The household unintentionally failed to report changes in its household circumstances.

3. The household unintentionally received benefits or more benefits than it was entitled to receive pending a fair hearing decision because the household requested a continuation of benefits based on the mistaken belief that it was entitled to such benefits.

4. The household was receiving SNAP solely because of basic categorical eligibility and the household was subsequently determined ineligible for Colorado Works (CW) or Social Security Income (SSI) during the time that the benefits were being received. The claim must be based on a change in net income and/or household size.

5. The SSA failed to take action that resulted in the household's basic categorical eligibility and improper receipt of SSI. The claim must be based on change in net income and/or household size.

C. “Intentional Program Violation (IPV) /Fraud Claims” - A claim shall be handled as an IPV/fraud claim only if:

1. An administrative disqualification hearing (ADH) official or a court of appropriate jurisdiction has found a household member has committed an IPV or fraud; or, 2. A signed waiver of ADH is received; or 3. A signed disqualification consent agreement has been obtained.

Prior to a waiver or consent agreement being signed or the determination of IPV/fraud, the claim against the household shall be handled as an inadvertent household error claim. 4.801.2 Establishing Claims Against Households A. Establishing a claim 1. The local office shall establish claims in accordance with the thresholds outlined below.

a. For participating households, the local office shall not establish a claim for overpayment due to Administrative Error (AE) or Inadvertent Household Error (IHE), except in the following circumstances:

1. When the amount of the claim is greater than $200; or 2. When the over-issuance is identified through a federal or state level quality control review; or, 3. When the IHE claim is being pursued as an IPV, except that if the IHE claim does not result in an IPV, collection shall not be pursued.

b. For households not participating in SNAP, the local office shall not establish a claim for over-issuance except in the following circumstances:

1. When the amount of the AE claim is greater than $400;

2. When the amount of the claim is due to an IHE and is greater than $200; or 3. When the over-issuance is identified through a federal or state level quality control review.

4. When an IHE claim is being pursued as an IPV, except that if the IHE claim does not result in an IPV, collection shall not be pursued.

2. An AE or IHE claim shall not be established for a period of more than twelve (12) months from the date the local office was notified, in writing or orally, or discovered through the normal course of business, that an error occurred which led to the household receiving more benefits than it was entitled to receive.

A claim associated with an IPV must be calculated back to the month the act of IPV first occurred and cannot be established for a period more than six (6) years from the date the local office was notified, in writing or orally, or discovered through the normal course of business, that an error occurred which led to the household receiving more benefits than it was entitled to receive.

3. Claims shall be established for benefits that are trafficked. The trafficking of benefits means the same as described in 26-2-306, C.R.S. and 7 C.F.R. 271.2, which is incorporated by reference in section 4.000.1, above.

4. Claims shall be established against the following individuals:

a. All adult household members aged eighteen (18) years of age or older at the time the over-issuance occurred, even if one or more of the adult household members are participating in another SNAP household at the time the claim is established;

b. A person connected to the household, such as an authorized representative, who traffics SNAP benefits or otherwise causes an over-issuance to occur.

B. Timeframe to Establish a Claim Local offices shall establish all claims before the last day of the quarter following the quarter in which the over-issuance or trafficking incident was discovered.

1. The discovery date for AE claims is the date that the local office was notified, in writing or orally, or discovered through the normal course of business that an agency error occurred that caused the household to receive more benefits than it was entitled to receive.

2. The discovery date for IHE and IPV non-trafficking claims shall be the date that verification used to calculate the over-issuance is obtained.

3. The discovery date for claims resulting from trafficking is the date of the court decision or the date the household signed a waiver of administrative disqualification hearing form or a disqualification consent agreement. 4.801.3 Calculating the Amount of a Claim A. Compromising Claims If the full amount or remaining amount of an AE or IHE claim cannot be liquidated in three (3) years, the local office may compromise the claim by reducing it to an amount that will allow the household to pay the claim in three (3) years. IPV claims shall not be compromised, unless specified in a court decision. The local office may use the full amount of the claim, including any amount compromised, to offset lost benefits. Decisions regarding compromises shall be documented in the case record.

A payment plan on a claim that has been compromised may be renegotiated if necessary. Claims that are already reduced by either an administrative or district court order are considered compromised claims, and thus are not eligible for additional compromise.

Local offices shall review the household’s circumstances and determine if a compromise would be appropriate. Local offices do not have the option of refusing to consider compromising claims.

Local offices cannot institute a policy of never compromising claims Claims should be compromised if the household demonstrates need, such as the inability to repay the claim within three (3) years, or if the household proves that financial, physical, or mental hardship would exist if forced to pay the full amount of the original claim. Some circumstances include, but are not limited to, medical hardships, high shelter costs, loan payments, and other extraordinary expenses. A compromise based on hardship may be applied to a SNAP case regardless of whether the household is still receiving SNAP benefits.

Consideration should be given to the future earning potential of the household over the next three (3) years to pay back the claim based on age, disability, and other household factors.

B. Claims Resulting from Trafficking The value of claims resulting from trafficking related offenses is the value of the trafficked benefits as determined by the individual's admission, through adjudication, or the documentation that forms the basis for the trafficking determination. Documentation could include such items as notarized statements or printouts from the EBT systems.

C. Agency Error and Inadvertent Household Error Claims 1. If the household received a larger allotment than it was entitled to receive, the local office shall establish a claim against the household that is equal to the difference between the allotment that the household received and the actual allotment it should have received.

Benefits authorized under Colorado Electronic Benefits Transfer System (CO/EBTS) shall be used to calculate the claim. After calculating the amount of a claim and establishing claims, the local office must offset the amount of the claim against any amounts which have not yet been restored to the household. Expungements and any return of benefits that occur must be used to offset the amount of the claim.

2. The claim must also be offset against restored benefits owed to:

a. Any household that contains a member who was an adult member of the original household;

b. Any household that contains an authorized representative that caused the overissuance or trafficking.

c. In no circumstance may the local office collect more than the amount of the claim.

3. For households eligible under BCE, a claim shall only be determined when it can be calculated because of changed household net income and/or household size. A claim shall not be established if there was not a change in net income and/or household size.

If a household receives both TANF and SNAP and mis-reports information to TANF in accordance with the TANF reporting requirements, and the mis-report of information to TANF resulted in the household being over-issued TANF or ineligible for TANF, any resulting SNAP claim should be based on the actual TANF issued.

4. The correct allotment shall be calculated using the same methods applied to certification.

The twenty percent (20%) earned income deduction shall not be applied to that part of any earned income that the household failed to report in a timely manner when this act is the basis for the claim; therefore, any portion of the claim that is due to earned income being reported in an untimely manner will be calculated without allowing the twenty percent (20%) earned income deduction. The circumstances of the household shall be used to calculate the claim. In instances when a claim is caused by the household’s failure to report information as required, the amount of the claim is based on the allotment difference from what the household received compared to what the household would have received if the household would have reported the information as required. For example, if a simplified reporting household did not report income at initial application as required, the income used to calculate the over-issuance would be the income that the household received in the month of application, as this would have been used to determine the household’s ongoing monthly amount. Actual income received each subsequent month is not required to calculate each month of the claim, as any fluctuation in monthly income that was received by the household after the initial month of application was not required to be reported by the household. If the household failed to report a change in household circumstances that would have resulted in an increase in benefits during the period of the claim, the local office shall act on the change in information as of the date the change was reported to the local office.

5. When a household certified below 130% FPL, as defined in section 4.401.1, above fails to report an increase in household income over 130% FPL. The local office shall establish the claim for each month in which an over-issuance of SNAP has occurred.

a. In cases involving household failure to report an increase in income within the required timeframes, the first (1st) month affected by the household's failure to report shall be the first (1st) month in which the change would have been effective had it been timely reported. However, in no event shall the determination of the first (1st) month in which the change would have been effective be any later than two (2) months from the month in which the change occurred. For purposes of calculating the claim, the local office shall assume that the change would have been reported properly and timely acted upon by the local office.

b. If the household timely reported an increase in income but the local office failed to act on the change within the required timeframes, the first (1st) month affected by the local office's failure to act shall be the first (1st) month the office would have made the change effective had it acted timely. If a Notice of Adverse Action was required, the local office shall assume, for the purpose of calculating the claim, that the Notice of Adverse Action period would have expired without the household requesting a fair hearing.

D. IPV Claims 1. Prior to a waiver of ADH or consent agreement being signed or the determination of IPV/fraud, the claim being pursued as an IPV claim shall be pursued as an IHE claim.

2. For each month that a household received an over-issuance due to an act of IPV/fraud, the local office shall determine the correct amount of SNAP benefits, if any, the household was entitled to receive. If the household member is determined to have intentionally failed to report a change in its household's circumstances, the claim shall be established for each month in which the failure to report would have affected the household's SNAP allotment.

3. Once the amount of the IPV claim is established, the local office shall offset the claim against any amount of lost benefits that have not yet been restored to the household.

E. Court Actions In cases where a household member was found guilty of fraud by a court of appropriate jurisdiction, the local office should request that the matter of restitution be brought before the court or addressed in the agreement reached between the prosecutor and individual. 4.801.4 Collecting Payments on Claims A. Claim Liability 1. Liable Individuals All adult household members aged eighteen (18) years or older at the time the overissuance occurred, sponsors, or other persons, such as an authorized representative who trafficked or otherwise caused an over-issuance or trafficking to occur, that are connected with the household shall be jointly and severally liable for the value of any over-issuance of benefits to the household.

2. Initiating Collection Action a. Local offices shall initiate collection action against all adult members or persons connected to the household at the time an over-issuance occurred. Under no circumstances shall the office collect more than the amount of the claim.

b. The local office may pursue collection action against any household that has a member that was connected to the household that received or created an overissuance.

c. The local office shall initiate collection action for an unpaid or partially paid IPV claim even if collection action was previously initiated against the household while the claim was being handled as an IHE claim. Collection action shall be initiated unless the household has already repaid the over-issuance because of an IHE demand letter described in section 4.801.4, C, 1, below, or the local office has documentation that shows the household cannot be located.

B. Postponing Collection Action Collection action on IHE claims may be postponed in cases where an over-issuance is being referred to an ADH or a court of appropriate jurisdiction, and the local office determines that collection action will prejudice the case. For cases in which the household is appealing an AE or IHE claim, collection action shall be suspended pending a final decision. A household’s appeal may include, but not be limited to, the establishment of the claim, the amount of the claim, and/or the household’s liability to repay the claim.

C. Notifying a Household of a Claim 1. Notice of Over-Issuance and Repayment Agreement Local offices shall initiate collection action on agency error and inadvertent household error claims by sending the household a State-prescribed written demand letter for the over-issuance. The letter shall inform the household of its rights and responsibilities concerning repayment of the claim as well as providing information on the availability of free legal services. All households that owe a claim shall be sent a demand letter. If the claim or the amount of the claim was not established at a fair hearing, the state agency must provide the household with a one-time Notice of Adverse Action. If the hearing official determines that a claim does, in fact, exist against the household, the household must be re-notified of the claim. The demand for payment may be combined with the notice of the hearing decision. Delinquency must be based on the due date of this subsequent notice and not on the initial pre-hearing demand letter sent to the household.

2. Calculation of Claim The local office shall mail the household an explanation of how the claim was calculated, showing each individual month and the cause for the claim. The State-prescribed form shall be used to determine and calculate the amount of the claim and to notify the household of the calculation. The form shall be mailed on a schedule that coincides with the mailing of the demand letter.

D. Negotiating Payment Plans Households participating in the program are subject to allotment reduction in accordance with

Section 4.801.41. B, unless the claim is being collected at a higher amount, per agreement with the household. Allotment reduction must begin with the first allotment issued ten (10) calendar days after the demand letter is mailed.

When a household is subject to allotment reduction, then a repayment agreement is not necessary unless the household wants to make voluntary payments in addition to the allotment reduction or elects to make monthly payments in amount greater than what would be repaid through allotment reduction.

If a household is not participating in the program, then the local office shall negotiate a payment schedule with the household for repayment of any amounts of the claim not repaid through a lump sum payment.

1. Establishing a Payment Plan The local office shall negotiate a payment schedule with the household for repayment of any amounts of the claim not repaid through a lump sum payment or through allotment reduction. Payments shall be accepted in regular installments. The household may use SNAP benefits as full or partial payment of any installment. The local office shall ensure that the negotiated amount of any payment schedule to be repaid each month through installment payments is not less than the amount that could be recovered through an allotment reduction. Once negotiated, the amount to be repaid each month through installment payments shall remain unchanged regardless of subsequent changes in the household's monthly allotment. However, both the local office and the household shall have the option to initiate renegotiation of the payment schedule if they believe that the household's economic circumstances have changes enough to warrant such action.

2. Household’s Failure to Respond to the Repayment Agreement If the household is not participating in the program when collection action for claim is initiated or if collection action has been initiated for repayment of a claim and no response is made to the first (1st) demand letter, additional demand letters shall be sent at reasonable Intervals, such as thirty (30) calendar days apart. The demand letters shall be sent until the household responds by paying or agreeing to pay the claim, until the criteria for suspending collection has been met or until the local office initiates ether collection actions.

E. Determining Delinquency 1. Claims shall be considered delinquent under the following circumstances:

a. If a claim has not been paid by the due date on the demand letter or a satisfactory payment arrangement has not been made. The claim shall remain delinquent until payment is received in full, an allotment reduction is invoked, or a new repayment schedule is negotiated. The date of delinquency for such claims is the due date on the initial demand letter.

b. If a satisfactory payment arrangement has been made for a claim and payment has not been received by the due date specified in the established repayment schedule, the date of delinquency for such claims is the due date of the missed installment payment, unless the claim was delinquent prior to entering into a repayment agreement, in which case the due date will be the due date on the initial demand letter. The claim will remain delinquent until payment is received in full, allotment reduction is invoked, or once the local office resumes or renegotiates the repayment schedule.

c. For purposes of the Federal Treasury Offset Program (TOP), a delinquent claim is one which is past due more than one hundred twenty (120) calendar days.

2. Claims shall not be considered delinquent under the following circumstances:

a. If another SNAP claim for the same household is currently being paid, either through an installment agreement or an allotment reduction, and the local office expects to begin collection on the claim once the prior claim(s) is settled;

b. If collection is coordinated through the court system and the local office has limited control over collection action; and c. If a household timely requests a fair hearing on the existence or amount of the claim and the local office suspends collection action pending a final agency decision. A claim awaiting a fair hearing decision shall not be considered delinquent.

If the hearing officer determines that a claim does in fact exist against the household, the household shall be sent another demand letter. Delinquency shall be based on the due date of this subsequent demand letter and not on the initial pre-hearing demand letter sent to the household. If the hearing officer determines that a claim does not exist, the claim is deleted and shall be terminated, and all collection activity ceased.

F. Joint Collections Received for a Combination SNAP and PA Claim An unspecified joint collection is when funds are received in response to correspondence or a referral that contained both the SNAP and other program claims, and the debtor does not specify to which program to apply the payment. The local office shall ensure that unspecified joint collections are pro-rated among the programs involved. When an unspecified joint collection is received for a combined PA and SNAP claim, each program shall receive its prorated share of the amount collected. 4.801.41 Methods of Collecting Payment on Claims The local office shall collect claims through one of the following methods:

A. Lump Sum The local office shall collect payments for total or partial payments of a claim in one lump sum if the household is financially able to pay the claim; however, the household shall not be required to liquidate all of its resources to make this repayment. If the household requests to make a lump sum cash and/or food benefit payment as full or partial payment of the claim, the local office shall accept this method of payment.

B. SNAP Allotment Reduction 1. The local office shall collect payments for claims from households currently participating in the Program by reducing the household's SNAP allotment. For claims where there is a court-ordered judgment for repayment, allotment reduction shall not occur.

Prior to reduction, the local office shall inform the household of:

a. The appropriate formula for determining the amount of SNAP to be recovered each month;

b. The amount of SNAP the local office expects will be recovered each month; and, c. The availability of other methods of repayment.

2. The household's allotment will be reduced based on the recoupment amounts for each type of claim unless a payment schedule has been negotiated with the household.

The local office may collect on a claim by invoking benefit allotment reduction on two (2) separate households for the same claim. However, the local office is not required to perform this simultaneous reduction.

3. The amount of SNAP to be recovered each month through allotment reduction shall be determined as follows:

a. For AE claims and IHE claims, the amount of SNAP to be recovered each month from a household shall either be ten percent (10%) of the household's monthly allotment or ten dollars ($10) each month, whichever is greater.

b. For IPV claims, the amount of SNAP benefit reduction shall either be twenty percent (20%) of the household's monthly allotment or twenty dollars ($20) per month, whichever is greater.

4. Benefits authorized for an initial month will not be reduced to offset a claim. Ongoing benefits will be recouped based on the above criteria.

C. Benefits from an EBT Account 1. A household may pay all or a portion of the claim by using benefits from its EBT account.

The local office shall obtain written permission from the household to deduct benefits from the EBT account to pay a claim. The written agreement shall be obtained prior to removing benefits from the EBT account and shall include:

a. A statement that this collection activity is strictly voluntary;

b. The amount of the payment;

c. The frequency of the payments (i.e., whether monthly or one (1) time);

d. The length of the agreement; and e. A statement that the household may revoke this agreement at any time.

2. If the household provides oral permission, the local office can make a one- time deduction from an active EBT account for a one (1)-time reduction. The county shall provide the household with a written receipt within ten (10) business days. The receipt shall contain the information used for an active EBT account and indicate that this is a one-time reduction.

3. When a local office pursues payment on a claim by applying SNAP benefits from the household’s stale EBT account, prior written notice shall be given to the household of the existing stale EBT account that may be applied to an outstanding claim. The county shall notify the household that the benefits will be applied to the claim unless the household objects to this offset. The household must be given ten (10) calendar days to object before the benefits can be applied as a payment to the claim. A stale EBT account means an account that has benefits but has not been accessed for at least three (3) consecutive calendar months.

D. Offset Against Taxpayer's State Income Tax Refund 1. The state department and local office may recover over-issuances of PA benefits through the offset (intercept) of a taxpayer's state income tax refund. Rent rebates are subject to the offset procedure. This method may be used to recover over-issuances that have been:

a. Determined by final agency action;

b. Ordered by a court as restitution; or, c. Reduced to judgment.

2. Pre-Offset Notice Prior to certifying the taxpayer's name and other information to the Department of Revenue, the state department shall notify the taxpayer in writing at his or her last known address that the state intends to use the tax refund offset to recover the over-issuance.

The pre-offset notice shall include the name of the local office claiming the over-issuance, a reference to SNAP as the source of the over-issuance, and the current balance owed.

3. Household Objection to Pre-Offset Notice The taxpayer is entitled to object to the offset by filing a request for a DRC or state-level hearing within thirty (30) calendar days from the date the state department mails the preoffset notice to the taxpayer. At the hearing on the offset, the local office or administrative adjudicator shall not consider whether an over-issuance has occurred, but may consider, if raised by the taxpayer in his or her request for a hearing, whether:

a. The taxpayer was properly notified of the over-issuance ;

b. The taxpayer is the person who owes the over-issuance ;

c. The amount of the over-issuance has been paid or is incorrect;

d. The debt created by the over-issuance has been discharged through bankruptcy;

e. Other special circumstances exist as described in Section 4.801.42.

E. Federal Treasury Offset Program (TOP)

The TOP, including the Federal Salary Offset Program (FSOP), is a mandatory government-wide delinquent debt matching and payment offset system in which Colorado SNAP participates.

The TOP allows collection of delinquent debts by intercepting any allowable payment from the federal government. Federal payments eligible for offset include federal income tax refunds, federal employee salary, federal retirement payments (including military), contractor or vendor payments, and federal benefits such as Social Security and railroad retirement.

1. Claims Submitted for Offset a. A delinquent claim may be submitted to the USDA, FNS for the TOP. To submit a claim to the TOP, the claim must be determined to be past due and legally enforceable. To determine that a claim is past due and legally enforceable, it must be determined that notification and collection attempts have taken place.

b. For purposes of the TOP, a delinquent claim is one which is past due more than one hundred twenty (120) calendar days.

c. A claim is not considered delinquent if a fair hearing is pending concerning the claim; or the claim has either been discharged by bankruptcy or is subject to the automatic stay of the bankruptcy; or the claim is not considered delinquent as described within Section 4.801.4, E, 2.

2. Processing Fee TOP, including the FSOP, is authorized to apply a processing fee each time a successful offset for collection occurs. Federal payroll offices participating in the TOP process may add another separate processing fee. The delinquent SNAP debtor is responsible for the fee each time it is applied. A TOP offset taken in error and later refunded will have the processing fee refunded, except for partially refunded offsets.

3. Notifying a Household of the TOP At the time delinquent debts are sent to be certified to the FNS for intercept by the TOP, all delinquent debts for every individual are sent at one time. Prior to a claim being certified to the FNS as a debt owed to the local office, the individual shall be mailed an offset notice. The notice shall provide the following information:

a. The local office has documentation that the individual identified with his or her Social Security Number (SSN) is liable for the specified unpaid balance of the claim;

b. The individual has been notified about the claim and prior collection efforts have been made. The claim is past due and legally enforceable. All adults are liable for the over-issuance of SNAP if they were household members when the SNAP benefits were over-issued. False statements concerning such liability may subject individuals to legal action (see Section 4.801.4, A);

c. Debts over one hundred twenty (120) days delinquent to be referred to the Treasury for an administrative offset. The local office intends to refer the claim within sixty (60) days of the date of the notice unless the individual makes other repayment arrangements acceptable to the local office;

d. Instructions on how to pay the claim, including the name, address, and telephone number of a person in the county who can discuss the claim and the intended offset with the individual;

e. The individual is entitled to request a review of the debt’s eligibility for referral to TOP. Individual review requests must be honored, regardless of whether they are received after the deadline requested. Claims that are currently under review will not be referred for the tax intercept; and f. All claims for the household that are to be certified to TOP.

4. The individual may document any legitimate reason that the claim is not past due or legally enforceable.

5. The individual should contact the local office if they believe that a bankruptcy proceeding prevents the collection of the claim or if the claim has been discharged in bankruptcy.

6. In some circumstances, the married individual may want to contact the IRS before filing his/her income tax return. This is true if the individual is filing a joint return and his or her spouse is not responsible for the SNAP claim and has income and withholding and/or estimated federal income tax payments. In such cases, the spouse may receive his or her portion of any joint return based on procedures prescribed by the IRS.

7. A federal employee may have his or her net disposable pay subject to garnishment under the offset. The Treasury may garnish up to fifteen percent (15%) of the net disposable pay. A federal employee may petition for a hearing only at the federal level to dispute the existence or the amount of the claim. The hearing occurs after the review period at the state-level and the subsequent submission to the Treasury as a valid offset.

8. An OOA adjudicator within CDHS will review the proposed offset and issue only a final agency decision. The OOA shall find that the claim is past due and legally enforceable unless the household can provide documentation to show one (1) of the following:

a. The claim is not delinquent or was already paid, and the individual provides proof of payment.

b. The individual is not the person that is liable for the claim.

c. A bankruptcy action prohibits collection of the claim because the automatic stay under Section 362 of the Bankruptcy Code is in effect with respect to the individual or his or her spouse, or that the claim was discharged by a bankruptcy proceeding.

d. There is some other reason that the claim is not delinquent or is not legally enforceable.

9. The final agency decision by the OOA regarding the paper review will be issued by means of written findings. No oral argument is permitted. The written findings shall include the following:

a. If the OOA determines that the claim is past due and legally enforceable:

1. The individual shall be notified that the claim will continue to be referred for the offset; and, 2. The individual is entitled to have the FNS review the OOA’s decision.

FNS must receive a request to do so within thirty (30) calendar days after the date of the state agency's notice of review decision. A request for FNS review shall include the individual's SSN. The notice shall also provide the address of the regional office including the phrase “Tax Offset Review” in the address.

b. If the OOA determines that the claim is not past due or legally enforceable, it shall notify the individual and the local office that the claim will not be referred for the offset.

c. While the OOA or FNS is conducting a review of the debt, the debt is not eligible for referral to TOP.

F. Pursuing Other Collection Activities 1. Local offices may pursue other collection actions, as appropriate, to obtain restitution of a claim against any household which fails to respond to a written demand letter for repayment of an agency error or inadvertent household error claim. In cases where a household member was found guilty of fraud by a court of appropriate jurisdiction, the local office may request that the matter of restitution be brought before the court or addressed in the agreement reached between the prosecutor and individual.

2. Other collection actions that the local office may pursue include the use of a collection agent, civil action, or criminal filing.

3. If the local office chooses to pursue other collection actions and the household pays the claim, payments shall be submitted to the Colorado Department of Human Services as required by Section 4.801.8. The local office's retention of recoveries shall be based on the actual amount collected from the household through such collections actions.

4. The local office shall not use other, involuntary collection methods against individuals in a household that is already having its benefit reduced. 4.801.42 Criteria for Suspending Collection Action [Rev. eff. 1/1/16]

The provisions within this section apply to Agency Error (AE) claims, Inadvertent Household Error (IHE) claims, and intentional Program violation (IPV) claims, unless otherwise stated.

A. The local office shall document the reason for suspending collection action. Suspended claims may be reactivated to offset a restoration of lost benefits or to pursue collection should collection action become feasible.

B. Collection action on a claim shall be suspended only under the following circumstances:

1. A claim may be suspended if no collection action was initiated because of one of the following conditions:

a. The local office has documentation that shows the household cannot be located;

b. A court decision postpones collection activity for a period of time.

2. If collection action was initiated and at least one (1) demand letter was sent, further collection action against an agency error claim or an inadvertent household error claim for a non-participating household may be suspended when:

a. The household cannot be located.

b. The cost of further collection action is likely to exceed the amount that can be recovered.

c. The household is determined to be financially unable to pay the claim.

d. If the local office can document that an individual found guilty of intentional program violation/fraud cannot be located, collection action shall be suspended.

3. Collection action may be suspended on any claim for a non-participating household after six (6) months of no response. The local office should be alert to other methods of pursuit of the claim (see Section 4.801.41, F). 4.801.43 Criteria for Terminating Collection Action [Rev. eff. 1/1/16]

The provisions within this section apply to Agency Error (AE) claims, Inadvertent Household Error (IHE) claims, and intentional Program violation (IPV) claims.

A. A terminated claim is a claim in which all collection activity has ceased. A terminated claim is no longer considered a receivable subject for continued state and federal agency collection and reporting requirements unless otherwise stated.

Voluntary payments from a household on a terminated claim do not reactivate the claim. A terminated claim cannot be reactivated to pursue collection.

B. Collection action on a claim shall be terminated only in the following situations:

1. A claim may be determined uncollectible after the collection action has been suspended for three (3) years. Prior to terminating such a claim, the local office may submit the claim for state or federal offset or pursue other collection actions. A terminated claim may not be reactivated to offset restoration of lost benefits.

2. A claim may be terminated if it has been delinquent for a period of three (3) years. Prior to terminating such claim, the local office may submit the claim for state or federal offset or pursue other collection actions.

3. A claim shall be terminated if found to be invalid by an administrative fair hearing decision or a court determination.

4. A claim shall be terminated if all adult members are deceased and the agency is not pursuing collection from the estate.

5. A claim that is twenty-five dollars ($25) or less and delinquent for ninety (90) calendar days may be terminated. 4.801.5 Claims Discharged Through Bankruptcy A. IPV claims tied to an actual determination of fraud through either an ADH or a court hearing cannot be discharged through bankruptcy. If an individual signs an ADH waiver and admits to committing fraud or guilt when accepting the disqualification, the IPV claims cannot be discharged through bankruptcy. If the individual signs the ADH waiver without admitting to fraud or guilt, there is no actual determination of fraud and the IPV claim may potentially be dischargeable through bankruptcy.

B. Local offices shall act on behalf of, and as an agent of, FNS in any bankruptcy proceedings against bankrupt households owing SNAP claims. Local offices shall possess any rights, priorities, liens, and privileges and shall participate in any distribution of assets, to the same extent as FNS. Acting as FNS, local offices shall have the power and authority to file objections to discharge proof of claims, exceptions to discharge, petition for revocation of discharge, and any other documents, motions, or objections which FNS might have filed. 4.801.6 Interstate Claims Collection In cases where a household moves out of the state, the local office that last handled the case involving a claim may initiate or continue collection action against the household for any over-issuance that occurred while the household was under that local office's jurisdiction. Counties may transfer a claim to another state or Colorado county if the other state or Colorado county accepts the transfer.

Counties are not obligated to accept the transfer of a claim from another state or Colorado county but have the option of accepting the claim and pursuing collection on that claim. Counties that accept the transfer of a claim shall pursue collection activities and retain appropriate incentives for the collection. 4.801.7 County Retention of Recoveries Counties may retain twenty percent (20%) of collections from inadvertent household error claims and thirty-five percent (35%) of collections from intentional Program violation/fraud claims. The total amount of collections from agency error claims is retained by the USDA, Food and Nutrition Service. 4.801.8 Submission of Claim Payment Activity to USDA, FNS The FNS-209 Report (Status of Claims against Households) is an automated report and is run quarterly.

The report is utilized to reflect all claims activities during a quarter and reflects all the payments made during the quarter. SNAP benefits received as a claim payment shall be recorded in the automated system and any corrections that need to be made to payments are made through the automated system.

The report is available for review from the first of the month immediately following the end of the quarter and continues to be available through the last working day of the quarter. A consolidated final report is available to be printed by local offices following the last working day of the quarter.

This FS-209 report is run quarterly even if the local office has not collected any payments or other claims activities. The local office shall not be required to submit Form FS-209 if the material on the automated system FS-209 is accurate and complete for that local office.

4.802 APPEAL PROCESS

Any household that is aggrieved by any action of the local office affecting the household's participation in SNAP may appeal by requesting a local-level dispute resolution conference (DRC) and/or a state-level fair hearing.

The right of a household to a DRC and state-level hearing is primarily to ensure that a proposed eligibility determination or action is valid, to protect the person against an erroneous action concerning benefits, and to ensure reasonable promptness of local office action. The individual may choose to request a DRC or bypass the DRC and appeal directly to the Colorado Department of Human Services (CDHS) for a state-level fair hearing.

CDHS may deny fair hearings to those households that are disputing a mass change, or the fact that a statewide reduction, cancellation, or suspension was ordered. In such instances, CDHS is not required to hold a fair hearing unless the request is based on the household's belief that the rules were misapplied.

If the household has a combined appeal, the appeal will be bifurcated. The SNAP fair hearings unit will process and hear the SNAP appeal, and the Office of Administrative Courts (OAC) will process and hear the other benefits program appeal(s). The SNAP fair hearings unit will provide the parties with any necessary instructions and/or procedures related to combined appeals. 4.802.1 Time Period for Requesting an Appeal A. A household shall be allowed to request a DRC or state-level fair hearing on the following:

1. Any action by the local office that occurred in the previous ninety (90) calendar days.

2. A loss of benefits that occurred in the previous ninety (90) calendar days. Such SNAP action shall include a denial of a request for restoration of benefits lost more than ninety (90) calendar days, but less than a year prior to the request.

3. At any time during a certification period a household may request a fair hearing to dispute its current level of benefits.

B. An aggrieved household shall be advised that the use of a DRC is optional, and it shall in no way delay or replace the state-level fair hearing process. If the household does not want a DRC but desires to have the disputed matter considered only at a state-level hearing, this fact should be indicated in the case record. In these cases, the request for an appeal shall be forwarded to the SNAP fair hearings unit. 4.802.2 Continuation of Benefits Pending Final Agency Decision A. Eligibility for Continuation of Benefits 1. If a household requests a state-level fair hearing or local-level dispute resolution conference any time prior to the effective date of the Notice of Adverse Action and its certification period has not expired, the household's participation in the program shall be continued on the basis authorized immediately prior to the Notice of Adverse Action unless the household specifically waives continuation of benefits.

Households which were not given a ten (10) day advance notice period plus one (1) additional calendar day for mailing time, or five (5) additional calendar days for mailing for households participating in the address confidentiality program (ACP), prior to the effective date of the Notice of Adverse Action shall be given ten (10) calendar days after the date the notice is mailed to appeal and receive continued benefits unless the household specifically waives continuation of benefits.

2. If a request for an appeal is not made within the times specified above, benefits shall be reduced or terminated as provided in the Notice of Adverse Action. However, if the household established that its failure to make the request within the established timeframe was for circumstances beyond the individual’s control, the local office shall reinstate the household’s benefits on the basis authorized immediately prior to the Notice of Adverse Action, unless the household indicates it has waived continuation of benefits.

Such circumstances are: illness, illness of another household member requiring the presence of the member, a household emergency, the unavailability of transportation, or other circumstances that would preclude the individual from taking the required action.

3. When benefits are reduced or terminated because of a mass change, participation on the prior basis shall be reinstated only if the issue being contested is that SNAP eligibility or benefits were improperly computed or that federal regulations or state rules were misapplied or misinterpreted by the local office.

4. Households appealing a decision based on information reported as part of the recertification process are not eligible for continued benefits. The benefit allotment that a household is certified to receive shall not be issued beyond the end of the household’s assigned certification period without a new determination of eligibility. The household’s benefit allotment beginning with the new certification period shall be based on the new review of eligibility.

B. Household’s Requirement to Request a Continuation of Benefits If the letter or form requesting an appeal does not positively indicate that the household has waived continuation of benefits, the local office shall assume that continuation of benefits is desired, and the benefits shall be issued accordingly.

C. Establishing a Claim on Benefits That Were Continued If the local office action is upheld by the hearing decision, a claim shall be established against the household for all over-issuances. This includes over-issuances due to the household receiving a continuation of benefits that the household was determined not eligible to receive. Such claims shall be classified as an inadvertent household error claim.

D. The certification office shall promptly inform the household in writing if the benefits are reduced or terminated pending the final agency decision. Once benefits are continued or reinstated, benefits shall not be reduced or terminated prior to the receipt of the final agency decision unless:

1. The certification period expires. The household may reapply and may be determined eligible for a new certification period with a benefit amount as determined by the local 2. The administrative adjudicator makes a preliminary determination, in writing and at the hearing, that the sole issue is one of federal law or regulation and that the household's claim that the local office improperly computed the benefits or misinterpreted or misapplied such law or regulation is invalid.

3. A change affecting the household's eligibility or basis of issuance occurs while the final agency decision is pending, and the household fails to request a hearing after the subsequent Notice of Adverse Action.

4. A mass change affecting the household's eligibility or basis of issuance occurs while the final agency decision is pending. During the fair hearing period, the local office shall adjust allotments to consider reported changes, information considered verified upon receipt, and mass changes, but not the factors on which the fair hearing is based. 4.802.21 Households Disputing Restoration of Lost Benefits A. The household has the right to appeal through the fair hearing process if the household disagrees with any action taken to grant or restore lost benefits.

B. If the local office has determined that a household is entitled to restoration of lost benefits but the household is appealing some action in calculating or restoring the lost benefits, the household shall receive the lost benefits as determined by the local office, pending the hearing results. Once a final agency decision is reached, the local office shall comply with that decision.

C. To be eligible for restored benefits, the household shall have had its SNAP benefits wrongfully delayed, denied, or terminated. The term denial shall include the situation where, through certification office error, the net income was larger than required under proper determination, and because of this improperly set net income, the household was unable to get the full allotment for which it was eligible. Delay shall mean that eligibility determination was not accomplished within the prescribed time limits set forth in Section 4.205.2. 4.802.3 Rights During an Appeal A. A household is entitled to the following:

1. Be represented by an authorized representative, such as legal counsel, relative, friend, or other spokesman, or they may represent themselves at the DRC or state-level fair 2. Adequate opportunity to examine the case file and all documents and records used by the local office in making its decision and all documents and records that are to be used at the hearing at a reasonable time before the date of the hearing as well as during the The contents of the case file including the application form and documents of verification used by the local office to establish the household's eligibility and allotment shall be made available, provided that confidential information, such as the names of individuals who have disclosed information about the household without its knowledge; or the nature or status of pending criminal prosecutions; or confidential informants; or privileged communications between the local office and its attorney is protected from disclosure.

If requested by the household or its representative, the local office shall provide a free copy of the portions of the case file that are relevant to the hearing. Confidential information that is protected from release and other documents or records which the household will not otherwise have an opportunity to contest, or challenge shall not be introduced at the hearing nor affect the hearing officer's decision.

3. Present new information or documentation to support reversal or modification of the proposed adverse action.

B. The household, its representative, and the local office shall be entitled to:

1. Present the case or have it presented by a legal counsel or other person.

2. Bring witnesses.

3. Advance arguments without undue interference.

4. Question or refute any testimony or evidence, including an opportunity to confront and cross-examine adverse witnesses.

5. Submit evidence to establish all pertinent facts and circumstances in the case. 4.802.4 Local Office Responsibility During an Appeal A. Upon request, the local office shall make available without charge the specific materials necessary for a household or its representative to determine whether a hearing should be requested or to prepare for a hearing. If the individual making the request communicates in a language other than English, the local office is required to provide bilingual staff or an interpreter who can effectively translate between the client’s language and English. The local office shall ensure that the hearing procedures are verbally explained in that language, upon request. The local office shall also help a household with its hearing process. Households shall be advised of any legal services available that can provide representation at the hearing.

B. The local office shall expedite hearing requests from households, such as migrant farm workers, that plan to move from the jurisdiction of the hearing officer before the hearing decision would normally be reached. Hearing requests from these households shall be processed faster than others, if necessary, to enable them to receive a decision before they leave the area.

C. The local office shall have the burden of proof, by a preponderance of the evidence, to establish the basis of the issue being appealed whether the appeal is at a state-level fair hearing or at a local-level DRC. This burden of proof applies to all matters other than IPV, which is outlined in sections 4.803.2, C and 4.803.2, E. 4.802.5 Local-Level Dispute Resolution Conferences (DRC)

A. Before taking action to deny, terminate, reduce, or recover SNAP benefits, the local office shall provide the household an opportunity for a DRC. The individual may choose to bypass the DRC process and appeal directly to the SNAP fair hearings unit for a state-level fair hearing.

B. If the household requests a DRC, the local office shall arrange one to attempt to resolve the disputed action. The household may be represented by legal counsel or have other persons present to aid the household in the DRC.

C. Failure of the client to request a DRC within the prior notice period or failure to appear at the time of the scheduled DRC without making a timely request for postponement shall constitute abandonment of the right to a DRC, unless the client can show good cause for their failure to appear. “Good cause” includes, but is not limited to:

1. Death or incapacity of a client, or a member of his or her immediate family, or the representative;

2. Any other health or medical condition of an emergency nature; or 3. Other circumstances beyond the control of the client, and which would prevent a reasonable person from making a timely request for a DRC or postponement of a scheduled DRC.

D. The local office may consolidate the SNAP DRC with disputes regarding other assistance payments programs, the Colorado Works (CW) Program, or disputes concerning Medicaid eligibility if the facts are similar and consolidation will facilitate the resolution of all disputes. 4.802.51 Management of Local-Level Dispute Resolution Conference (DRC)

A. General Requirements The DRC shall be conducted on an informal basis. Every effort shall be made to ensure that the household understands the local office’s specific reasons for the proposed action and the applicable State Department's rules. The local office shall have available at the DRC all pertinent documents and records in the case file relevant to the specific action in dispute.

B. Scheduling 1. To the extent possible, the DRC shall be scheduled and conducted within the prior notice period. If the local office cannot conduct the DRC within this period, for whatever reason, the adverse action in dispute shall be delayed until a DRC can be held, unless the household waives continuation of benefits.

2. If a DRC is requested to attempt to resolve a contested denial of expedited service, it shall be scheduled within two (2) working days of the receipt of the request for a DRC unless the household requests that it be held later. Prior notice is not required.

3. The local office shall provide reasonable notice to the household of the scheduled time and location for the DRC, or the time of the scheduled telephone conference. Notice shall be in writing; however, verbal notice may be given to facilitate the DRC process.

C. Location The DRC shall be held in the local office where the proposed decision is pending and before a person who was not directly involved in the initial determination of the action in question. The DRC may be conducted either in person or by telephone. If a telephonic conference is requested, it shall be agreed upon by the client. In the event the household does not speak English or is visually or hearing impaired, an interpreter or translator shall be provided by the local office.

D. County Representatives The individual who initiated the action in dispute shall not conduct the DRC. The individual who initiated the action in dispute shall attend the DRC and present the factual basis for the disputed action. The person designated to conduct the DRC shall be in a position which, based on knowledge, experience, and training, would enable them to determine if the proposed action is valid.

E. Joint Dispute Resolution Processes Two (2) or more local offices may establish a joint DRC process. If two or more counties establish a joint process, the location of the DRC need not be held in the county or agency taking the action, but the DRC location shall be convenient to the client.

F. Notice of DRC Decision 1. If the additional information presented in the DRC proves that the adverse action is not warranted, the case record shall be documented, and the Notice of Adverse Action cancelled.

2. At the conclusion of the DRC, the person presiding shall reduce to writing the agreement entered by the parties. Such agreement shall be signed by the parties and/or their representatives and shall be binding upon the parties. A copy of the written decision shall immediately be provided to the client and/or his or her representative. The local office shall also forward a copy of the decision to the State Department, within five (5) working days of the hearing, regardless of whether the client agrees with the outcome.

3. In the event the dispute is not resolved, the person presiding shall prepare a written statement indicating that the dispute was not resolved. The decision shall include:

a. A statement explaining the client’s right to request a state-level fair hearing;

b. The time limit for requesting a state-level hearing; and, c. If appropriate, a statement that the household’s previous benefit amount will continue pending a final state decision in accordance with Section 4.802.2, if appealed to the state within the appeal timeframe provided on the original Notice of Action cooresponding to the disputed action.

4.802.6 STATE-LEVEL FAIR HEARINGS

4.802.61 MANAGEMENT OF STATE-LEVEL HEARINGS

A. Scheduling 1. The SNAP fair hearings unit at the Colorado Department of Human Services (CDHS) or the Office of Administrative Courts (OAC), if so designated by CDHS, shall arrange the time, date, and place of the state-level fair hearing so that the hearing is accessible to the household. At least ten (10) calendar days prior to the hearing, advance written notice shall be provided to all parties involved to permit adequate preparation of the case. The household, however, may request less advanced notice to expedite the scheduling of the hearing. The notice shall:

a. Advise the household or its representative of the name, address, and phone number of the person to notify in the event it is not possible for the household to attend the scheduled hearing.

b. Specify that the household's hearing request will be dismissed if the household or its representative fails to appear for the hearing without good cause.

c. Include a copy of the information outlining CDHS’ state-level fair hearing procedures.

d. Explain that the household may examine the case file prior to the hearing.

2. Hearing requests for households that plan to move from the area, such as migrant farm workers, shall be processed faster than others, if necessary, to enable them to receive a decision and any appropriate restoration of benefits before they leave the area.

3. The administrative adjudicator shall complete the hearing no more than twenty-five (25) calendar days from when the SNAP fair hearings unit received the notice of appeal. The household may request and is entitled to receive a postponement (also referred to as a continuance) of the scheduled hearing. The postponement shall not exceed 30 days and the time limit for action on the final agency decision may be extended for as many days as the hearing is postponed. A county may not request and is not entitled to receive a postponement.

4. The administrative adjudicator may respond to a series of individual requests for hearings by conducting a single group hearing related to SNAP appeals. The snap fair hearings unit may consolidate only SNAP related cases where individual issues of fact are not disputed and where related issues of state and/or federal law, regulation, or policy are the sole issues being raised. In all group hearings, the regulations governing individual hearings shall be followed. Each individual household shall be permitted to present its own case or have its case presented by a representative.

B. Hearings Conducted by Phone The hearing may be conducted by telephone using conference call techniques or by video conference unless one of the parties objects to either of these methods. If a hearing is held by telephone using conference call techniques or by video conference, the rules of procedure (including a recording of the hearing) shall be the same as a face-to-face hearing.

C. Attendance The hearing shall be attended by a representative of the local office and by the household and/or its representative. The hearing may also be attended by friends or relatives of the household if the household so chooses. The administrative adjudicator shall have the authority to limit the number of persons in attendance at the hearing if space limitations exist.

D. Administrative Adjudicator The administrative adjudicator shall:

1. Administer all oaths or affirmations as required by the State;

2. Ensure all relevant issues are considered;

3. Request, receive, and make part of the record all evidence determined necessary to decide the issues being raised;

4. Regulate the conduct and course of the hearing consistent with due process to ensure an orderly hearing;

5. Order, where relevant and useful, an independent medical assessment or professional evaluation from a source mutually satisfactory to the household and the local office;

6. Provide a hearing record and prepare and file an initial hearing decision with the Office of Appeals (OOA) which shall serve each party with a copy of the initial decision. 4.802.62 Hearing Denials or Dismissals A. CDHS shall not deny or dismiss a request for a hearing unless:

1. The request is not received within the time period specified in Section 4.802.1.

2. The request is withdrawn in writing by the household or its representative; or, 3. The household or its representative fails, without good cause, to appear at the scheduled B. The administrative adjudicator shall not enter a default against any party for failure to file a written answer to the notice of hearing but shall base the initial decision upon the evidence presented at the hearing.

C. When the administrative adjudicator dismisses an appeal for reasons other than failure to appear, the decision of the administrative adjudicator shall be an initial decision, which shall not be implemented pending review by the Office of Appeals and entry of a final agency decision.

D. When an appellant fails to appear at a duly scheduled hearing, having been given proper notice, and without having given timely advance notice to the administrative adjudicator of acceptable good cause for inability to appear at the hearing at the time, date and place specified in the notice of hearing, then the appeal shall be considered abandoned, and an order of dismissal shall be entered by the administrative adjudicator and served upon the parties by the Office of Appeals (OOA). The order of dismissal for failure to appear shall not be implemented pending review by the OOA and entry of a final agency decision.

The appellant, however, shall be afforded a period of ten (10) calendar days from the date the order of dismissal was mailed, during which the appellant may explain in a letter to the administrative adjudicator the reason for his or her failure to appear. If the administrative adjudicator, then finds that there was acceptable good cause for the appellant not appearing, the administrative adjudicator shall vacate the order dismissing the appeal and reschedule another hearing date.

If the appellant does not submit a letter seeking to show good cause within a period of ten (10) calendar days, the order of dismissal shall be filed with the OOA. The OOA shall confirm the dismissal of the appeal by an agency decision, which shall be served upon the parties and the interested division of the State Department. Within three (3) working days after the effective date of the decision, the local office shall implement necessary actions to provide benefits in the correct amount, terminate benefits, recover benefits incorrectly paid, and/or other appropriate actions in accordance with the rules.

If the appellant submits a letter seeking to show good cause and the administrative adjudicator finds that the stated facts do not constitute good cause, the administrative adjudicator shall enter an initial decision confirming the dismissal. 4.802.63 State-Level Hearing Decisions A. Decisions of the administrative adjudicator shall not run counter to Federal law, State Department

rule, or state statute, and shall be based on the hearing record.

The exclusive record for an initial decision by the administrative adjudicator shall constitute the verbatim transcript or recording of testimony and exhibits, or an official report containing the substance of what transpired at the hearing, together with all papers and requests filed in the proceedings. This record shall be retained in accordance with normal retention periods. This record shall also be available to the household or its representative at any reasonable time for copying and inspection.

B. Following the conclusion of the state hearing, the administrative adjudicator shall promptly prepare and issue an initial decision and file it with the OOA.

C. Initial Decision 1. The administrative adjudicator shall render an initial decision within ten (10) calendar days of the hearing date. However, if the head of the household or the household’s representative requests a delay in the proceedings, the time limit for action on the decision may be extended for as many days as the hearing is delayed, up to thirty (30) calendar days.

2. The initial decision shall make an initial determination whether the county or the Colorado Department of Human Services (CDHS) or its agent acted in accordance with, and/or properly interpreted, the rules of the State Department. The administrative adjudicator may determine whether statutes were properly interpreted and applied only when no implementing state rules exist. The administrative adjudicator has no jurisdiction or

authority to determine issues of constitutionality or legality of departmental rules.

3. The initial decision shall advise the household that failure to file exceptions to provisions of the initial decision will waive the right to seek judicial review of a final agency decision affirming those provisions.

4. The Office of Appeals shall promptly serve the initial decision upon each party by first class mail and shall transmit a copy of the decision to the divisions of the State Department that administer the program(s) pertinent to the appeal.

5. The initial decision by the administrative adjudicator shall summarize the facts of the case, specify the reasons for the initial decision, and identify the supporting evidence and the pertinent rules.

6. The Office of Appeals at CDHS, as the designee of the Executive Director, shall review the initial decision of the administrative adjudicator and shall enter a final agency decision affirming, modifying, or reversing the initial decision. The Office of Appeals may issue an order of remand upon receipt of the initial decision and identification of an issue that warrants a remand before the initial decision is sent to the parties. Additionally, the Office of Appeals may issue an order of remand at the time of the substantive review of an initial decision for final agency decision. An order of remand is not a final agency decision that is subject to judicial review. The initial decision shall not be implemented pending review by the Office of Appeals and entry of a final agency decision. While review of the initial decision is pending before the Office of Appeals, the record on review, including any transcript or tape of testimony filed with the Office of Appeals, shall be available for examination by any party at the Office of Appeals during regular business hours.

D. Exceptions to the Initial Decision 1. Any party seeking a final agency decision that reverses, modifies, or remands the initial decision of the administrative adjudicator must file a written notice of intent to file exceptions to the decision with the OOA within five (5) calendar days - plus three (3) calendar days for mailing - from the date the initial decision is mailed to the parties. If the party has filed such a notice of intent, the party will have fifteen (15) calendar days, plus three (3) calendar days for mailing from the date the initial decision is mailed to the parties to file its written exceptions with the OOA. Exceptions shall state specific grounds for reversal, modification, or remand of the initial decision. Exceptions that fail to state specific grounds for reversal, modification, or remand of the initial decision shall be considered as only arguments of general dissatisfaction.

2. If any party asserts that the administrative adjudicator findings of fact are not supported by the weight of the evidence, the OOA will request the SNAP fair hearings unit provide an audio recording of the hearing to the OOA. If the local office asserts that the administrative adjudicator’s findings of fact are not supported by the weight of the evidence, the local office shall provide a hearing transcript to the OOA on or before the deadline for the filing of exceptions. If the local office’s yearly budget is not sufficient to pay the cost of a hearing transcript, the local office may request that the OOA review an audio recording of the hearing in lieu of a hearing transcript. Such requests must be mailed or emailed to the OOA at least five (5) calendar days before the deadline for the filing of exceptions. Additionally, the letter must indicate the insufficiency of the local office’s budget to pay for a hearing transcript and the letter must be signed by the county department’s director. The OOA shall issue an order regarding the request, and if granted, the OOA shall request the audio recording from the SNAP fair hearings unit. If the division(s) of the State Department responsible for administering the program(s) relevant to the appeal assert(s) that the administrative adjudicator’s findings of fact are not supported by the weight of the evidence, it shall simultaneously with, or prior to the filing of exceptions, file a hearing transcript with the OOA on or before the deadline for filing exceptions.

3. Considering the federal timeliness requirements for SNAP cases, a party may not request an extension of time to file exceptions unless a party is able to show sufficient good cause as to why an extension of time should be granted. The determination of good cause is within the sole discretion of the OOA. When an extension of time is granted by the OOA, the extension shall not be for more than five (5) calendar days after the original exceptions filing deadline. Local offices or the State Department will need to immediately review initial decisions to assess any need to request an audio recording from the SNAP fair hearings unit to receive the audio recording and expedite the transcription of the audio recording through whatever transcription service it chooses. Any party requesting transcription services shall be fully responsible for the cost of such.

4. If the exceptions do not challenge the findings of fact, but instead assert only that the administrative adjudicator improperly interpreted or applied state rules or relevant statutes, no transcript review or audio recording review is required.

5. The OOA shall serve a copy of the exceptions on each party by first class mail and by electronic mail if the party has consented to receiving communications by electronic mail.

Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties in which to file a written response to such exceptions. The OOA shall not permit oral argument.

6. The OOA shall not consider evidence that was not part of the record before the administrative adjudicator. However, the case may be remanded to the administrative adjudicator for rehearing if a party establishes in its exceptions that material evidence has been discovered that the party could not with reasonable diligence have produced at the 7. The division(s) of the State Department responsible for administering the program(s) relevant to the appeal may file exceptions to the initial decision, or respond to exceptions filed by a party, even though the Division has not previously appeared as a party to the appeal. The Division's exceptions shall be filed in compliance with the requirements of

section 4.802.63, D, 1 and 2, above. Exceptions filed by a Division that did not appear as a party at the hearing shall be treated as requesting a review of the initial decision upon the State Department's own motion.

E. Final Agency Decisions 1. The OOA shall enter a final agency decision resolving the appeal within sixty (60) calendar days after the request for appeal was received by the SNAP fair hearings unit.

2. In the absence of exceptions filed by any party or by a division of the State Department, or when exceptions are filed, the OOA shall review the initial decision and may review the hearing file of the administrative adjudicator and/or the taped testimony of witnesses before entering a final agency decision. Review by the OOA shall determine whether the initial decision properly interprets and applies the rules of the State Department or relevant statutes and whether the findings of fact and conclusions of law support the decision. If a party or Division of the State Department objects to the final agency decision entered upon review by the OOA, the party or Division may seek reconsideration.

3. The OOA shall mail copies of the final agency decision to all parties by first class mail.

4. For purposes of requesting judicial review, the effective date of the final agency decision shall be the third (3rd) day after the date the decision is mailed to the parties, even if the third day falls on Saturday, Sunday, or a legal holiday. The parties shall be advised of this in the final agency decision.

F. Motion for Reconsideration of a Final Agency Decision 1. A motion for reconsideration of a final agency decision may be granted by the OOA for the following reasons:

a. Upon a showing of good cause for failure to file exceptions to the initial decision within the fifteen (15) calendar day period; or, b. Upon a showing that the final agency decision is based upon a clear or plain error of fact or law. An error of law means failure by the OOA to follow a rule, statute, or court decision that controls the outcome of the appeal.

2. No motion for reconsideration shall be granted unless it is filed in writing with the OOA within fifteen (15) calendar days of the date that the final agency decision is mailed to the parties. The motion shall state specific grounds for reconsideration of the agency decision.

3. The OOA shall mail a copy of the motion for reconsideration to each party of record and to the appropriate Division of the State Department.

G. Acting on Decisions 1. Initial decisions shall not be implemented pending review by the OOA and entry of a final agency decision.

2. The State Department or local office shall initiate action to comply with the final agency decision within three (3) working days after the effective date. The acting department/office shall comply with the decision, even if reconsideration is requested, unless the effective date of the agency decision is postponed by order of the OOA or a reviewing court.

3. If it is ruled that the household had its SNAP benefits wrongfully delayed, denied, or terminated, the local office shall provide retroactive benefits. If it is decided that benefits were over-issued before and during the pendency of the determination of final agency action, a claim for over-issued benefits will be prepared.

4. Final agency decisions which result in an increase in household benefits shall be reflected in the benefit allotment within ten (10) days of the receipt of the decision, even if the local office is obligated to provide a supplementary allotment or otherwise provide the household with the opportunity to obtain the allotment outside of the normal cycle.

However, the local office may take longer than ten (10) days if it elects to make the decision effective in the household's normal issuance cycle, provided that the issuance will occur within sixty (60) days from the household's request for the hearing.

5. Final agency decisions which result in a decrease in household benefits shall be reflected in the next scheduled issuance following receipt of the decision unless the decision is stayed by the OOA upon a showing of irreparable harm. 4.803 IPV AND FRAUD [Rev. eff. 1/1/16]

A. Local offices shall be responsible for investigating any case of alleged intentional program violation/fraud and insuring that appropriate cases are acted upon either through administrative hearings; by referral to a court of appropriate jurisdiction; by obtaining a waiver of administrative hearing; or by obtaining a signed disqualification consent agreement.

B. Local offices are encouraged to refer for prosecution under state fraud statutes those individuals suspected of committing fraud, particularly if large amounts of benefits are suspected of being fraudulently obtained or the individual is suspected of committing more than one (1) fraudulent act. The local office shall confer with its legal representative to determine the types of cases that will be accepted for possible prosecution.

Local offices are also encouraged to enter into prosecution agreements with their district court.

Agreements should include information on how, and under what circumstances, cases will be accepted for possible prosecution and any other criteria set by the court for accepting cases for prosecution, such as a minimum amount of over-issuance that resulted from the intentional program violation.

C. Administrative disqualification procedures or referral for prosecution should be initiated by the local office anytime it has sufficient documentary evidence to substantiate that an individual has committed one or more acts of intentional program violation/fraud. If administrative disqualification procedures or referral for prosecution is not initiated for a case involving an overissuance caused by a suspected act of intentional program violation/fraud, an inadvertent household error claim shall be established against the household.

D. In cases where the determination of fraud is reversed by a court of appropriate jurisdiction or by a final agency decision, the local office shall reinstate the individual in the Program if the household is otherwise eligible. The local office shall restore any benefits that were lost as a result of the E. The local office shall inform the household in writing of disqualification penalties for IPV each time it applies for SNAP benefits. The penalty warning will appear in clear, boldface lettering on the SNAP application forms and shall serve as notification to the household. 4.803.1 Documenting and Reporting IPV/Fraud to the State Department Local offices shall enter into the automated system individuals disqualified for intentional program violation/fraud prior to the second (2nd) to the last working day of the month. In addition, local offices shall prepare quarterly a form FS-36A, Investigation/Intentional Program Violation/Fraud Report. The completed report shall be due fifteen (15) calendar days after the end of the quarter to the State Department. 4.803.2 Determination of an IPV /Fraud A. An intentional program violation shall be established only if an administrative disqualification hearing official or a court of appropriate jurisdiction has found a household member has committed an intentional program violation or fraud or if a signed waiver of administrative hearing or a signed disqualification consent agreement has been obtained.

B. For purposes of determining, through administrative disqualification hearings, whether a person has committed an IPV, the determination shall be based upon whether the person intentionally:

1. Made a false or misleading statement, or misrepresented, concealed, or withheld facts;

2. Committed any act that constitutes a violation of the Food and Nutrition Act of 2008, as amended, these SNAP rules, Federal SNAP regulations, or any state statute for the

purpose of using, presenting, transferring, acquiring, receiving, possessing, or trafficking of SNAP benefits, authorization cards or reusable documents as part of an automated benefit delivery system access device.

“Intentionally” means a false representation of a material fact with knowledge of that falsity, or omission of a material fact with knowledge of that omission.

C. The determination of IPV/fraud shall be based upon clear and convincing evidence that demonstrates that the household member(s) committed and intended to commit IPV. “Clear and convincing” means evidence which is stronger than a “preponderance of evidence” and which is unmistakable and free from serious or substantial doubt.

D. The same act of IPV/fraud repeated over a period of time shall not be separated so that separate disqualification periods can be imposed.

E. The burden of proving IPV/fraud is with the local office.

F. Disqualification periods shall be imposed based on the following:

1. Administrative Disqualification Hearing (ADH)

If an IPV/fraud is determined through an ADH, the individual must be notified in writing once it is determined that they are to be disqualified. The disqualification period shall begin no later than the second month which follows the date the individual receives written notice of the disqualification.

2. Waiver of an ADH If an IPV/fraud is determined through the client signing a waiver of an administrative disqualification hearing form, then the period of disqualification shall begin with the first month which follows the date the household member receives written notification of the 3. Court Decisions If an individual is determined through a court to be disqualified for an IPV/fraud, but the date for initiating the disqualification period is not specified, the local office shall initiate the disqualification period for currently eligible individuals within forty-five (45) calendar days of the date the disqualification was ordered. Any other court-imposed disqualification shall begin within forty-five (45) calendar days of the date the court found a currently eligible individual guilty of civil or criminal misrepresentation or fraud.

4. Disqualification Consent Agreements Unless contrary to the court order, the period of disqualification shall begin within fortyfive (45) calendar days from the date the household member signed the disqualification consent agreement. However, if the court imposes a disqualification period or specifies the date for initiating the disqualification period, the state department shall disqualify the household member in accordance with the court order. 4.803.3 Time Period and Types of Disqualifications [Rev. eff. 1/1/16]

A. IPV

Individuals who have waived a hearing for IPV or who have been found to have committed an IPV through a local-level or state administrative IPV decision shall be ineligible to participate in SNAP for twelve (12) months for the first (1st) IPV; twenty-four (24) months for the second (2nd) IPV; and permanently for the third (3rd) IPV/fraud.

B. Receiving Duplicate Benefits Individuals who misrepresent their identity or residency to receive duplicate benefits shall be ineligible to participate in SNAP for a period of ten (10) years. Receiving duplicate benefits is considered an attempt to receive or the receipt of more than one original allotment of benefits during a calendar month. A permanent disqualification for a third (3rd) offense would override the disqualification period for duplicate benefits.

C. Trafficking Benefits 1. The penalties for trafficking SNAP benefits are outlined in Section 26-2-306(2), C.R.S.

2. An individual convicted through a court of law of trafficking in SNAP of five hundred dollars ($500) or more will be disqualified permanently.

D. Drug Convictions An individual shall not be ineligible due to a drug conviction unless misuse of SNAP benefits is

part of the court findings. An individual found guilty of purchasing controlled substances, as defined in Section 18-18-102 (5), C.R.S., with SNAP benefits will be disqualified for twenty-four (24) months on the first (1st) conviction by a court of law and permanently disqualified on a second (2nd) conviction by a court of law. The disqualification periods shall also apply to individuals with a felony conviction entered on or after July 1, 1997, for possession, use, or distribution of controlled substances only if the conviction is directly related to the misuse of SNAP benefits.

E. An individual found guilty in a court of law of trading or purchasing firearms, ammunition, or explosives with SNAP benefits will be permanently disqualified on the first (1st) conviction. An individual will be disqualified even in the cases of deferred adjudication. 4.803.4 Pursuing Disqualifications for IPV/Fraud [Rev. eff. 1/1/16]

A. The provisions of these rules concerned with state-level fair hearings at Sections 4.802.6 and at 4.802.3 are also applicable for state and local administrative disqualification hearings.

B. Whenever the local office has accumulated evidence to substantiate that a person has committed one or more acts of intentional program violation as defined above, the establishment of an intentional program violation shall be determined via:

1. An administrative disqualification hearing; or, 2. A signed waiver of administrative hearing; or, 3. For cases referred to a court of appropriate jurisdiction, through a signed disqualification consent agreement for plea bargained cases or cases of deferred adjudication.

The local office may conduct a local-level administrative disqualification hearing for intentional Program violation or may use the Office of Administrative Courts of the Colorado Department of Personnel and Administration to conduct a state-level administrative disqualification hearing. The local office may also initiate court action by referring an intentional program violation under state fraud statutes to a court of appropriate jurisdiction.

C. If the local office determines that there is evidence to substantiate that a person has committed an IPV/fraud, the local office shall, prior to initiating an administrative disqualification hearing, allow that person the opportunity to waive his or her right to an administrative disqualification hearing or, for cases referred to a court of appropriate jurisdiction, to sign a disqualification consent agreement for plea bargained cases or cases of deferred adjudication. However, prior to providing the request for waiver, there shall be a review of the evidence against the household member by a staff member who was not involved in the investigation of the household and who has a thorough enough understanding of SNAP policy to ensure that policy is being correctly applied and that the evidence meets the “clear and convincing” criteria (see Section 4.803.2, C) necessary to warrant the pursuit of an IPV/fraud determination.

D. An administrative disqualification hearing may be initiated regardless of the current eligibility of the individual charged. An administrative hearing should be initiated under the following circumstances:

1. Whenever the facts of the individual case do not warrant civil or criminal prosecution through the appropriate court system; or, 2. In cases that were previously referred for prosecution and were declined by appropriate legal authority; or, 3. In previously referred cases where no action was taken within a reasonable period of time and which were formally withdrawn by the local office.

E. Administrative hearings shall not be requested against an accused individual whose case is currently being referred for prosecution or subsequent to any action taken against the accused individual by the prosecutor or court of appropriate jurisdiction, if the factual issues of the case arise out of the same or related circumstances.

F. To request a state or local-level administrative hearing for intentional program violation, the local office shall submit a request to the Colorado Department of Personnel and Administration, Office of Administrative Courts. To request a local-level administrative hearing, the local office shall submit a request to the local-level hearing officer. When initiating an administrative disqualification hearing for intentional program violation/fraud, the Notice of Hearing form shall be sent to the household member at least thirty (30) calendar days in advance of the scheduled local hearing. At the time of the hearing, the local office will have the opportunity to present the full body of evidence.

G. The Department of General Support Services, Division of Administrative Hearings, may combine a fair hearing and an administrative disqualification hearing into a single hearing if the factual issues arise out of the same or related circumstances and the household receives prior notice that the hearings will be combined. The amount of the claim will be contained on the notice of confirmation. If the intentional program violation hearings and fair hearings are combined, the Office of Administrative Courts (OAC) will follow the timeliness standards for conducting intentional program violation hearings. If the hearings are combined for the purpose of settling the amount of the claim and determining whether or not intentional program violation has occurred, the household shall lose its right to a subsequent fair hearing on the amount of the claim.

However, OAC shall, upon request of the household, allow the household to waive the thirty (30) day advance notice period required in Section 4.803.43 when the intentional program violation hearing and fair hearing are combined. 4.803.41 Waiver of Administrative Disqualification Hearing [Rev. eff. 1/1/16]

A. Households mailed a request for waiver of the administrative disqualification hearing shall be provided a copy of the statement of rights. The household shall be notified that it has fifteen (15) days from the date the waiver of administrative disqualification hearing was dated and mailed to respond by returning a completed waiver.

B. The completion of the waiver of the administrative disqualification hearing for intentional program violation is voluntary and the local office shall not require its completion nor by its actions appear to require the completion of the waiver.

C. If the household member suspected of intentional program violation signs the waiver of the administrative disqualification hearing and returns the waiver to the local office within fifteen (15) days from the date it is dated and mailed by the local office, that person and the head of household shall be provided with a notice of disqualification for waived hearing of intentional program violation D. The disqualification shall begin with the first (1st) month following the month the notice of disqualification is received by the household member.

E. No further administrative appeal procedure exists after an individual voluntarily waives his/her right to an administrative disqualification hearing for intentional program violation. The disqualification penalty cannot be changed by a subsequent fair hearing decision. However, the household member is entitled to seek relief in a court having appropriate jurisdiction. The period of disqualification may be subject to stay by a court of appropriate jurisdiction or other injunctive remedy.

F. If the waiver is not returned, the local offices that conduct local-level administrative disqualification hearings shall, within five (5) working days after the deadline for receipt of the waiver of administrative hearing, mail to the household a Notice of Intentional Program Violation Hearing together with a copy of the hearing procedure. 4.803.42 Scheduling an Administrative Disqualification Hearing for IPV A. The time and place of the state or local-level administrative disqualification hearing shall be arranged so that the hearing is accessible to the household member suspected of intentional program violation.

The state-level hearing may be conducted by telephone using conference call techniques unless one of the parties objects to this method. If a hearing is held by telephone, the rules of procedure, including recording of the hearing, shall be the same as a face-to-face hearing. The household member charged with intentional program violation has the right to request a face-to-face hearing at any time, including up to and during the telephonic hearing, but not once the telephonic hearing is concluded.

B. Persons that have been charged with intentional program violation and notified that a local-level administrative disqualification hearing has been scheduled have the right to request that their case be heard by a state-level Administrative Law Judge in the Office of Administrative Courts within (10) calendar days of being notified of a local-level hearing. If a state-level hearing is requested, the local office shall forward the request to the Office of Administrative Courts no later than three (3) working days from receipt of the request. No local-level administrative disqualification hearing shall be held if the accused requests a state-level hearing within these specified guidelines.

C. If the household member or representative cannot be located or fails to appear at a hearing initiated by the local office without good cause, the hearing shall be conducted without the household member represented. However, the household member may subsequently appeal a disqualification from a decision on the basis of not being notified in accordance with Section 4.803.43. If the household provides a statement of non-receipt and the county or the office of administrative courts cannot document receipt of the notice, a re-hearing of the evidence shall be scheduled and the previous decision shall no longer be valid. If the household member is not represented, the hearing official shall carefully consider the evidence and determine if the individual intended to commit an act of intentional program violation.

D. If the household member is found to have committed intentional program violation but the State Department or a local hearing official later determines that the household member or representative had good cause for not appearing at a hearing initiated by the local office, the previous decision shall no longer remain valid and the Office of Administrative Courts or locallevel hearing officer shall conduct a new hearing. The hearing official who originally ruled on the case may conduct the new hearing. The household member who has received notice has a period of ten (10) calendar days from the date of the hearing to present reasons indicating a good cause for failure to appear. A hearing official shall enter the good cause into the record. 4.803.43 Notifying a Household of an IPV Administrative Disqualification Hearing A. The administrative adjudicator shall provide written notice to the household member suspected of intentional program violation at least thirty (30) calendar days in advance of the date an administrative disqualification hearing initiated by the local office has been scheduled.

B. The notice shall be mailed by Certified Mail, Return Receipt Requested, or by first class mail or the notice may be served on the individual by any other reliable method, such as personal delivery by a SNAP worker or other employee, affidavit of service, Federal Express, etc. If no proof of receipt is obtained, a statement of non-receipt by the household member shall be considered as good cause for not appearing at the hearing. The notice shall contain at a minimum:

1. The date, time, and place of the hearing;

2. The charge(s) against the household member;

3. A summary of the evidence and how and where the evidence can be examined;

4. A warning that the decision will be based solely on information provided by the local office if the household member fails to appear at the hearing;

5. A statement that the household member or representative will have ten (10) calendar days from the date of the scheduled hearing to present good cause for failure to appear in order to receive a new hearing;

6. A warning that the disqualification penalties for fraud under SNAP that could be imposed and a statement of which penalty the hearing officer believes is applicable to the case scheduled for hearing. The disqualification penalties for fraud are as follows:

a. Twelve (12) month disqualification for the first (1st) violation, twenty-four month disqualification for the second (2nd) violation, and permanently for the third (3rd) violation, except as provided for in paragraphs b, c, d, and e, of this section;

b. Individuals found to have made a fraudulent statement or representation with respect to the identity or place of residence of the individual in order to receive multiple food stamp benefits simultaneously shall be ineligible to participate in the Program for a period of ten (10) years, except if the client has received his/her 3rd violation. In such cases, the individual shall be disqualified permanently.

c. Individuals found guilty of purchasing controlled substances, as defined in

section 18-18-102(5), C.R.S., with SNAP benefits by a court of law shall be ineligible to participate in the program:

1. For a period of twenty-four (24) months upon the first occasion of such violation; and, 2. Permanently upon the second occasion of such violation.

d. Individuals found by a federal, state, or local court to have used or received benefits in a transaction involving the sale of firearms, ammunition or explosives shall be permanently ineligible to participate in the program upon the first occasion of such violation.

e. An individual convicted by a federal, state, or local court of having trafficked benefits for an aggregate amount of five hundred dollars ($500) or more shall be permanently ineligible to participate in the program upon the first occasion of such violation.

f. The penalties in paragraphs c and d of this section shall also apply in cases of deferred adjudication as described in Section 4.804, where the court makes a finding that the individual engaged in the conduct described in paragraph c and d, of this section.

g. If a court fails to impose a disqualification or a disqualification period for any IPV, the state department shall impose the appropriate disqualification penalty specified within this section, unless it is contrary to the court order.

7. A statement of which penalty the hearing officer believes is applicable to the case scheduled for the hearing.

8. A statement that the hearing does not preclude the state or federal government from prosecuting the household member for fraud in a civil or criminal court action or from collecting the over-issuance.

9. The name and telephone number of the agency that the individual can call to obtain free legal advice.

10. For local offices conducting a local-level ADH, the notice shall inform the client that they may request to have a state-level ADH rather than a local-level ADH.

C. A copy of the local-level hearing procedures, and the demand letter for over-issuance (if not sent previously) shall be attached to the thirty (30) day advance notice for the local-level hearing. The Administrative Law Judge shall provide a copy of the state hearing procedures with the thirty (30) day advance notice.

D. The Administrative Law Judge shall not enter a default against the household member for failure to file a written answer to the notice of hearing but shall base the initial decision upon the evidence introduced at the hearing. 4.803.44 Participation While Awaiting an Administrative Disqualification Hearing A pending state or local-level administrative disqualification hearing shall not affect the individual's or the household's right to be certified and to participate in the program. Since the local office cannot disqualify a household member for intentional program violation until it obtains a signed waiver of administrative hearing or until the local hearing official or State Department finds that the individual has committed intentional program violation, the local office shall determine eligibility and benefit level of the household in the same manner it would be determined for any other household.

A. If the action for which the household member is suspected of intentional program violation does not affect the household's current circumstances, the household would continue to receive its allotment based on the latest certification action or be recertified based on a new application and its current circumstances.

B. The household's benefits shall be terminated if the certification period has expired and the household, after receiving its notice of expiration, fails to reapply.

C. The local office shall also reduce or terminate the household's benefits if the local office has documentation which substantiates that the household is ineligible or eligible for fewer benefits (even if these facts led to the suspicion of intentional program violation and resultant hearing) and the household fails to request a fair hearing after receipt of a Notice of Adverse Action. 4.803.45 Administrative Disqualification Hearing (ADH) Procedures A. At the ADH, the Administrative Law Judge (ALJ) or local hearing officer shall advise the household member or representative that they may refuse to answer questions during the B. A hearing decision and notification to the parties shall occur within ninety (90) calendar days from the date the household member is notified in writing that a state or local-level hearing requested by the local office has been scheduled.

C. Following the conclusion of the hearing at the state-level, the ALJ shall prepare and issue an initial decision that shall contain a determination of whether the county or State Department acted in accordance with, and properly interpreted the rules and regulations of the State Department.

For the purpose of the decision, material issues of law shall be defined. The ALJ has no jurisdiction or authority to determine issues of constitutionality or legality of departmental rules or regulations. This decision is prepared and filed with the Colorado Department of Human Services for service to each party.

In the case of a hearing before the Administrative Law Judge (ALJ), this determination shall be an initial decision to be reviewed by the Office of Appeals. The initial decision shall not be implemented pending review by the Office of Appeals and entry of a final agency decision. The initial decision shall advise the household that failure to file exceptions to provisions of the initial decision will waive the right to seek judicial review of a final agency decision affirming those provisions.

D. A local-level hearing officer shall meet the ninety (90) calendar day timeframe, issue the decision to the client, and forward a copy to the state department.

E. The household member or his/her representative is entitled to a postponement of up to thirty (30) calendar days if the request for postponement is made at least ten (10) calendar days prior to the scheduled hearing date, unless good cause can be shown for failure to request postponement within the required timeframe. If the hearing is postponed, the above limits shall be extended for as many days as the hearing is postponed.

F. The local office shall make the hearing procedures in this staff manual available to any interested party.

G. A verbatim transcript or recording of testimony and exhibits shall be made. This transcript or recording together with all papers and requests filed in the proceeding shall be retained by the local office for a period of three (3) years from the initiation of the action and shall be available to the household or its representatives during business hours for copying and inspection. 4.803.5 Local-Level IPV Hearings A. Local-Level Hearing Official 1. The individual who acts as a local-level hearing officer for the local office shall meet the following requirements:

a. They shall be an impartial individual who does not have a personal stake or involvement in the case;

b. They cannot have been directly involved in the initial determination of the action which is being contested and was not the immediate supervisor of the eligibility technician who initiated the IPV action;

c. The individual shall be:

1. An employee of the county;

2. An individual under contract with the county; or 3. An employee of another public agency, statutory board, or other legal entity designated by the county to conduct hearings.

2. The individual who acts as a local-level hearing officer is required to carefully consider the evidence and determine, based on clear and convincing evidence, if the individual intended to commit an IPV.

B. Notice of Local-Level Hearing Decision 1. If the local-level administrative disqualification hearing finds the household member did not commit an IPV, the local-level hearing officer shall provide a written notice that informs the household, the local office, and the State Department of the decision.

2. The decision shall contain the reasons for the hearing officer's decision and a response to client presented arguments and identify the evidence presented by both client and the local office.

3. If a local-level hearing officer determines that an IPV occurred, the household shall be notified in accordance with Section 4.803.7 and accompanying the decision shall be an Appeal Request for the household to appeal the decision to a state-level administrative disqualification hearing.

4. If mailed, the notice shall be sent by either first class mail or certified mail (return receipt requested), or the notice may be served on the individual(s) by any other reliable method.

If no proof of receipt is obtained, a statement of non-receipt by the household member shall be considered good cause for not appearing at the hearing 5. A copy of the local-level hearing decision shall be forwarded to the state department for review at the same time the decision is mailed to the client.

C. Appeal of Local-Level Decision 1. The household may appeal the decision of the local-level administrative disqualification hearing to the Office of Administrative Courts. An appeal must be received by the local office or by the Office of Administrative Courts within fifteen (15) calendar days of the date of household receipt of the local-level decision. The household shall be allowed to participate as described in Section 4.803.44.

2. If the household member appeals a local-level hearing to a state-level hearing, the Office of Administrative Courts shall provide a written notice to that household member at least ten (10) calendar days in advance of the scheduled hearing. The ten (10) calendar day advance notice shall contain at a minimum:

a. The date, time, and place of the hearing.

b. A statement that the Office of Administrative Courts will dismiss the hearing request and the household member will be disqualified in accordance with the local hearing decision if the household member or its representative fails to appear for the hearing without good cause.

c. A statement that the hearing does not preclude civil or criminal prosecution, or from collecting the over-issuance.

d. A listing of the household members' rights.

e. A copy of the Office of Administrative Courts hearing procedures shall be attached to the ten (10) calendar day advance notice.

3. If the household member fails to appear for the administrative disqualification hearing appeal, the Office of Administrative Courts (OAC) shall dismiss the hearing request. The Administrative Law Judge shall promptly serve copies of the order on the household member and the local office. The order shall inform the household member that they will continue to be disqualified in accordance with the local-level hearing decision. The household member will be afforded a ten (10) calendar day period from the date the order of dismissal was mailed to explain in a letter to the OAC the reason for failing to appear. If the OAC determines that the household member or its representative has good cause for not appearing, the Administrative Law Judge shall reschedule another hearing date.

If the appellant does not submit a letter seeking to show good cause within the ten (10) calendar day period, the order of dismissal shall be filed with the Office of Appeals of the State Department. The Office of Appeals shall confirm the dismissal of the appeal by an agency decision, which shall be served on the parties and the interested Division of the State Department. Within three (3) working days after the effective date of the decision, the local office shall implement necessary actions to provide benefits in the correct amount, to terminate benefits, to recover benefits incorrectly paid, and/or other appropriate actions in accordance with the rules. If the appellant submits a letter seeking to show good cause and the Administrative Law Judge (ALJ) finds that the stated facts do not constitute good cause, the ALJ shall enter an initial decision confirming the dismissal. The appellant may file exceptions to the initial decision pursuant to Section 4.802.63, D. 4.803.6 State-Level Administrative Disqualification Hearing A. Initial Decisions 1. The State Administrative Law Judge (ALJ) will forward the initial decision to the Colorado Department of Human Services, Office of Appeals. The Office of Appeals shall promptly serve a copy of the initial decision upon each party by first class mail.

2. Any party, or the Divisions of the State Department responsible for administering programs relevant to the appeal, if seeking an agency decision which reverses, modifies or remands the initial decision, may file exceptions to the initial decision as set forth in

Section 4.802.63, D. The parties and the Division may also request reconsideration of the agency decision pursuant to Section 4.802.63, F.

B. Final Decisions 1. The Office of Appeals shall review the initial decision of the Administrative Law Judge and shall enter a final agency decision affirming, modifying, reversing, or remanding the initial decision, pursuant to Section 4.802.63, E.

2. For purposes of requesting judicial review, the effective date of the final agency decision shall be the third (3rd) day after the date the decision is mailed to the parties, even if the third (3rd) day falls on Saturday, Sunday, or a legal holiday. The parties shall be advised of this in the agency decision.

3. The state department or local office shall initiate action to comply with the final agency decision within three (3) working days after the effective date. The department shall comply with the decision even if reconsideration is requested unless the effective date of the agency decision is postponed by order of the Office of Appeals or a reviewing court.

4. If the household member has committed IPV, that member shall be disqualified in accordance with the disqualification periods specified in Section 4.803.3. The same act of IPV shall not be separated so that separate penalties can be imposed. 4.803.7 Notification of Final Administrative Disqualification Hearing Decision Once the local-level hearing decision or a final state-level decision has been made, written notice, prior to disqualification, will be provided to the household member, to the local office, and to the state department containing:

A. The decision;

B. The reason for the decision including pertinent regulations and a response to client presented arguments;

C. The disqualification period, including the date the disqualification will take effect. For local-level hearing decisions, the decision shall notify the individual that the disqualification period will take effect, unless a state-level hearing is requested. If the individual is no longer participating, the notice shall inform them that the period of disqualification shall take effect in accordance with

Section 4.803.2, F;

D. For local-level administrative hearings, if the household member is not satisfied with the decision given in a local-level administrative disqualification hearing (see Section 4.803.5, C), they may request a hearing through the Office of Administrative Courts; and E. For state-level administrative hearings, if the household member is not satisfied with the final state agency decision of a state-level administrative hearing, they may seek judicial review pursuant to Section 24-4-106, C.R.S.

4.804 COURT ACTION

A. Local offices are encouraged to refer for prosecution under state fraud statutes those individuals suspected of committing fraud, particularly if large amounts of benefits are suspected of being fraudulently obtained or the individual is suspected of committing more than one (1) fraudulent act. The local office shall confer with its legal representative to determine the types of cases that will be accepted for possible prosecution.

B. An individual must be found guilty of fraud through criminal court in order for the local office to impose a disqualification penalty. However, when a determination of guilt is not obtained because of a case involving court-deferred adjudication or plea-bargaining, a disqualification penalty may be imposed if a signed consent agreement is obtained from the individual.

C. A summary or copy of a referral for prosecution shall, together with the date of the referral, be forwarded to the state department.

D. Local offices shall disqualify an individual found guilty of fraud or the length of time specified by the court. If the court fails to impose a disqualification period, the local office shall impose an appropriate disqualification in accordance with Section 4.803.3, unless imposing a disqualification would be contrary to the court order.

E. If disqualification is ordered but a date for initiating the disqualification period is not specified, the local office shall initiate the disqualification period for individuals within forty-five (45) calendar days from the date the disqualification was ordered. Any other court-imposed disqualification shall begin within forty-five (45) calendar days from the date the court found an individual guilty of civil or criminal misrepresentation or fraud.

F. Once a disqualification period has been imposed against a currently participating household member, the period of disqualification shall continue uninterrupted until completed regardless of the eligibility of the disqualified member's household.

G. If the court finds that the individual committed fraud, the county shall mail to the household, prior to the disqualification whenever possible, a notice informing the household of the disqualification and the date the disqualification will take effect, and shall advise the remaining household members of the allotment they will receive during the period of disqualification or that they must reapply because the certification period has expired. 4.804.1 Disqualification Consent Agreement (DCA)

A. Criteria for DCA If county prosecutors pursue a DCA, the agreement shall provide the household advance notification of the consequences of consenting to the disqualification. The consent agreement shall contain the following:

1. A statement for the accused individual to sign that they understand the consequences of consenting to disqualification.

2. A signature block for the accused individual;

3. A statement that the head of household must also sign the consent agreement if the accused individual is not the head of household;

4. A signature block for the head of household;

5. A statement that consenting to disqualification will result in disqualification and a reduction in benefits for the period of disqualification, even though the accused individual was not found guilty of civil or criminal misrepresentation or fraud;

6. A warning that the disqualification penalties for fraud under SNAP that could be imposed and a statement of which penalty the hearing office believes is applicable to the case scheduled for the hearing; and 7. A statement of the fact that the remaining household members, if any, will be held responsible for repayment of the resulting claim, unless the accused individual has already repaid the claim as a result of meeting the terms of the agreement with the prosecutor or the court order.

B. Imposing Disqualifications When Consent Agreements are Obtained 1. If the household member suspected of fraud signs the disqualification consent agreement, the household member shall be disqualified in accordance with the disqualification periods specified in Section 4.803.2, F, unless contrary to the court order.

2. Once a disqualification penalty has been imposed against a currently participating household member, the period of disqualification shall continue uninterrupted until completed, regardless of the eligibility of the disqualified member's household. However, the disqualified member's household shall continue to be responsible for repayment of the over-issuance that resulted from the disqualified member's suspected fraudulent act, regardless of its eligibility for Program benefits.

C. Notification to Household of Disqualification 1. If the household member suspected of fraud signs the disqualification consent agreement, the local office shall provide written notice to the household member. The notice shall be provided prior to disqualification. The notice shall inform the household member of the disqualification and the date the disqualification will take effect.

2. The local office shall also provide to the remaining household members, if any, the allotment they will receive during the period of disqualification or notice that they must reapply because the certification period has expired. The procedures for handling the income and resources of the disqualified member are described in Section 4.411.1.

4.900 ADMINISTRATIVE PROCEDURES

4.901 ADMINISTRATION OF SNAP

A. SNAP shall be administered in every county of the state in accordance with the regulations promulgated by the Colorado Department of Human Services and these rules.

B. SNAP shall be administered by the local offices of social/human services unless the State Department enters into a written agreement with a particular county to have a state-administered program in that county. As a condition for receiving grant-in-aid from the state for PA and welfare activities, each county must bear the proportion of the total administrative and program costs for all assistance payments and social services activities as required by Section 26-1-122, C.R.S.

C. Local offices of social/human services shall comply with all requirements concerning security and case processing for the automated system.

D. Counties shall receive approval from the State Department, prior to using any county-developed forms in the administration of SNAP. 4.901.1 Compliance with State Department If a county does not comply with the rules of the State Department that govern the administration of SNAP, which require the establishment of a SNAP Program in each county and the payment of the county's share of the cost of the program, the State Department may do one or more of the following:

A. Utilize the remedies described in Section 26-1-109(4) (a)-(e), C.R.S.

B. Recover all or part of the county share of the cost of SNAP by reducing any other grant-in-aid to the county for PA or welfare purposes by a corresponding amount.

C. If the county does not comply, judicial enforcement may be pursued under Section 24-4-106(3)

C.R.S.

D. Take any other appropriate action to enforce compliance with the rules governing SNAP.

4.902 COUNTY ADMINISTRATION REQUIREMENTS 4.902.1 Local SNAP Office Local offices shall ensure that adequate locations and hours of operation exist to meet the needs of SNAP clients in their areas. Each location shall have ample availability for parking and shall be accessible to persons with disabilities. Hours of operation shall be sufficient to ensure the timely processing of applications and issuance of EBT cards according to existing guidelines. Counties must establish procedures for the operation of the local office that best serves households within that county. Local offices shall establish procedures to assist households with special needs including, but not limited to: households containing persons who are aged sixty (60) and older or persons with disabilities; households in rural areas with low-income members; households experiencing homelessness; households containing adult members who are not proficient in English; and households containing working persons.

A household must apply for SNAP in its county of residence. A local office that receives an application that belongs to another county may secure the application date, process the application to completion, issue the household an EBT card, and then transfer the case to the correct county once the final eligibility decision is made. If a household is determined eligible for participation, it may request and be designated to receive SNAP from a local office that is more accessible. It is possible for an issuance unit in one local office to determine eligibility, authorize SNAP benefits, and issue EBT cards to an eligible household that resides in another county in Colorado.

Local offices may also transfer certification and/or EBT card issuance duties for those households only receiving SNAP that live closer to the local office in a neighboring county than the county of residence. 4.902.2 Phone Directory Listings A. Each local office telephone number available to the public shall be listed under each of the following two alphabetical listings:

1. SNAP certification and issuance office, street address, phone number. If there are separate certification and issuance offices in the county, they may be listed in this manner: local office (certification only) or (issuance only), street address, phone number.

2. (Name of the county) Department of Human/Social Services, local office (certification only) or (issuance only), street address, phone number.

B. Each local office shall provide a toll-free number or a number where collect calls will be accepted for households outside the local calling area.

C. The listings above are not to restrict any other listings that may be provided within the telephone directory, but only to standardize the availability of SNAP to the public. 4.902.3 Certification Personnel and Facilities Requirements A. County employees assigned to certify households for participation in SNAP shall be employed in accordance with the current standards for a merit system personnel administration that is guided by a set of six broad merit principles outlined in the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728), as amended. The principles cover recruiting, compensation, training, retention, equal employment opportunity, and guidance on political activity. Only such qualified employees shall interview SNAP households and determine household eligibility or ineligibility and the level of benefits.

B. Every local office must utilize an appropriate amount of the staff allocated to it and utilize effective and efficient practices in administering SNAP. Facilities must, within available state legislative appropriations and federal and required county matching funds, be of adequate size and layout to assure the privacy necessary to allow workers to conduct confidential interviews and perform other office duties efficiently and effectively. Any persons or organizations who are parties to a strike or lockout shall not be permitted to interview or certify households or to secure verification required of such households. However, such individuals may be used as a source of verification for information provided by applicant households if, under normal circumstances, they could be expected to be the best verification source. An eligibility technician who is the spouse of a striker is not considered party to a strike but shall not certify his or her household. 4.902.31 Bilingual Staff, Interpreter, and Translator Requirements A. Local offices determined by the State Department to have a significant population of Limited English Proficiency (LEP) households shall provide sufficient bilingual staff and/or translators for the timely processing of applications. Local office staff shall be trained and familiar with these procedures.

B. During those periods when there is a significant influx of seasonal or migrant farmworkers, local offices shall provide sufficient bilingual staff and/or translators for the timely processing of such applicants.

C. If translators or interpreters are utilized, the local office shall ensure that the translators or interpreters are readily available to assist in pre-screening clients for expedited processing standards and completing the interview and other activities necessary to determine the eligibility of the applicant household. The local office shall not require the client to provide a translator or interpreter, or to in any way imply that an interpreter is required, as a condition for being prescreened or interviewed by the local office, nor shall the local office postpone or in any way delay the pre-screening process or appointments because of the unavailability of bilingual staff or translators/interpreters. 4.902.32 Restrictions on Staff A. Volunteers or other personnel who do not meet the criteria outlined in Section 4.902.3 may not be allowed to interview or certify households but may be used for pre-screening, assistance in the completion of applications, obtaining verifications to support statements made on the application, and the transportation of clients. In certain situations, volunteers may act as authorized representatives for households unable to come to the local office.

B. Volunteers may also be used as translators or interpreters when necessary to pre-screen clients and to complete the interview. If volunteers are utilized, the local office shall ensure that volunteers are available, as necessary, for the timely processing of applications. Such volunteers utilized to pre-screen clients or to translate/interpret during the interview shall be educated on confidentiality requirements.

C. Any persons or organizations who are parties to a strike or lockout shall not be permitted to interview or certify households or to secure verification required of such households. However, such individuals may be used as a source of verification for information provided by households if, under normal circumstances, they could be expected to be the best verification source. An eligibility technician who is the spouse of a striker is not considered party to a strike but shall not certify his or her household.

The facilities of persons or organizations who are parties to a strike or lockout may not be used in the certification process or as a site for certification interviews. 4.902.4 Local Office Case Review Responsibilities Local offices shall establish a documented method to review a random sample of current SNAP determinations (certifications, denials, and terminations) to determine the correctness of eligibility determinations accomplished. A record of the cases reviewed must be kept for management evaluation/audit purposes. Local offices must be able to demonstrate to the satisfaction of the State Department that the frequency and scope of the reviews are adequate to ensure the integrity of both the program and clients. Additionally, local offices must demonstrate a consistent process for tracking error trends, correcting case records timely, and providing eligibility technicians an opportunity to improve their program knowledge. 4.902.5 Retention of Case Records Each local office shall retain all program records in an orderly fashion for audit and review purposes for no less than three (3) years from the month of origin of each record. In addition:

A. The local office shall retain fiscal records and accountable documents for three (3) years from the date of fiscal or administrative closure. Fiscal closure means that obligations for or against the federal government have been liquidated. Administrative closure means that the state agency has determined and documented that no further action to liquidate the obligation is appropriate. Fiscal records and accountable documents include, but are not limited to, claims and documentation of lost benefits.

B. Case records relating to intentional program violation (IPV) disqualifications and related notices to the household shall be retained indefinitely until the local office obtains reliable information that the individual who was disqualified has died or until the information is received from the national disqualified recipient database system that all records associated with a particular individual, including the disqualified client database record, may be permanently removed from the database because of the individual's eightieth (80th) birthday. 4.902.6 Non-Discrimination Complaint Requirements Both state and local offices shall ensure that all local office staff responsible for the administration, issuance, review, and eligibility determination of SNAP are knowledgeable about civil rights procedures and are able to assist clients with the filing of civil rights complaints. Local office staff must undergo stateprescribed training on civil rights procedures annually.

4.903 STATE ADMINISTRATION RESPONSIBILITIES 4.903.1 Information Available to the Public A. Federal regulations, federal procedures embodied in Food and Nutrition Service (FNS) notices and policy memos, the SNAP rules, and State Plans of Operation (including specific planning documents such as corrective action plans) shall be available upon request for examination by members of the public during office hours at the State Department. Copies of materials are available to recipient organizations, action centers, and other individuals for a minimal printing charge.

B. The SNAP rules shall be available for examination upon request at each local office within each county. They are also available online through the Secretary of State’s official publication of State Agency rules in the Colorado Code of Regulations, accessible at: https://www.sos.state.co.us/CCR/Welcome.do. 4.903.2 Reporting Lawsuits FNS regulations require prompt notification from the State Department of any lawsuits involving the administration of SNAP.

As SNAP is administered under the supervision of the State Department, it is mandatory that all legal proceedings involving SNAP be brought to the attention of the State Department immediately for notification to the FNS. 4.903.3 Management Evaluations (ME)

The State Department is responsible for supervising the administration of SNAP. To ensure compliance with program requirements, the State Department is responsible for conducting ME reviews to measure compliance with the provisions of these rules. The objectives of the ME review system are to:

A. Provide a systematic method of monitoring and assessing program operations in the counties;

B. Provide a basis for counties to improve and strengthen program operations by identifying and correcting deficiencies;

C. Provide a continuous flow of information between the counties, the State Department, and FNS to develop solutions to problems in SNAP policy and procedures; and, D. Provide a review of target program areas as identified by USDA, FNS. 4.903.31 Frequency of ME Reviews The State Department shall conduct an ME review of all SNAP operations:

A. At least once annually on each large project area containing more than twenty-five thousand and one (25,001) participating households;

B. At least once every two (2) years on each medium project area containing five thousand (5,000) to twenty-five thousand (25,000) participating households; and, C. At least once every three (3) years on each small project area containing four thousand nine hundred and ninety-nine (4,999) or fewer participating households.

The State Department may conduct ME reviews on an alternative schedule with the written approval of the USDA, FNS. The State Department may also perform reviews of specific local offices or program elements. The USDA, FNS, or the State Department, may identify the need for a special review, or the local office may request a special review.

Reviews will generally include all aspects of program administration in the large project areas. The reviews may be more limited in scope in the medium and small project areas. The USDA, FNS, generally identifies target program areas that it requires for review each fiscal year.

The State Department will complete the ME report for all counties that are reviewed and will be responsible for monitoring the county responses to any findings.

The county shall be responsible for submitting any factual corrections to the ME review within twenty (20) state working days and shall submit a final plan to correct all other cited deficiencies within twenty (20) state working days of receiving the review. The response shall include specific actions, persons responsible for implementation, and the date for completion. When the review identifies ongoing problems in critical areas, the county response shall also include a method for monitoring implementation of the plan and reporting progress to the state department on at least a quarterly basis. 4.903.32 Compliance Action for ME Reviews The State Department is the designated entity responsible for ensuring that corrective action is taken at the state and/or county level on the deficiencies found by the ME Reviews.

The state may impose fiscal sanctions on counties that do not make good-faith efforts to address ongoing problems in critical areas. Fiscal sanctions may be imposed in accordance with Section 4.901.1, which requires local offices to operate the program in accordance with state rules. 4.903.4 Quality Assurance (QA) Reviews QA reviews are conducted during the annual federal QA review period, which is the twelve (12) month period from October 1 of each calendar year through September 30 of the following calendar year.

A. QA reviews are federally mandated to provide:

1. A systematic method of measuring the validity of the SNAP caseload;

2. A basis for determining error rates;

3. A timely and continuous flow of information on which to base corrective action at all levels of administration; and, 4. A basis for establishing liability for errors that exceed the federal error rate target and the State's eligibility for an increased share of federal administrative funding and/or federal high-performance bonuses.

B. Reviews are conducted on:

1. Active cases to determine if the household is eligible and, if eligible, whether the household is receiving the correct SNAP benefits.

2. Negative cases to determine if households that were denied or terminated were, in fact, not eligible to participate in SNAP and that the household received an accurate, timely notice as defined in sections 4.205.2, 4.209.1, and 4.608. The review of a negative case includes:

a. A household case record review;

b. An error analysis;

c. Client notification; and, d. The reporting of review findings. 4.903.41 QA Review Procedures A. Each month a statistically random sample of active and negative cases is selected for QA review.

The sampling of both active and negative cases is accomplished through the master file from the automated system.

B. Case records for the monthly selected sample may be reviewed by QA in the local office, or the local office may be requested to forward the case recrods to the appropriate state QA office for review prior to the field reviews and verification of eligibility factors. Local offices shall make case records available for review no later than seven (7) business days from the date that the request is received by the local office.

C. When the local office receives a request for one or more cases for QA review, the following steps shall be taken in preparing the case record:

1. All documents and notes supporting eligibility decisions and/or basis of issuance related to the case and actions taken by the local office that apply to the sample/review month shall be included in the case record.

2. Accomplishment of the objectives of QA depends upon the successful operation of all aspects of the sampling system, including the elimination of bias to prevent bias, the local office shall not take any action that might alter the findings or misrepresent the household’s circumstance including, but not limited to:

a. Making changes that would affect eligibility and payment;

b. Adding or removing documentation/verification from the official case record; or, c. Contacting the household sampled, the QA reviewer, or making collateral contacts to obtain additional information to clarify the household’s circumstances, obtain statements or coerce the household into saying or doing anything that might alter the findings or misrepresent the household’s circumstances for the review month.

D. These provisions do not apply to routine case management such as acting on reported changes, completing recertifications, or issuing a notice of expiration. 4.903.42 Refusal to Cooperate with QA Review Households selected for review are required to cooperate with federal and state QA review processes.

Households that refuse to cooperate in a QA review shall be declared ineligible for SNAP benefits in this

section. The state QA reviewer shall notify the local office of the household's refusal to cooperate in the review process, including everyone who refused, and the local office shall document the refusal to cooperate in the statewide automated system.

A. Within ten (10) calendar days from the date of receipt of QA's notification of the household's refusal to cooperate, the local office shall take action to disqualify or terminate the entire household from participation in SNAP and each household member who refused to cooperate shall be entered into the automated system to initiate a period of ineligibility. The period of ineligibility is as follows:

1. For refusal to cooperate with a state QA review, the period of ineligibility shall exist for the remainder of the current federal fiscal year plus one hundred twenty-five (125) days and shall expire on February 2 of that federal fiscal year.

2. For refusal to cooperate with a federal QA review, the period of ineligibility shall exist for the remainder of the current federal fiscal year plus nine (9) months and shall expire on June 30 of that federal fiscal year.

B. If a member or members who refused to cooperate with a QA review leaves the household, the ineligibility period shall follow the household member(s) who refused to cooperate.

If a household is disqualified or terminated for refusal to cooperate with a QA review, the household may reapply. The household cannot be determined eligible until it cooperates with the QA review and provides verification of all eligibility factors.

C. If a household that has refused to cooperate with a state QA review reapplies more than one hundred twenty-five (125) days after the end of the annual federal QA review period, or refused to cooperate with a federal review and reapplies more than nine (9) months from the end of the annual federal QA review period, the household shall not be determined ineligible for its refusal to cooperate and is required to provide verification of all eligibility factors before it can be approved for benefits. 4.903.43 QA Findings and Required Responses QA shall notify local offices on State-prescribed forms of the review findings for each sampled active and negative case. Brief descriptions of the review findings shall be given with references to applicable rule sections.

A. When the review findings document no error and/or only other observations have been noted, a response is not required by the local office; however, any observation that affects the payment accuracy must be corrected and a claim or restoration established in accordance with Sections 4.801.2 and 4.702. The report of review findings shall be retained in the case record.

B. When the review findings document that an error resulted in ineligibility, over-issuance, underissuance, or an incorrect negative action, the local office shall take action to correct any errors discovered within ten (10) calendar days.

If the local office disagrees with a review finding then a response should be sent to the State Department for further review.

C. Upon receiving the local office's response to the QA review findings, the State Department shall review the action taken by the local office and either concur with the QA findings; concur with the local office rebuttal; or concur/disagree with the corrective action taken by the local office.

1. The local office shall be notified of the final QA review findings.

2. Upon receipt of final notification of the results of the findings, the local office must take corrective action to terminate ineligible households within ten (10) calendar days, restore lost benefits, or establish a claim in accordance with Sections 4.801.2 and 4.702.

D. Local offices are required by the State Department to report twice a year to the State Department the status of all QA review findings that required case corrections. 4.903.44 Federal QA Reviews For purposes of validating the State's QA findings, the FNS Regional Office will conduct a sub-sample rereview of the State QA sample. As part of this re-review process, the Federal Regional Office will conduct case record reviews to the extent necessary to determine the accuracy of state QA findings. The FNS Regional Office may request case records and/or verify any aspects of state QA findings. The local offices shall forward case records in their entirety as outlined in Section 4.903.41 that are selected for FNS regional office review within ten (10) calendar days of the request.

4.904 OUTREACH

Outreach activities performed by state and local personnel shall be ineligible for federal matching funds.

Although activities to recruit participation in SNAP are prohibited, all local offices shall perform program informational activities. Program informational activities are those activities that convey information about SNAP, including household rights and responsibilities to households through means such as publications, telephone hotlines, and face-to-face contacts.

All program informational material shall be available in languages other than English and shall include a statement that the program is available to all without regard to race, color, sex, age, mental or physical disability, religious creed, national origin, or political belief.

4.905 D-SNAP

D- SNAP, or the Disaster Supplemental Nutritional Assistance Program, may be implemented because of a “major disaster” or “temporary emergency” to provide temporary assistance to households affected by these misfortunes. A Presidential disaster declaration for individual assistance must be declared for the affected areas to be eligible for D-SNAP.

A “major disaster” is any hurricane, tornado, storm, flood, high water, wind-driven water, tidal wave, earthquake, drought, fire, or other catastrophe that is determined to be a major disaster by the President pursuant to the Disaster Relief Act of 1974, Section 302(a). A similar definition is provided under State law in 24-33.5-703, C.R.S.

A “temporary emergency” means an emergency caused by any disaster, resulting from either natural or human causes, other than a major disaster as declared by the President under the Disaster Relief Act of 1974, Section 302(a), which is determined by FNS to have disrupted commercial channels of food distribution.

In such Presidentially declared disasters, emergency SNAP allotments can be authorized by the USDA, FNS. In Colorado, the Governor can accept such federal assistance on behalf of the state if they determine and declare a major disaster. When authorized by the Governor and FNS, the state department may authorize those counties, within which all or part of the disaster area lies, to distribute emergency SNAP allotments in those areas.

The State Department shall provide special certification material and forms designed for certification of disaster victims. Certification shall be done for households that are victims of a disaster that disrupts commercial channels of food distribution; if such households need temporary SNAP and if commercial channels of food distribution have again become available to meet the temporary food needs of those households. _________________________________________________________________________ Editor’s Notes

History Rules SB&P, R-4010, R-4011, R-4100, R-4220, R-4222, R-4223, R-4224, R-4225, R-4230, R-4242 emer.

rule eff. 10/01/2008.

Rules SB&P, R-4010, R-4011, R-4100, R-4220, R-4222, R-4223, R-4224, R-4225, R-4230, R-4242 eff. 12/01/2008.

Rules SB&P, 4010.11, 4230 emer. rules eff. 04/01/2009; expired eff. 06/06/2009.

Rules SB&P, 4010.11, 4230 eff. 07/01/2009.

Rules SB&P, B-4242, B-4242.1, B-4242.12, B-4242.13 eff. 03/02/2010.

Rules SB&P, B-4011.1-4011.11, B-4011.131-B-4011.136, B-4011.22-B-4011.3, B-4220-B-4220.12, B- 4224, B-4230.1, B-4242.11-B-4242.13, B-4430.2-B-4430.22(B) eff. 02/01/2011.

Rules SB&P, B-4222.8, B-4223, B-4225.7.A.17 emer. rules eff. 06/10/2011.

Rules SB&P, B-4222.8, B-4223, B-4225.7.A.17 eff. 09/01/2011.

Rules SB&P, B-4224(A-C) emer. rules eff. 10/01/2011.

Rules SB&P, B-4224(A-C) eff. 01/01/2012.

Rules SB&P, B-4221.312, B-4230.11-B-4230.12, B-4240, B-4242.34-B-4242.36, B-4315, B-4317.4-B- 4317.6, B-4600-B-4611, B-4640-B-4653, B-4695.1, B-4730-B-4800.3 eff. 05/01/2012.

Rules SB&P, B-4430.22.D-G, B-4430.32.B-H eff. 07/01/2012.

Rules SB&P, B-4010.42 eff. 08/01/2012.

Rules SB&P, B-4011.31-B-4011.32, B-4110.1-B-4110.2 eff. 11/01/2012.

Rules SB&P, B-4224 eff. 04/01/2013.

Rules SB&P, B-4100-B-4100.D, B-4220.11-B-4220.12, B-4223.1, B-4223.5-B-4223.5.B, B-4223.51 emer. rules eff. 10/01/2013.

Rules B-4010.12, B-4230-B-4230.1, B-4430.4 emer. rules eff. 11/01/2013.

Rules SB&P, B-4100-B-4100.D, B-4220.11-B-4220.12, B-4223.1, B-4223.5-B-4223.5.B, B-4223.51 eff. 12/01/2013.

Rules SB&P, B-4010.12, B-4230-B-4230.1, B-4430.4 eff. 01/01/2014.

Entire rule eff. 09/01/2014.

Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3-4.407.31 emer. rules eff. 10/01/2014.

Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3-4.407.31 eff. 12/01/2014.

Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3.A-B, 4.407.31 emer. rules eff. 10/02/2015.

Rules SB&P, 4.207.3, 4.401.1-4.401.2, 4.407.1, 4.407.3.A-B, 4.407.31, 4.801.2-4.801.43, 4.803- 4.803.41, 4.803.43, 4.803.5, 4.803.7, 4.804.1 eff. 01/01/2016. Rule 4.704.1 repealed eff. 01/01/2016.

Rules SB&P, 4.609 eff. 02/01/2016.

Rule 4.609.1 emer. rule eff. 02/05/2016.

Rules SB&P, 4.208.1, 4.603.A eff. 04/01/2016.

Rules SB&P, 4.609.1 eff. 05/01/2016.

Rule 4.609.1.A emer. rule eff. 05/06/2016.

Rule 4.609.1.A eff. 09/01/2016.

Rules 4.207.3.C, 4.401.1.C, 4.401.2.D, 4.407.1, 4.407.3.B, 4.407.31.A.4, 4.407.31.B.3, 4.407.31.C.3, 4.407.31.D.2 emer. rules eff. 09/09/2016.

Rules 4.407.6, 4.502 B.3.b eff. 1 0/01/2016.

Rules 4.403.A.1, 4.404.D, 4.405.G.1, 4.405.1, 4.506.D, 4.604.D-E, 4.606.B.2.a, 4.608.B, 4.802.2.A.1 eff. 11/01/2016.

Rules 4.207.3.C, 4.401.1.C, 4.401.2.D, 4.407.1, 4.407.3.A-B, 4.407.31.A-D eff. 01/01/2017.

Rules 4.050, 4.070, 4.070.2, 4.070.22, 4.304.4 A-C, 4.402 A, 4.405 F, 4.504.6 E, 4.504.61 B.1, 4.802.1 A.1, 4.903.31 eff. 07/01/2017.

Rules 4.100, 4.306.1, 4.310, 4.403, 4.405.2 eff. 10/01/2017. Rules 4.100, 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408 emer. rules eff. 10/01/2017; expired 12/30/2017.

Rules 4.100, 4.207.3, 4.404.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408, eff. 01/01/2018.

Rules 4.206, 4.400, 4.401.1, 4.401.2, 4.408 A, 4.502 A.4, 4.603, 4.604 emer. rules eff. 06/01/2018.

Rules 4.206, 4.207.2, 4.207.3, 4.210 B, 4.309.3, 4.309.31, 4.309.4, 4.309.41, 4.400, 4.401.1, 4.401.2, 4.407.4 A, 4.408 A, 4.410 D.2, 4.502 A.4, 4.603, 4.604, 4.604.1 eff. 09/01/2018.

Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 emer. rules eff. 09/07/2018.

Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 emer. rules eff. 12/07/2018.

Rules 4.207.3, 4.401.1, 4.401.2, 4.407.1, 4.407.3 A-B, 4.407.31 eff. 02/01/2019.

Rules 4.070, 4.070.2-4.070.21, 4.100, 4.200-4.202, 4.202.2-4.202.32, 4.203-4.203.2, 4.204 A, 4.205- 4.205.2, 4.205.4, 4.206, 4.208-4.208.1, 4.209, 4.301-4.303, 4.304.2-4.304.3, 4.304.41, 4.305.2, 4.306, 4.307, 4.308-4.308.1, 4.309.21, 4.309.31-4.309.4, 4.401-4.402.1, 4.403-4.403.1, 4.404- 4.405.1, 4.406, 4.407, 4.407.5-4.407.6, 4.408-4.408.2, 4.410, 4.411.1, 4.500-4.502, 4.504, 4.504.6-4.504.61, 4.505.2, 4.505.51-4.505.6, 4.505.7, 4.506-4.507, 4.601-4.609.6, 4.702.1- 4.702.2, 4.702.4, 4.703, 4.801-4.801-41, 4.802, 4.802.2-4.802.21, 4.802.51, 4.802.61-4.802.62, 4.803, 4.803.2, 4.803.43, 4.803.45, 4.803.5, 4.804.1 eff. 03/15/2019. Rules 4.204.1, 4.209.11, 4.505.62, 4.600 repealed eff. 03/15/2019.

Rule 4.802.63 D.1 emer. rule eff. 07/02/2019.

Rules 4.100, 4.304 B, 4.304.41 C, 4.305 B, 4.309.1, 4.309.31, 4.309.4 A, 4.309.41, 4.401 A, 4.401.1, 4.401.2, 4.405.2, 4.405.2 A.18, 4.407.4 A, 4.407.6, 4.407.6 B.2, 4.410 B, 4.410 J.11, 4.610, 4.701 B, 4.701.2 E.1, 4.801.4 E, 4.801.41 E, 4.802.61-4.802.63, 4.902.1 eff. 10/01/2019.

Rules 4.100, 4.206 E, 4.207.3, 4.304.4 A, 4.401.1, 4.401.2, 4.404 I, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.603 H, 4.604 E emer. rules eff. 10/01/2019.

Rules 4.309.31 C, 4.309.41 C emer. rules eff. 11/08/2019.

Rules 4.100, 4.206 E, 4.207.3, 4.304.4 A, 4.401.1, 4.401.2, 4.404 I, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.603 H, 4.604 E eff.12/30/2019.

Rules 4.309.31 C, 4.309.41 C eff. 01/30/2020.

Rules 4.100, 4.310-4.313, 4.504.6, 4.801.2-4.801.5 emer. rules eff. 02/07/2020.

Rules 4.100, 4.310-4.313, 4.504.6, 4.801.2-4.801.5 eff. 04/30/2020.

Rules 4.100, 4.204 A, 4.207.3 D, 4.311, 4.311.3 B, 4.311.3 D.1, 4.312.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4 emer. rules eff. 10/01/2020.

Rules 4.100, 4.204 A, 4.207.3 D, 4.311, 4.311.3 B, 4.311.3 D.1, 4.312.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4 eff. 11/30/2020.

Rules 4.207.3 D, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B, 4.407.3 C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E emer. rules eff. 10/01/2021.

Rules 4.207.3 D, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B, 4.407.3 C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E eff. 11/30/2021.

Entire rule eff. 03/30/2022.

Rules 4.000.1, 4.207.3 D, 4.310.3 C.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E, 4.801.41 D.3, 4.801.41 E.8-9, 4.801.43 A-B.1, 4.802, 4.802.1, 4.802.2 D, 4.802.3 A.1, 4.802.5, 4.802.51, 4.802.61-4.802.63, 4.803.43 A emer. rules eff. 10/01/2022.

Rules 4.901, 4.902.1, 4.902.3, 4.901.31, 4.902.32, 4.902.4, 4.902.5, 4.902.6, 4.903.1, 4.903.2, 4.903.3, 4.903.31, 4.903.32, 4.903.4, 4.903.41, 4.903.42, 4.903.43, 4.903.44 eff. 11/01/2022.

Rules 4.000.1, 4.207.3 D, 4.310.3 C.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31 A.4, 4.407.31 B.3, 4.407.31 C.3, 4.407.31 D.2, 4.408 E, 4.801.41 D.3, 4.801.41 E.8-9, 4.801.43 A-B.1, 4.802, 4.802.1, 4.802.2 D, 4.802.3 A.1, 4.802.5, 4.802.51, 4.802.61-4.802.63, 4.803.43 A eff. 11/30/2022.

Rules 4.000.1, 4.202.2, 4.204 A, 4.206 E, 4.207.3 A, 4.209.1 C.1, 4.302 A.3,B.1, 4.304 B.4, 4.304.1 A-C, 4.304.3 B, 4.305 B.2-3, 4.305.2 C,H, 4.305.3 D, 4.306 A-B, 4.306.1, 4.308.1 F, 4.309.41 E, 4.310.3, 4.310.4, 4.310.5 A, 4.310.6 E.2, 4.311.1, 4.311.3 A, 4.401 A, 4.401.1, 4.403 A.1-2, 4.403.12 E.2, 4.405 C, 4.407.31 A.1.b, 4.407.61 A, 4.408 A, 4.500 C, 4.502 B, 4.504, 4.504.5 D,H.3.b, 4.504.6 D.10, 4.504.61 B, repealed 4.505 B, 4.505.6 J, 4.505.61, 4.506, 4.506 C, 4.603 C,G, 4.604 D, 4.609, 4.609.1, 4.609.4, 4.609.6, 4.701, repealed 4.801.4 D.3, 4.801.41 E.3,5, 4.802.2 A.4, 4.802.4 C, 4.803.2 F.1, 4.803.43 B,B.10, 4.803.45 A, 4.803.5 A,C, 4.803.7 C-E, 4.804.1 A, 4.905 eff. 09/30/2023.

Rules 4.000.1, 4.207.3 D, 4.311, 4.311.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408 E emer. rules eff. 10/01/2023.

Rules 4.000.1, 4.207.3 D, 4.311, 4.311.1, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.407.31, 4.408 E eff. 11/30/2023.

Rules 4.000.1, 4.140 A, 4.201 G, 4.207.1 B, 4.207.3 A.3, 4.304-4.304.32, 4.311.3 C.2, 4.402 A.2, 4.403 F, 4.403.2 C, 4.407 A, 4.407.2 A, 4.407.4 A.2, 4.505.4, 4.707.9, 4.707.91 eff. 08/30/2024.

Rules 4.000.1, 4.207.3 D, 4.311 A.2, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31, 4.408 E emer. rules eff. 10/01/2024.

Rules 4.000.1, 4.207.3 D, 4.311 A.2, 4.401.1, 4.401.2, 4.407.1, 4.407.3 B-C, 4.407.31, 4.408 E eff. 11/30/2024.

Rules 4.207.3, 4.401.1-2, 4.407.1, 4.407.3, 4.407.31 emer. rules eff. 10/03/2025.

Rules 4.207.3 D, 4.401.1, 4.401.2, 4.407.1, 4.407.3, 4.404.31 eff. 12/30/2025.

## **2508** County Finance and Accounting, Executive Director Rules (Volume 5)

##### **11 CCR 2508-1** Rule Manual Volume 5, Finance and Accounting Rules {#sec-11-ccr-2508-1 omnilex-key=us-co-regs-official--department-9--11 CCR 2508-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 5, FINANCE AND ACCOUNTING RULES

11 CCR 2508-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT/REGULATORY ANALYSIS, AND

SPECIFIC STATUTORY AUTHORITY OF REVISIONS MADE TO STAFF MANUAL VOLUME 5

Revisions to sections 5.210.31, 5.210.312, 5.210.313, 5.210.314, 5.210.315, 5.221.2, 5.221.3, 5.221.32, 5.221.322, 5.221.323 were finally adopted at the 11/1/85 State Board meeting, with an effective date of 1/1/86 (Document 6). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 5.105.416, 5.105.481, 5.111.25, 5.220.11, 5.220.2 and 5.550.1 were finally adopted at the 12/6/85 meeting with an effective date of 2/1/86 (Document 8). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 5.640.51, 5.640.53, 5.640.54, 5.640.56, and 5.640.57 were finally adopted at the 12/6/85 meeting with an effective date of 2/1/86 (Executive Director Document 1). Statement of Basis and

Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to sections 5.312 through 5.313.3 were finally adopted at the 6/6/86 meeting with an effective date of 8/1/86 (Executive Director Document 1 and Document 2). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions and additions to Section 5.505.2, were finally adopted at the 7/11/86 State Board meeting, with an effective date of 9/1/86 (Document 13). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Addition of Sections 5.155, 5.155.1, 5.155.2, were emergency adopted at the 7/11/86 State Board meeting, with an effective date of 7/11/86 (Document 10). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions and additions to sections 5.650 and 5.221.3 were finally adopted at the 9/5/86 State Board meeting, with an effective date of 11/1/86 (Document 2). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions and additions to section 5.155 were finally adopted emergency at the 9/5/86 State Board meeting with an effective date of 8/1/86 (Document 5). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 5.155.1, 5.155.2 were emergency adopted at the 10/3/86 State Board meeting, with an effective date of 10/3/86 (Document 3). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Revisions, deletions, and additions to sections 5.224.1, 5.224.2, 5.225, 5.340.3, 5.420, 5.700, 5.710, 5.715 - 5.720, 5.730, and 5.740 were finally adopted at the 11/7/86 State Board meeting, with an effective date of 1/1/87 (Documents 11, 14, 1 E.D., 2 E.D.). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to section 5.505.2 were adopted emergency at the 11/7/86 State Board meeting, with an effective date of 11/7/86 (Document 19). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Revisions to sections 5.155.1 and 5.155.2 were finally adopted emergency at the 11/7/86 State Board meeting, with an effective date of 10/3/86 (Document 17). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 5.111.13 and 5.502 were finally adopted following publication at the 3/6/87 State Board meeting, with an effective date of 6/1/87 (Document 1 E.D.). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Deletion of sections 5.721 through 5.724.21 were finally adopted following publication at the 6/5/87 State Board meeting, with an effective date of 8/1/87 (Document 18). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 5.505.2 and 5.505.3 were finally adopted following publication at the 8/7/87 State Board meeting, with an effective date of 10/1/87 (Document 15). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions and deletions to sections 5.505.2 - 5.505.3 and 5.155.1 - 5.155.2 were emergency adopted at the 9/11/87 State Board meeting, with an effective date of 9/11/87 (Documents 18 and 28). Statement of

Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Deletions to section 5.155.1 - 5.155.2 were final adoption of emergency at the 10/2/87 State Board meeting, with an effective date of 9/11/87 (Document 11). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 5.505.2 through 5.505.3 were emergency and final adoption at the 11/6/87 State Board meeting, with an effective date of 11/6/87 (Document 14). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 5.223 through 5.224 were emergency adopted at the 1/8/88 State Board meeting, with an effective date of 1/8/88 (Document 9). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 5.505.2 and 5.505.3 were finally adopted following publication at the 6/3/88 State Board meeting, with an effective date of 8/1/88 (CSPR# 88-2-8-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to section 5.111 were finally adopted following publication at the 8/5/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-1-15-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 5.210 and 5.221 were emergency adopted at the 9/9/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-8-1-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 5.210 and 5.221 were final adoption of emergency at the 10/7/88 State Board meeting, with an effective date of 10/1/88 (CSPR# 88-8-1-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to sections 5.010 - 5.013, 5.154, 5.210, and 5.640 were finally adopted following publication at the 10/7/88 State Board meeting, with an effective date of 12/1/88 (CSPR# 88-8-12-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 5.000, 5.010 - 5.013, 5.120, 5.155, 5.200 - 5.221, 5.223 - 5.230, 5.300, 5.315, 5.400 - 5.411, 5.430 - 5.511, 5.550 - 5.630, and 5.640 were finally adopted following publication at the 10/7/88 State Board meeting as Executive Director rule, with an effective date of 12/1/88 (CSPR# 88-2- 19-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 5.111, 5.153, and 5.390 were finally adopted following publication at the 4/7/89 State Board meeting as Executive Director rule, with an effective date of 6/1/89 (CSPR# 88-12-6-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to Table of Contents and sections 5.100 - 5.120, 5.157 - 5.211, 5.230, 5.300 - 5.392, 5.450, and 5.900 - 5.910 were finally adopted following publication at the 1/5/90 State Board meeting as an Executive Director rule, with an effective date of 3/1/90 (CSPR# 89-9-19-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 5.210 through 5.211 were adopted emergency at the 7/6/90 State Board meeting as Executive Director rule, with an effective date of 7/6/90 (CSPR# 90-6-4-1b). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 5.210 through 5.211 were final adoption of emergency at the 8/3/90 State Board meeting as Executive Director rule, with an effective date of 7/6/90 (CSPR# 90-6-4-1b). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to Table of Contents and sections 5.100 - 5.101, 5.111, 5.315, 5.391 - 5.392, and 5.910 were finally adopted following publication at the 11/2/90 State Board meeting as an Executive Director rule, with an effective date of 1/1/91 (CSPR# 90-5-3-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 5.105 were adopted emergency at the 11/2/90 State Board meeting as an Executive Director rule, with an effective date of 1/1/91 (CSPR# 90-9-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to section 5.105 were final adoption of emergency at the 12/7/90 State Board meeting, during the Executive Director Rule-making session as an Executive Director rule, with an effective date of 1/1/91 (CSPR# 90-9-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to the entirety of Staff Manual Volume 5 were final adoption following publication at the 11/1/91 State Board meeting, during the Executive Director Rule-making session as an Executive Director rule, with an effective date of 1/1/92 (CSPR# 91-3-26-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to Staff Manual Volume 5 were final adoption following publication at the 4/3/92 Executive Director Rule-making session, with an effective date of 6/1/92 (CSPR# 91-11- 12-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to the Table of Contents and section 5.420 were final adoption following publication at the 8/6/93 Executive Director Rule-making session, with an effective date of 10/1/93 (CSPR# 93-4-28-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to section 5.101.331 were final adoption following publication at the 1/7/94 Executive Director

Rule-making session, with an effective date of 3/1/94 (CSPR# 93-5-26-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the Revisions to sections 5.153, 5.360, and 5.420 were final adoption following publication at the 4/1/94 Executive Director Rule-making session, with an effective date of 6/1/94 (CSPR# 94-2-16-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 5.105 and 5.210 were final adoption following publication at the 6/3/94 Executive Director Rule-making session, with an effective date of 8/1/94 (CSPR#'s 94-2-9-1 and 94-2-9-2).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Rewrite of this Finance Staff Manual was final adoption following publication at the 1/3/97 Executive Director Rule-making session, with an effective date of 3/1/97 (CSPR# 96-9-3-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 5.010 - 5.013, 5.101 - 5.105, and 5.153 were final adoption following publication at the 1/8/99 Executive Director Rule-making session, with an effective date of 3/1/99 (CSPR# 98-10- 28-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revision of Section 5.424 was final adoption following publication at the 2/6/2009 Executive Director rulemaking session, with an effective date of 4/1/2009 (Rule-making# 08-8-13-3). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Rewrite of this Finance Staff Manual was final adoption following publication at the 3/10/2004 Executive Director Rule-making session, with an effective date of 5/1/2004 (Rule-making# 03-6-30-2). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Department of Human Services, Office of Performance Improvement, Boards and Commissions Division.

Rewrite of these rules was final adoption following publication at the 5/4/2012 Executive Director Rulemaking session, with an effective date of 7/1/2012 (Rule-making# 11-9-12-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

5.000 FINANCE AND ACCOUNTING

5.100 PURPOSE AND SCOPE

These rules are the fiscal rules for county departments of social/human services concerning public assistance, social services, other forms of assistance, and the administration of the above including but not limited to internal controls, financial reporting, accounting, and auditing.

5.200 ROUTINE REPORTING PERIOD 5.201 Monthly Reporting to the Colorado Department of Human Services The county social/human services director shall report to the Colorado Department of Human Services at such times and in such manner and form as the Colorado Department of Human Services may from time to time direct. The routine reporting period from the county to the Colorado Department of Human Services is a calendar month. The Controller of the Colorado Department of Human Services shall determine the date required to submit financial data for each monthly reporting cycle.

5.300 PROCUREMENT PROCESS 5.301 Counties Shall Follow County Procurement Processes County departments of social/human services shall follow county procurement processes. If counties do not have procurement processes in place, State Procurement Rules shall be used pursuant to 1 CCR 101 through 1 CCR 109. 5.302 Compliance with Office of Management and Budget (OMB) Circulars County departments of social/human services shall comply with 2 C.F.R. Part 200 and any other applicable federal cost circulars. When counties are a pass-through entity, they shall hold their subrecipients and contractors accountable for compliance with 2 C.F.R. Part 200 and any other applicable circulars. No later amendments or editions are incorporated.

Copies of this material are available by contacting the Controller of the Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado, 80203, and online at http://www.ecfr.gov/cgibin/retrieveECFR?gp=&SID=87f8582883b9a1bdf2ba739bee355a07&mc=true&n=pt2.1.200&r=PART&ty= HTML. Additionally, any incorporated material in these rules may be examined at any State publications depository library. 5.400 County Allocations 5.401 Counties Shall Use Colorado Department of Human Services Guidance [Rev. eff. 7/1/12]

County departments of social/human services shall refer to an annual Colorado Department of Human Services county allocation letter which sets forth program allocations, as well as procedures that counties shall follow regarding any appeal of an allocation, closeout of actual expenditures each year, as well as methodology and data used to calculate annual allocations by program.

5.500 CONTRACTS 5.501 Contract Procedures County departments of social/human services shall adhere to all county guidelines for contract processes and procedures. In the absence of county procedures, county departments of social/human services shall follow State contract processes and procedures pursuant to 1 CCR 101 through 1 CCR 109.

5.600 TRAVEL 5.601 Travel Procedures County departments of social/human services shall adhere to all county guidelines for travel policies and reimbursement procedures. In the absence of county policies and procedures, county departments of social/human services shall follow State travel policies and procedures pursuant to 1 CCR 103-1.

5.700 REQUIRED USE OF STATEWIDE AUTOMATED SYSTEMS

County departments of social/human services shall use the Colorado Department of Human Services automated statewide client and/or provider information systems. These systems are designed to collect and store program data; assist with eligibility and payment determinations; generate forms and reports; create electronic benefit authorizations; and add to, delete, or make changes to the information on file.

5.800 REPORTING OF EMPLOYEE THEFT OR EMBEZZLEMENT

Any suspected theft or embezzlement of federal, State or local funds shall be immediately reported to at least one level of management above the party(s) suspected or to the county social/human services board. In addition, theft or embezzlement of State and/or federal funds or assets totaling $5,000 or more per incident shall be reported in writing to the county social/human service board and to the Audit Division Director of the Colorado Department of Human Services at 4126 South Knox Court, Denver, Colorado 80236.

5.900 MAINTAIN INTERNAL CONTROLS AND ADEQUATE SEGREGATION OF DUTIES

County departments of social/human services shall maintain a written set of internal control policies and procedures that promote a sound internal control environment that ensures an adequate and appropriate segregation of duties. The same staff may not initiate, authorize, and record a transaction, if staff also has the ability to receipt or disburse monies for that same transaction. _________________________________________________________________________ Editor’s Notes

History

Rule sections SB&P, 5.424 eff. 04/01/2009.

Entire rule eff. 07/01/2012.

Entire rule eff. 04/01/2017.

## **2509** Social Services Rules (Volume 7; Child Welfare, Child Care Facilities)

##### **12 CCR 2509-1** Overview of Child Welfare Services {#sec-12-ccr-2509-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-1}

DEPARTMENT OF HUMAN SERVICES

OVERVIEW OF CHILD WELFARE SERVICES

12 CCR 2509-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 7.000 OVERVIEW OF CHILD WELFARE SERVICES – PROGRAM AREAS AND TARGET GROUPS FOR 3, 4, 5, 6, AND 7 Child Welfare Services constitutes a specialized set of services defined at Section 26-5-101(3), C.R.S., that are intended to strengthen the ability of families to protect and care for their own children, prevent involvement or continued involvement in the child welfare system, minimize harm to children and youth, and ensure permanency planning. The goal of the treatment/prevention plan shall be to support the intactness of families, when appropriate, through the provision of services aimed at stabilizing the family situation and strengthening the parents/guardians in fulfilling their parental responsibilities to their children. Intervention shall be guided by respect for the family's integrity, knowledge of the legal bases for action, and sound social work practice.

The following principles shall underlie the provision of Child Welfare Services:

A. Children and youth, including youth who have run away, are experiencing homelessness, or who are unaccompanied, shall have the right to be raised in an environment free from abuse or neglect preferably by their families of origin by providing reasonable efforts to maintain the family unit through the provision of in-home services.

B. Placement shall be considered when there is evidence that leaving the child in the home would jeopardize the safety of the child or the community. Reasonable efforts shall be made to prevent placement or to reunite the family as soon as safely possible if removal is necessary. In determining reasonable efforts to be made, and in making such reasonable efforts, the child's health and safety shall be the paramount concern. A court may determine that reasonable efforts shall not be required; otherwise, reasonable efforts shall be made to preserve and reunify families.

C. Appropriate and culturally competent and trauma informed services that promote safety shall be provided to families, children, and youth in their own homes and in out-of-home placements.

D. Children and youth who have been removed from the care of their parents shall have the right to a diligent search according to Section 7.304.52 (12 CCR 2509-4) for extended family members who can be considered as placement resources, to be placed in a safe environment, to not be moved indiscriminately from one placement to another, and to have the assurance of a permanency plan. It is the responsibility of all adults involved in a child/youth’s life, including but not limited to county department personnel, parents, foster parents, adoptive parent/s, Guardians Ad Litem, counsel for youth, Court-Appointed Special Advocates, next of kin, treatment providers, and others, to seek opportunities to foster sibling relationships, to promote continuity, and to help sustain family relationships.

E. Consideration of the child's age, culture, language, religion, and other needs shall guide the choice of all services provided. Race, color, and national origin of the child and the prospective parents are considered in foster and adoptive placements only in extraordinary circumstances.

F. Case planning shall involve the parents so that relevant services can be provided to permit timely rehabilitation and reunification.

G. Child Welfare Services shall be provided in collaboration with other community agencies on behalf of children, youth, and their families. Assessment tools or resources available through these community agencies shall be incorporated in the assessment, based on the culture and other needs of the family.

7.000.1 PROGRAM AREAS (PA) AND TARGET GROUPS

Services are available from county departments in the following Program Areas:

A. Program for Prevention and Intervention Services to Children, Youth and Families at Risk of Involvement with Child Welfare (PA3)

The Program Area 3 (PA3) program provides prevention and intervention services for children, youth, and families at risk of involvement with child welfare. Services may be provided to assist families to safely care for their children.

B. Program for Youth in Conflict (PA 4)

Program Area 4 services are provided to reduce or eliminate conflicts between a child/youth and their family members, which may include the community, when those conflicts affect the child/youth's well-being, the normal functioning of the family or the well-being of the community.

The focus of services shall be on alleviating conflicts, protecting the child/youth, family, and the community, re-establishing family stability, and/or assisting the youth to emancipate successfully.

Target groups for Program Area 4 are children/youth who are youth in conflict, as defined in 7.000.2.

C. Program for Children in Need of Protection (PA 5)

Program Area 5 services are provided to protect children, whose physical, mental or emotional well-being is threatened by the actions or omissions of parents, legal guardians or custodians, or persons responsible for providing out-of-home care, including a foster parents, an employee of a residential child care facility, and a provider of family child care or center-based child care.

Target groups for Program Area 5 are children whose physical, mental, or emotional well-being is threatened or harmed due to the abuse or neglect and children who are subjected to circumstances in which there is a reasonable likelihood that they are at risk of harm due to abuse or neglect by their parents or caretakers which shall include children who are alleged to be responsible for the abuse or neglect and are under the age of ten (10).

D. Program for Children and Families in Need of Specialized Services (PA 6)

Program Area 6 services are to provide statutorily authorized services to specified children/YOUTH and families in which the reason for service is not protective services or youth in conflict. These services are limited to children/youth and families in need of adoption assistance, relative guardianship assistance, or Medicaid only services, to children/youth for whom the goal is no longer reunification, or youth who opt into services provided by the Foster Youth in Transition Program as established in § 19-7-301, C.R.S. The purpose of services in Program Area 6 is to fulfill statutory requirements in the interests of permanency planning for children/youth.

Children/youth must meet specific program requirements to receive services under the target groups.

Target Group information is located at Section 7.203 (12 CCR 2509-3).

E. Program for Resource Development (PA 7)

The purpose of Program Area 7 is to develop and coordinate the external resources necessary to fulfill the objectives of the social services programs.

Target Groups served by this program area are the individuals who will be serving children and families in such roles as volunteers, foster or kinship parents for children, adults, personal caregivers, homemakers or child care parents, or adoptive parents. 7.000.2 DEFINITIONS [Rev. eff. 1/1/16]

A: The following are definitions of commonly used terms used in these rules:

“Abuse” or “child abuse and/or neglect” is defined in Section 19-1-103(1) and 19-3-102(1), C.R.S.

“Actual knowledge” means direct and clear awareness of something, such as a fact or condition.

“Affected by alcohol or substance exposure.” A child is born affected by alcohol or substance exposure when it impacts the child’s physical, developmental, and/or behavioral response.

“Age or developmentally appropriate” means 1. Generally considered as suitable for children and youth of the same chronological age or level of maturity, or that are determined to be developmentally appropriate based upon the development of cognitive, emotional, physical, and behavioral capacities that are typical for an age or age group; and, 2. In the case of a specific child or youth, suitable for the child or youth based on the developmental stages attained, and with respect to the cognitive, emotional, physical, and behavioral capacities of the child or youth.

“Agency response” means the protocol prescribed by the state and county departments that guides practice pertaining to the protection of children in the dual-track response system.

“Application” means an action by a person or an authorized representative who indicates verbally or in writing to the county department a desire to receive human/social services.

“Assessment” means the work conducted by a case worker to engage the family and the community to gather information to identify the safety, risks, needs and strengths of a child, youth, family, and community to determine the actions needed. “Assessment” and “investigation,” as used in Sections 19-3-308 - 19-3-308.5, C.R.S., are interchangeable in these rules.

“Authorized caregiver” means an individual or agency who is authorized by a parent, guardian or custodian to provide care to a child and who agrees to provide such care. The authorization may be temporary and need not be in writing unless otherwise required by law.

“Background check” means a set of required records that are obtained and analyzed to determine whether the history of a prospective foster parent, kinship foster parent, or non-certified kin meets legal and safety criteria when considering the placement or continued placement of children and youth in the care of the person(s). The checks include all adults residing in the home. The following individual checks are required pursuant to Sections 19-3-406, and 26-6-910, C.R.S.:

1. CBI and FBI fingerprint-based criminal history record information checks;

2. State Judicial Department court case management system checks;

3. State automated case management system and child abuse and/or neglect registry checks in all states that adults living in the home have resided in the five years preceding the date of application; and, 4. The CBI sex offender registry checks and national sex offender public website, publicly operated by the United States Department of Justice using the following minimum criteria:

a. Known names and addresses of each adult residing in the home; and, b. Address only of the residence.

“Caregiver” means a child's parent, stepparent, guardian, legal custodian, relative, or any other person who resides in the child's home or who is regularly in the child's home for the purpose of exercising care over the child. It also includes the spousal equivalent or domestic partner of a parent or legal guardian. A “caregiver” shall not include a person who is regularly in the child's home for the purpose of rendering care for the child if such person is paid for rendering care and is not related to the child.

“Certificate” means a legal document granting permission to operate a foster care home or a kinship foster care home.

“Child” means any person from birth to eighteen (18) years of age.

“Child” means any person from birth to eighteen (18) years of age.

“Child Abuse and Neglect Reporting Hotline System” or “the hotline system” is the telephone system that:

1. Routes calls that are received through the toll-free, statewide child abuse and neglect hotline or county dedicated child abuse and neglect reporting telephone lines to the applicable entity responsible for accepting a report of child abuse and/or neglect, or the applicable entity responsible for responding to an inquiry;

2. Records calls; and, 3. Captures call data including but not limited to call volume, average call wait time, and average call duration.

“Child Care Service” means care of a child under the age of thirteen (13) years for a portion of a day, but less than twenty-four (24) hours. These services may be provided in the child’s own home by a person other than the parent or the primary caregiver in a relative home, an exempt day care home, in a licensed or certified day care home, or licensed group day care facility. Older children who need protection or have a special need may be approved for service by the county department.

“Child in need of services” includes a child who receives services regardless of whether the services are court ordered, county provided or voluntarily arranged by the family, or a child who needs services even if the services are not provided.

“Child’s vulnerability” refers to circumstances that place a child at a greater risk for abuse and/or neglect such as being six years of age or younger or having limited capacity to self-protect or provide self-care due to physical, emotional, and/or cognitive limitations.

“Child Welfare Child Care” means child care assistance used to maintain children in their own homes or in the least restrictive out-of-home care when there are no other child care options available. This care is less than twenty-four (24) hours daily. See section 7.302, “Child Welfare Child Care” (12 CCR 2509-4).

“Child Welfare Services” are the services and payments for services (other than medical services covered by the “Colorado Medical Assistance Act”) available, directly or indirectly, through the state and county departments for the benefit of eligible persons pursuant to rules adopted by the State Department or State Board of Human Services.

“Client” means any person applying for or receiving child welfare services from a county department.

“Colorado Safety Assessment Tool” means the tool in the State automated case management system that guides a case worker through a safety assessment process.

“Concurrent planning” means the simultaneous preparation of plans to:

1) Assist the child's parents or caregivers in completing a treatment plan that, when completed successfully will allow the child to return home safely; and, 2) Place the child in a setting that will become the child's permanent home if the parents or caregivers are unable to successfully complete their treatment plan.

“Continuously available” means the assignment of a person to be near an operable telephone, pager system, cellular telephone, or to have such arrangements made through agreements with the local law enforcement agencies.

“Convicted”, for the purposes of the criminal history record information check, means a plea of guilty accepted by the court, including a plea of guilty entered pursuant to a deferred sentence under section 18-1.3-102, C.R.S., a verdict of guilty by a judge or jury, or a plea of no contest accepted by the court, or having received a disposition as a juvenile or having been adjudicated a juvenile delinquent based on the commission of any act that constitutes sexual assault, as defined in subsection (96.5) of section 19-1-103, C.R.S.

1. For non-certified kinship care and kinship foster care, a conviction does not include juvenile delinquency history, which includes deferred judgment or adjudication agreements, adjudications, diversion, deferral, or plea agreements.

“Counsel for youth” means an attorney-at-law who provides specialized client directed legal representation for a child or youth and who owes the same duties, including undivided loyalty, confidentiality, and competent representation, to the child or youth as is due an adults client.

Counsel for youth may be appointed by a court to represent a child or youth in a proceeding pursuant to articles 1, 3, or 7 of title 19, C.R.S. or may be assigned by the office of the child’s representative pursuant to article 7 of title 19, C.R.S. Counsel for youth does not mean defense counsel for a juvenile pursuant to article 2.5 of title 19, C.R.S.

“County Department” means a county department of human or social services or, if applicable, the county agency responsible for providing child welfare services as defined by Section 26-5- 101(3), C.R.S.

“De novo” means that when an issue is reviewed, affording no deference to the original decision.

“Dedicated Child Abuse and Neglect Reporting Telephone Line” is a county department telephone number that is used to receive calls related to child abuse and/or neglect. Calls to county departments’ dedicated child abuse and neglect reporting telephone lines will be routed through the statewide hotline system for recording and data collection purposes and routed to the county departments’ hotline workers.

“Delinquent act” means a violation of any statute, ordinance, or order enumerated in Section 19- 2- 104(1) (a), C.R.S. If a juvenile is alleged to have committed or is found guilty of a delinquent act, the classification and degree of the offense shall be determined by the statute, ordinance, or order that the petition in delinquency alleges was violated.

“Differential Response” is a dual-track response system for referrals that meet the criteria for assignment. The two response options are the High Risk Assessment (HRA) and the Family Assessment Response (FAR).

“Disaster” means the occurrence or imminent threat of widespread or severe damage, injury, or loss of life or property resulting from any natural cause or cause of human origin, including but not limited to fire, flood, earthquake, wind, storm, wave action, hazardous substance incident, oil spill or other water contamination requiring emergency action to avert danger or damage, volcanic activity, epidemic, air pollution, blight, drought, infestation, explosion, civil disturbance, hostile military or paramilitary action, or a condition of riot, insurrection, or invasion existing in the state or in any county, city, town, or district in the state as defined in Section 24-33.5-703(3), C.R.S.

“Disqualifying factor” for the purpose of completing background checks for non-certified kinship care, kinship foster homes, and foster homes, means information that precludes safe placement of a child and/or youth by a county department of human or social services or a child placement agency into a prospective home. Factors include, but are not limited to:

1. A criminal conviction that is prohibited;

2. Confirmed child abuse and/or neglect in the state automated case management system or another state’s child abuse and neglect registry, and following a review of the information, it is determined that the placement is unsafe;

3. Identification of the person(s) or an adult residing in the home on the Colorado Bureau of Investigation (CBI) sex offender registry or the national sex offender public website operated by the United States Department of Justice (excluding youth in the custody of the county department of human or social services); and, 4. Convictions and dispositions in the court case management system that are similar to CBI findings.

“Domestic partner” means a person who is in a family-type living arrangement with a parent and who would be a stepparent if married to that parent. “Domestic partner” and “spousal equivalent” are interchangeable in these rules.

“Domestic violence” means the commission or threatened commission of violence, including coercion, control, punishment, intimidation or revenge upon a person by a person with whom there is or was an intimate relationship.

“Dually identified crossover youth” means youth who are currently involved in the juvenile justice system and the child welfare system or have a history in the child welfare system that includes, but is not limited to, a family assessment response service plan or an open case.

“Egregious incident of abuse and/or neglect” means an incident of suspected abuse and/or neglect involving significant violence, torture, use of cruel restraints, or other similar, aggravated circumstance.

“Egregious neglect”, for the purpose of determining severity level, is when the physical or emotional needs of the child are not met and involves significant violence, torture, use of cruel restraints, or other similar, aggravated circumstance.

“Egregious physical abuse”, for the purpose of determining severity level, is physical abuse involving significant violence, torture, use of cruel restraints, or other similar, aggravated circumstance.

“Emancipation from foster care” occurs when a youth reaches eighteen (18) years of age and is no longer under the jurisdiction of the court or is married or enters military service.

“Emancipation Transition Plan” means a personalized youth-driven written document that supports emancipation from foster care and is intended to prevent the youth from becoming homeless.

“Emergency” means an unexpected event that places life or property in danger and requires an immediate response through the use of state and community resources and procedures as defined in Section 24-33.5-703(3.5), C.R.S.

“Emotional abuse” means an identifiable and substantial impairment of the child's intellectual or psychological functioning or development or a substantial risk of impairment of the child's intellectual or psychological functioning or development as a result of the action or inaction of the alleged person responsible for abuse and/or neglect.

“Environment injurious to the welfare of a child” is when the environment caused injuries to the welfare of the child or reasonably could be foreseen as threatening to the welfare of the child and is in control of the parent, guardian, custodian or authorized caregiver.

“Expunge” is to designate a report or record as not having existed for the purpose of employment and background screening. However, a founded finding of abuse and/or neglect that is later expunged shall not preclude the county department from maintaining records of the report in the case file or in the state automated case management system for purposes of future safety and risk assessments.

“Facility” means a residential child care facility, specialized group facility, foster care home, family child care home, or any other facility subject to Colorado “Child Care Licensing Act,” part 1 of

article 6 of title 26; noncertified kinship care providers that provide care for children with an open child welfare case who are in the legal custody of a county department; or a facility or community placement, as described in section 19-2-403, C.R.S., for a juvenile committed to the custody of the department of human services. “Facility” does not include any adult detention or correctional facility.

“Fair Hearing” means any procedure by which an Administrative Law Judge reviews facts in relation to an adverse action taken by a county department pursuant to Section 3.850 of the Department of Human Services’ Income Maintenance rules (9 CCR 2503-8).

“Family” means parents, adults fulfilling a parental role, guardians, children, and others individuals related by ancestry, adoption, or marriage or as defined by the family.

“Family Assessment Response (FAR)” means the differential response track established for low and moderate risk situations where no finding of abuse and/or neglect is made.

“Family search and engagement” means the diligent and timely good faith effort to locate and contact any noncustodial parent, all grandparent(s), other adult relatives, and the parent of a sibling of a child/youth who has been removed from their legal custodian’s home. Family search and engagement shall extend beyond the United States, its territories, or Puerto Rico, as appropriate.

“Family time” means any form of contact or engagement between parents, legal custodians, guardians, siblings, and children or youth for the purposes of preserving and strengthening family ties.

“Fatal neglect,” for the purpose of determining severity level, is when the physical or medical needs of the child are not met, resulting in death.

“Fatal physical abuse,” for the purpose of determining severity level, means excessive or inappropriate force used resulting in a child's death.

“Finding” means the determination about whether an incident of abuse and/or neglect occurred.

“Foster care” means the placement of a child into the legal custody or legal authority of a county department for physical placement of the child in foster family care homes, certified and noncertified kinship family care homes, or licensed facility.

“Foster care home” means a home that is certified by a county department or a child placement agency pursuant to Section 26-6-910, or a federally recognized tribe pursuant to applicable federal law, for child care in a place of residence of a family or person for the purpose of providing twenty-four-hour family foster care for a child/youth less than twenty-one years of age who is unrelated to the head of the home.

1. The term includes any foster care home receiving a child/youth for regular twenty four (24) hour care and any home receiving a child/youth from any state-operated institution for child care or from any child placement agency. Foster care home also includes those homes licensed by the Colorado Department of Human Services pursuant to Section 26-6-104, C.R.S., that receive neither moneys from the counties, nor children/youth placed by the counties.

“Founded” means that the abuse and/or neglect assessment established by a preponderance of the evidence that an incident(s) of abuse and/or neglect occurred. “Founded” can also be utilized in a referral when there is a law enforcement fatality investigation with no surviving child sibling, or a law enforcement investigation of a third party incident of abuse and/or neglect. “Founded” and “confirmed,” as used in sections 19-3-308 - 308.5, C.R.S., are interchangeable in these rules.

“Framework” is a method for organizing and analyzing information as it pertains to child safety.

“Good cause” to modify the process would be limited to emergency conditions or circumstances beyond the control of the party seeking the modification such as, but not limited to, impossibility for a party to meet a specified deadline, incapacity of the party or representative, lack of proper notice of the availability of the appeal process, additional time required to obtain documents which were timely requested but not delivered, or other situations which would prevent a reasonable person from meeting a deadline or complying with the process without modification.

“Gray Area” is a heading included in the RED Team framework. This section captures any information, questions or areas needing further exploration. This may include risk factors that require some type of follow up to determine their validity and impact on the child(ren). Information captured in the “Gray Area” section may be routinely reviewed by child welfare staff to determine trends, or potential areas needing further discussion and /or elaboration when gathering information from reporters.

“Guardian ad litem” means a person appointed by a court to act in the best interests of a person whom the person appointed is representing in proceedings pursuant to title 19, C.R.S. and who, if appointed to represent a person in a dependency and neglect proceeding pursuant to article 3 of title 19, C.R.S. must be an attorney-at-law licensed to practice law in Colorado.

“High Risk Assessment (HRA)” means the differential response track established for high risk situations where the alleged victim child(ren) are identified and a finding of abuse and/or neglect is made.

“Hotline County Connection Center” is an entity contracted by the State Department to route calls to county departments, and at county departments’ request subject to the approval of the State Department’s Executive Director, receive reports and inquiries on their behalf.

“Household” is defined as:

1. One or more adult(s) and child(ren), if any, related by blood, or law, residing together.

2. Where adults, other than spouses, domestic partners, or spousal equivalent reside together, each is considered a separate household. Emancipated minors and children living under the care of individuals not legally responsible for that care are also considered separate households.

3. When determining monthly gross income in establishing a foster care fee, a stepparent, who is not legally responsible for a child, is not considered a member of the household. Stepchildren for whom the custodial parent(s) are not legally responsible are not considered part of the household in establishing a foster care fee.

“Housing First” means an approach to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements. Supportive services are offered to maximize housing stability and prevent returns to homelessness as opposed to addressing predetermined treatment goals prior to permanent housing entry.

“Human trafficking” refers to sex trafficking or trafficking for sexual servitude and/or labor trafficking or involuntary servitude.

• “Sex trafficking” or “human trafficking of a minor for sexual servitude” means a child/youth trades sex or sexual activity in exchange for something of value. Sex trafficking occurs when a child/youth is exploited (sold, recruited, harbored, transported, transferred, isolated, enticed, provided, received, or obtained) by any means, maintained or made available by a family member, institution, or third party for purposes of commercial sexual activity.

• “Labor trafficking” or “human trafficking for involuntary servitude” means a child/youth is coerced to perform labor services. Labor trafficking occurs when a child/youth is exploited (sold, recruited, harbored, transported, transferred, isolated, enticed, provided, received, or obtained) by a family member, institution, or third party for purposes of forcing the youth to perform labor or labor services.

“Human trafficking screen” is the tool used by child welfare staff to identify risk factors associated with human trafficking.

“Impending danger” means a threat(s) to child safety not occurring at present but likely to occur in the near future and likely to result in moderate to severe harm to a child.

“Inconclusive” means that the abuse and/or neglect assessment established that there was some likelihood that an incident(s) of abuse and/or neglect occurred but assessment could not obtain the evidence necessary to make a founded finding.

“Independent Living Assessment” means an evaluation of the youth's daily living skills. This assessment will document the youth's strengths and needs, as well as capacity and motivation to learn the appropriate skills.

“Initial criminal history record check” means a Colorado Crime Information Center or National Crime Information Center check.

“Inquiry” means a request for information or for specific services.

“Institutional Abuse and/or Neglect” means any incident of “child abuse or neglect” as defined in sections 19-1-103(1) and 19-3-102(1), C.R.S. regarding:

1. A child under eighteen (18) years of age; or 2. A youth under twenty-one (21) years of age who is under court jurisdiction; and, 3. The incident occurs in a child care facility or 24-hour facility, 4. A facility subject to the Colorado “Child Care Licensing Act”, 5. A non-certified kinship care home with providers that provide 24-hour care for child(ren) with an open child welfare case who are in the legal custody of a county department, or, 6. A facility or community placement for a juvenile committed to the custody of the department of human services.

“Institutional Lack of Supervision” is when a provider fails, through an action or omission, to provide supervision or to make supervision decisions that align with the behavioral, developmental and/or physical needs of the child(ren) or youth.

“Institutional Medical Neglect” is when a facility care provider does not provide adequate medical care, and/or fails to exercise reasonable medical judgment, and the child, youth, or young adult has been harmed.

“Intrafamilial abuse and/or neglect” means any case of abuse and/or neglect, as defined in Sections 19-1-103(1) and 19-3-102(1) and (2), C.R.S., that occurs within a family or non-certified kinship care context by a caregiver; except that “intrafamilial abuse” shall not include abuse and/or neglect by a person who is regularly in the child's home for the purpose of rendering care for the child if such person is paid for rendering care and is not related to the child.

“Juvenile” means any person between ten (10) and twenty-one (21) years of age.

“Kin” for purposes of a kinship foster care home or non-certified kinship care home, means a relative of the child and/or youth, a person ascribed by the family as having a family-like relationship with the child and/or youth, or a person that has a prior significant relationship with the child and/or youth. These relationships take into account cultural values and continuity of significant relationships with the child and/or youth.

“Kinship foster care home” means a kinship foster care home that has been certified pursuant to

Section 26-6-910 to care for a relative or kin only. A kinship foster care home provides twentyfour-hour kinship foster care for a child or youth who is a relative or kin, who is less than twentyone years of age, and who is eligible for the same foster care reimbursement, assistance, and other supports as foster care homes pursuant to Section 26-6-904.5. “kinship foster care home” does not include non-certified kinship care as that term is defined in Subsection (21.5) of this

section.

A “known” incident of abuse and/or neglect exists when a child has been observed being subjected to circumstances or conditions that would reasonably result in abuse and/or neglect.

“Living in the home” for purposes of kinship care including non-certified kinship reimbursement means regularly lives, shares common areas, and sleeps in the non-certified kinship home. An individual who is living, sharing common areas, and sleeping in the non-certified kinship home temporarily for more than two consecutive weeks is considered a household member.

“Local educational agency” means the local public school district, charter institute, Colorado school for the deaf and the blind, and/or board of cooperative education services (BOCES).

Individual schools are part of their respective LEAs; for purposes of these regulations, communication with school-level staff is sufficient to satisfy requirements to communicate with the LEA.

“Mandatory reporter” means a person required by Section 19-3-304, C.R.S., to report suspected abuse and/or neglect.

“Medium,” a term found in the comprehensive child welfare information system that when used for the purposes of determining severity level, has the same meaning as the term “moderate.”

“Minor neglect,” for the purposes of determining severity level, is when the physical or emotional needs of the child are marginally or inconsistently met, but there is little or no impact on the child's functioning.

“Minor physical abuse,” for the purposes of determining severity level, is excessive or inappropriate force used resulting in a superficial injury.

“Missing” means when a child or youth has been reported to the county department of human or social services as absent from out-of-home placement or their designated residence, and the child/youth's whereabouts are unknown to parents, caregivers or the county department of human or social services.

“Moderate neglect,” for the purpose of determining severity level, is when the physical or emotional needs of the child are inadequately met resulting in some impairment in the child's functioning.

“Moderate physical abuse,” for the purposes of determining severity level, is excessive or inappropriate force used resulting in an injury that may require medical attention.

“Moderate to severe harm” means the consequence of maltreatment at a level consistent with a moderate, severe or fatal level of physical abuse, sexual abuse and/or neglect.

“Near fatal neglect”, for the purpose of determining severity level, is when the physical or emotional needs of the child are not met in an incident in which a physician determines that a child is in serious, critical, or life-threatening condition as the result of sickness or injury caused by suspected abuse and/or neglect.

“Near fatal physical abuse”, for the purpose of determining severity level, involves an incident in which a physician determines that a child is in serious, critical, or life-threatening condition as the result of sickness or injury caused by suspected abuse and/or neglect.

“Near fatality” means a case in which a physician determines that a child is in serious, critical, or life-threatening condition as the result of sickness or injury caused by suspected abuse and/or neglect.

“Non-certified kinship care” means a child/youth who is less than twenty-one years of age is being cared for by a relative or kin, who has a significant relationship with the child/youth, in circumstances when there is a safety concern by a county department in the home of the parent or legal guardian and the relative or kin has not met the foster care certification requirements for a kinship foster care home or has chosen not to pursue certification.

“Parent who is incarcerated” means a parent confined in a department of corrections facility, a private correctional facility under contract with The Department of Corrections, or a jail.

“Pattern of misdemeanors” for the purposes of the criminal history record information check shall be defined as:

A) Three (3) or more convictions of 3rd degree assault as described in section 18-3- 204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6-800.3(1), C.R.S. ; OR, B) Five (5) misdemeanor convictions of any type, with at least two (2) convictions of 3rd degree assault as described in Section 18- 3-204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6- 800.3(1), C.R.S.; or, C) Seven (7) misdemeanor convictions of any type.

D) For non-certified kinship care and kinship foster care, a pattern of misdemeanor convictions means two or more convictions of domestic violence within the preceding five years pursuant to Section 19-3-406 (5)(i), C.R.S. and shall not include A-C of this definition.

“Personal Contact” is a method of contact in which two people exchange information in person or through live communication either via telephone or other emerging communications technology.

“Plan of Safe Care” means a collaborative process to create a documented plan for the health, safety, and well-being of an infant reported with prenatal substance exposure, following the infant's release from the care of a healthcare provider, and address the health, support, and substance use treatment needs of the affected family or caregiver(s) according to the requirements outlined in 12 CCR 2509-2 section 7.107.5.

“Potential disqualifying factor” for the purpose of completing a background check for non-certified kinship care and kinship foster care homes, means information that may preclude the placement of a child and/or youth by a county department of human or social services or a child placement agency into a prospective home. Factors include, but are not limited to:

1. A criminal conviction that may be prohibited;

2. Confirmed child abuse and/or neglect in the state automated case management system or another state’s child abuse and neglect registry, and following a review of the information, it is determined that any safety concerns can be mitigated;

3. The court orders and affirms the placement of the child or youth with kin; or, 4. Additional documented information that was acquired that raises concern about safety in the home.

“Preponderance of evidence” means credible evidence that a claim is more likely true than not.

“Present danger” means an immediate, significant, and clearly observable threat to child safety that is actively occurring and will likely result in moderate to severe harm to a child.

“Primary caregiver” means the caregiver who assumes the most responsibility for care of the child.

“Provider” means a vendor of goods and/or services under the child welfare services program.

“Purchased services” are those services made available to clients through another public agency, a private agency, or a private individual under contract with the state or county department.

“Reasonable and prudent parent standard” means careful and sensible parental decisions that maintain the health, safety, and best interests of the child or youth while encouraging the emotional and developmental growth of the child or youth that a provider shall use when determining whether to allow a child or youth in foster care under the responsibility of the county or in non-secure residential settings under the responsibility of the Division of Youth Services (DYS) to participate in extracurricular, enrichment, cultural, and social activities based upon the criteria in Section 7.701.200 (12 CCR 2509-8).

“Reasonable efforts” means the exercise of diligence and care throughout county department involvement with children, youth, and families.

“RED team” is the acronym for review, evaluate and direct. The RED team is a group decision making process that utilizes the framework and agency response guide to determine county department response to referrals.

“Referral” means a report made to the county department that contains one or more of the following:

1. Allegations of child abuse and/or neglect as defined in Section 19-1-103(1) and 19-3-102(1), C.R.S.;

2. Information that a child or youth is beyond the control of his/her parent;

3. Information about a child or youth whose behavior is such that there is a likelihood that the child or youth may cause harm to him/herself or to others, or who has committed acts that could cause him/her to be adjudicated by the court as a delinquent;

4. Information indicating that a child or youth meets specific Program Area 6 requirements and is in need of services.

“Report” means an initial report of known or suspected child abuse or neglect.

“Risk” means detailed worries/concerns of what could happen in the future (risk level indicates the likelihood).

“Roadmap to Success” means part of the Family Services Plan that is developed in consultation with the youth, caseworker, care provider(s), and, at the option of the youth, up to two (2) other significant persons chosen by the youth. The plan shall document services and supports that will assist the youth in successfully transitioning to adulthood.

“Safe” means a condition where there is no present or impending threat of harm to a vulnerable child from current known family conditions, or the protective capacities in the family are sufficient to control existing dangers of threats of danger and protect the vulnerable child.

“Safety intervention” means the actions and decisions required to:

1. Identify and assess threats to child safety;

2. Plan for an unsafe child or children to be protected;

3. Facilitate caregivers in taking responsibility for child protection; and, 4. Manage plans designed to assure child safety while a safe and permanent home is established.

“Safety Plan” means a time-limited written plan that:

1. Establishes protection for a child in an effort to prevent out of home placement in situations of moderate to severe harm;

2. Is made by the family or natural supports, safety service providers, and the county department; and, 3. Does not rely on the person responsible for abuse and/or neglect to initiate protective actions in order for the plan to be operationalized.

“Severity level” means the assessment of the harm to the child victim or the act of abuse and/or neglect as minor, moderate, severe or fatal as defined in these rules. Sexual abuse severity is to be determined based upon the type of contact, duration of contact, and the emotional impact upon the child.

“Severe neglect”, for the purpose of determining severity level, is when the physical or emotional needs of the child are not met resulting in serious injury or illness.

“Severe physical abuse”, for the purpose of determining severity level, means excessive or inappropriate force used resulting in a serious injury that requires medical attention or hospitalization.

“Sibling” means one of two or more individuals who is descended from one or two mutual parents.

The term also includes stepsiblings, former stepsiblings, and/or adoptive siblings. This also includes an individual that is considered by state or tribal law to be a sibling of the child/youth or the individual would have been considered a sibling of the child/youth under state or tribal law but for a termination or other disruption of parental rights, such as the death of a parent.

“Spousal equivalent” means a person who is in a family-type living arrangement with a parent and who would be a stepparent if married to that parent. “Spousal equivalent” and “domestic partner” are interchangeable in these rules.

“State automated case management system” means the state automated child welfare information system computer database.

“Substance exposed newborn” Reference sections 19-1-103 AND 19-3-102, C.R.S. (2020).

The “State Department” means the Colorado Department of Human Services.

“Supervised Independent Living Placement (S.I.L.P.)” means a placement in foster care where a youth lives independently in the community under the supervision of the county department.

Receiving funds is not a necessary condition for a youth to be in an S.I.L.P. Youth shall receive casework services on S.I.L.P. with or without receipt of the I.L.A. stipend.

“Supplemental Security Income (SSI)” means the monthly cash payments made by the Social Security Administration to an aged, blind, or disabled individual who meets the requirements under Title XVI of the Social Security Act.

“Supportive Activities” means those activities of the informational, statistical, clerical personnel, and staff training systems that support the child welfare services program.

“Support Plan” means a written plan developed in the absence of safety concerns. It is familydriven, department-facilitated, and includes the family’s network, which may include extended family, friends, informal supports and community resources. A support plan is concrete, agreed upon, and includes specific actions that the family and network are doing to mitigate risk and ensure future safety.

A “suspected” incident of abuse and/or neglect means an incident based on a single act or patterns of behavior, conditions, statements or injuries that would lead to a reasonable belief that abuse and/or neglect has occurred or that there is a serious threat of harm to the child.

“Third-party abuse and/or neglect” means a situation where a child is subjected to abuse and/or neglect by any person who is not a parent, stepparent, guardian, legal custodian, spousal equivalent, or any other person not included in the definition of intrafamilial abuse or institutional abuse.

If a referral meets criteria for assignment and involves human trafficking allegations by a thirdparty, the ability of the parent to be protective of the child should be assessed.

“Threat of moderate to severe harm” relates to conditions, behaviors or attitudes that could result in moderate to severe harm.

“Threatened by substance use” The newborn child’s health or welfare is threatened by substance use when the medical, physical, and/or developmental needs of the newborn child are likely to be inadequately met or parent and/or caregivers are likely unable to meet the newborn child’s needs.”

“Toll-free, Statewide Child Abuse and Neglect Hotline” is the telephone number that is advertised to the public as a place for reporting known or suspected child abuse and/or neglect.

“Traditional response” means the response used by counties not selecting to participate in Differential Response for all assessments of low, moderate, and high risk.

“Unfounded” means that the abuse and/or neglect assessment established that there is clear evidence that no incident of abuse and/or neglect occurred.

“Unregulated Custody Transfer” Refers to when a parent, guardian, custodian or an individual with whom a child has been placed for adoption transfers (or intends to transfer) custody of the child/youth to another person with the intent, at the time of the transfer, of abandoning their rights and responsibilities of the child/youth permanently, outside of a legal adoption or guardianship proceeding, judicial award of custody, other judicial or tribal action, or Colorado's Safe Haven Law as described in section 19-3-304.5, C.R.S.

Unregulated custody transfer does not apply when a transfer of custody of a child/youth by a parent, guardian, or custodian of the child/youth is to:

1. A parent of the child/youth, 2. A stepparent of the child/youth, 3. An adult who is related to the child/youth by blood, marriage, adoption, or other relationship recognized by other law, 4. An adult who, at the time of the transfer, has had a meaningful and safe relationship with the child/youth for at least six months prior to the transfer, and whom the transferring individual believes, at the time of transfer, to be a fit custodian for the child/youth, 5. An Indian Custodian, as outlined in the “Indian Child Welfare Act Of 1978”, 25 U.S.C. section 1903(6).

“Unsafe” means a condition where there is a present or impending threat(s) of moderate to severe harm to a child and protective capacities of the caregiver(s) are insufficient to control danger or threats of danger.

“Voluntary Services Agreement” means a standardized voluntary services agreement approved by the state department and is entered into by a participating youth pursuant to section 19-7-306, C.R.S.

“Youth” means any person at least twelve (12) years of age and under twenty-one (21) years of age.

“Youth in conflict” means a child/youth who is involved in a conflict which results in the high likelihood of suffering substantial harm and/or injury to the child/youth, family, and/or community.

“Youth who are Experiencing Homelessness” has the same meaning as “Homeless Youth,” which is defined at section 24-32-723(2)(b), C.R.S. (2020) and 26-5.7-102(2), C.R.S. (2020).

“Youth who have Run Away” means a child/youth who has become homeless or who left and remains away from home without the permission of their parent(s), caregiver(s), or legal guardian(s).

“Youth who are Unaccompanied” means a child/youth who is at risk of or is experiencing abuse, neglect, or is a youth in conflict and who is living without financial, physical, and/or housing support from family, or whose parent(s), caregiver(s), and/or legal guardian(s) whereabouts are unknown.

B. The following are definitions of terms related to assessments of medical neglect of infants and toddlers with disabilities:

“Designated Hospital Liaison” means the person named by the hospital or health care facility to act as the contact with the county department in all aspects of cases of suspected withholding of medically-indicated treatment from infants and toddlers with disabilities and with life threatening conditions.

“Hospital Review Committee (H.R.C.)” means an entity established to deal with medical and ethical dilemmas arising in the care of patients within a hospital or health care facility. Where they exist, the committee may take many organizational forms, such as an “infant care review committee” or an “institutional-bioethics committee”. The functions for a committee may differ from institution to institution, including the authorization to review and recommend treatment in specific cases.

“Infant with a disability” means a child less than one year of age who was born with a lifethreatening condition and who may have additional non-lethal physical or mental disabilities. The definition includes children over the age of one year who have been continuously hospitalized since birth, who were born extremely premature, or who have a long-term disability. These procedures do not imply that treatment should be changed or stopped when an infant reaches one year of age. The primary population to be addressed in these regulations is that of the hospitalized infant. Any other situations involving medical neglect of children will be provided for under the existing protections of the Colorado Children's Code regarding medical care of children.

“Reasonable medical judgment” means a medical judgment that would be made by a reasonably prudent physician, knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved.

“Withholding of medically-indicated treatment” means the failure to respond to the infant's lifethreatening conditions by providing treatment (including appropriate nutrition, hydration, and medication) that, in the treating physician's reasonable medical judgment, will be most likely to be effective in improving or correcting all such conditions. The term does not include, however, the failure to provide treatment to an infant (other than appropriate nutrition, hydration or medication) when, in the treating physician's (or physicians') reasonable medical judgment any of the following circumstances apply:

1. The infant is chronically and irreversibly comatose;

2. The provision of treatment would merely prolong dying, not be effective in improving or correcting all of the infant's life-threatening conditions, or otherwise be futile in terms of the survival of the infant;

3. The provision of treatment would be virtually futile in terms of the survival of the infant and the treatment itself under such circumstances would be inhumane. 7.000.3 – 7.000.5 (None) [Emergency eff. 6/5/15; Rev. eff. 9/1/15] 7.000.6 COUNTY RESPONSIBILITIES [Eff. 1/1/15]

All current and prospective employees of the county department, who in their position have direct contact with any child in the process of being placed or who has been placed in out of home care, shall submit a complete set of fingerprints to the Colorado Bureau of Investigation (CBI) that were taken or submitted by a qualified law enforcement agency to obtain any criminal record held by the CBI.

A. The person's employment is conditional upon a satisfactory criminal background check; and subject to the same grounds for denial or dismissal as outlined in 26-6-104(7), C.R.S., including:

1. Checking records and reports; and, 2. Individuals who have not resided in the state for two years shall be required to have a Federal Bureau of Investigation (FBI) fingerprint-based criminal history.

B. Payment of the fee for the criminal record check is the responsibility of the individual being checked.

C. Prospective employees who are transferring from one county department to another are not required to be re-fingerprinted if they complete the following process:

1. New employees must obtain their CBI clearance letter or a photocopy of their processed fingerprint card from their former employer. They must attach it to a new fingerprint card, with the top portion completed.

2. The new fingerprint card must include the new employer's address. “Transfer-County Department” must be inserted in the “Reason Fingerprinted” block.

3. The CBI clearance letter (or photocopy of the old fingerprint card) and the new fingerprint card must be sent with money order payable to the CBI.

4. County departments that have accounts with CBI are not required to send the money order, and they shall enter their CBI account number in the OCA block of the new fingerprint card. 7.000.61 (NONE) [Eff. 1/1/15] _________________________________________________________________________ Editor’s Notes

History

Rule 7.000.73 eff. 11/01/2007.

Rule SB&P eff. 10/01/2008.

Rules SB&P, 7.000.5 eff. 11/01/2008.

Rules SB&P, 7.001.42-7.001.46 eff. 02/01/2009.

Rules SB&P, 7.000.5, 7.003.3 eff. 04/01/2009.

Rule SB&P eff. 05/01/2009.

Rule 7.000.6 emer. rule eff. 08/07/2009.

Rules SB&P, 7.000.6 eff. 11/01/2009.

Rule SB&P emer. rule eff. 11/06/2009.

Rules SB&P, 7.000.5(K)(M-EE) eff. 02/01/2010.

Rules SB&P, 7.000.6-7.000.61 eff. 03/02/2010.

Rules SB&P, 7.001.46, 7.001.6 eff. 06/01/2010.

Rule SB&P eff. 07/01/2010.

Rule SB&P emer. rule eff. 08/06/2010.

Rule SB&P emer. rule eff. 10/01/2010.

Rule SB&P eff. 11/01/2010.

Rule SB&P eff. 12/01/2010.

Rule SB&P emer. rule eff. 12/03/2010.

Rule SB&P eff. 01/01/2011.

Rule SB&P eff. 03/02/2011.

Rule SB&P eff. 04/01/2011.

Rule SB&P eff. 08/01/2011.

Rule SB&P emer. rule eff. 08/10/2011.

Rules SB&P, 7.001.41.J eff. 11/01/2011.

Rules SB&P, 7.000.71 eff. 12/01/2011.

Rule SB&P eff. 01/01/2012.

Rule SB&P eff. 02/01/2012.

Rules SB&P, 7.000.5, 7.003.3 eff. 04/01/2012.

Rules SB&P, 7.001.45, 7.001.5, 7.003.3 eff. 05/01/2012.

Rule SB&P eff. 06/01/2012.

Rule SB&P eff. 07/01/2012.

Rule SB&P emer. rule eff. 07/13/2012.

Rules SB&P, 7.000.3, 7.000.6.D, 7.000.6.M, 7.001.5, 7.003.3.C.1.c eff. 08/01/2012.

Rules SB&P, 7.003.3-7.003.3.B.4 emer. rules eff. 09/07/2012.

Rule SB&P eff. 10/01/2012.

Rules SB&P, 7.003.3-7.003.3.B.4 eff. 12/01/2012.

Rule SB&P eff. 03/02/2013.

Rules SB&P, 7.000.75 eff. 04/01/2013.

Rule SB&P eff. 07/01/2013.

Rule SB&P eff. 08/01/2013.

Rule SB&P eff. 10/01/2013.

Rules SB&P, 7.000.3, 7.001-7.001.11 eff. 01/01/2014.

Rule SB&P eff. 02/01/2014.

Rule SB&P eff. 03/02/2014.

Rule SB&P eff. 07/01/2014.

Rule SB&P eff. 08/01/2014.

Rules SB&P, 7.000-7.000.61 eff. 01/01/2015.

Rule SB&P eff. 04/01/2015.

Rules 7.000.3-7.000.5 emer. rules repealed eff. 06/05/2015.

Rule SB&P eff. 07/01/2015.

Rule SB&P eff. 08/01/2015.

Rule SB&P eff. 09/01/2015; Rules 7.000.3-7.000.5 repealed eff. 09/01/2015.

Rule SB&P eff. 10/01/2015.

Rules SB&P, 7.000.2.A eff. 11/01/2015.

Rules SB&P, 7.000.2.A eff. 01/01/2016.

Rule SB&P eff. 02/01/2016.

Rule SB&P eff. 03/01/2016.

Rule 7.000.2 A eff. 01/01/2017.

Rule 7.000.2 A eff. 02/01/2017.

Rule 7.000.2 A eff. 12/01/2017.

Rules 7.000.1 B, 7.000.2 eff. 03/15/2019.

Rule 7.000 eff. 01/01/2020.

Rule 7.000.2 A emer. rule eff. 05/08/2020.

Rules 7.000 D, 7.000.2 A eff. 06/01/2020.

Rule 7.000.2 A eff. 08/01/2020.

Rule 7.000.2 A eff. 12/01/2020.

Rules 7.000 A, 7.000.2 A eff. 01/30/2021.

Rules 7.000.1 C, 7.000.2 A eff. 07/30/2021.

Rule 7.000.2 A eff. 09/01/2021.

Rules 7.000.1 D-E, 7.000.2 A eff. 12/30/2021.

Rule 7.000.2 A eff. 03/02/2022.

Rule 7.000.2 A eff. 04/30/2022.

Rule 7.000.2 eff. 06/30/2022.

Rules 7.000, 7.000.2 eff. 03/02/2023.

Rule 7.000.2 eff. 03/01/2024.

Rule 7.000.2 eff. 06/01/2024.

Rule 7.000.2 eff. 12/01/2024.

Rule 7.000.2 eff. 01/01/2025.

Rule 7.000.2 eff, 05/30/2025.

Rule 7.000.2 eff. 12/01/2025.

Annotations Rules 7.000.73 B.-G. (adopted 09/01/2006) were not extended by House Bill 07-1167 and therefore expired 05/15/2007.

Rule 7.000.3 (adopted 11/07/2014) was repealed by Senate Bill 15-100 effective 05/11/2015.

##### **12 CCR 2509-2** Referral and Assessment {#sec-12-ccr-2509-2 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-2}

Department of Human Services REFERRAL AND ASSESSMENT 12 CCR 2509-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] 7.100 REFERRAL AND ASSESSMENT [Eff. 8/1/17] 7.101 DOCUMENTATION OF REFERRALS [Eff. 8/1/17]

All reports that meet the definition of a referral for intrafamilial, third party, or institutional abuse and/or neglect shall be entered into the state automated case management system, unless two certified staff determine the referral is duplicative of a previously entered referral, as outlined in 7.103.5 (E). Any time a case is opened, it shall come through the referral or assessment process in the state automated case management system with the exception of Interstate Compact on the Placement of Children (ICPC), out of state subsidized adoption, and Division of Youth Corrections (DYC) Medicaidonly. 7.102 HOTLINE REQUIREMENTS [Eff. 1/1/15]

The establishment of a statewide child abuse and neglect reporting hotline system is intended to provide an additional resource for the public to make an initial report of suspected or known abuse and/or neglect. 7.102.1 COUNTY HOTLINE RESPONSIBILITIES [Eff. 8/1/17]

A. County departments shall establish a dedicated child abuse and neglect reporting telephone line to receive calls from the statewide child abuse and neglect reporting hotline system.

B. County departments shall ensure that all calls received through the statewide child abuse and neglect reporting hotline system will be answered by a live person designated by the county, which may include county staff, local law enforcement, the Hotline County Connection Center, and/or an answering service.

C. County departments shall ensure that any county department staff that responds to inquiries regarding child abuse and/or neglect or gathers information for reports of child abuse and/or neglect are trained and annually certified according to the requirements outlined in Section 7.603 (12 CCR 2509-7).

D. County departments shall ensure that all reports and inquiries received through the statewide child abuse and neglect reporting hotline system are documented in the state automated case management system by the end of the next business day following receipt as defined in Section 7.103.10.

E. When county departments select a routing method in the statewide child abuse and neglect reporting hotline system that prevents call data from being collected by the hotline system, county departments shall provide the State Department with designated monthly reports.

1. County departments shall use a uniform template, provided by the State Department, to report the following:

a. Call volume, b. Average call duration; and, c. Average wait time.

2. The monthly reports shall be due to the State Department by the third business day of the following month. 7.102.2 HOTLINE COUNTY CONNECTION CENTER RESPONSIBILITIES [Eff. 8/1/17]

A. Hotline County Connection Center staff shall be continuously available twentyfour (24) hours a day, seven (7) days a week to receive and immediately route hotline calls to the appropriate county department.

The appropriate county department shall be determined by the following criteria in order of priority:

1. Residence of the child;

2. Current location of the child; or, 3. Incident location.

B. All Hotline County Connection Center staff shall be trained and annually certified according to the requirements outlined in Section 7.603 (12 CCR 2509-7).

C. Hotline County Connection Center staff shall ensure that all hotline calls are documented in the state automated case management system. 7.102.3 TRANSFER OF HOTLINE RESPONSIBILITIES [Eff. 8/1/17]

A. With the express written consent of the Board of County Commissioners of a county, a county department may request that the State Department assist that county with the taking of calls or initial contacts from the public of reports of possible child abuse and/or neglect or of inquiries. The Executive Director of the State Department must approve this arrangement in writing (26-5-111(3) (B), C.R.S.).

B. A county department may request that the State Department receive after-hours reports or inquires on behalf of the county department by submitting a written request to the State Department. The Board of County Commissioners must officially approve the use of the hotline system on behalf of the county. Approval of such arrangement shall be approved by the State Department Executive Director or his/her designee (26-5-111(4) (E), C.R.S.).

C. In the event of a natural disaster or other emergency situation in which county departments cannot receive reports or inquiries from the statewide child abuse and neglect reporting hotline system, county departments may request that the Hotline County Connection Center receive their reports or inquiries, until they are able to resume normal operations.

D. County departments may request another county department to receive reports and inquiries from the statewide child abuse and neglect reporting hotline system on behalf of the county department subject to the Board of County Commissioners’ approval. Documentation of agreement from both county departments must be submitted to the State Department’s Executive Director or his/her designee prior to implementation.

Reports and inquiries taken by a county department or the Hotline County Connection Center on behalf of another county department must follow the requirements defined in 26-5-111, C.R.S. and Sections 7.101, 7.101.1, 7.102.1 D., 7.103, 7.103.1, and 7.103.2.

E. When the Hotline County Connection Center or another county department enters a report of child abuse and/or neglect into the state automated case management system on behalf of another county department, it shall transfer the referral to the appropriate responsible county department through the state automated case management system within two (2) hours after the call is completed. The method for notification is as follows:

1. When a referral is sent during regular business hours, notification shall be through telephone call, voicemail, e-mail, text, or other emerging technology, and shall be documented in the state automated case management system; or, 2. When a referral is sent outside of regular business hours, notification shall be through personal contact to a person who is the appropriate county department representative, and shall be documented in the state F. When a county department receives referrals from the Hotline County Connection Center or another county department, the county department shall confirm receipt of the referral within two (2) hours through the state automated G. When the Hotline County Connection Center or another county department enters an inquiry into the state automated case management system on behalf of another county department, they shall transfer the inquiry to the appropriate county department as follows:

1. Child welfare inquiries regarding child(ren/youth) or families with child welfare involvement shall be transferred to the appropriate county department through the state automated case management system within two (2) hours after the call is completed.

a. When a child welfare inquiry is sent outside of regular business hours, notification shall be through personal contact to a person who is the appropriate county department representative, and shall be documented in the state automated case management system.

2. All other inquiries and requests for non-child welfare information shall be transferred to the appropriate county department through the state automated case management system within two (2) hours after the call is completed.

H. When a county department receives an inquiry from the Hotline County Connection Center or another county department, the county department shall confirm receipt of the inquiry as follows:

1. Child welfare inquiries regarding child abuse and/or neglect or families with child welfare involvement shall be confirmed through the state automated case management system within two (2) hours of receipt.

a. When a child welfare inquiry is received outside of regular business hours the county department shall also confirm receipt through personal contact with the appropriate county department representative, and shall be documented in the state automated 2. All other inquiries and requests for non-child welfare information shall be confirmed through the state automated case management system by the close of the next business day. 7.103 Receipt Of Referral Alleging Intrafamilial Or Third Party Abuse And/Or Neglect And/Or A Youth In Conflict– Information To Be Gathered A. Upon receipt of a report alleging intrafamilial or third party abuse and/or neglect, and/or a youth in conflict, the county departments or the Hotline County Connection Center shall gather and document the following information, when available.

1. Reporting party’s:

a. Name;

b. Address;

c. Telephone number;

d. Reporter type; and e. Relationship to the alleged victim child(ren)/youth and/or a youth in conflict.

2. Alleged victim child(ren)/youth’s and/or a youth in conflict:

a. Name;

b. Address;

c. Current specific location;

d. School or child care (if applicable);

e. Birth date(s) or estimated age(s);

f. Information as to whether or not the child(ren)/youth have American Indian or native Alaskan heritage, and if so, the tribal affiliation;

g. Race and ethnicity;

h. Developmental delays;

i. Disability status;

j. LGBTQ identity, including sexual orientation and gender identity, if k. English proficiency, including preferred language, if applicable; and l. Any relevant cultural considerations.

3. Family and household members:

a. Names;

b. Birth date(s) or estimated age(s);

c. Relationship to each other;

d. Relationship to the alleged victim child(ren)/youth and/or a youth in conflict;

e. Race and ethnicity;

f. Developmental delays;

g. Disability status;

h. LGBTQ identity, including sexual orientation and gender identity, if i. English proficiency, including preferred language, if applicable; and j. Any relevant cultural considerations.

4. Person(s) alleged to be responsible for the abuse and/or neglect:

a. Name;

b. Birth date(s) or estimated age(s);

c. Present location;

d. Current or last known address;

e. Relationship to the alleged victim child(ren)/youth;

f. Race and ethnicity;

g. Developmental delays;

h. Disability status;

i. LGBTQ identity, including sexual orientation and gender identity, if j. English proficiency, including preferred language, if applicable; and k. Any relevant cultural considerations.

5. Narrative describing the presenting problems and specific allegations of the abuse and/or neglect, including but not limited to:

a. When it occurred;

b. Location;

c. Witness(es) of the incident; and d. Description of any injury that was sustained.

e. When substance exposed newborn is a referral reason, the county departments or the hotline county connection center shall ask the Colorado Plan of Safe Care enhanced questions.

6. The date, time, and location the alleged victim child(ren)/youth and/or a youth in conflict were last seen by the reporting party.

7. The nature of any other environmental hazards in the home which may impact child(ren)/youth or worker safety.

8. The name and contact information of any individuals who may have information about the referral, and/or the identity and contact information of collateral agencies and individuals involved with the family.

9. Date and time referral received.

10. Family strengths and supports, and/or other protective factors or actions taken.

11. Any evidence of known domestic violence or intimate partner violence in the child(ren)’s home, including any evidence of previous cases of known domestic violence or intimate partner violence in the child(ren)’s home.

B. If at any point during the referral process, a county department becomes aware of an allegation that a child(ren)/youth is, or may be, a victim of sex trafficking, the county department shall:

1. Report immediately, and no later than twenty-four (24) hours from when 2. Document the details of the report to law enforcement in the C. If at any point during the referral process when the reporting party is a runaway and homeless youth provider, and a county department becomes aware that a youth is experiencing homelessness, has run away, or is unaccompanied and is seeking shelter, then the county department shall gather and document the following information:

1. Does the provider believe there is a reasonable plan in place to keep the child or youth free from harm, and, if not, what the provider believes would prevent harm, 2. Has the shelter provider notified parent(s)/guardian(s) and, if so, what is their response; and 3. When did intake of the child or youth occur and how many days are left in the 21-day shelter period allowable pursuant to section 26-5.7-107, C.R.S. 7.103.1 Jurisdiction for Referrals Concerning Intrafamilial and Third-Party Abuse and/or Neglect [Eff. 1/1/15]

A. The county department with jurisdiction for responding to a referral concerning intrafamilial or third-party abuse is the department for the county in which the alleged victim child(ren) resides the majority of the time except when custody of the alleged victim child(ren) is shared equally between caregivers. When custody is shared equally between caregivers, the county department with jurisdiction is the department for the county in which the person(s) alleged to be responsible for the abuse and/or neglect reside, if known.

B. When a family is homeless as defined in 42 U.S.C. Section 11302, the county department with jurisdiction is the department for the county in which the alleged victim child(ren)’s primary nighttime residence is located.

C. If the jurisdiction is unable to be determined by A or B, above, the county department with jurisdiction is the department for the county in which the alleged victim child(ren) are currently present, as set forth in Section 19-3-201, C.R.S.

D. County departments shall use available resources to determine jurisdiction including, but not limited to:

1. Colorado benefits management system;

2. Alleged victim child(ren)’s school or daycare;

3. History within the state automated case management system;

4. Colorado courts;

5. Where services may be provided. 7.103.11 Transfer of Jurisdiction [Eff. 1/1/15]

A. If the county department that receives a referral determines that another county department has jurisdiction, the county department that received the referral shall:

1. Gather and document all information as available in Section 7.103.1, A;

2. Gather and document all information necessary to determine jurisdiction; and 3. Contact the county determined to have jurisdiction within the following timeframes:

a. If the referral is assigned an immediate response, within four (4) hours of determining jurisdiction.

b. If the referral is assigned either a three (3) day or five (5) day response, within one (1) business day of determining jurisdiction.

B. The county determined to have jurisdiction shall screen the referral.

C. When the county department that received the referral makes a decision based upon the referral prior to determining jurisdiction, the county department determined to have jurisdiction shall uphold that decision including assignment and response time, unless:

1. Additional or new information is gathered by the county department determined to have jurisdiction.

2. The additional or new information shall relate to the safety of the child.

3. The child welfare or county department director of the county department determined to have jurisdiction overrides the decision.

4. The authorization, information, and justification for any change shall be documented in the referral notes.

D. If an immediate response is necessary, the county department where the child is located at the time of the referral is the responsible county department while jurisdiction is determined.

7.103.2 RECEIPT OF REFERRAL ALLEGING INSTITUTIONAL ABUSE

AND/OR NEGLECT – INFORMATION TO BE GATHERED [Eff. 8/1/17]

A. Upon receipt of a report alleging institutional abuse and/or neglect the county departments or the Hotline County Connection Center shall gather and document the following information when available.

1. Reporting party’s:

a. Name;

b. Address;

c. Telephone number;

d. Reporter type; and, e. Relationship to the alleged victim child(ren)/youth.

2. Alleged victim child(ren)/youth’s:

a. Name;

b. Address;

c. Current specific location;

d. School or child care (if applicable);

e. Birth date(s) or estimated age(s);

f. Any developmental delays, physical disabilities, competency or cultural considerations; and, g. Primary language.

3. Narrative describing the presenting problems and specific allegations of the abuse and/or neglect, including but not limited to:

a. Time and date;

b. Location;

c. Witness(es) of the incident;

d. If any injury was sustained;

e. Provision of medical treatment, and if no medical treatment has been provided whether in reporter’s opinion the injury sustained requires medical services; and, f. Provider's actions or omissions in relation to the incident.

4. Person(s) alleged to be responsible for the abuse and/or neglect:

a. Name;

b. Birth date(s) or estimated age(s);

c. Present location;

1. If the person(s) is a staff person(s), determine if the person(s) has been moved to a non-child contact role, and/or separated from the alleged victim child(ren)/youth.

2. If the person(s) is another resident, determine where he/she is in relation to the alleged victim child(ren)/youth.

d. Current or last known address;

e. Any developmental delays, physical disabilities, competency or cultural considerations; and, f. Telephone number.

5. Institution where the incident occurred:

a. Name;

b. Address;

c. Telephone number;

d. Whether the institution has been notified of the allegation; and, e. Any actions taken by the institution.

6. Parent(s)/guardian(s) of the alleged victim child(ren)/youth:

a. Name;

b. Address;

c. Telephone number; and, d. Whether the parent(s)/guardian(s) have been notified.

7. Determine who has legal custody of the alleged victim child(ren)/youth.

When a county department or other state holds legal custody;

a. Obtain the agency’s name, telephone number and/or staff representative’s name and telephone number; and, b. Whether the institution has completed notification of the custodial county/agency.

8. Date and time referral received.

B. If at any point during the referral process, a county department becomes aware of an allegation that a child(ren)/youth is, or may be, a victim of sex trafficking, the county department shall:

1. Report immediately, and no later than twenty-four (24) hours from when 2. Document the details of the report to law enforcement in the state 7.103.21 Jurisdiction for Referrals Concerning Institutional Abuse and/or Neglect [Eff. 1/1/15]

The county in which the facility is located shall have jurisdiction for responding to a referral concerning institutional abuse, to include, non-certified kinship care providers that provide care for children with an open child welfare case who are in the legal custody of a county department.

7.103.3 RECEIPT OF REFERRAL, JURISDICTION, AND INITIAL REVIEW

WHEN A YOUTH IS SEEKING RE-ENTRY SERVICES THROUGH THE FOSTER

YOUTH IN TRANSITION PROGRAM

A. Upon receipt of a report regarding a youth in need of services to re-enter through the Foster Youth in Transition Program pursuant to the Colorado Revised Statutes, pursuant to section 19-7-301, C.R.S., et seq, the county or Hotline County Connection Center shall gather the following information, when available:

1. The reporting party’s:

a. Name;

b. Address;

c. Telephone number;

d. Reporter type; and e. Relationship to the youth seeking services.

2. The following information regarding the youth seeking services:

a. Legal name;

b. Address or county where the youth self attests to reside;

c. Current specific location and contact information; and d. Birth date(s) or estimated age(s).

B. The county in which a youth self attests to reside shall have jurisdiction for a reentry referral to the Foster Youth in Transition Program.

C. Upon receipt of a request for re-entry services through the Foster Youth in Transition Program a county department shall initiate a review of eligibility, notifications, provision of services, and timelines as described in 7.203.40, ET SEQ. (12 CCR 2509-3). 7.103.4 Initial Review When available, the county department shall gather the information in Section 7.103.1, A and/or B, and conduct an initial review. The initial review shall decide if no further action is required, if the referral shall be assigned for assessment, the appropriateness of an immediate response to an assessment, the need for RED Team review, and/or the appropriateness of a referral to prevention services. It shall include, but not be limited to, the following actions:

A. Review the child(ren)/youth’s vulnerability as defined in section 7.000.2.

B. Review the comprehensive child welfare information system and any available county department files within twenty-four (24) hours for:

1. Prior referrals and/or involvement with the alleged victim child(ren), family, and person(s) alleged to be responsible for the abuse and/or neglect;

2. Actions taken; and 3. Services provided to inform whether there is known or suspected abuse and/or neglect or serious threats of harm to a child.

C. As available and appropriate, obtain information from collateral sources such as schools, Colorado court data, medical personnel, law enforcement agencies, or other care providers.

D. All referrals shall be reviewed and approved by a supervisor, and documented in the comprehensive child welfare information system. The review shall include, at a minimum, two certified child welfare staff. Documentation shall provide justification for the decision. If there is disagreement in the referral disposition and/or the referral is determined to be complex and/or unclear, the referral shall be reviewed through the RED Team process.

E. Prevention services shall be considered, if available, for screened out referrals.

F. When an institutional referral is received regarding county certified foster homes or county certified kinship homes, the certifying county shall be notified. The certifying county shall review the referral for support and service considerations and certification concerns. The notification and review shall be documented in the comprehensive child welfare information system.

G. When an institutional referral is received regarding non-certified kinship homes, the custodial county shall be notified. The custodial county shall review the referral for support and service considerations. The notification and review shall be documented in the comprehensive child welfare information system. 7.103.5 Referrals Requiring No Further Action County departments may determine that a referral does not require further action and screen it out for the following reasons:

A. The current allegations have previously been assessed;

B. The alleged victim child(ren) or youth in conflict are not located or reside in the State of Colorado. In this circumstance, the county department shall inform the other state or county department of the referral;

C. Referral does not meet criteria of abuse and/or neglect as defined in statutes and regulations;

D. Referral lacks sufficient information to locate the alleged victim child(ren) or youth in conflict; or E. Referral is duplicative of a previous referral. In this circumstance, the county department shall associate the duplicate referral with the previous referral, regardless of disposition status, or enter the subsequent narrative information into an existing not yet dispositioned referral and associate the hotline identification number in the comprehensive child welfare information system.

When duplicative calls are received from individuals with no firsthand knowledge of an incident, such as learning of the concern via public media, the hotline identification number may be associated with the previously entered referral, regardless of disposition status.

When a mandatory reporter is calling to inquire if an incident has already been reported, the following minimum information shall be gathered to determine if duplicative: the date of the incident; name(s) of the alleged victim(s); name(s) of the alleged person(s) responsible for abuse and/or neglect; household address; a brief summary of the safety concern.

A referral cannot be considered duplicate if any of the following circumstances are present:

1. Different incident date;

2. Different alleged victim;

3. Different alleged person responsible for abuse and/or neglect;

4. Different household, and/or 5. Additional information poses a new or renewed threat of safety to the child(ren)/youth.

If a mandatory reporter reports an incident that has already been reported, the call can be documented as an inquiry containing confirmation that the mandatory reporter was informed of the previous report identification number. The inquiry should also include the steps taken by the screener to determine the report is duplicative. The inquiry should then be attached to the existing referral in the comprehensive child welfare information system. If the screener can not determine the above factors, the report shall be entered as outlined in 7.101.

F. The person alleged to be responsible for the abuse and/or neglect is a third (3rd) party and (10) years of age or older. In this circumstance, the county department shall send the referral to the appropriate law enforcement agency.

G. There is no current allegation of child abuse and/or neglect;

H. More appropriate services for the child/youth who is alleged to be a youth in conflict are currently being provided by another agency;

I. Referral does not meet the definition of youth in conflict as defined in 12 CCR 2509-1 section 7.000.2;

J. The referral contains concerns related to the unregulated custody transfer of a child/youth and no allegations of child abuse/neglect. In this circumstance the county department shall send the referral to the appropriate law enforcement agency or agencies; and K. The decision to screen out a referral shall be made by a minimum of two (2) certified child welfare staff from the same county or in conjunction with another county. When there is disagreement to screen out, the referral shall be reviewed through the red team process. 7.103.6 Criteria For Assigning A Referral For Assessment A. County departments shall screen in and assign a referral for assessment if it:

1. Contains specific allegations of known or suspected abuse and/or neglect as defined in section 7.000.2;

2. Provides sufficient information to locate the alleged victim; and 3. Identifies a victim under the age of eighteen (18); or 4. Identifies a victim between eighteen (18) and under twenty-one (21) years of age who is under the continuing jurisdiction of the court and in the care of a facility.

B. Any time a case is opened, it shall come through the referral or assessment process in the comprehensive child welfare information system with the exception of Interstate Compact on the Placement of Children (ICPC), out of state subsidized adoption, out of state Medicaid, Interstate Compact on Adoption and Medicaid Assistance (ICAMA), or Division of Youth Services (DYS) Medicaid only.

C. The county department shall review and respond, either with a face-to-face intervention or by telephone, when notified by the court-appointed detention screener or a law enforcement officer of a child/youth in the custody of a law enforcement agency who is inappropriate for secure detention but cannot be returned home.

D. When it is reported that there has been an unregulated custody transfer of a child/youth, the county department may conduct an assessment and take appropriate action to protect the welfare of the child/youth as provided in other areas of rule, regardless of any additional concern of abuse or neglect. If an assessment is completed regarding concerns of an unregulated custody transfer of an adopted child/youth, and it is determined that a person has transferred or intends to transfer custody in violation of section 19-5.5-203, C.R.S., then the county department shall:

1. Provide notice of the assessment to the Colorado Department of Human Services when it involves an unregulated custody transfer of an intercountry adopted child/youth.

2. Send the referral to the appropriate law enforcement agency or agencies. 7.103.70 Response Time for Referrals Assigned for Assessment A. County departments shall assign the appropriate response time for assessments based upon the date the referral is received using the following criteria:

1. An immediate response is required when a referral indicates that:

a. There may be present danger of moderate to severe harm; or, b. The child's vulnerability and/or factors such as drug and alcohol abuse, violence, isolation, or risk of flight increase the need for immediate response.

c. An immediate response shall require a response within eight (8) hours from the receipt of the referral. If the victim child(ren)/youth cannot be located within the initial timeframe, subsequent face to face contact attempts shall continue to be made every twenty-four (24) hours from the time of the initial attempted contact.

2. A three (3) calendar day response is required when a referral indicates that:

a. There may be impending danger of moderate to severe harm; or, b. The alleged victim child(ren)’s vulnerability and/or factors such as drug and alcohol abuse, violence, isolation, or risk of flight, increase the need for intervention in the near future.

c. The three (3) calendar day count starts on the day following the receipt of a referral, and expires at the end of the third calendar day at 11:59 PM following receipt of the referral.

d. If the victim child(ren)/youth cannot be located within the initial timeframe, subsequent face to face contact attempts shall continue to be made within every subsequent three calendar days.

3. A five (5) working day response is required when:

a. A referral indicates an absence of safety concerns.

b. The five (5) day count starts on the first business day following the receipt of a referral and expires at the end of the fifth business day at 11:59 PM following the receipt of the referral.

c. If the victim child(ren)/youth or child/youth in conflict cannot be located within the initial timeframe, subsequent face to face contact attempts shall continue to be made within every subsequent five business days.

B. The decision of how quickly to initiate an assessment shall be based on specific reported information that is credible and that indicates whether a child may be unsafe or at risk of harm.

C. When an additional alleged victim, who was not included in the initiating referral, is identified during an assigned assessment, the requirements for face to face contact shall be applied in accordance with the assigned response timeframe, beginning on the date the additional alleged victim is identified. 7.103.71 RED Teams A. County departments shall maintain and make available the RED team process.

B. The RED Team process shall be documented in the framework. The documentation shall provide justification for the decisions.

C. All RED Team decisions shall be approved by a certified supervisor by the end of the calendar day and documented in the comprehensive child welfare information system by the end of the next business day. 7.103.8 DIFFERENTIAL RESPONSE [Eff. 1/1/15]

A. County departments interested in participating in Differential Response shall conduct the following:

1. Submit a letter of interest to the State Department;

2. Form a County Differential Response Implementation Committee;

3. Attend Differential Response Training and Coaching Sessions as determined by the State Department;

4. Complete the Readiness Self-Assessment Process;

5. Demonstrate the ability to meet the State Department’s performance expectations on safety and well-being measures; and, 6. Demonstrate county staff understands how to correctly enter information into the comprehensive child welfare information system.

Upon successful completion of the above efforts, a county may be selected to participate in Differential Response by the Executive Director of the State Department.

B. County departments that implement Differential Response shall utilize the RED Team framework to review referrals, determine response times, and determine the appropriate track assignment in accordance with the approved RED Team process.

1. High Risk Assessment (HRA) is mandatory for a child fatality, near fatality, or egregious incident determined to be the result of abuse and/or neglect, institutional abuse, and intrafamilial sexual abuse. RED Teams may use discretion to assign a High Risk Assessment (HRA) based on the following factors: present danger, multiple previous referrals, and/or presenting case characteristics such as type of alleged maltreatment paired with high vulnerability of the alleged victim.

2. The Family Assessment Response (FAR) is for referrals with low to moderate risk. RED teams may use discretion to assign the Family Assessment Response (FAR) in assessments alleging a child fatality, near fatality, or egregious incident. If it is determined that a child fatality, near fatality or egregious incident is the result of abuse and/or neglect, the track shall be changed to a High Risk Assessment. Institutional abuse or intrafamilial sexual abuse shall not be assigned the Family Assessment Response (FAR).

3. All RED Team decisions shall be approved by a supervisor by the end of the calendar day and documented in the comprehensive child welfare information system by the end of the next business day.

7.103.9 DUTIES TO REPORTING PARTIES – INFORMATION TO BE

PROVIDED [Eff. 1/1/15]

A. Within SIXTY (60) calendar days of receiving a referral alleging abuse and/or neglect from a mandatory reporter listed in Section 19-1-307(2)(e.5)(I), C.R.S., the county department shall notify such individual when:

1. The county department is aware the individual is and continues to be officially and professionally involved in the ongoing care of the child who was the subject of the referral; and, 2. The mandatory reporter has a need to know in order to fulfill his or her professional and official role in maintaining the child’s safety; and, 3. Unless the county department has actual knowledge that the mandatory reporter continues to be officially and professionally involved in the ongoing care of the child who was the subject of the report, a county department shall request written affirmation from a mandatory reporter stating that the reporter continues to be officially and professionally involved in the ongoing care of the child who was the subject of the report and describing the nature of the involvement.

B. The county department shall notify the mandatory reporter of the following information:

1. The name of the child and the date of the referral;

2. Whether the referral was accepted for assessment;

3. Whether the referral was closed without services;

4. Whether the assessment resulted in services related to the safety of the child;

5. The name of and contact information for the county caseworker responsible for the assessment; and, 6. Notice that the reporting mandatory reporter may request updated information within ninety (90) calendar days after the county department received the referral and information concerning the procedure for obtaining updated information.

7.103.10 DOCUMENTATION REQUIREMENTS – WHEN SUPERVISOR

APPROVAL IS REQUIRED [Eff. 1/1/15]

A. All referrals including the information gathered pursuant to Sections 7.103.1 and 7.103.2 shall be entered into the comprehensive child welfare information system by the end of the next business day following receipt of the referral.

B. The initial review shall be documented in the comprehensive child welfare information system by the end of the next business day following receipt of the referral. The supervisor is to ensure that the review and the documentation have occurred.

C. The decision to screen out a referral for further action shall be documented in the comprehensive child welfare information system by the end of the following business day that the decision is made. This shall include an explanation of the reasons why no further action was needed. The determination to screen out a referral for further action must be approved by a supervisor.

D. All RED Team decisions shall be approved by a supervisor by the end of the calendar day and documented in the comprehensive child welfare information system by the end of the next business day. 7.104 Intrafamilial, Institutional, And Third-Party Abuse And/Or Neglect Assessments [Eff 3/1/18]

The requirements of this section address intrafamilial, institutional and third-party abuse and/or neglect assessments except for assessments involving safe haven voluntarily surrendered infants, as described in section 19-3-304.5, C.R.S. Assessment rules pertaining to safe haven voluntarily surrendered infants are set forth in section 7.106.4.

A. The assessment shall begin with face-to-face contact with the alleged victim child(ren)/youth and includes, but is not limited to:

1. Face-to-face contact with the primary caregiver;

2. Assessing for current or impending danger and taking action to secure safety, if indicated;

3. Assessing risk, needs, protective capacities and strengths of child(ren)/youth and families; and, 4. Obtaining culturally relevant and appropriate resources for the alleged victim child(ren)/ youth and their families.

B. At the point of first contact with the alleged victim child(ren)/youth, the assessment shall focus immediately on whether the child(ren)/youth is safe, and include the following:

1. To assess for safety, county departments shall consider:

a. The safety threshold criteria for current or impending danger of moderate to severe harm;

b. The current or impending dangers described in the Colorado Family Safety Assessment tool;

c. Child(ren)/youth vulnerabilities/strengths;

d. Caregiver strengths/protective capacities; and, e. Actions that respond to the current or impending danger.

2. If the child(ren)/youth is unsafe, the caseworker shall analyze whether:

A. A safety plan can reasonably be expected to control current or impending danger while the assessment continues, and if so, develop a safety plan as described in Section 7.107.16 AND 7.107.17.

B. If a safety plan cannot reasonably be expected to control current or impending danger the caseworker shall, if necessary, initiate an out-of-home placement. Section 19-3-401, C.R.S., describes the process of taking children/YOUTH into custody.

C. If the child(ren)/youth is unsafe, the safety plan, or decision to initiate an out-of-home placement shall be reviewed and approved by a supervisor as soon as possible and no later than twenty-four (24) hours from the face to face interview or observation with the alleged victim child(ren)/youth. Documentation of the approval shall be entered in the state automated case management system.

3. For county departments implementing Differential Response, in the first sixty (60) calendar days of a Family Assessment Response (FAR), upon supervisory approval, the caseworker may change tracks to a High Risk Assessment (HRA) to assess, attain or maintain child(ren)/youth safety due to lack of cooperation or additional information gathered during the assessment, or if requested to do so by the person(s) alleged to be responsible for the abuse and/or neglect.

4. For county departments implementing Differential Response, if at any point safety cannot be sustained in a Family Assessment Response (FAR), the caseworker, with approval from the supervisor, shall open a case and/or request court orders.

5. If at any point new information is gathered that contains information defined in Section 7.103, a new referral shall be generated.

C. Safety interventions shall be used continuously throughout all assessments.

Safety interventions are defined as the actions and decisions required to:

1. Identify and assess current or impending danger to child(ren)/youth safety;

2. Plan for an unsafe child(ren)/youth to be protected;

3. Work with caregivers to identify safety and network supports for child(ren)/youth protection; and, 4. Manage plans designed to assure child(ren)/youth safety while a safe and permanent home is established.

D. When determining jurisdiction within open assessments, when current or impending danger is identified, the responding county shall consider the following:

1. The timeframes and completion of activities within the assessment including response time, completion of the safety and risk assessment, and the assessment closure;

2. Verification of the new residence and documentation of efforts to determine correct jurisdiction;

3. Considerations of distance between reported residence and new residence; and, 4. Assessment completion and the need for further services.

E. When determining jurisdiction within open assessments and no current or impending danger is identified, the county with the open assessment shall complete the assessment. 7.104.1 Intrafamilial Abuse And/or Neglect Assessment A. The assessment shall begin as soon as reasonably possible following receipt of the referral according to the assigned response time.

B. The assessment shall be conducted as set forth in Section 19-3-308(2),(3),(4) through 19-3-308.5, C.R.S., and the following:

1. The assessment shall include a face to face interview or observation of the alleged victim child(ren)/youth within the assigned response timeframe, according to the following procedures:

a. Interviews shall be face-to-face with the child(ren)/youth if the child(ren)/youth has the verbal, emotional, and/or developmental ability to relate information relevant to safety decisions. If the child(ren)/youth does not have such verbal, emotional, and/or developmental ability, face to face observation of the child(ren)/youth, as appropriate to assess the allegations in the referral, is sufficient. Documentation shall support why the child(ren)/youth was unable to be interviewed and how allegations were addressed during the observation.

b. When child(ren)/youth are unable to be interviewed within the assigned response time, caseworkers shall document interviews with household members and collaterals to determine that the child(ren)/youth is safe or in current or impending danger.

Documentation shall support why the child(ren)/youth was unable to be interviewed.

c. If a caseworker gathering information in the Colorado Family Safety Assessment tool determines child(ren)/youth are unsafe and it is unreasonable to interview the child(ren)/youth at the time of removal, the caseworker shall interview the child(ren)/youth as soon as it is reasonable. Documentation shall support why the child(ren)/youth was unable to be interviewed.

d. Caseworkers and other child welfare staff shall not be required to have face to face contact with a child(ren)/youth who are undergoing lifesaving medical intervention, in critical condition or deceased. Information of abuse and/or neglect shall be gathered through interviews with household members and collaterals and documented in the state automated case management system. The caseworker shall interview or observe the victim child(ren)/youth once they are medically cleared.

e. Interviews shall be conducted out of the presence of the person(s) alleged to be responsible for the abuse and/or neglect.

f. The requirements of section (e) above do not apply in a Family Assessment Response (FAR) where the initial interview may be conducted with the entire family, when doing so does not compromise the safety of the child(ren). Children may be interviewed outside the presence of the suspected person(s) responsible for the abuse and/or neglect at any point during the assessment.

g. Information obtained from the interview with the non-offending parent and victim child(ren)/youth shall not be revealed to the alleged perpetrator of domestic violence, and shall be subject to the rules of discovery and governed by the confidentiality provisions under Section 7.605.

h. If face to face interview(s) or observation(s) cannot be accomplished with the alleged victim child(ren)/youth within the assigned response timeframe, reasonable efforts to interview or observe the child(ren)/youth shall continuously be made as defined in 7.103.61(D). Efforts shall be documented in the state automated case management system and continue until the interview or observation occurs or the assessment is completed.

C. The assessment shall include;

1. Face to face interviews and/or observations with:

a. All victim children/youth within the assigned timeframe, except as identified in 7.104.1(B)(1),(a),(b),(c) and (d); and, b. Household members.

2. Documentation of efforts to engage non-custodial parent(s); and other persons identified through the assessment who may have information regarding the alleged abuse and/or neglect.

3. The extent of child(ren)/youth abuse and/or neglect, to include, but not limited to:

a. Impact to the child(ren)/youth;

b. Type and severity of injuries, if applicable; and, c. Child(ren)/youth’s explanation of the abuse and/or neglect.

4. Circumstances surrounding the child(ren)/youth abuse and/or neglect, to include, but not limited to:

a. Caretaker explanation of the abuse and/or neglect;

b. Environmental influences; and, c. Contributory factors.

d. Child(ren)/youth functioning;

e. Caregiver(s) functioning; and, f. Parenting practices and disciplinary practices.

5. The assessment shall include visiting the alleged victim child(ren)/youth’s place of residence or place of custody if:

a. The home conditions are the subject of the assessment; or, b. Information obtained in the interview process indicates assessment of the home environment is necessary due to current or impending danger.

6. The assessment shall determine the names and conditions of any children living in the same household as the alleged victim child(ren)youth.

7. The assessment shall include consideration of race/ethnicity, religion, accepted work-related practices of agricultural communities, and accepted child-rearing practices of the culture in which the alleged victim child(ren)/youth participate.

8. When assessing allegations of interfamilial abuse and/or neglect, the assessment shall include record checks of all adults residing in the household to assess for felony, and/or misdemeanor criminal convictions, related to child abuse and/or neglect, crimes of violence, domestic violence, or unlawful sexual behavior. Information gathered from record checks shall be used as one component to inform the overall assessment process. Records checks shall include:

a. The state automated case management system;

b. Colorado court management system of the state judicial department; and c. The National Sex Offender Public Website operated by the United States Department of Justice.

d. When county departments have a memorandum of understanding to allow access to the National Crime Information Center (NCIC) data, b and c may be substituted with documentation that a NCIC check was completed.

9. When assessing allegations of sexual abuse, the county department shall:

a. Use due diligence in following specific check criteria for each website;

b. Immediately report any violations of sex offender registration to local law enforcement; and, c. Report all law enforcement verified matches of sex offenders to the individual supervision officer/agent or team responsible for community supervision and public safety;

d. Use both the state and national websites to check if a person alleged to be responsible of the abuse and/or neglect is a sex offender; and, e. County departments may use local law enforcement to check if a person alleged to be responsible for the abuse and/or neglect is a sex offender.

10. The assessment shall include documentation of efforts to interview and advise the person(s) alleged to be responsible for the abuse and/or neglect of the referral and afford such person(s) an opportunity to respond to the allegations. Interviews with third party person(s) responsible for abuse/neglect are not required in assessments.

11. The assessment shall include use of the Colorado Family Safety Assessment tool as describe in Section 7.107.1.

12. The assessment shall include use of the Colorado Family Risk Assessment tool as described in Section 7.107.2.

13. The assessment shall include documentation of reasonable efforts to prevent out-of-home placement, unless an emergency exists, and to maintain the family unit. Reasonable efforts include, but are not limited to:

a. Engaging family and extended family in safety planning as described in Section 7.107.17, if appropriate;

b. Providing in-home services, if appropriate and available;

c. Removing the person(s) alleged to be responsible for the abuse and/or neglect from the home rather than the child(ren)/youth, if possible;

d. Work with the caregiver to place the child(ren)/youth in a safe environment; or, e. Engaging family and extended family in securing a kinship placement.

14. When assessing allegations of substance exposed newborns, the county department shall develop and document a Colorado Plan of Safe Care according to the requirements outlined in section 7.107.5.

D. If at any point during the assessment, a county department becomes aware of an allegation that a child(ren)/youth is, or may be a victim of human trafficking, the county department shall:

1. Report, to the appropriate law enforcement agency, within twenty-four (24) hours from when the county department becomes aware and, 2. Document the details of the report to law enforcement in the statewide automated case management system, AND, 3. Complete the human trafficking screen to identify risk factors or indicators related to human trafficking. 7.104.12 Audio or Video Recording of The Interview or Observation [Eff. 1/1/15]

A. The interview or observation may be audio or video taped except when it is impracticable under the circumstances or will result in trauma to the child, as determined by the county department.

B. If audio or video recording is conducted, the following standards shall be followed:

1. The interview shall be conducted by a competent interviewer, and may occur at a child advocacy center, as defined in Section 19-1-103(19.5), C.R.S., that has a Memorandum of Understanding with the county department responsible for the assessment or by a competent interviewer for the county department.

2. The child shall be advised that audio or video taping of the interview is to be conducted and the advisement shall be documented in the state automated case management system. If the child objects to videotaping of the assessment, such taping shall not be conducted by the county department.

3. If it is the county department’s policy to routinely video or audio tape interviews, and an exception is made, the reason for the exception shall be documented in the state automated case management system.

4. If there is a request by any party to the action to view or listen to an audio or video tape, the child and/or, the guardian ad litem or counsel for youth shall be notified in advance of the request, when possible.

5. Access to these audio or video tapes shall be subject to the rules of discovery and governed by the confidentiality provisions under Section 7.605. 7.104.13 Conclusion Of Assessment – Timing, Findings, Services [Eff. 3/1/18] 7.104.131 Timing [Eff. 3/1/18]

A. High Risk Assessments (HRA) or Traditional Response Assessment shall be approved by a certified supervisor and closed within sixty (60) calendar days of the date the referral was received.

B. The initial assessment phase of a Family Assessment Response (FAR) shall be approved by a supervisor and closed within sixty (60) calendar days from the date the referral was received.

If ongoing services are identified in the assessment phase of a FAR, the FAR shall be opened into the service phase. The service phase shall include a treatment/prevention plan which is specific, measurable, achievable, realistic, and time limited (SMART). The treatment/prevention plan shall be created in collaboration with the family. This treatment/prevention plan must meet the guidelines in 7.301.2 for purposes of treatment/prevention plans.

C. The Colorado Family Safety Assessment tool shall be approved in the state automated case management system by a certified supervisor as soon as possible and no later than fourteen (14) calendar days from the date the alleged victim child(ren)/youth was interviewed or observed.

D. The Colorado Plan of Safe Care shall be approved in the state automated case management system and approved by a supervisor within sixty (60) calendar days from the date the referral was received. 7.104.132 Findings and Services A. County departments shall enter a finding of founded, inconclusive or unfounded, as an outcome of all high risk or traditional assessments in the state automated case management system no later than sixty (60) days after the receipt of the referral.

1. Youth under the age of 13 at the time of an alleged incident shall not be listed as a person responsible for abuse and/or neglect for the purpose of assessment.

2. Youth 13 years old and older and under the age of 18 at the time of an alleged incident shall not be listed as a person responsible for abuse and/or neglect for the purpose of assessment unless;

a. The youth is a parent of the alleged victim child, or;

b. The incident is determined to meet the criteria of founded, and the severity level of the abuse and/or neglect is at a level of severe, egregious, near-fatal, or fatal as defined in 12 CCR 2509-1, 7.000.2.

B. County departments may elect to defer entering a founded finding pursuant to

Section 19-3- 309.5, C.R.S. If the county department elects to defer entering a finding of founded abuse and/or neglect, the county shall enter into a preconfirmation agreement and follow the procedures described in Section 7.108.

C. If the person alleged to be responsible for the abuse and/or neglect is unknown or cannot be determined, a finding of “founded” may be entered into the state D. In a Family Assessment Response (FAR), no finding shall be made.

E. Prior to closing an assessment, county departments shall refer all victim child(ren) under the age of five (5) to the appropriate state or local agency for developmental screening when the county department makes a finding of founded abuse and/or neglect.

F. County departments may refer any child under the age of five (5) to the appropriate state or local agency for developmental screening in a Family Assessment Response (FAR) or Traditional Response Assessment, if a parent consents and the child presents with needs that might benefit from a developmental screening as determined by the county department.

G. In a High Risk Assessment (HRA) or traditional response assessment, county departments shall enter the findings of abuse and/or neglect in the state automated case management system even if there is a criminal or civil proceeding pending against the person found responsible for the abuse and/or neglect arising out of the same incident. 7.104.14 Documentation Required During Assessment A. At the time of a new assessment, county departments shall document that a review related to prior involvement as set forth in Section 7.104.1, B, 6, has occurred. This shall be documented in the assessment closure summary of the B. The results of any record checks including felony, and/or misdemeanor criminal convictions, related to child abuse and/or neglect, crimes of violence, domestic violence, or unlawful sexual behavior on all adults residing in the household being assessed, and attempts to access other information as set forth in Section 7.104.11 shall be documented in the comprehensive child welfare system.

C. The full name(s), including nicknames and/or aliases, address(es), and date(s) birth of the person(s) alleged to be responsible for the abuse and/or neglect shall be documented in the comprehensive child welfare information system.

D. All interactions with the family, including efforts to engage the family and extended family, as part of the assessment shall be documented in the comprehensive child welfare information system. Any specific information gathered, such as electronic media, photographs or videotapes shall be filed in the case record and referenced in the comprehensive child welfare information system.

E. When a face to face interview or observation of the alleged victim child(ren)/youth is video or audio taped, the required advisement of the child(ren)/youth shall be documented.as set forth in section 7.104.12.

F. If it is the county department's policy to routinely video or audio tape interviews, and an exception is made, the reason for the exception shall be noted in the G. The Colorado Family Safety Assessment tool shall be completed with household members and documented in the comprehensive child welfare information system. Documentation and approval by a certified supervisor in the comprehensive child welfare information system is required as soon as possible and no later than fourteen (14) calendar days from the date the alleged victim child(ren)/youth was interviewed or observed.

H. If a Family Assessment Response (FAR) is changed to a High Risk Assessment (HRA), the change shall be made in the comprehensive child welfare information system and all information documentation shall be transferred.

I. Any reasonable efforts to prevent out-of-home placement shall be documented in the comprehensive child welfare information system.

J. If the assessment contains allegations of human trafficking, the human trafficking screening tool shall be completed and documented in the assessment closure summary in the comprehensive child welfare information system.

K. The Colorado Plan of Safe Care shall be completed with the parent/caregiver(s), documented in the comprehensive child welfare information system, and approved by the supervisor within sixty (60) calendar days from the date the referral was received.

L. Review and update household demographics in the comprehensive child welfare information system with the family for accuracy. 7.104.141 Documentation Required at Conclusion of Assessment [Eff. 3/1/18]

A. County departments shall document the completed assessment in the state automated case management system, including completion of the assessment closure summary. Supervisors shall approve the closure of the assessment within sixty (60) calendar days from the date of the referral. The assessment closure shall include the following:

1. Brief summary of initial concerns and any additional concerns discovered during the assessment, the actions that were taken, and/or protective factors that exist which mitigate the harm, danger or risk;

2. Worker analysis of:

a. Relevant criminal, Colorado courts state management system of the state judicial department, national sex offender registry history, and/or child welfare history gathered throughout the assessment, and any concerns identified related to the current assessment;

b. Efforts to engage the family and extended family;

c. For High Risk Assessments (HRA), or Traditional Response Assessments, that require a finding, clearly summarize the type, severity level and facts that support the decision; and, d. Family and/or agency plan, if applicable.

B. In a HRA or Traditional Response Assessment, county departments shall enter the findings of abuse and/or neglect in the state automated case management system even if there is a criminal or civil proceeding pending against the person found responsible for the abuse and/or neglect arising out of the same incident.

The reported data shall include the following:

1. The name, address, gender, date of birth, and race of the victim child(ren);

2. The composition of the victim child(ren)’s immediate family;

3. At a minimum, the name and last known mailing address of the person found to be responsible for the abuse and/or neglect, the date of birth, and Social Security Number, if known;

4. The type of abuse and/or neglect;

5. The severity level of the abuse and/or neglect;

6. Any previous incidents of abuse and/or neglect of the victim child(ren) or siblings;

7. The name(s) and address(es) of any person(s) previously found responsible for abuse and/or neglect, if known;

8. The name of the source of the referral submitted to the county department, if known;

9. The county department that conducted the assessment of the referral; and, 10. The date the referral was made and the date the county department made the finding of founded abuse and/or neglect. 7.104.15 Notice A. Notice of the outcome of an assessment shall be made as described below.

Unless otherwise described below or authorized by law, no other entity shall receive notification.

B. Regardless of the outcome of the assessment and as allowable by law, county departments shall notify and document in the state automated case management system:

1. The parent(s), guardian(s), custodian(s), or caregiver(s) of the alleged victim child(ren)/youth of the outcome of the assessments. Non-custodial parent(s) shall also be notified of the outcomes of the assessments unless;

a. Documentation supports efforts to locate the non-custodial parent were unsuccessful; or, b. Documentation supports that it is not in the best interests of the child(ren)/youth to give notice to the non-custodial parent.

2. The person alleged to be responsible for the abuse and/or neglect of the outcome of the assessment;

3. The specified mandatory reporter, who is identified in and meets the criteria of section 7.103.9.A.1-3;

a. The name of the child(ren)/youth;

b. The date of the referral;

c. Whether the referral was accepted for assessment;

d. Whether the referral was closed without services;

e. Whether the assessment resulted in services related to the safety of the child;

f. The name and contact information for the county caseworker responsible for the assessment; and, g. The county procedure for requesting updated information within ninety (90) calendar days after the county department received the referral.

4. Where applicable, the local licensing unit, the director or administrator of the facility, the agency with licensing or certifying authority and the State Department, Division of Child Welfare, if the abuse and/or neglect assessment involved a state-licensed or county-certified facility. The referral and assessment may be used for investigations and licensing action where the referral involves a licensed child care provider as defined in the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act, sections 26-6- 901 through 26-6-923, C.R.S.

C. When the assessment results in a finding of founded abuse and/or neglect, county departments shall provide additional notice as described below:

1. County departments shall notify the local law enforcement agency and the District Attorney's Office of a founded report. Any copies of child abuse/neglect reports provided to law enforcement or the District Attorney’s office shall be marked confidential.

2. County departments shall notify the person found responsible for child abuse and/or neglect of the finding by first-class mail to the responsible person's last known mailing address, using a form approved by the State Department. County departments shall retain a copy of the notice in the case file showing the date of mailing. The notice shall include the following information:

a. The type and severity level of the abuse and/or neglect, the date the referral was made to the county department, which county department completed the assessment, the date the county department made the finding in the state automated case management system, and information concerning persons or agencies that have access to the information.

b. The circumstances under which information contained in the state automated case management system will be provided to other individuals or agencies.

c. How to access the county’s dispute resolution process. County departments are authorized to offer a county dispute resolution process to persons alleged to be responsible for abuse and/or neglect.

d. The right of the person found to be responsible for abuse and/or neglects to request a state level appeal as set forth in sections 7.111 through 7.112. The county department shall provide the State Department approved appeal form to the person found to be responsible for abuse and/or neglect.

e. Notice that the scope of the appeal is limited to challenges that the finding(s) are not supported by a preponderance of the evidence or that the actions found to be abuse and/or neglect do not meet the legal definitions of abuse and/or neglect. The State Department will be responsible for defending the determination at the state level fair hearing.

f. A full explanation of all alternatives and deadlines is contained in sections 7.111 through 7.112.

D. When an assessment is completed involving an unregulated custody transfer of a child/youth adopted through an intercountry adoption, and it is learned that a person has transferred or intends to transfer custody in violation of section 19- 5.5-203, C.R.S., then the county department shall forward the assessment to the Colorado Department of Human Services.

7.104.2 INSTITUTIONAL ABUSE AND/OR NEGLECT - GROUNDS FOR

ASSESSMENT

This section addresses assessments of referrals alleging institutional abuse and/or neglect as defined in Section 7.000.2. except that:

A. A referral of a minor injury resulting from physical restraint shall not, by itself, require an assessment unless there are surrounding circumstances that would indicate abusive and/or neglectful behavior by the care provider. Such circumstances include referrals alleging:

1. Abusive or neglectful behavior, 2. A pattern of frequent injuries by the same caregiver/staff, and/or 3. Similar incidents in the same facility.

B. A referral of medical concern(s) alleging the licensed medical/mental healthcare provider as the person responsible for abuse and/or neglect regarding medical decision(s) or action(s) within the scope of their license(s) shall not by itself require assessment unless there are surrounding circumstances that would indicate abusive and/or neglectful behavior by the medical/mental healthcare provider. 7.104.21 Agency Responsible for Conducting Institutional Abuse and/or Neglect Assessment [Eff. 1/1/15]

A. The county department in which the facility named in the referral is located shall conduct the assessment. The assessment shall follow the institutional abuse and/or neglect protocol described in Section 7.104.22.

B. The assessment shall be conducted by a qualified and neutral party in those situations in which the county department is the supervisory agency, such as for certified county foster and group homes. Such an assessment shall be arranged for by the responsible county department with either another county department, another agency within the community who accepts delegated responsibility, or a disinterested and qualified staff person within the county department. 7.104.22 Institutional Abuse and/or Neglect Assessment – Timing and Requirements [Rev. eff. 11/1/15]

The county department conducting the assessment shall assign priority in response time using the criteria set forth in Section 7.103.61, B.

A. A face-to-face interview with the alleged victim child(ren) according to procedures for interviewing children described in Section 7.104.1.

B. The assessment shall include the following actions:

1. A face-to-face interview with the alleged victim child(ren)according to procedures for interviewing children described in Section 7.104.1 and the following:

a. The alleged victim child(ren) shall be interviewed in a setting which is as neutral as possible and where confidentiality can be maintained;

b. The alleged victim child(ren) shall not be taken off the grounds for the interview unless the county department has court ordered custody or law enforcement has taken the child into protective custody;

c. The person(s) alleged to be responsible for the abuse and/or neglect and other related parties (i.e., foster parents, spouse or other facility staff) shall not be allowed to be present during the interview with the alleged victim child(ren); and, d. The county department shall, if necessary, obtain a court order to access the alleged victim child(ren) if the facility refuses access.

2. The assessment shall determine if there are other victim child(ren) not named in the referral and immediately assess the safety of those individuals.

3. The assessment shall obtain the names and addresses of any other alleged victim child(ren) who may no longer be in the facility and interview those individuals, if appropriate.

4. The assessment shall include interviews of witnesses, including children and staff who may have additional information.

5. The assessment shall include making reasonable efforts to interview and advise the person(s) alleged to be responsible for the abuse and/or neglect of the referral and afford such person(s) an opportunity to respond to the allegations.

6. The assessment shall include obtaining a detailed description of the incident and of the injuries and an assessment of the appropriateness of physical management or restraint if this was involved.

7. If applicable, the assessment shall include documentation of compliance with the reasonable and prudent parent standard in Section 7.701.200, F.

D. If at any point during the assessment, a county department becomes aware that a child/youth is, or is alleged to be, a victim of sex trafficking, the county department shall:

1. Report immediately, and no later than twenty-four (24) hours from when 2. Document the details of the report to law enforcement in the state 7.104.23 Documentation – Report Required [Eff. 1/1/15]

A. A written report of the assessment documented in the state automated case management system shall be prepared by the county department that conducted the assessment within sixty (60) calendar days after receipt of the referral.

B. A report shall be provided as described below:

1. A written report shall be provided to the facility administrator/director.

2. A written report shall be provided to the agency with licensing/certifying

authority.

3. The Institutional Abuse Review Team, Early Childhood and Learning Division, and the State Department’s Twenty-Four (24) Hour Monitoring Team, when the incident involves a twenty-four (24) hour care facility shall be provided a report through the state automated case management system.

4. The same custodial counties as required in Section 7.104.24 shall be provided a report through the state automated case management system.

C. The report shall include, at a minimum, the following information:

1. Name(s) of person(s) alleged to be responsible for the abuse and/or neglect;

2. The name(s), age(s), and duration of the alleged victim child(ren)’s placement in the facility being assessed;

3. The name of the facility and the county in which it is located;

4. The name of director/administrator of the facility;

5. The approximate number of children served by the facility;

6. The age range of children served by the facility and type of children served (e.g., child with developmental disabilities);

7. A summary of activities involved in the assessment, including a list of the individuals interviewed;

8. A summary of findings or conclusions, including the information on which the findings or conclusions are based; and, 9. A summary of the recommendations and/or need for an identified corrective or remedial action. 7.104.24 Notice A. The following individuals shall receive notice:

1. The licensing authority or certifying unit shall be notified that a referral concerning abuse and/or neglect has been received within one (1) working day after receipt of the referral.

2. The licensing authority or certifying unit shall be notified if the assessment indicates there is an immediate threat to the child(ren)’s health, safety, or welfare within one (1) working day of such determination.

3. Custodial agencies, including county departments, other states, and appropriate divisions of the State Department shall be notified as follows:

a. Immediately, if there are safety issues or if an injury requires medical treatment; and, b. Following completion of the assessment, if a child in their custody was the subject of a referral or if the assessment reveals concerns regarding the childcare practices which could negatively impact the child(ren).

4. Parents or legal guardians of alleged child(ren) victim(s) shall be notified as follows:

a. By the custodial counties when alleged abuse and/or neglect occurs in out-of- home care setting.

b. By the assessing county when there is no custodial county.

c. By the assessing county when alleged abuse and/or neglect occurs in less than twenty-four (24) hour childcare with notification provided prior to an interview with child(ren), when possible.

d. When an assessment is being or has been conducted on a referral of abuse and/or neglect; and shall include the nature of the alleged abuse and/or neglect and the findings of the assessment; and, e. If circumstances do not allow for direct contact, then notification of the allegations of abuse and/or neglect and findings shall be provided in writing.

5. Parents or legal guardians of uninvolved children in less than twenty-four (24) hours licensed childcare settings shall be given notice of an assessment within seventy-two (72) hours when it has been determined by the State Department or county department that:

a. The incident of alleged child abuse and/or neglect that prompted the assessment is at the level of a moderate, severe, or fatal incident of abuse and/or neglect, or involves sexual abuse.

b. Notice to the parents or legal guardians of the uninvolved children is essential to the assessment of the specific allegation of abuse and/or neglect or is necessary for the safety of children cared for at the facility; and, c. A determination has been made and a state or county department supervisor has provided written approval of the determination for which basis and approval may be in electronic form.

6. The director of the facility or director’s designee shall be:

a. Apprised of the allegation of abuse and/or neglect; and, b. Advised regarding the results of the assessment and provided a verbal report immediately once a determination is made. If the county department is unable to make a determination regarding the person(s) alleged to be responsible for abuse and/or neglect, the director shall also be advised so that decisions regarding the continued employment of the employee can be made by the facility.

7. Guardians’ ad litem of alleged victims and or counsel for youth by the custodial county when there is an assessment of an allegation of abuse and/or neglect in out-of-home care.

7.104.3 THIRD-PARTY ABUSE AND/OR NEGLECT – GROUNDS FOR

ASSESSMENT [Eff. 1/1/15]

This section addresses assessments of referrals alleging abuse and/or neglect by a third-party, as defined in Section 7.000.2, who is not related to the alleged victim child(ren) in the contexts described in the previous sections addressing intrafamilial and institutional abuse and/or neglect. 7.104.31 Third-Party Abuse and/or Neglect Assessment- Timing and Requirements A. When the referral alleges abuse and/or neglect by a third-party ten (10) years of age or older, the county department shall immediately forward the referral to the appropriate law enforcement agency for screening and investigation.

B. When the referral alleges human trafficking of a minor the county department shall forward the referral to the appropriate law enforcement agency.

C. When the referral alleges the abuse and/or neglect by a child under ten (10) years of age, county departments shall be the agency responsible for the assessment. The assessment shall focus on:

1. Whether or not the incident occurred;

2. The entire situation including the actions or omissions of adults who are responsible for care of the children involved; and, 3. Any interventions that may be necessary to secure safety and address treatment needs.

D. If a county department reasonably believes that the protection and safety of a child is at risk due to an act or omission on the part of the persons responsible for the child’s care, the county department shall make a referral concerning intrafamilial abuse and/or neglect.1/1/15] 7.104.32 Documentation – Report from Law Enforcement [Eff. 1/1/15]

County departments shall attempt to obtain a copy of the report summarizing any investigation that was conducted by law enforcement. If the report is obtained, it shall be the basis upon which the county department enters a founded finding of abuse and/or neglect into the state automated case management system. 7.105 Assessments Involving Allegations of A Youth In Conflict A. The youth in conflict assessment shall be used based on the following criteria:

1. The referral is assigned for assessment;

2. The referral meets the definition of youth in conflict, as defined in section 7.000.2; and 3. The referral does not contain any new allegations of abuse and/or neglect.

B. The assessment at a minimum shall include:

1. Face-to-face contact with the child/youth alleged to be a youth in conflict if the child/youth is able to be located.

2. Face-to-face contact with the primary caregiver;

3. Assessing the likelihood of substantial harm resulting from the conflict and the caregiver’s response to the conflict;

4. Considering the strengths and needs of the household;

5. Considering appropriate resources for the child/youth and the household;

6. Making efforts to engage non-custodial parent(s);

7. Making reasonable efforts to prevent out of home placement which includes: engaging family and extended family including sibling/s and their families in supporting the child/youth in conflict and their caregiver; providing in home services if appropriate and available; and engaging family and extended family in securing a kinship placement if needed;

8. Reviewing and updating household demographics in the comprehensive child welfare information system with the family for accuracy.

9. The use of the Colorado Family Safety Assessment Tool as described in

section 7.107.2;

10. The use of the Colorado Risk Assessment Tool as described in section 7.107.2;

11. If at any point during the assessment, it becomes apparent that the child/youth is demonstrating symptoms of a mental health disorder, intellectual and/or developmental disability (IDD), a referral shall be made to a mental health and/or IDD provider for prescreening and services;

12. If at any point new information is gathered that contains information defined in section 7.103, a new referral shall be generated; and 13. Documentation of assessment activities within the comprehensive child welfare information system 7.106 ADDITIONAL CATEGORIES OF ASSESSMENTS [Eff. 1/1/15]

7.106.1 EGREGIOUS INCIDENTS OF ABUSE AND/OR NEGLECT, NEAR

FATALITIES, OR CHILD FATALITIES [Eff. 1/1/15]

The requirements of this section address assessments of referrals of an incident of suspected abuse and/or neglect involving any of the following circumstances:

A. Significant violence, torture, use of cruel restraints, or other similar, aggravated circumstance;

B. A child has died; or, C. A physician has determined that a child is in serious, critical, or life-threatening condition as a result of sickness or injury. 7.106.11 Assessment Procedures – Timing and Requirements [Eff. 1/1/15]

A. County departments shall conduct a High Risk Assessment (HRA), or traditional response assessment of egregious incidents of abuse and/or neglect, a near fatality, or a child fatality in intrafamilial and institutional settings in those cases in which:

1. There is reason to know or suspect that abuse and/or neglect caused or contributed to the incident; or, 2. The cause of the incident is unknown or the information given is not consistent with the degree or type of injury and/or subsequent death.

B. County departments shall:

1. Coordinate with the following agencies to ensure prompt notification of an incident of egregious abuse and/or neglect, near fatality, or fatality of a child, which is suspicious for abuse and/or neglect:

a. Law enforcement;

b. District attorney’s office;

c. Coroner’s office; and, d. Hospitals.

2. Coordinate the assessment with law enforcement. At a minimum in cases in which there are no surviving children, county departments shall provide law enforcement and the coroner with information related to any prior involvement with the child, the family, or the person alleged to be responsible for the abuse and/or neglect.

3. Assess the condition of any surviving child(ren) and take action necessary to ensure their protection by:

a. Visiting the child(ren)’s home or place of custody;

b. Interviewing and/or observing the child(ren);

c. Examining the child(ren) to include an assessment of the child(ren)’s overall current physical, mental, or emotional condition;

d. Assessing the safety of the home environment, to include an interview with the parents, guardians, and/or legal custodians; and, e. Seeking an emergency protective order only when there are reasonable grounds to believe that a surviving or non-injured child(ren) is at risk of severe emotional or physical harm in his/her home environment. 7.106.121 Additional Actions When County Department has had Prior/Current Involvement A. When a county department has custody of the child/youth and/or protective supervision, it shall immediately take the following actions:

1. Notify the parents, guardians, and/or legal custodians of the incident. If the parents, guardians, and/or legal custodians reside in another county or state, the county department shall coordinate with the county department of residence for the parents, guardians, and/or legal custodians to provide personal notification, whenever possible.

2. Notify the sibling/s in an age-appropriate and developmentally appropriate manner of the event and any placement changes from the Department of Human Services directly or indirectly in consideration of the victim’s preferences when possible.

3. Notify the director of the county department of the incident. The county director shall also be immediately notified if the department has had prior child welfare involvement within the last three (3) years that was directly related to the egregious incident of abuse and/or neglect, near fatality or fatality to include referrals that have been screened out. A complete copy of the child/youth’s case record shall be made available to the director of the county department.

4. Notify the court, the attorney for the county department, and the Guardian Ad Litem (when one has been assigned) and/or counsel for youth (when one has been assigned) of the incident involving any child/youth who is under the court’s jurisdiction.

B. Upon notification of an egregious incident of abuse and/or neglect, near fatality or fatality in which the county department has had prior child welfare involvement within the last three (3) years with the child, family, or person alleged to be responsible for abuse and/or neglect, the director of the county department shall take the following actions:

1. Designate an individual(s) who will be responsible for assessing the egregious incident of abuse and/or neglect, near fatality or fatality. In the event of a conflict of interest, the county department shall arrange for the assessment to be conducted by another county department with personnel having appropriate training and skill.

2. When a county department determines that an incident of egregious abuse and/or neglect, near fatality, or fatality of a child is founded for child abuse and/or neglect, the director shall ensure that the county department conducts a complete internal administrative review of any child welfare involvement in the case prior to the egregious incident of abuse and/or neglect, near fatality or fatality. This review shall be referred to as the county department’s internal review and shall be completed whenever the county department has had current or prior involvement with the child, family or person alleged to be responsible for the abuse and/or neglect, within the last three (3) years. The review shall include, at a minimum:

a. Assessment of the interventions made by the county department.

b. Evaluation of the case plan.

c. Identified areas of strengths and/or weaknesses in the casework process.

d. Analysis of any systemic issues that may have led to delays or oversights.

e. Evaluation of the role played by other community agencies and the overall case coordination.

f. Recommendations for staff training or changes in the system that would avoid other similar occurrences.

3. Submit a written report of the county department’s internal review within ninety (90) calendar days of the initial notification of the egregious incident of abuse and/or neglect, near fatality or fatality to the State Department.

C. If another county department also has current and/or prior involvement with the child, family or person alleged to be responsible for the abuse and/or neglect within the three (3) year period of the incident of egregious abuse and/or neglect, near fatality or fatality (including referrals that were screened out), the State Department shall decide whether a county department internal review report will be required. 7.106.13 Reporting to the State [Eff. 9/1/2018]

A. Within twenty-four (24) hours (excluding weekends and holidays) of a county department becoming aware of an egregious incident of abuse and/or neglect, or near fatality or fatality of any child, which is suspicious for abuse and/or neglect, the county department shall call or email the following known information to the State Department which shall also be documented on the state prescribed form:

1. Name and age of victim;

2. The referral identification number generated by the state automated case 3. Known circumstances around the egregious incident of abuse and/or neglect, near fatality or fatality;

4. A description of physical injuries or medical condition of the child(ren) at the time of receipt of the information;

5. The names and ages of surviving or non-injured child(ren) who may be at risk;

6. A brief description of family/caregiver’s prior involvement with child welfare, if any;

7. The actions taken by the county department to date and future actions to be taken;

8. The involvement of other professionals in the case;

9. Whether the child was in out-of-home placement at the time of the incident; and, 10. For fatal incidents, the county shall enter the child’s date of death in the state automated case management system.

B. Upon notification of an egregious incident of abuse and/or neglect, near fatality or fatality, the county department shall take the required steps to restrict access to the state automated case management system to the current assessment of the egregious incident of abuse and/or neglect, near fatality or fatality, and any prior involvement in the state automated case management system regarding this child, the child’s family members, and the person(s) suspected of the abuse and/or neglect. Access shall remain restricted until the conclusion of the state child fatality review, at such time the county department shall determine whether the records shall be unrestricted.

C. The county department shall provide the following information to the State Department within sixty (60) calendar days of the initial notification of the egregious incident of abuse and/or neglect, near fatality or fatality, to the extent possible, and no longer than sixty (60) calendar days without a written request from the county department for an extension and subsequent State Department approval granting an extension:

1. The completed referral/assessment summary in the state automated case 2. Copies of any pertinent social, medical, and mental health evaluations of all involved subjects (child(ren), family, caregivers, etc.);

3. Coroner's records, including autopsy report;

4. Police reports of present investigation as well as any prior criminal history of all subjects;

5. A copy of any of the case record not obtainable in the state automated case management system;

6. A statement of any human services and Medicaid assistance or services that were being provided to the child and are recorded in the state automated case management system, the Colorado Benefits Management System, or the Colorado child care automated tracking system, any member of the child’s family, or the person alleged to be responsible for the abuse and/or neglect; and, 7. The age, income level, and education of the legal caregiver at the time of the fatality. 7.106.14 State Review of an Incident of Egregious Abuse or Neglect, Near Fatality or Fatality of a Child [Eff. 1/1/15]

When a county department determines that an incident of egregious abuse and/or neglect, near fatality, or fatality of a child is founded for child abuse and/or neglect, and where a county department had previous involvement within 3 years prior to the date of the incident, the county department shall submit reports outlined in 7.106.13 C for review by the State Department in accordance with Section 7.106 of this rule, and cooperate with the State Department’s review. The State Department shall conduct a multidisciplinary review of such cases, where a county department had previous involvement in the three years prior to the incident of egregious abuse and/or neglect, near fatality, or fatality. A county representative(s) from each county having previous involvement in the three years prior to the incident shall participate in the multidisciplinary review in person, by telephone, or through other emerging technology.

The State Department Child Fatality Review shall occur within forty-five (45) business days of the State Department receiving all required and relevant reports and information critical to an effective fatality review. These reviews shall include:

A. The circumstances around the incident of egregious abuse or neglect against a child, near fatality, or child fatality;

B. The services provided to the child, the child's family, and the perpetrator by the county department for any county with which the family has had previous involvement, as defined in paragraph (c) of subsection (2) of this section, within three years prior to the incident of egregious abuse or neglect against a child, near fatality, or fatality of a child due to abuse or neglect;

C. The county department's compliance with statutes, regulations, and relevant policies and procedures that are directly related to the incident of egregious abuse or neglect against a child, near fatality, or fatality;

D. Identification of strengths and best practices of service delivery to the child and the child's family;

E. Consideration of factors that may have contributed to conditions leading to the incident of egregious abuse or neglect against a child, near fatality, or fatality, including, but not limited to, lack of or unsafe housing, family and social supports, educational life, physical health, emotional and psychological health, and other safety, crisis, and cultural or ethnic issues;

F. The supports and services provided to siblings, family members, and agency staff after the incident of egregious abuse or neglect against a child, near fatality, or fatality; and, G. The quality and sufficiency of coordination between state and local agencies 7.106.15 CASE SPECIFIC REVIEW REPORT [Eff. 1/1/15]

The Department will author confidential and non-confidential case specific review reports in accordance with Section 26-1-139, C.R.S. As part of this process, the Department shall request a response to the case specific review report from any county having previous involvement with the family as defined in Section 26-1-139(2)(c), C.R.S., and include the response(s) in the final confidential and non-confidential report. 7.106.16 CHILD FATALITY REVIEW TEAM ANNUAL REPORT [Eff. 1/1/15]

By July 1 of each year, the Department will author an annual Child Fatality Review Team report. It shall contain the following information:

A. Policy recommendations based on the collection of reviews required by Section 26-1-139(5)(a), C.R.S.

B. Status of recommendations made in prior case specific, executive summary reports. This shall include all recommendations from publicly posted reports from the most recent, complete calendar year and all recommendations from prior years that were not completed at the time of the last annual report.

C. Aggregate demographic data. This may include, but not be limited to, data such as age of children at the time of the incident, race/ethnicity of the children, relationship of the perpetrator to the child, and other factors determined to be of importance.

D. A summary of review findings from reports completed on incidents from the most recent complete calendar year.

E. Joint recommendations made with the Colorado Department of Public Health and Environment's Child Fatality Prevention System as required by Section 25-20.5- 407(1)(i), C.R.S.

7.106.2 MEDICAL NEGLECT OF INFANTS AND TODDLERS WITH

DISABILITIES – GROUNDS FOR ASSESSMENT [Eff. 1/1/15]

The requirements of this section address assessments of referrals of medical neglect involving:

A. Infants less than one (1) year of age who were born with a life-threatening condition and who may have additional non-lethal physical or mental disabilities;

B. Toddlers under three (3) years of age who have been continuously hospitalized since birth, who were born extremely premature, or who have a long-term disability. 7.106.21 Agency Responsible for Conducting the Assessment [Eff. 1/1/15]

A. The county department responsible for conducting the assessment of a referral of medical neglect shall be the county in which the caregivers of the hospitalized infant reside.

B. If the caregivers’ residence cannot be determined, the county department in which the hospital is located shall be responsible for conducting the assessment. 7.106.22 Assessment Procedures – Timing and Requirements [Eff. 1/1/15]

County departments shall:

A. Work with medical organizations, hospitals, and health care facilities to implement procedures that ensure a timely response and resolution of referrals of medical neglect;

B. Obtain all relevant medical data concerning the child. County departments shall seek a court order to obtain records if the request for such material is refused;

C. Coordinate with any existing hospital review committees, which may have evaluated and recommended treatment in the case under assessment;

D. If, after assessing the medical neglect referral, there are indications that the referral of medical neglect may be founded, the county department shall interview the parent(s); and, E. Refer the matter to the local law enforcement agency in cases in which the infant has died before the assessment is completed and the county department has reason to suspect withholding of medically indicated treatment. The matter shall be referred to the law enforcement agency in the location where the child died.

However, if it is determined that treatment was not medically indicated, or that medically-indicated treatment had not been withheld, then the report shall be deemed unfounded. 7.106.23 Medical Decisions Regarding Infants and Toddlers [Eff. 1/1/15]

A. County department staff shall make no medical decisions regarding infants and toddlers and shall seek an independent medical consultation when indicated.

B. If the parent(s) wish to seek a second medical opinion, the county department shall provide referral assistance.

C. If the county department finds that an independent medical evaluation is necessary to determine the infant or toddler's medical prognosis, the county department shall recommend to the parent(s) that an independent medical evaluation be done.

D. If the county department determines that medically-indicated treatment or palliative care is being or will be withheld; and:

1. The infant or toddler's condition requires an urgent response, or, 2. Efforts by the county department or hospital personnel to obtain parental consent to treatment would be futile or already have failed, then the matter shall be brought to court under a petition. The petition may include a request to place temporary custody of the child with the county department to ensure proper medical treatment is provided. The county department shall immediately secure a court order if indicated.

7.106.3 ASSESSMENT OF MEDICAL NEGLECT IN WHICH RELIGIOUS

CONSIDERATIONS ARE INVOLVED - GROUNDS FOR ASSESSMENT [Eff. 1/1/15]

County departments shall assess cases of medical neglect including those cases in which there is a failure to provide medical treatment based upon the parent's, guardian's, or custodian's religious beliefs and there is concern that such failure will result in a threat to child’s health and welfare. 7.106.31 Assessment Procedures – Timing and Requirements [Eff. 1/1/15]

The assessment shall be conducted as described below:

A. The county department shall obtain a medical evaluation if the child’s condition presents substantial concern for the child’s health and welfare. This evaluation shall be obtained with the consent of the parents, guardians, or legal custodians.

If such consent is refused, the county department shall seek a court order to obtain medical evaluation;

B. The county department shall consult with medical practitioners and consider whether the child’s condition is life-threatening or will result in serious disability without professional medical care; and, C. If the child's condition is determined to be life-threatening or could result in serious physical impairment or serious disability without professional medical care, the county department shall seek a court order authorizing the provision of the necessary medical care in the event that such care is refused by the parent, guardian, or legal custodian. The county department may, but is not required to, seek temporary custody of the child in order to obtain judicial authorization for treatment. 7.106.32 Spiritual Healing Considerations [Eff. 1/1/15]

If spiritual healing is involved, the county department shall follow the guidelines defined in Section 19-3-103(2)(a), (b), C.R.S., to decide whether the method is a “recognized” method of religious healing and whether such healing is considered to be medically effective for the child's condition. 7.106.33 Impact of Parental Interference on Findings [Eff. 1/1/15]

A. If a parent, guardian, legal custodian, or caregiver inhibits or interferes with the provision of medical evaluation or treatment according to a court order, that act would constitute neglect and in such circumstances a referral shall be made to law enforcement and the county department may file a dependency and neglect petition.

B. For purposes of entering founded findings of abuse and/or neglect into the state automated case management system, reporting to police for criminal investigation, and filing of dependency and neglect petitions, no child who is under treatment by a recognized method of religious healing shall, for that reason alone, be considered to have been neglected and dependent unless the child's parent, legal guardian, custodian, or caregiver inhibits or interferes with the provision of medical services according to court-ordered medical evaluation or treatment. 7.106.4 Safe Haven Voluntarily Surrendered Infant Grounds for Assessment The requirements of this section address assessments of referrals when an infant is voluntarily surrendered to staff at a hospital, community clinic emergency center, or fire station within 72 hours of birth and the parent does not express an intent to return for the infant in accordance with section 19-3-304.5, C.R.S. Requirements set forth in

section 7.104 through 7.104.15 do not apply to safe haven voluntarily surrendered infant assessments. 7.106.41 Agency Responsible for Conducting the Assessment The county department responsible for conducting the assessment of a referral of a safe haven voluntarily surrendered infant shall be the county in which the infant was voluntarily surrendered. 7.106.42 Assessment Procedures – Timing and Requirements County departments shall:

A. Assign priority in response time using the criteria set forth in section 7.103.60.

B. Conduct a face-to-face observation with the alleged victim child in accordance with the assigned response time.

C. Conduct a check with law enforcement for reported missing infants.

D. Place the infant in a potential adoptive home.

E. Open a case to pursue permanency.

F. Report the assessment to the state department within 5 business days of receiving a referral of a voluntarily surrendered infant.

G. If additional allegations of known or suspected abuse and/or neglect are identified during the course of the assessment, the requirements set forth in sections 7.104 through 7.104.15 shall apply. 7.106.43 Findings A. A parent shall not be the subject of a confirmed allegation of abuse and/or neglect solely based on surrendering an infant pursuant to section 19-3-304.5, C.R.S. 7.106.44 Documentation Required at Conclusion of Assessment A. Enter a closure summary containing a brief summary of initial concerns and any additional concerns discovered during the assessment and the actions that were taken.

B. The assessment shall be approved by a certified supervisor and closed within sixty (60) calendar days of the date the referral was received.

7.107 INSTRUMENTS, TOOLS, AND INTERVIEW PROCEDURES

The following instruments, tools, and procedures are intended to assist county departments in making informed and reliable decisions. 7.107.1 COLORADO FAMILY SAFETY ASSESSMENT TOOL [Rev. eff. 1/1/17]

There shall be a transition period for completion of training and access to the new Colorado Family Safety Assessment Tool in the state automated case management system. All county child welfare case carrying staff and supervisors shall be trained and have access to the new tool by January 1, 2017. 7.107.11 Parameters for Use of the Colorado Family Safety Assessment Tool The Colorado Family Safety Assessment shall be completed:

A. At the time of initial response with household members.

B. As soon as additional household members are available, each household member shall be assessed using the current or impending dangers identified in the Colorado Family Safety Assessment tool.

C. If household members are not available at the time of initial response, the Colorado Family Safety Assessment shall be completed based on the information available and based on the interview or observation of the alleged victim child(ren)/youth and/or child/youth in conflict.

D. If no current or impending danger is identified within 14 calendar days through the Colorado Family Safety Assessment, interviews with additional household members identified outside of the 14 calendar days, shall be documented in the state automated case management system.

E. At the time of contact with the alleged victim child(ren)/youth and/or child/youth in conflict, or other family members and current or impending danger is identified, the entire Colorado Family Safety Assessment tool shall be completed.

F. The tool shall be completed using available information and accessible household members to mitigate the danger.

G. Prior to end dating a safety plan.

H. Whenever there is a significant change in household circumstances or situations that might pose a new or renewed threat to the safety of child(ren)/youth.

I. Prior to reunification.

J. Prior to child(ren)/youth returning home.

K. In all program area 5 (PA 5) referrals being assessed, except:

1. Institutional abuse assessments, as described in section 7.104.22;

2. Fatality assessments when there are no surviving siblings, or 3. When caregivers have abandoned an infant as described in C.R.S. 19-3- 304.5. 7.107.12 Safety Threshold [Eff. 1/1/17]

The following criteria shall be present to determine that current or impending danger exists. Meeting these criteria indicates that the household members behavior, condition or situation threatens the safety of a child(ren)/youth:

A. The threat to child(ren)/youth safety is specific and observable;

B. Conditions reasonably could result in moderate to severe harm to a child(ren)/youth;

C. This harm is likely to occur if not resolved;

D. A child(ren)/youth is vulnerable to the threat of harm as defined in the Colorado Family Safety Assessment tool, and/or through professional observation; and, E. The caregiver(s) is unable and/or unwilling to control conditions, situation and/or behaviors that threaten child(ren)/youth safety. 7.107.13 Assessment of Current or Impending Danger [Eff. 1/1/17]

A. The county department shall use the current or impending dangers outlined in the Colorado Family Safety Assessment tool to assess for the safety of identified child(ren)/youth.

B. The list of current or impending danger descriptions shall be referenced when assessing threats to child(ren)/youth safety and prior to checking current or impending dangers in the Colorado Safety Family Assessment Tool. 7.107.14 Safety Assessment Decision [Eff. 1/1/17]

A. If none of the current or impending dangers In The Colorado Family Safety Assessment tool are identified, the remaining required sections of the tool shall be completed within fourteen (14) calendar days and no further safety intervention is required.

B. If assessment of the child(ren)/youth and household members determines that the child(ren)/youth is safe and emergency out-of-home placement occurred prior to the completion of the Colorado Family Safety Assessment, efforts should be made to return responsibility for the child(ren)/youth’s safety back to the caregiver(s).

C. The caregiver strengths and protective capacity shall be assessed using the strengths and protective capacities listed in the Colorado Family Safety Assessment tool to determine whether a caregiver has the capacity and willingness to assure the child(ren)/youth’s protection.

D. If the assessment of the child(ren)/youth and household members determines the child(ren)/youth is unsafe, further assessment, analysis and planning are necessary as described in 7.107.17. 7.107.15 Actions that Respond to Current or Impending Danger [Eff. 1/1/17]

The action required shall be determined and based on the completion of the Colorado Family Safety Assessment tool as follows:

A. If no current or impending danger to the child(ren)/youth has been identified as a

part of the assessment, no further safety intervention is required;

B. If current or impending danger to the child(ren)/youth has been identified as a

part of the Colorado Family Safety Assessment tool and caregivers’ strengths, protective capacities and/or actions control for the identified danger, no further safety intervention is required; or, C. If current or impending danger has been identified and caregiver(s) or family actions do not control the current or impending danger, safety intervention analysis is required. 7.107.16 Safety Intervention Analysis [Eff. 1/1/17]

A. When current or impending danger is identified as described in section 7.107.15 (c) one of the following shall be initiated:

1. A safety plan shall be developed that can reasonably be expected to control for identified current or impending danger to the child(ren)/youth;

2. Human or social service’s custody shall be obtained if it is the only plan that sufficiently controls for the current or impending danger. 7.107.17 Safety Planning [Eff. 1/1/17]

A. A safety plan shall be developed for all child(ren)/youth in current or impending danger when a safety plan can reasonably be expected to control for identified dangers.

B. Safety plans shall be reviewed and approved by a supervisor as soon as possible and no later than twenty-four (24) hours from the interview or observation with the alleged victim child(ren)/youth.

C. Safety plans shall be documented in the state automated case management system no later than fourteen (14) calendar days from the date the alleged victim child(ren)/youth was interviewed or observed.

D. Safety plans shall include the following:

1. Identification of each family member and safety management provider who is participating in the plan;

2. A description of actions to be taken that address each specific current or impending danger, including:

A. Frequency of each action;

B. Who is responsible for each action;

C. The safety response shall have an immediate impact on controlling the identified current or impending danger; and, D. Be readily accessible at a level required to ensure safety.

3. When available, caregiver(s) acknowledgement of current or impending dangers and willingness to participate in the safety plan; and, 4. Caseworker activities to oversee the safety plan.

E. Parents, caregivers, and others who are a part of the safety plan shall sign the safety plan and receive a copy. The signatures and paper form shall be retained in the file.

F. Safety plans shall not be developed if the safety analysis results in the decision that human or social services custody is the only plan that is sufficient to control for all identified current of impending danger. 7.107.18 Timing and Documentation [Eff.1/1/17]

A. The Colorado Family Safety Assessment tool shall be completed with household members at the time of the contact and documented in the state automated case management system no later than fourteen (14) calendar days.

B. The Colorado Family Safety Assessment tool shall be approved by a supervisor as soon as possible and no later than fourteen (14) calendar days from the date the alleged victim child(ren)/youth was interviewed or observed.

C. If the child(ren)/youth is determined to be in current or impending danger, the remainder of the Colorado Family Safety Assessment tool shall be completed at the time of contact with available information and accessible household members to determine the actions needed that respond to the current or impending danger and shall be documented in the state automated case management system within fourteen (14) calendar days of the alleged victim child(ren)/youth interview or observation.

D. If the child(ren)/youth is determined to be in current or impending danger, the safety assessment, safety plan, or decision to initiate human or social services custody shall be reviewed and approved through contact with a supervisor as soon as possible and no later than twenty-four (24) hours from the interview or observation with the alleged victim child(ren)/youth. Supervisor contact and approval shall be documented in the state automated case management system within fourteen (14) calendar days of the alleged victim child(ren)/youth interview or observation. 7.107.2 Colorado Family Risk Assessment Tool [Rev. eff. 7/10/17]

There shall be a transition period for completion of training and access to the new Colorado Family Risk Assessment Tool in the state automated case management system. All county child welfare case carrying staff and supervisors shall be trained and have access to the new tool by January 1, 2017. 7.107.21 Parameters for Use of the Colorado Family Risk Assessment Tool [Eff. 1/1/17]

A. The Colorado Family Risk Assessment tool shall be completed:

1. With the household members;

2. As part of any Program Area 5 assessment, except:

a. Institutional assessment as described in section 7.104.22;

b. Fatality assessment when there are no surviving siblings; or, c. When caregivers have abandoned an infant as described in C.R.S. 19-3-304.5.

B. The Colorado Risk Assessment Tool shall be used to:

1. Determine risk for future abuse and/or neglect;

2. Aid in determining if services should be provided; and, 3. Aid in determining the appropriate level of services. 7.107.22 Procedures for Completing the Colorado Family Risk Assessment Tool [Eff. 1/1/17]

The Colorado Family Risk Assessment tool shall be completed with the family, and shall address all areas of risk on the tool. 7.107.23 Risk Analysis [Eff. 1/1/17]

If the risk assessment score is high, the county shall document reasonable efforts to hold a family engagement meeting to discuss next steps with the family. 7.107.24 Timing and Documentation [Eff. 1/1/17]

A. The completed Colorado Family Risk Assessment shall be documented in the state automated case management system within thirty (30) calendar days from the date the referral was received.

B. Family Engagement Meetings shall be documented in the framework in the state C. If the risk assessment score is high and the county department decides to close the assessment without providing services, the county department shall document in the statewide case management system how they reached the decision. 7.107.3 YOUTH SAFETY ASSESSMENT TOOL (Reserved for Future Use)

7.107.4 COLORADO HUMAN TRAFFICKING SCREEN PARAMETERS FOR USE:

The Colorado human trafficking screen shall be completed:

A. Anytime a county accepts a referral for assessment with human trafficking concerns.

B. Anytime during an open assessment or case where new concerns related to human trafficking arise.

C. Anytime a child/youth in state custody returns to care from runaway or missing status 7.107.5 Colorado Plan of Safe Care parameters for use The Colorado Plan of Safe Care shall be completed:

A. Any time a referral is accepted for assessment and the child meets the definition of substance exposed newborn as described in 19-1-103(1)(a)(vii), C.R.S and 19-3-102(1)(g), C.R.S.

B. The Colorado Plan of Safe Care shall be completed based on the information available and based on the interview or observation of the alleged victim child(ren) and in collaboration with parents, caregivers, medical providers, and others who may be a part of the plan.

C. A Colorado Plan of Safe Care shall be documented in the state automated case management system and approved within sixty (60) calendar days from the date the referral was received. 7.107.51 When to complete a Colorado Plan of Safe Care The action required shall be determined and based on an assessment that contains an allegation of substance exposed newborn as follows:

A. If a Colorado Plan of Safe Care has not been created by a medical, treatment or community provider, the caseworker shall create a Colorado Plan of Safe Care, and/or;

B. When a Colorado Plan of Safe Care has been developed by a medical, treatment or community provider, the caseworker shall update the Colorado Plan of Safe Care to reflect the current circumstances. 7.108 DEFERRAL PROCESS – WHEN PERMITTED [Eff. 1/1/15]

A. County departments may follow the deferral process in the following circumstances:

1. When the person has had no previous allegations of abuse and/or neglect assessed;

2. When the abuse and/or neglect that the person is found to be responsible for is at the level of minor incident of abuse and/or neglect, pursuant to

Section 7.000.2;

3. When the person found to be responsible for the abuse and/or neglect and the county department decide on a mutually agreeable method for resolving the issues related to the referral; and, 4. When the requirements set forth in the agreement for resolving the issues related to the referral of abuse and/or neglect can be completed within sixty (60) calendar days after the receipt of the referral.

B. County departments are not obligated to enter into any agreements to defer entering a finding of founded abuse and/or neglect into the state automated case management system.

C. The agreement shall be in writing and signed by the caseworker and the person found to be responsible for the abuse and/or neglect, and reviewed by the supervisor.

D. Upon deciding to enter into the deferral process, the county department shall document the decision in the state automated case management system. 7.108.1 DEFERRAL PROCESS COMPLETED [Eff. 1/1/15]

If the person who is found to be responsible for the abuse and/or neglect completes the agreement, as determined by the county department, the county department shall make an individual finding of “deferred” with an overall finding of founded into the state automated case management system regarding the referral of abuse and/or neglect related to the assessed incident. 7.108.2 DEFERRAL PROCESS NOT COMPLETED [Eff. 1/1/15]

If the person who is found to be responsible for the abuse and/or neglect does not complete the agreement, as determined by the county department, the county department shall make an entry for the individual and overall finding of “founded” into the state automated case management system regarding abuse and/or neglect related to the assessed incident.

7.109 ENTERING FOUNDED FINDINGS REPORTS OF CHILD ABUSE OR

NEGLECT [Eff. 1/1/15]

In a High Risk Assessment or non-dual track counties, the county department shall enter the founded finding even if there is a criminal or civil proceeding pending against the person responsible arising out of the same incident. The reported data shall include the following:

A. The name, address, gender, date of birth, and race of the child(ren) victim(s);

B. The composition of the victim’s immediate family;

C. At a minimum, the name and last known mailing address of the person found to be responsible for the child abuse or neglect, and the date of birth and Social Security Number, if known;

D. The type of abuse or neglect;

E. The severity of the abuse or neglect;

F. Any previous incidents of child abuse or neglect of child or siblings;

G. The name(s) and address(es) of any person(s) responsible for previously founded abuse or neglect, if known;

H. The name of the source of the referral submitted to the county department, if known;

I. The county department that investigated the referral; and, J. The date the suspected abuse or neglect referral was made to the county department and the date the county department made a founded finding of the abuse or neglect.

7.110 NOTICE TO THE PERSON FOUND TO BE RESPONSIBLE FOR CHILD

ABUSE OR NEGLECT [Eff. 1/1/15]

A. The county department shall notify the person found responsible for child abuse or neglect of the finding by first-class mail to the responsible person's last known mailing address, using a form approved by the State Department. The county department shall retain a copy of the notice in the case file showing the date of mailing.

B. At a minimum, the notice shall include the following information:

1. The type and severity level of the abuse or neglect, the date the referral was made to the county department, which county department completed the assessment, the date the county made the finding in the state automated case management system, and information concerning persons or agencies that have access to the information.

2. The circumstances under which information contained in the state automated case management system will be provided to other individuals or agencies.

3. How to access the county’s dispute resolution process. Counties are authorized to offer a county dispute resolution process to persons alleged to be responsible for an incident of child abuse or neglect.

4. The right of the person found responsible to request a state level appeal as set forth in Section 7.111. The county shall provide the State Department approved appeal form to the person.

5. Notice that the scope of the appeal is limited to challenges that the finding(s) are not supported by a preponderance of the evidence or that the actions found to be child abuse or neglect do not meet the legal definitions of child abuse or neglect. The State Department will be responsible for defending the determination at the State level fair hearing.

6. A full explanation of all alternatives and deadlines contained in Sections 7.111 through 7.112. 7.111 STATE LEVEL APPEAL PROCESS [Eff. 6/1/23]

A. Persons found responsible for an incident of child abuse or neglect by the county department shall have the right to a state level appeal to contest the finding. The request for appeal of the decision shall first be submitted to the State Department unit designated to handle such appeals. If the State Department and the Appellant are unable or unwilling to resolve the appeal in accordance with the provisions set forth below in this section, the State Department shall forward the appeal to the Office of Administrative Courts (OAC) to proceed to a fair hearing before an Administrative Law Judge (ALJ).

B. The grounds for appeal shall consist of the following:

1. The findings are not supported by a preponderance of credible evidence;

2. The actions ultimately found to be abusive or neglectful do not meet the statutory or regulatory definitions of child abuse or neglect.

C. The person found to be responsible for child abuse or neglect shall have ninety (90) calendar days from the date of the notice of founded finding to appeal the finding in writing to the State Department. The written appeal shall be submitted via the State approved online form or using the hard copy appeal form provided to the person found responsible for child abuse or neglect by the county department and shall include:

1. The contact information for the Appellant;

2. A statement detailing the basis for the appeal; and, 3. The county department notice of finding of responsibility for child abuse or neglect.

D. The state level appeal process must be initiated by the person responsible for child abuse or neglect or his/her legal representative. The Appellant need not hire an attorney to appeal the county determination. If the individual is a minor child, the appeal may be initiated by his/her parents, legal custodian, or legal representative.

E. The appeal must be submitted to the State Department within ninety (90) calendar days of the date of the notice of founded finding. If the appeal is filed more than ninety (90) calendar days from the date of the notice of founded finding, the Appellant must show good cause for not appealing within the prescribed period as set forth in Section 7.000.2, A. Failure to request State review within this ninety-day (90) period without good cause shall be grounds for the State Department to not accept the appeal.

F. The founded finding shall be utilized for safety and risk assessment, employment, and background screening by the State Department while the administrative appeal process is pending.

G. The Appellant shall have the right to appeal even if a dependency and neglect action or a criminal prosecution for child abuse is pending arising out of the same report. The State Department shall hold in abeyance the administrative process pending the outcome of the dependency and neglect or criminal action if requested by the Appellant or if the State Department determines that awaiting the outcome of the court case is in the best interest of the parties. If the Appellant objects to the continuance, the continuance shall not exceed one hundred eighty (180) days without the Appellant having the opportunity to seek review of the extended continuance by an Administrative Law Judge. The pendency of other court proceeding(s) shall be considered to be good cause to continue the appeal past the one hundred eighty (180) day timeframe.

H. The following circumstances shall be considered to be admissions to the factual

basis of the finding of responsibility for child abuse or neglect entered into the state automated case management system and shall be considered to be conclusive evidence of the person’s responsibility for child abuse or neglect to support a motion for summary judgment submitted to the Office of Administrative Courts:

1. When a Dependency and Neglect Petition has been adjudicated against or a deferred adjudication entered against the Appellant on the basis of Sections 19-3-103 or 19-3-102 (1)(a), (b), or (c), C.R.S., arising out of the same factual basis as the founded finding in the state automated case 2. The Appellant has been found guilty of child abuse, or has pled guilty or nolo contendere to child abuse as part of any plea agreement including, but not limited to, a deferred judgment agreement, arising out of the same factual basis as the founded finding in the state automated case management system; or, 3. The Appellant has been found guilty or has pled guilty or nolo contendere to a domestic violence related or alcohol traffic related offense arising out of the same factual basis as the founded report in the state automated I. When an Appellant requests an appeal, the State Department shall request the records relied upon in making the finding from the county department responsible for entering the finding, which has been appealed. The county department shall submit the record to the State Department as soon as practicable within the time frame requested by the Department.

J. After the Appellant requests an appeal, the State Department shall inform the Appellant regarding the details of the appeal process, including timeframes and contact information.

1. The Appellant, as the party in interest, shall have access to the county record in order to proceed with the appeal. Appellant’s use of the county file for any other purpose is prohibited unless otherwise authorized by law.

2. Prior to providing access to the Appellant, the State Department shall redact identifying information contained in the county file to comply with state and federal law regarding the confidentiality of child abuse or neglect records or other protected information including, but not limited to, reporting party name(s) and addresses, Social Security Number, foster parent identifying information, and information pertaining to other parties in the case that the appellant does not have a legal right to access.

K. The State Department is authorized to enter into settlement negotiations with the Appellant as part of the litigation process. The State Department is authorized to enter into settlement agreements that modify, overturn or expunge the reports as reflected in the state portion of the state automated case management system.

The State Department is not authorized to make any changes in the county portion of the state automated case management system. In exercising its discretion, the State Department shall take into consideration the best interests of children, the weight of the evidence, the severity of the abuse or neglect, any pattern of abuse or neglect reflected in the record, the results of any local court processes, the rehabilitation of the Appellant, and any other pertinent information.

L. The State Department and the Appellant shall have one hundred twenty (120) days from the date that the State Department receives the appeal to resolve the issue(s) on appeal. The 120 day time limit may be extended by agreement of both the Appellant and the State Department if it is likely that the additional time will result in a fully executed settlement agreement or resolution of the appeal.

M. As soon as it is evident within the 120 days that the Appellant and the State Department will not resolve the issue(s) on appeal, the State Department shall forward a copy of the Appellant’s original appeal document(s) to the Office of Administrative Courts in order to initiate the Office of Administrative Courts fair hearing process.

N. If, by the end of the 120 day period, the State Department has been unable to contact the Appellant using the information submitted by the Appellant, including by first class mail, and the Appellant has not contacted the State Department, the appeal shall be deemed abandoned. The finding entered by the county department shall be upheld in the state automated case management system without further right of appeal. The State Department shall notify the Appellant of this result by first class mail to the address submitted by the Appellant.

7.112 STATE FAIR HEARING BEFORE THE OFFICE OF ADMINISTRATIVE

COURTS

A. When the Office of Administrative Courts receives the appeal documents from the State Department, the Office of Administrative Courts shall docket the appeal and enter a procedural order to the parties indicating the following:

1. The date and time for a telephone scheduling conference with the parties.

2. During the telephone scheduling conference, the Office of Administrative Courts shall determine the date for the hearing. Following the scheduling conference, the Office of Administrative Courts will issue a further procedural order and notice of hearing. The order/notice will contain the hearing date, the fourteen (14) day deadline for the notice of issues, the fourteen (14) day deadline for response and deadline for filing pre-hearing statements. Any party requiring an extension or modification of any of the deadlines in the order may file a request with the Administrative Law Judge. The Office of Administrative Courts shall also issue a protective order which will protect and govern the handling of all pleadings, discovery, and evidence. The order must be signed by an Administrative Law Judge and must state that:

a. Any documents exchanged by the parties containing confidential information, including, but not limited to pleadings, Trails reports and investigative records, medical records, law enforcement investigation records, and documents regarding child victims will be used for the sole purpose of proceeding with this appeal.

b. The parties may disclose confidential information to their attorneys or any expert witness only as necessary for the prosecution or defense of the appeal. The appellant is not authorized to disclose or use confidential information for any other purpose.

c. The parties may exchange discovery containing information that is confidential under department rule 12 CCR 2509-2, § 7.111.

d. To the extent that the parties may disclose confidential records to expert witnesses, the parties shall provide a copy of the protective order to the expert witnesses and advise the expert witness of his or her obligation not to disclose the records or information learned from the confidential records.

e. The exchange and use of the confidential information or records does not waive the right of either party to object to the admission of the documents into evidence on any grounds.

f. If the parties use or offer confidential information or records as evidence during the course of the hearing, counsel and the parties shall take reasonable measures to protect such information or records from public disclosure including but not limited to filing records under seal.

g. The appellant must destroy or return to the department all protected health and abuse and neglect information (including all copies made) at the end of the appeal or, should the appellant choose to pursue any further administrative remedies, when those remedies have been exhausted.

h. The hearing regarding the factual basis for the child abuse and/or neglect finding shall be closed to the public.

i. This order does not prohibit the department from using documents or information as authorized, required, or permitted by law.

3. The notice of issues shall include the following:

a. The specific allegations(s) that form the basis of the county department’s finding that the Appellant was responsible for child abuse or neglect;

b. The specific type and severity of child abuse asserted against Appellant and the legal authority supporting the finding; and, c. To the extent that the State Department determines that the facts contained in the state automated case management system support a modification of the type or severity of child abuse or neglect determined by the county department, the State Department shall so notify the county department and the Appellant of that modification and the process shall proceed on the modified finding(s).

4. The Appellant shall respond to the State Department’s submittal by providing the factual and legal basis supporting the appeal to the State Department and to the Office of Administrative Courts.

5. If the Appellant fails to participate in the scheduling conference referenced above or fails to submit the response referenced herein, the Office of Administrative Courts shall deem the appeal to have been abandoned by the Appellant and render an Initial Decision Dismissing Appeal. In accordance with the procedures set forth below, the Office of Appeals may reinstate the appeal for good cause shown by the Appellant.

6. In the event that either party fails to respond to a motion to dismiss filed in the appeal, the Administrative Law Judge shall not consider the motion to be confessed and shall render a decision based on the merits of the motion.

B. The Administrative Law Judge shall conduct the appeal in accordance with the Administrative Procedure Act, Section 24-4-105, C.R.S. The rights of the parties include:

1. The State Department shall have the burden of proof to establish the facts by a preponderance of the evidence and that the facts support the conclusion that the Appellant is responsible for the child abuse or neglect indicated in the notice of issues provided by the State Department. The state automated case management system is not the only acceptable evidence for establishing that the finding is supported by a preponderance of evidence;

2. Each party shall have the right to present his or her case or defense by oral and documentary evidence, to submit rebuttal evidence, and to conduct cross-examination;

3. Subject to these rights and requirements, where a hearing will be expedited and the interests of the parties will not be subsequently prejudiced thereby, the Administrative Law Judge may receive all or part of the evidence in written form or by oral stipulations;

4. A telephonic hearing may be conducted as an alternative to a face-to-face hearing unless either party requests a face-to-face hearing in writing. The written request for a face-to-face hearing must be filed with the Office of Administrative Courts and the other party at least ten (10) calendar days before the scheduled hearing. A request for a face-to-face hearing may necessitate the re-setting of the hearing; and, 5. Where facilities exist that have videoconferencing technology local to the county department that made the founded finding, either party may request that the hearing be conducted via that technology. The requesting party shall investigate the feasibility of this approach and shall submit a written request outlining the arrangements that could be made for video conference. The Office of Administrative Courts shall hold the hearing via videoconferencing for the convenience of the parties whenever requested and feasible. A request for a hearing via videoconferencing may necessitate the re-setting of the hearing.

C. At the conclusion of the hearing, unless the Administrative Law Judge allows additional time to submit documentation, the Administrative Law Judge shall take the matter under advisement. After considering all the relevant evidence presented by the parties, the Administrative Law Judge shall render an Initial Decision for review by the Colorado Department of Human Services, Office of Appeals.

D. The Initial Decision shall uphold, modify or overturn/reverse the county finding.

The Administrative Law Judge shall have the authority to modify the type and severity level of the child abuse or neglect finding to meet the evidence provided at the hearing. The Administrative Law Judge shall not order the county to modify its record; rather, the State Department shall indicate the outcome of the appeal in its portion of the state automated case management system.

E. When an Appellant fails to appear at a duly scheduled hearing having been given proper notice, without having given timely advance notice to the Office of Administrative Courts of acceptable good cause for inability to appear at the hearing at the time, date and place specified in the notice of hearing, then the appeal shall be considered abandoned and the Administrative Law Judge shall enter an Initial Decision Dismissing Appeal. In accordance with the procedures set forth in Section 7.114, the Office of Appeals may reinstate the appeal for good cause shown by the Appellant. 7.113 TRANSITION TO THE NEW APPEAL PROCESS [Eff. 1/1/15]

Appeals shall be submitted to the Colorado Department of Human Services section authorized by the Executive Director to process these appeals, using the state approved appeal form provided to individuals who have been found responsible for an incident of child abuse or neglect. 7.114 STATE DEPARTMENT OFFICE OF APPEALS FUNCTIONS [Eff. 1/1/15]

A. Review of the Initial Decision and hearing record and entry of the Final Agency Decision shall be pursuant to state rules at Sections 3.850.72 - 3.850.73 (9 CCR 2503-8).

B. Review shall be conducted by a State adjudicator in the Office of Appeals not directly involved in any prior review of the county report being appealed.

C. The Final Agency Decision shall advise the Appellant of his/her right to seek judicial review in the State District Court, City and County of Denver, if the Appellant had timely filed Exceptions to the Initial Decision.

D. If the Appellant seeks judicial review of the Final Agency Decision, the State Department shall be responsible for defending the Final Agency Decision on judicial review.

E. In any action in any court challenging a county’s founded finding of child abuse or neglect, the State Department will defend the statutes, rules, and state-mandated procedures leading up to the finding, and will defend all county actions that are consistent with statutes, rules, and state-mandated procedures. The State Department shall not be responsible for defending the county department for actions that are alleged to be in violation of, or inconsistent with, state statutes, state rules or state-mandated procedures. 7.115 CONFIDENTIALITY OF APPEAL RECORDS [Eff. 1/1/15]

A. All records submitted by the parties as part of the state level appeal process and all notices, orders, agency notes created by or made part of the State Department’s agency record shall be confidential and shall not be released or disclosed unless such release or disclosure is permitted by the applicable state statutes or Section 7.605.

B. Initial and Final Agency Decisions where information identifying the Appellant, victim(s), other family members, or other minors have been blocked out may be released to the public.

Editor’s Notes

History

Rule 7.111 eff. 10/01/2007.

Entire rule repealed eff. 08/01/2012.

Entire rule eff. 01/01/2015.

Rules 7.107.1, 7.107.2 emer. rules eff. 07/10/2015.

Rules 7.104.22, 7.107.1, 7.107.2 eff. 11/01/2015.

Rules 7.104.1 A-C, 7.104.22 D eff. 10/01/2016.

Rules 7.107.1-7.107.2 eff. 11/01/2016.

Rule 7.106.14 eff. 07/01/2017.

Rules 7.100, 7.101, 7.102.1-7.102.3, 7.103, 7.103.2 eff. 08/01/2017.

Rules 7.103.61, 7.103.8 A eff. 02/01/2018.

Rules 7.102.3 G.1, 7.103.3-7.103.6, 7.104, 7.104.1 eff. 03/02/2018.

Rules 7.106.121 B.2-3, 7.106.13 C eff. 09/01/2018.

Rules 7.103 A, 7.103.4, 7.103.5, 7.103.60, 7.103.61, 7.105, 7.107.11 eff . 03/15/2019.

Rule 7.104.131 eff. 01/01/2020.

Rules 7.105 B.7, 7.106.121 A eff. 06/01/2020.

Rule 7.103 C eff. 01/30/2021.

Rules 7.104.1 C.10, 7.104.1 D, 7.104.14 J, 7.104.31, 7.107.4 eff. 07/30/2021.

Rule 7.112 A.2 emer. rule eff. 09/03/2021.

Rule 7.112 eff. 11/30/2021.

Rules 7.103 B.2, 7.103 C, 7.103.3-7.103.10 eff. 12/30/2021.

Rules 7.104, 7.106.121 B.1, 7.106.4-7.106.44 eff. 01/30/2022.

Rules 7.103 A.5.e, 7.104.1 C.14, 7.104.131 D, 7.104.14 K, 7.107.5, 7.107.51 eff. 03/30/2022.

Rules 7.103.2 A.3, 7.103.21, 7.103.4 F-G, 7.103.6 A.4, 7.104.2, 7.104.24 A.6-7 eff. 06/30/2022.

Rules 7.104.12, 7.104.24, 7.106.121 A eff. 03/02/2023.

Rule 7.111 C eff. 06/01/2023.

Rules 7.103.4, 7.103.71, 7.104.132 eff. 07/01/2023.

Rule 7.104.2 eff. 03/01/2024.

Rules 7.102.1 D, 7.104.132 A.2, 7.104.15 B.3 eff. 06/01/2024.

Rules 7.103.5 I-J, 7.103.6 A, 7.103.6 D, 7.104.15 B.3, 7.104.15 B.4, 7.104.15 C.2.d, 7.104.15 C.2.f, 7.104.15 D eff. 05/30/2025.

Rules 7.103 A.2.h-l , 7.103 A.3.e-i , 7.103 A.4.f-k, 7.103 A.11, 7.104.14, 7.105 eff. 10/01/2025.

Rules 7.103, 7.103.5 J, 7.103.6 D, 7.104.15 D eff. 01/30/2026.

Rules 7.101, 7.103.5 E, 7.103.5 F, 7.103.5 J, 7.103.70 C eff. 06/30/2026.

##### **12 CCR 2509-3** Program Areas, Case Contacts, and Ongoing Case Requirements {#sec-12-ccr-2509-3 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-3}

DEPARTMENT OF HUMAN SERVICES

PROGRAM AREAS, CASE CONTACTS, AND ONGOING CASE REQUIREMENTS

12 CCR 2509-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] ______________________________________________________________________ 7.200 PROGRAM AREAS, CASE CONTACTS, AND ONGOING CASE REQUIREMENTS [Eff. 1/1/15]

7.200.1 PROGRAM AREA 3 - PROGRAM FOR PREVENTION AND

INTERVENTION SERVICES FOR CHILDREN, YOUTH, AND FAMILIES AT RISK OF

INVOLVEMENT WITH CHILD WELFARE [Eff. 1/1/15]

The Program Area 3 definition is located at 7.000.1, A (12 CCR 2509-1).

A. Prevention services are voluntary and based on a human services professional decision regarding the family’s need and on youth and family choice. Services may include:

1. Services that reduce risk and increase protective factors to decrease the likelihood of child abuse and neglect; or, 2. Services provided when a child or youth is in conflict with his/her family members, community, or at risk for abuse or neglect and do not meet the definition of unsafe as found in Section 7.000.2, A (12 CCR 2509-1).

Services cannot be provided when the child’s circumstance meets the definition of unsafe as found in Section 7.000.2, A (12 CCR 2509-1).

B. Intervention services are voluntary and based on a human services professional decision regarding the family’s need and youth and family choice. Services may include:

1. Proactive efforts to intervene when the immediate health, safety or wellbeing of a child is not at-risk; or, 2. Services provided after a referral has been screened out; or, 3. Services provided when a case is assessed as not requiring child protection or youth in conflict services and the case is closed; or, 4. Services provided when a child welfare case has been closed, the child is safe as defined in Section 7.000.2, A (12 CCR 2509-1), and additional supports would improve a family’s protective factors and reduce the possibility of recurrence of abuse or neglect. 7.200.11 Eligibility Criteria [Eff. 1/1/15]

A. County Department A county is eligible to provide Program Area 3 prevention and intervention services when the county has a state-approved service delivery plan. The service delivery plan shall be submitted as an addendum to the Core Services Plan and shall include the process for referral and assessment to the prevention and intervention service.

B. Families, Youth, and Children Families, youth, and youth/children are eligible for prevention and intervention services if a child/youth is in conflict with his/her family members, in conflict with the community, or at risk of abuse or neglect and do not meet criteria for a child protection or youth in conflict case.

Families, youth, and children are eligible for prevention and intervention services if a human services professional has determined the family has a need for the service.

C. Community Agency or Another Division within the County Department A community agency or another division within the county department is eligible to refer a family, youth, or child for prevention or intervention services, or to provide services to a family, youth, or child if so stated in the county’s stateapproved service delivery plan addendum to the Core Services Plan. 7.200.12 County Responsibilities [Rev. eff. 9/1/15]

The county department shall be responsible:

A. To deliver prevention and intervention services according to the state-approved service delivery plan that is an addendum to the Core Services Plan.

B. To ensure community agencies and/or other divisions within the county provide prevention and intervention services according to the state-approved service delivery plan.

C. To ensure community agencies and/or other division within the county department refer families, youth, and children to the prevention and intervention service according to the contract with the county Child Welfare Division.

D. To ensure community agencies and/or other divisions of human services offer prevention or intervention services according to the contract with the county department.

E. To ensure documentation in the approved state automated case management system of the names, age, ethnicity, gender, service provided, and the reason the service ended for families, youth, and children referred for or provided prevention and intervention services.

F. To ensure documentation in the approved state automated case management system of all required data elements of each funding source used for prevention and intervention services.

G. To follow the rules and requirements governing the specific funding stream the county elects to use to provide prevention and intervention services.

H. To follow the rules and regulations promulgated by the State Board of Human Services. 7.200.13 Funding Sources [Eff. 1/1/15]

Counties may use any available funding source to provide services under program area three, in accordance with the rules and requirements governing the specific funding stream utilized. 7.200.14 Referral [Eff. 1/1/15]

A. The county department shall provide a referral and intake process wherein all persons have the opportunity to apply for services. In the referral and intake process, the assigned social service staff shall accept applications and screen referrals.

B. A referral report shall be completed in all appropriate situations, and at a minimum must include:

1. Demographic information.

2. Referring source.

3. Results of initial assessment.

4. Dispositional decision.

C. The county department, if requested, shall provide the referring source with an explanation of the action taken as a result of the referral. 7.200.15 Initial Functional Assessment [Eff. 1/1/15]

An initial assessment by the county department of social services staff shall include:

A. The appropriateness of referral;

B. Determining if the case is open in the agency;

C. Awareness of agency and community resources and their current availability;

D. Initial assessment of problem and service needs;

E. Determining if another agency can better serve the client;

F. Information about risk factors that can be used in making decisions about urgency of service delivery; and, G. Determining whether an emergency exists that meets the emergency assistance criteria in accordance with Section 7.601. 73 (12 CCR 2509-7). 7.201 Program Area 4 - Youth in Conflict The Program Area 4 definition and target group information is located at Section 7.000.1, B (12 CCR 2509-1).

REFERRAL AND ASSESSMENT ACTIVITIES FOR PROGRAM AREA 4 ARE

LOCATED IN SECTION 7.105, ET AL. (12 CCR 2509-2). 7.201.1 Provision of Ongoing Youth in Conflict Case Services A. Youth in Conflict services shall be based on the assessment completed in accordance with 12 CCR 2509-2; 7.105, and the conflict between the parent/caregiver and the child/youth. Services shall be offered that preserve the child/youth’s permanency with their family, caregiver, kin and/or community whenever possible. If placement is required, the child/youth shall be placed in the least restrictive setting, consistent with the child/youth and family’s assessed needs. When the child/youth cannot be safely returned to the family from whom they were removed, services shall be provided to achieve an alternative permanency plan that provides for the child/youth’s safety and well-being in a timely manner.

B. At the point of case opening, county departments shall ensure pertinent information regarding child/youth safety, permanency, and well-being are transferred to any newly assigned caseworker. This shall be accomplished through at least one of the following methods, based on the nature of the case and the capacity of the county department, and shall be documented in the state automated case management system:

1. Family engagement or other equivalent review team meeting involving caseworkers and/or supervisors, family and community providers; or 2. Staffing between caseworkers and/or supervisors. 7.202 PROGRAM AREA 5 - CHILDREN IN NEED OF PROTECTION [Eff. 1/1/15]

Program Area 5 definition and target group information is located at Section 7.000.1, C (12 CCR 2509-1). Intake information is located at Section 7.101, et.al. (12 CCR 2509- 2).

Referral and assessment activities for Program Area 5 are located in Section 7.101, et al. (12 CCR 2509-2).

7.202.1 PROVISION OF ONGOING CHILD PROTECTION SERVICES (CPS)

A. If a safety plan exists, the assigned caseworker and supervisor shall review it as the first step in ongoing services planning.

B. Ongoing child protection services shall be based on the safety and risk issues identified in the safety assessment tool and plan, risk assessment tool, family social history and assessment summary in the Family Services Plan. Services shall be provided to protect the child(ren) or youth from further abuse or neglect through building parental capabilities and increasing parental involvement. This shall be accomplished in a manner that preserves the family when this can safely be done. When the family from whom the child(ren) or youth were removed cannot safely be preserved, services shall be provided that preserve the child(ren)'s or youth’s continuity within the extended family and/or home community when feasible. The child(ren) or youth shall be placed in the least restrictive setting, consistent with the child(ren) or youth’s and family’s assessed needs. When the child(ren) or youth cannot safely return to the family from whom they were removed, services shall be provided to achieve an alternative permanent plan that provides for a child(ren)'s or youth’s safety and well-being in a timely manner.

C. At the point of case transfer, county departments shall assure pertinent information regarding child safety, permanency, and well-being are translated to the new assigned caseworker. This shall be accomplished through the following methods, based on the nature of the case and the workload ability of the county department:

1. Decision-making meeting involving caseworkers and/or supervisors, family and community providers;

2. Staffing between caseworkers and/or supervisors;

3. Written transfer summary; and/or, 4. Documentation in the state automated case management system.

D. The county department shall complete the safety assessment tool consistent with requirements outlined in Section 7.107.1 (12 CCR 2509-2).

E. The county department shall complete the risk assessment tool consistent with requirements outline in Section 7.107.2 (12 CCR 2509-2).

F. The county department shall complete monthly contacts according to requirements outlined in section 7.204.

G. The county department shall provide courtesy supervision services when requested by another county or state when there is court jurisdiction and such services must continue in order to protect the child or youth. In cases where there is no court jurisdiction, the receiving county shall conduct an assessment to determine if services are needed in order to protect the child or youth. Services shall be provided if indicated. Other services include:

1. The requirement to utilize Interstate Compact on the Placement of Children (ICPC) procedures to obtain courtesy supervision shall not be used by a county to deny a request from another state to provide assessment of a child’s safety.

2. When there is court jurisdiction, ICPC procedures shall be followed by the sending state in order to obtain courtesy supervision of a case in Colorado.

3. The contacts requirements in Section 7.204, shall apply to cases being provided courtesy supervision when there is court jurisdiction and also for voluntary cases for which it is determined that services are indicated.

H. If a child protection service client for whom services are still needed moves to another county or state, the county or state of current residence should be notified within ten (10) days and provided with written appropriate, relevant information. Change in venue procedures as outlined in Section 7.304.4 (12 CCR 2509-4), shall be followed. If there is no court order for services, the receiving county shall provide outreach and assessment services up to sixty (60) calendar days. If during the sixty (60) calendar days period it is determined that further services are not indicated or the family is unwilling to accept services, the receiving county shall close the case.

I. All Program Area 5 cases shall remain in that program area as long as the child or youth is at risk for abuse/neglect and the case plan is to reunify the family.

Cases on appeal for termination of parent-child legal relationship shall remain in Program Area 5 until the termination is finalized.

7.202.2 ONGOING SERVICES FOR CASES OF MEDICAL NEGLECT OF

INFANTS WITH DISABILITIES [Eff. 1/1/15]

The county department shall make available the following services:

A. Monitoring Court-Ordered Treatment When either the court has ordered or the parent(s) have agreed upon a course of treatment, the county department shall monitor developments to ensure this treatment is provided. When there is a failure to provide treatment, the county department shall notify the court and immediately petition the court to take appropriate action.

B. Coordinating With Other Resources The county department shall contact agencies that provide services to child(ren) with special needs, and help the parents with referrals to appropriate agencies that provide services for infants with similar disabilities and for their families.

Referrals shall be made to agencies with financial resources for costs of medical and rehabilitative services. Information shall be provided regarding parental support groups and community educational resources. This information shall be made available, as is deemed appropriate under the circumstances, whether the county department has taken legal action or not. 7.203 PROGRAM AREA 6 - CHILDREN IN NEED OF SPECIALIZED SERVICES [Eff. 1/1/15]

The definition of Program Area 6 is located at Section 7.000.1, D (12 CCR 2509-1).

Specific groups and target groups that are included within Program Area 6 are shown below.

7.203.1 CHILD WITH ADOPTION ASSISTANCE OR RELATIVE GUARDIANSHIP

ASSISTANCE [Eff. 1/1/15]

Requirements for the Adoption Assistance Program and the Relative Guardianship Assistance Program were consolidated into their respective sections.

A. The Adoption Assistance Program is located in Section 7.306.4 (12 CCR 2509- 4).

B. Relative Guardianship Assistance is located in Section 7.311 (12 CCR 2509-4). 7.203.2 CHILD WITH MEDICAID ONLY SERVICES [Eff. 1/1/15] 7.203.21 Target Groups [Eff. 1/1/15]

A. Children in foster care who have been determined Title IV-E eligible and have moved into or out of Colorado.

B. Children for who an adoption assistance agreement is in effect and who have moved into or out of Colorado. See Section 7.306.4 (12 CCR 2509-4) for details regarding children with adoption assistance.

C. Children with a Title IV-E Relative Guardianship Assistance agreement with a payment in effect and who have moved into or outside of Colorado.

D. Children eligible for Home and Community Based Services or Home Health Care Services as defined in Section 8.500 of the Department of Health Care Policy and Financing's Medical Assistance rules (10 CCR 2505-10). Children enrolled in the Home and Community Based-Developmentally Disabled Waiver Program administered through Community Centered Boards and the Department of Human Services, Developmental Disabilities. 7.203.22 Intake/Assessment [Eff. 1/1/15]

For children and youth moving to Colorado, the county department shall:

A. Verify from the Interstate Compact on the Placement of Children (ICPC) request from the sending state that the child or youth is eligible for IV-E foster care from the state of origin.

B. For adopted children and youth, include a copy of the Interstate Compact on Adoption and Medical Assistance (ICAMA) form and the adoption assistance agreement in the child's file or provide a copy of the Guardianship Assistance agreement.

C. Enter information about the child or youth into the state automated case management system and verify that a Medicaid card has been sent to the foster care provider, the adoptive parent, or the guardian.

D. Notify the foster care provider, the adoptive parent, or the guardian using the SS- 4 Form that the child or youth is eligible for Medicaid only services from Colorado. In addition, advise the provider to notify the county department if foster care is stopped by the originating state or of any change of address. In the case of an adopted child or youth, or those with a guardian, advise the adoptive parent or guardian to notify the county department and the state of origin of any change of address.

E. Verify annually from the state of origin that the child or youth is eligible for Medicaid. 7.203.23 Procedures for Children Eligible for Home and Community Based Services or Home Health Care Services [Eff. 1/1/15]

A. The county department shall open a case Home and Community Based when an application for Home and Community Based Services (HCBS) or Home Health Care Services is completed. The county department shall provide services as required in Section 8.500 of the Department of Health Care Policy and Financing's Medical Assistance rules (10 CCR 2505-10) for children in Home and Community Based Services or Home Health Care Services Programs.

B. The county department shall close the case on the state automated case management system no later than the end of the month following the month that the child begins to receive services from the case management agency unless the child remains eligible for services under Program Areas 4 or 5.

7.203.3 CHILDREN WHOSE DISPOSITION IS NO LONGER REUNIFICATION

WITH FAMILY [Eff. 1/1/15]

The target group includes children for whom all efforts at reunification with the family are exhausted. The parent-child legal relationship may or may not be terminated. 7.203.31 Eligibility [Eff. 1/1/15]

A. A child shall be eligible for services in this target group only if he/she has prior eligibility in another target group and has a permanent plan other than reunification.

B. Children in this target group shall receive services as addressed in the placement services, relative guardianship, legal guardianship, relinquishment, independent living, and adoption sections of these rules. Contact requirements for these children shall be in accordance with Section 7.001.6 (12 CCR 2509-1). These contacts shall be documented in the state automated case management system. 7.203.32 County Department Procedures [Eff. 1/1/15]

A. The county department shall document in the case file all efforts at reunification for the children in this target group.

B. The county department shall ensure that the Family Services Plan contains a plan for permanent placement with a relative, adoption, relative guardianship or legal guardianship/permanent custody, or other planned permanent living arrangement, as appropriate (see Section 7.301.24, N; 12 CCR 2509-4 ).

C. When the permanent plan is not adoption the county department shall document in the case file why adoption is not appropriate.

7.203.4 FOSTER YOUTH IN TRANSITION PROGRAM

The Foster Youth in Transition Program provides developmentally appropriate, voluntary services to eligible youth and shall be available to all eligible youth. Services shall be offered using a housing first strategy to provide housing solutions to participating youth who are experiencing, or are at imminent risk of, homelessness. 7.203.41 Eligibility An eligible youth is an individual who:

A. Is at least eighteen but less than twenty-one years of age or such greater age of foster care eligibility as required by federal law;

B. Has a current dependency and neglect case pursuant to Article 3 of Title 19, C.R.S. or has had prior foster care or kinship care involvement in at least one of the following ways:

1. The youth was in foster care, as defined in 19-1-103, C.R.S., on or after the youth's sixteenth birthday; or 2. The youth was in non-certified kinship care, as defined in 19-1-103, C.R.S., on or after the youth's sixteenth birthday and was adjudicated dependent and neglected pursuant to Article 3 of Title 19, C.R.S; or 3. The youth turned eighteen years of age when the youth was a named child or youth in a dependency and neglect case open through Article 3 of Title 19, C.R.S.

C. Are engaged in, or intends to engage in, at least one of the following, unless an exception applies or are waived by federal law:

1. Completing secondary education or an educational program leading to an equivalent credential;

2. Attending an institution that provides post secondary or vocational education;

3. Working part- or full-time for at least eighty hours per month; or 4. Participating in a program or activity designed to promote employment or remove barriers to employment.

5. The requirement described in 7.203.41(C) does not apply to a youth who is incapable of engaging in any of the activities as a result of a medical condition that is supported by regularly updated documentation in the 90 day supervisory review; and D. Seeks to enter into a voluntary services agreement, or the youth has entered into and is substantially fulfilling the youth's obligations pursuant to a voluntary services agreement with the appropriate county department. 7.203.42 Eligibility determinations, appeals, and notifications upon receipt of a referral for services through the Foster Youth in Transition Program the county shall:

A. Determine if the youth is eligible for the Foster Youth in Transition Program within three (3) business days;

1. If the youth is eligible:

a. Within three (3) business days of referral, provide the youth:

i. Notice of eligibility;

ii. A description of the program, including the voluntary nature, services available, and ongoing eligibility requirements; and iii. A copy of the voluntary services agreement.

b. Within three (3) business days of a youth opting into the Foster Youth in Transition Program:

i. Execute a voluntary services agreement in collaboration with the youth and provide them with a copy; and then ii. Provide written notice to the office of the child’s representative that the youth has entered into a voluntary services agreement in the Foster Youth in Transition Program.

c. When a youth enters into a voluntary services agreement, a case shall be opened through program area 6.

d. If an eligible youth does not opt in, the county shall close the referral within 30 days of receipt of the referral.

2. If the county determines the youth is not eligible, the county shall notify the youth within three (3) business days of receiving the referral:

a. That they are not eligible and the reasons for that determination in developmentally appropriate language;

b. Contact information for the office of the child’s representative; and c. A written description of their right to appeal and contact information for the individual or unit assigned to hear appeals at the state department.

3. The state department shall be authorized to hear eligibility appeals and make a final determination of eligibility based on information available in the comprehensive child welfare information system and juvenile court records within three (3) business days of receiving the request for appeal.

The state department shall provide the youth and their counsel an opportunity to explain why they believe they are eligible for the program prior to making a final determination. Final determinations of eligibility made by the state department are final agency decisions and subject to judicial review. The state department shall make the appeal policy available to the public. 7.203.43 Foster Youth in Transition Program services and procedures A. Procedures 1. When a youth enters the Foster Youth in Transition Program the program area is program area 6.

2. The participating youth shall have a new case opened in the child welfare information system as follows:

a. The new case shall be opened effective either:

i. The day the youth and county execute the voluntary services agreement if a youth is reentering; or ii. The day the court terminates any existing custody order, in either a dependency and neglect case or a juvenile delinquency case, if the youth is transitioning from an open program area 4 or 5 child welfare case; and b. Prior to opening a new case or creating a new client ID, the caseworker or supervisor shall complete a search in the comprehensive child welfare information system for any existing open cases or clients and ensure that only one program area 4 or 5 case is open that includes the youth as participating as a child; and c. For youth entering the program directly from an open case under program area 4, 5, or 6, there shall be no resulting interruption in case management services, housing, Medicaid coverage, or in foster care maintenance payments.

3. The county department shall ensure the family services plan contains an updated roadmap to success as described in 7.305.2 (12 CCR 2509-04).

The family services plan in Foster Youth in Transition Program cases does not require a treatment plan or family time sections for the youth’s parents or caregivers. Updates to the family services plan shall be entered into the comprehensive child welfare information system within sixty (60) days of the youth entering into a voluntary services agreement. The youth shall be provided a copy of the family services plan.

4. When a youth is entering the Foster Youth in Transition Program directly from another Program Area 4, 5, or 6 case, the youth shall be given the option to continue with the county who is currently serving the youth, or transition to the county in which the youth self-attests to residing in at the time the youth enters the foster youth in transition program.

5. When the youth’s residence has changed after jurisdiction has been established, county departments shall work cooperatively to:

a. Ensure services are provided by the appropriate county;

b. Petitions are filed in the court of the appropriate county;

c. Take into consideration the youth’s preference. If the youth does not have a preference, then the county shall consider the following, in no particular order or prioritization:

i. Which county is currently working with the youth;

ii. The county in which the youth self-attests to reside;

iii. Indications the youth intends to stay in the self- attested county;

iv. Access to services, supports, and/or relationships the youth needs in order to successfully transition to adulthood.

B. Services Each county department shall offer, at a minimum, the following services and supports to participating youth in the transition program. All services shall be provided by the county in a manner that is consistent with the youth’s developmental needs, culture, and supports the youths successful transition to adulthood.

1. Assistance with enrolling in the appropriate category of Medicaid for which the participating youth is eligible;

2. Assistance with securing safe, affordable, and stable housing in the following ways:

a. The participating youth's living expenses are fully or partially funded through foster care maintenance payments, in addition to any other housing assistance the youth is eligible to receive. Any expectations for the youth to contribute to the youth's own expenses must be based upon the youth's ability to pay.

b. With the participating youth's consent, the participating youth's housing may be in any placement approved by the county department or the court for which the participating youth is otherwise eligible, including a licensed host family home, as defined in Section 26-5.7-102 (3.5), C.R.S. or a supervised independent living placement, and that is the least restrictive option to meet the participating youth's needs; or c. If the participating youth needs placement in a qualified residential treatment program, then such placement must follow all relevant procedures pursuant to section 19-1-115, C.R.S., concerning the placement of a child or youth in a qualified residential treatment program.

3. Case management services, including the development of a case plan with a roadmap to success for the participating youth, as well as assistance in the following areas, as appropriate, and with the agreement of the participating youth:

a. Provision of appropriate community resources and public benefits to assist the participating youth in the transition to adulthood as documented by the roadmap to success;

b. Obtaining employment or other financial support and enhancing financial literacy;

c. Obtaining a driver's license or other government-issued identification card;

4. Upon request, and if services are available, support the youth with complying with any juvenile or criminal justice system requirements which may include referrals to assist with expunging the participating youth's court records, as appropriate, pursuant to section 19-1-306, C.R.S.;

5. Pursuing educational goals and applying for financial aid, if necessary;

6. Upon request, and if services are available, referral to services for obtaining the necessary state court findings and applying for special immigrant juvenile status pursuant to federal law, as applicable, or applying for other immigration relief for which the participating youth may be qualified;

7. Obtaining copies of health and education records;

8. Maintaining and building relationships with individuals who are important to the participating youth, including searching for individuals with whom the participating youth has lost contact. These services may be offered using family search and engagement as described in 7.304.52 (12 CCR 2509-04); and 9. Accessing information about maternal and paternal relatives, including any siblings.

C. Court procedures when youth transition from a Program Area 4 or 5 case into the Foster Youth in Transition Program 1. For a youth approaching their 18th birthday who is currently in foster care, or who is in non-certified kinship care and there is an open dependency and neglect case, the county shall partner with the youth to support the youth in making informed decisions about what the youth needs to emancipate successfully and whether to enter the Foster Youth in Transition Program. The county shall partner with the youth in preparing for the transition hearing described below:

a. The county shall request that a transition hearing be held within 35 days of the youth’s 18th birthday pursuant to 19-3-705, C.R.S.

b. At least seven (7) days prior to the transition hearing the county shall submit a report to the court that includes:

i. A description of the county’s reasonable efforts toward achieving the youth’s permanency goals and a successful transition to adulthood;

ii. An affirmation that the county has provided the youth with all of the records and documents the youth needs to successfully transition to adulthood, including the documents required by 7.305.5, written information concerning the youth’s family history, and contact information for siblings if available and appropriate;

iii. an affirmation that the county has informed the youth, in a developmentally appropriate manner, of the benefits and options available to the youth by the Foster Youth in Transition Program as described in 7.203.4 (12 CCR 2509-3) and the voluntary nature of the program;

iv. A statement of whether the youth has made a preliminary decision whether to emancipate or to enter into the Foster Youth in Transition Program and either or both of the following:

A. If it is anticipated that the youth will choose to emancipate, the report must include a copy of the youth’s emancipation transition plan as described in 7.305.2(F);

B. If it is anticipated that the youth will choose to enter the Foster Youth in Transition Program, the county shall file a petition pursuant to 19-7-307 at the same time as the report described in this section.

D. Permanency planning requirements described in 7.304.54 (12 CCR 2509-4) are required in all Foster Youth in Transition cases.

7.204 CASE CONTACT REQUIREMENTS

The primary purposes for case contacts shall be to assure child safety and well-being and move the case toward achieving identified treatment goals and permanency regardless of the reason the case is open.

For Program Areas 4, 5, and 6, and in cases in which child(ren)/youth remain in the home or are placed out of the home, the county department shall have face-to-face and telephone contact with the child(ren)/youth, parents, and relevant collateral contacts as often as needed to assure the safety, permanency and well-being of the child(ren)/youth while maintaining at least the minimum expectations outlined below.

A face-to-face contact is defined as an in-person contact for the purpose of observation, conversation, intervention or interview about substantive case issues, such as safety, risk and needs assessment, family service planning that may help to reduce future risk of abuse and neglect and to promote case progress and permanency.

If the governor declares a disaster and/or emergency, video conferencing technology may be used if, due to the emergency or disaster, the worker could not or should not make contact. This should be documented in the case management system and only done under limited circumstances related to the disaster and/or emergency declaration.

A. Child(ren)/youth:

1. Frequency: a face-to-face contact is required every month with child(ren)/youth in program areas 4, 5, and 6 in both in-home and out-ofhome cases. When child(ren)/youth are designated as runaways, they are still included in the population of child(ren)/youth for whom the case contact requirements apply.

2. Additional requirements: a portion of every face-to-face contact with the child(ren)/youth shall occur outside the presence of the provider/caregiver.

At least every other month, contact shall occur where the child(ren)/youth resides and shall include visual assessment of the child(ren)/youth’s living environment.

3. Additional requirements for out-of-home: two face-to-face visits with the child(ren)/youth shall occur in the first 30-days following an out-of-home placement. At least one of the visits shall occur where the child(ren)/youth reside.

4. Documentation:

a. The caseworker completing the visit shall record all contacts in the Comprehensive Child Welfare Information System(CCWIS).

b. If the caseworker is unable to make direct contact, contact may be made by an out-of-county caseworker identified as a certified caseworker.

c. If the child(ren)/youth is residing out of state, contact may be made by an out-of-state (ICPC) caseworker. Monthly visits are required even if the receiving state ordinarily conducts less than monthly visits for children in that state.

5. Who can make contact:

a. The primary caseworker, that caseworker’s supervisor, or the certified caseworker or that caseworker’s supervisor must make contact.

b. The caseworker who visits the child(ren)/youth must have working knowledge of the case.

c. The certified caseworker is an individual assigned responsibility for visiting the child(ren)/youth. The certified caseworker may be a caseworker employed by the county department or another county department; a caseworker or contract caseworker in another state; or a professional within the state who meets the qualifications listed at section 7.602 and training listed at section 7.603.1. C, D, AND E (12 CCR 2509).

d. The certified caseworker must not have specific supervision responsibilities for the private placement facility where the child(ren)/youth is placed, nor shall the certified caseworker be an employee of the placement facility where the child(ren)/youth is placed. The name and role of the certified caseworker assigned responsibility for visiting the child(ren)/youth shall be recorded in the assigned screen of the CCWIS.

e. If the governor declares a disaster and/or emergency and if neither the caseworker, certified caseworker, or supervisor are able to make face-to-face contact, another county caseworker may make contact. If, due to the emergency or disaster, the caseworker could not or should not make contact, even through video conferencing, if allowed, this should be documented in the CCWIS and only done under limited circumstances related to the disaster and/or emergency declaration.

6. Interstate compact on the placement of child(ren)/youth (ICPC): for cases governed by the ICPC, the assigned or contracted caseworker in the state where the child(ren)/youth is placed may be the caseworker. A written quarterly report on the contact must be requested by the Colorado caseworker or custodial agency. The Colorado caseworker or custodial agency assigned to the case shall document the caseworker’s visits in the comprehensive child welfare information system (CCWIS).

7. Other groups:

a. Finalized subsidized adoption services: contact must occur every three (3) years through face-to-face, real-time video resources, telephone, electronic mail or mail.

B. Parent(s)/guardian(s):

For program areas 4, 5, and 6 in both in-home and out of home cases, the primary purposes for contacts with parent(s)/guardian(s) are to assess the ability of the parent(s) to provide safely for the child(ren)/youth and make progress toward family service plan goals. There are no minimum contact expectations if a youth is participating in the foster youth in transition program.

1. Frequency: a face-to-face contact is required every calendar month with parent(s)/guardian(s) of the child(ren)/youth.

2. Exceptions: the exceptions to calendar month face-to-face contact with parents are as follows:

a. When the parent/guardian, as determined by the county, does not reside in the state;

b. When the parent/guardian is currently incarcerated and sentenced to incarceration for two or more years during the life of the case.

Monthly face-to face contact shall resume once a parent is released to a community setting or a parent's remaining time to be served falls below two years;

c. When the parent/guardian’s whereabouts are not known despite efforts to locate the parent/guardian. Such efforts must be documented monthly in the CCWIS;

d. The parent indicated and it is documented in the CCWIS that they do not want to be involved in the child(ren)/youth’s life and the worker’s face-to-face contact with the parent/guardian is not in the child(ren)/youth’s best interest as determined by the court;

e. Termination of parental rights/relinquishment is ordered.

f. If the court determines no further engagement is necessary, then continued monthly efforts to contact and document are no longer required. These orders must be entered at a minimum in the next 90-day review.

3. Engagement: monthly engagement must occur with all parents/guardians regardless of ability or requirement to have face-to-face contact, unless termination of parental rights has occurred, regardless of the status of appeal. This may include monthly efforts to engage through telephone calls, letters, or electronic communication.

4. Documentation: all case contacts with parent(s)/guardian(s) by the county department must be recorded in the CCWIS, and must reflect how the

purpose of the visit was accomplished.

a. Unable to complete: if the minimum case contacts are not able to be completed by the county in any given month, the county shall document those reasons in the CCWIS including the case circumstances, why the contact is not possible, and how the county department will monitor progress. If the court determines no further engagement is necessary then continued monthly efforts to contact and document is no longer required.

5. Who can make contact:

a. Contacts must be completed by someone who has working knowledge of the case and is employed or contracted with a county department of human/social services, or a service provider contracted through a county department of human/social services who has full responsibility for case planning and case management (for example, fully or partially privatized child welfare systems where full case management responsibilities are delegated to contract agencies).

b. If the parent(s)/guardian(s) reside on tribal land, the county department of human/social services shall coordinate and collaborate with the tribal agency to determine how contact with parent(s)/guardian(s) will occur.

C. Intended permanent caregiver(s):

The primary purposes for contacts with intended permanent caregiver(s) are to assess the ability of the intended permanent caregiver(s) to provide safely for the child(ren)/youth and make progress toward family service plan goals. The intended permanent caregiver(s) is determined and documented by the county department of human/social services in the CCWIS.

1. Frequency: a face-to-face contact is required every calendar month with intended permanent caregiver(s) of the child(ren)/youth.

2. Exception: calendar month face-to-face contact is not required with the intended permanent caregiver(s) when the intended permanent caregiver(s) resides out of the state.

3. Engagement: monthly engagement must occur with all intended permanent caregiver(s) regardless of ability or requirement to have faceto-face contact. This may include monthly efforts to engage through telephone calls, letters, or electronic communication.

4. Documentation: all case contacts with intended permanent caregiver(s) by the county department must be recorded in the CCWIS, and must reflect how the purpose of the visit was accomplished.

a. Unable to complete: if the minimum case contacts are not able to be completed by the county in any given month, the county shall document those reasons in the CCWIS including the case circumstances, why the direct contact is not possible, and how the county department will monitor progress.

5. Who can make contact:

a. Contacts must be completed by someone who has working knowledge of the case and is employed or contracted with a county department of human/social services, or a service provider contracted through a county department of human/social services who has full responsibility for case planning and case management (for example, fully or partially privatized child welfare systems where full case management responsibilities are delegated to contract agencies).

b. If the intended permanent caregiver(s) reside on tribal land, the county department of human/social services shall coordinate and collaborate with the tribal agency to determine how contact with intended permanent caregiver(s) will occur. 7.205 CASE CLOSURE [Eff. 1/1/15]

When there is no court jurisdiction and at least one of the following are met, services shall be terminated and the case shall be closed.

A.

1. Specific program eligibility criteria are not met.

2. Client no longer needs the service.

3. Client has died.

4. Services are completed.

5. The child reaches his/her 21st birthday.

B. The worker shall document the following in the case record:

1. Reason(s) for case closure.

2. A summary of services provided, which includes progress made toward stated goals.

3. A safety assessment at case closure for all program area 4 and 5 cases.

4. An emancipation transition plan for all youth who are eligible described in 7.305.2(F) (12 CCR 2509-04).

C. The county department shall close a case in the comprehensive child welfare information system no later than ninety (90) days after the last direct client contact. The county department shall assure the case is closed in the automated system as prescribed by the State.

D. The county department shall close a case in the comprehensive child welfare information system if there has been no direct client contact with the child and parents for ninety (90) calendar days despite the repeated efforts of the county department to maintain contact.

E. Exceptions to the ninety (90) calendar day limit may be necessary in cases where the county department has custody of the child. In such cases the county department shall document efforts to terminate county custody or document why such efforts are not in the best interest of the child. ______________________________________________________________________ Editor’s Notes

History Rules 7.202.62 A-F eff. 09/01/2007.

Rules 7.202.3-4; 7.202.51-52; 7.202.54-57 emer. rules eff. 08/01/2008.

Rules 7.202.3-4; 7.202.51-52; 7.202.54-57 eff. 10/01/2008.

Rule 7.202.55 eff. 11/01/2008.

Rules 7.202.3-4, 7.202.5, 7.202.53-54, 7.202.62 emer. rules eff. 11/07/2008.

Rules 7.202.3-4, 7.202.5, 7.202.53-54, 7.202.62 eff. 01/01/2009.

Rule 7.202.52 emer. rule eff. 01/01/2009.

Rules 7.202.52, 7.203.2-7.203.32 eff. 02/01/2009 Rules 7.203.1-4 eff. 02/01/2010.

Rules 7.202.61-62 eff. 06/01/2010.

Rules 7.202.4, 7.202.51.C, 7.202.57 D emer. rules eff. 12/03/2010.

Rules 7.200.1, 7.202.4, 7.202.51 C, 7.202.57 D, 7.202.604-607, 7.202.608 E eff. 03/02/2011.

Rules 7.203.2, 7.203.31-32 eff 04/01/2012.

Rules 7.202.4 E, 7.202.4 G eff. 07/01/2012.

Rules 7.202.75-7.202.8 emer. rules eff. 07/13/2012.

Rules 7.203.31, 7.203.42 emer. rules eff. 09/07/2012.

Rules 7.202.75-7.202.8 eff. 10/01/2012.

Rules 7.203.31, 7.203.42 eff. 12/01/2012.

Rules 7.202.1-7.202.532, 7.202.534-7.202.71, 7.202.72, 7.202.74-7.202.75 eff. 03/02/2013.

Rule 7.200.3 eff. 08/01/2013.

Rules 7.200-7.200.13 eff. 01/01/2014.

Entire rule eff. 01/01/2015.

Rule 7.200.12 eff. 09/01/2015.

Rules 7.201.1 D-E eff. 10/01/2016.

Rule 7.200.15 G eff. 12/01/2017.

Rule 7.205 B.3 eff. 12/01/2018.

Rules 7.201, 7.201.1, 7.204 D-E eff. 03/15/2019.

Rule 7.202.1 F eff. 04/01/2019.

Rules 7.202.1 F, 7.204, 7.204 B emer. rules eff. 05/08/2020.

Rules 7.202.1 F, 7.204, 7.204 B eff. 08/01/2020.

Rules 7.203.4, 7.203.41, 7.203.42 eff. 12/01/2020.

Rules 7.203.4, 7.203.41, 7.203.42, 7.203.43, 7.205 eff. 12/30/2021.

Rules 7.202.1 F, 7.204 eff. 04/30/2022.

Rules 7.203.41, 7.203.43 A.2.b, 7.203.43 A.4-5, 7.203.43 B.2, 7.203.43 D eff. 01/30/2023.

Rules 7.203.43 A.3 eff. 06/01/2024.

Rule 7.204 eff. 01/30/2026.

##### **12 CCR 2509-4** Child Welfare Services {#sec-12-ccr-2509-4 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-4}

DEPARTMENT OF HUMAN SERVICES

CHILD WELFARE SERVICES

12 CCR 2509-4 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 7.300 CHILD WELFARE SERVICES 7.300.1 FAMILY ENGAGEMENT [Eff. 5/1/12]

County departments of human/social services shall adopt family engagement practices. Family engagement means joining with the family/kin to establish common goals of safety, well-being, and permanency throughout the involvement and is inclusive of other systems. This is an overarching theme of practice throughout service assessment, planning, and delivery. Family engagement practice shall include, but not be limited to, family meetings, cultural responsiveness, and reflect the core principles below:

A. It focuses on the strengths and interests of the child, youth, and family.

B. It promotes family and youth choice through family and youth-driven decisions.

C. It actively supports that all families receive timely access to culturally responsive services they identify as necessary to safely care for their children and youth, and results in meaningful family involvement.

D. It supports relationship building and community participation.

E. It fosters mutual trust and respect between families, youth, agency, and stakeholders.

F. It values the support network and relationships of each individual.

G. Information sharing is open, honest, and clear.

H. It extends beyond the immediate family members to those identified by the family as a source of support and strength and who will serve beyond the involvement of the child welfare system to help sustain the reunification and/or ability to safely parent the children/youth.

7.301 ASSESSMENT AND FAMILY SERVICES PLANNING 7.301.1 ASSESSMENT [Eff. 1/15/15]

A. The Colorado Assessment Continuum (CAC) will be utilized throughout the case. The CAC includes the:

1. Safety assessment and plan, referenced in Section 7.107.1 and Section 7.107.16 (12 CCR 2509-2).

2. Risk assessment, referenced in Section 7.107.2 (12 CCF 2509-2).

B. Safety assessment and risk assessment are ongoing processes throughout the life of the case.

Safety and risk assessments, as defined in this manual, shall be completed for each Program Area 5 case accepted for assessment by the county department and shall be the basis for case planning. Each of these assessments shall be entered into the automated case management system in accordance with the timeframes referenced in Section 7.301.1, A, 1 and 2.

1. The family, including relatives with caretaking responsibilities for children in the household, shall be involved in all phases of assessment and case planning.

2. Assessment tools or resources available through community agencies shall be incorporated in the assessment, based on the culture, ethnicity and other needs of the 3. As a result of this assessment/evaluation, the caseworker and family shall identify the family’s current safety and risk, to include level of functioning, areas of strengths, specific areas of concern to be addressed, and changes that must occur to remedy the concerns that brought the family to the agency. This information shall be included in the Family Services Plan. 7.301.2 FAMILY SERVICES PLAN REQUIREMENTS [Eff. 09/1/07]

The county department shall complete the Family Services Plan document for each child/youth receiving services to assure that the child/youth's needs for safety, permanency, and well-being are met. The Family Services Plan shall incorporate the following principles:

A. A child/youth’s safety is paramount;

B. Children/youth belong in families;

C. Families need the support of communities; and, D. Community partners are key to achieving strong outcomes for children/youth and families. 7.301.21 Family Services Plan Timing Requirements The Family Service Plan document must be completed:

A. The Family Service Plan document must be completed within sixty (60) calendar days of the referral date in the automated case management system for children/youth. Discrete sections in the treatment/prevention plan are required for each child/youth participating as a child/youth, parent, provider and kin.

B. For youth fourteen (14) years of age and over in out-of-home placement, the Roadmap to Success, a plan for each youth to make a successful transition to adulthood, shall be completed within:

1. Sixty (60) calendar days of the youth reaching their fourteenth (14th) birthday; or 2. Sixty (60) calendar days of the youth entering out of home placement. 7.301.22 Family Service Plan Participants A. The county shall assure that the following parties participate in the development of the Family Services Plan and engagement activities, except in Foster Youth in Transition cases in which the youth and caseworker are the only required parties:

1. Caseworker;

2. Parent(s) or legal guardians;

3. Child/youth;

4. Immediate and extended family members as appropriate to the service needs of the family, child, and youth; and, 5. Service providers, including kin caregivers, out-of-home caregivers, and in-home providers.

B. In addition to all parties being encouraged to sign the plan, all parties shall be engaged in activities that indicate involvement in service planning, including, but not limited to:

1. Family engagement meetings; or, 2. Ongoing contacts could include, but are not limited to, face-to-face, family-time visitation, email, texts, technology with face-to-face capacity, emerging technology, or signatures on the Family Services Plan.

3. If a child/youth’s parent is incarcerated, the county department shall, upon knowledge of the incarceration and when the parent is expected to be incarcerated beyond thirty-fine (35) days from the Dependency and Neglect Dispositional court hearing, coordinate and facilitate available services with the Family Services Coordinator or other designated communications liaison of the facility where the parent is incarcerated.

C. Activities shall be documented in the State Department’s automated system and may be located in the record of contact notes, the framework field, ninety (90) day reviews, and progress reports to the court. Documentation shall reflect the various ways in which attempts were made to engage parents, child/youth, and providers. 7.301.23 Family Service Plan Documentation The treatment/prevention plan in the Family Services Plan shall document:

A. That services to be provided are directed at the areas of need identified in the assessment.

Outcomes to be achieved as a result of the services provided will be described in terms of specific, measurable, agreed upon, realistic, time-limited objectives and action steps to be accomplished by the parents, child/youth, service providers and county staff. For youth in foster youth in transition cases, the roadmap to success fulfills this requirement, as provided in 7.203.4 (12 CCR 2509-3).

B. That placement prevention strategies for the child/youth allow the child/youth to remain safely at home or with kin.

C. That services to be provided are designed to assure that the child/youth receives safe and proper care.

D. That services to be provided are culturally and ethnically appropriate and trauma-informed.

Appropriate cultural or ethnic considerations should include, but are not limited to, consideration of the child/youth's family, community, neighborhood, faith or religious beliefs, school activities, friends, and the child/youth's and family's primary language. 7.301.231 Integration of Safety and Risk Requirements [Rev. eff. 1/1/15]

Integration of safety and risk requirements into the case plan in the family services plan shall be accomplished in the following ways:

A. Safety and risk assessments completed in the assessment portion of the automated case management system shall automatically become a part of the case, when a case is opened.

B. Current or impending danger identified on the safety assessment will be the basis for developing treatment/prevention plan objectives.

C. Risk factors identified during a thorough and balanced assessment shall be considered in the treatment/prevention plans. 7.301.24 Family Service Plan Out-of-Home Placement Documentation For child(ren)/youth in out-of-home placement, the Family Services Plan documents:

A. The child/youth meets all of the out-of-home placement criteria listed in Section 7.304.3.

B. When the child/youth is part of a sibling group and the sibling group is being placed out of the home, it shall be presumed that placement of the entire sibling group in the joint placement is in the best interests of the children/youth in order to sustain family relationships. Such presumption may be rebutted by the county by a preponderance of the evidence that placement of the entire sibling group in the joint placement is not in the best interests of a child/youth or of the children/youth. The county shall make reasonable and continued efforts to locate a joint placement for all of the children/youth in the sibling group unless:

(1) it is not in the best interests of the children/youth to be placed as a group as determined by the county in consultation with the family, youth, and GAL /Counsel for youth (CFY) when possible, and (2) these efforts unreasonably delay permanency for any child/youth.

These efforts depend upon the county’s ability to locate an appropriate, capable, willing, and available joint placement for all of the children/youth in the sibling group. As soon as practicable after making a decision affecting sibling placement, the county department shall notify the GAL(s) and/or counsel for youth appointed to the case. Efforts to place siblings as a group shall be documented in the Colorado child welfare information system (CCWIS).

C. The problems to be resolved in order to facilitate reunification of the child/youth and family, and to safely maintain the child/youth in the home.

D. A description of the type of facility in which the child/youth is placed and the reason(s) the placement is appropriate and safe for the child/youth.

E. A description of the county’s efforts to place the child/youth in reasonable proximity to the home of the parents and to the “school of origin” as defined in § 22-32-138(g), C.R.S. For a child/youth placed a substantial distance from the home of the parent(s), from his or her “school of origin,” or in out-of-state placement, the county shall document how the placement meets the best interests of the child/youth, including how the county took into account proximity to parents and school in making its placement decision (see sections 7.304.54, J and 7.301.241).

F. A summary of efforts to ensure educational stability as outlined in Section 7.301.241.

G. That the placement is the least restrictive, safe, and most appropriate setting available consistent with the best interests and specific needs of the child. This includes documentation of initial and on-going efforts to place the child/youth with kin.

If the child/youth is moved to a more restrictive placement after the initial placement, the Family Services Plan documents how the more restrictive placement meets the child/youth's needs.

H. Health and educational information shall be documented in the State Department’s automated system and updated at the time of each case review, including addresses and other contact information about the child/youth’s current:

1. Education providers, including school, school district, and Board of Cooperative Education Services (BOCES) contacts who assist in the coordination of enrollment and services, and the child/youth’s academic progress.

2. Health care providers and the status of health care information.

I. Specific plans for how the county will carry out any court determinations or orders concerning the child/youth.

J. A description of the services and resources needed by the foster parents or kinship providers to meet the needs of the child/youth and how those services and resources will be provided.

K. family time requirements for the purposes of preserving and strengthening family ties in the most home-like environment and to promote cultural connections whenever possible.

The county department shall encourage the maximum parent, child, and sibling contact possible, including regular family time and participation by the parents in the care of the child or youth, when it is in the best interest of the child or youth. At a minimum, the family time plan shall address the following:

1. frequency, length (duration), location.

2. persons who may be present;

3. if family time must be supervised, and who will provide that supervision;

4. if informal resources are available and appropriate for transportation and supervision.

These resources must not compromise the child’s or youth’s mental, emotional, or physical health or safety.

5. the child’s or youth’s additional opportunities to communicate with a parent, sibling, or other relative.

L. For child(ren) under the age of fourteen (14), a description of services and a plan for accomplishing tasks to prepare child(ren) to be age appropriately self-sufficient, when independent living services are provided.

M. For youth aged fourteen (14) and older, a roadmap to success as early in placement as possible but no later than sixty (60) calendar days after the youth's fourteenth (14th) birthday.

N. Reasonable efforts have been made to maintain the child/youth in the home, or prevent or eliminate the need for removal of the child/youth from the home, or make it possible for the child/youth to return to the home; or when applicable, documentation of the circumstances that exist in which reasonable efforts to prevent removal or reunite the child and the family are not required (see Section 7.304.53, B, 3).

O. The specified permanency goal for the child/youth shall be based on the individual needs and best interests of the child/youth. Permanency goals shall include one of the following:

• Remain home;

• Return home;

• Permanent placement with a relative through adoption;

• Permanent placement with a relative through legal guardianship or permanent custody;

• Adoption (non-relative);

• Legal guardianship/permanent custody (non-relative);

• Return home through reinstatement of parental rights;

• Other planned permanent living arrangement through emancipation;

• Other planned permanent living arrangement through relative long term foster care;

• Other planned permanent living arrangement through non-relative long term foster care.

Permanency goals shall include the projected date (month, day, and year) by which the goal is to be accomplished for each child/youth receiving services.

1. The initial permanency goal for the child/youth is to return home with the following exceptions:

a. Children/youth whose parents are both deceased or have both voluntarily relinquished custody;

b. Children/youth whose parents cannot be located after family search and engagement activities, which shall begin no later than three working days following placement and shall not exceed three months;

c. Children/youth whose parents have been guilty of repeated and/or severe abuse or neglect of the child/youth or the child/youth's siblings such that termination of parental rights of both parents is appropriate;

d. Children/youth for whom it appears, after investigation, that a safe return home will not be possible even with the provision of reasonable efforts; or, e. Youth who are participating in the Foster Youth in Transition program.

2. After twelve months, the child/youth's caseworker and supervisor shall include written justification on the Family Services Plan for continuation of the goal of return home.

3. After eighteen months, the extraordinary circumstances which exist and the reasons which support the permanency goal of return home shall be documented in the Family Services Plan. Approval of the return home permanency goal by the caseworker, supervisor and county administrative review is documented in the case record.

4. In concurrent planning cases the alternate permanency goal shall be documented.

5. The permanency goal of other planned permanent living arrangement through emancipation shall only be used for youth ages sixteen to twenty-one.

6. For a child/youth who has been in foster care under the responsibility of the state for fifteen (15) of the last twenty-two (22) months, the county shall either file a motion for termination of parental rights no later than the end of the fifteenth (15th) month or document and submit to the court at the next review the compelling reason why it is in the child/youth's best interest not to terminate parental rights.

P. The steps the agency is taking to find an adoptive or other permanent living arrangement for a child/youth for whom the permanency plan is adoption or placement in another permanent home.

Q. The permanency goal for the child would be to remain home barring case circumstances that would indicate the need for an alternative permanency goal when a teen mother and her child are placed together in the same foster home and if a case is opened on the child. The county must see the child when visiting the teen mother in the foster home.

R. Requirements for use of Other Planned Permanent Living Arrangement goals as follows:

1. The county department may consider Other Planned Permanent Living Arrangement (OPPLA) as a permanency goal:

For youth who are sixteen (16) years of age or over and are demonstrating exceptional circumstances that prevent the youth from returning home, adoption, legal guardianship or permanent custody.

2. The goal shall be reviewed through the use of a family engagement meeting or equivalent team that reviews permanency needs. All of the following shall be submitted to and considered by the review team, and the recommendation shall be submitted to the court.

a. Documentation pertaining to the completion of an intensive and ongoing examination of kin and permanent connections. This process shall also address:

1) A comprehensive assessment of the youth's strengths and needs. In addition to updating the assessment of the youth's strengths and needs, the updated assessment or staffing shall address the youth's capacity to live within a family setting.

2) This review team shall also consider the youth’s desired permanency outcome.

b. A detailed description of efforts made to achieve permanency through the other goals and identification of the barriers to achieve them.

c. A detailed description of how OPPLA is in the best interest of the youth.

3. The following is to be documented and made available to the court at each court review.

a. Documentation of the barriers to permanency to date and compelling reasons why the other permanency goals are not attainable.

b. Documentation of the youth’s desired permanency outcome including giving the youth an opportunity to attend each hearing to voice his/her desired goal.

c. Documentation of intensive, ongoing, and as of the date of the hearing, unsuccessful efforts to return the youth home or secure a placement for the youth with a fit and willing relative (including adult siblings), a legal guardian, or an adoptive parent, including thorough efforts that utilize technology (including social media) to find biological family members for the youth.

d. Documentation of the steps taken to ensure that youth are being supported inengaging in age or developmentally appropriate activities and social events including:

1) The youth’s foster family home or other placement is following the reasonable and prudent parent standard; and, 2) The youth has regular, ongoing opportunities to engage in age or developmentally appropriate activities (including consulting with the youth in an age-appropriate manner about the opportunities of the youth to participate in the activities).

4. Documentation which includes the review team's reasons for approving Other Planned Permanent Living Arrangement (OPPLA) shall also be entered in the Family Service Plan as directed by the Division of Child Welfare.

5. The use of this goal shall be reviewed by a family engagement or equivalent review team at a minimum of every six (6) months. The county shall request that the court review the case every twelve (12) months to determine if the youth is demonstrating exceptional circumstances that prevent the youth from returning home, adoption, legal guardianship or permanent custody.

6. If this goal is not achieved through relative care, a family-like network of significant people shall be developed to provide the youth with a sense of belonging and with support expected to endure over a lifetime.

7. Youth who have an open case through the Foster Youth in Transition Program are presumed to meet the above requirements for a goal of other permanent planned living arrangement through emancipation. The goal shall be reviewed by the court on an annual

basis pursuant to 19-7-311, C.R.S.

S. Reinstatement of Parental Rights 1. The county department of human or social services may explore the use of reinstatement of parental rights as a permanency option for:

a. Children twelve (12) years of age and older, or child(ren) younger than twelve (12) years of age if they are part of a sibling group where at least one of the child(ren) or youth is twelve (12) or older and is pursuing reinstatement of parental rights; and, b. Child(ren) younger than twelve (12), if they are part of a sibling group where at least one of the child(ren) is twelve or older, and is pursuing reinstatement of parental rights; and, c. Child(ren) who currently do not have a legal parent; and, d. Child(ren) who currently are not in an adoptive placement and not likely to be adopted within a reasonable period of time; and, e Child(ren) who had all other permanency options exhausted; and, f. Cases when the termination of parental rights was ordered at least three-yearsprior or when it is determined by the court to be in the best interest of the child(ren) when termination occurred less than three years prior to the date of the petition for reinstatement is being filed with the court; and, g. Child(ren) and former parent(s) that consent to parental rights being reinstated;

h. Child(ren) where it is in their best interest, including the financial best interest, to have parental rights reinstated; and, i. Former parent(s) who have remedied the issues that led to the termination and those issues did not involve founded allegations of sexual abuse or an incident of egregious abuse or neglect against a child, a near fatality, or a suspicious fatality;

j. The child is in the legal custody of a county department.

2. A county department of human or social services that identifies reinstatement as a permanency option shall complete an assessment of the former parent(s). Completion of the assessment and the results of the assessment will be documented in the statewide case management system. The assessment shall include all of the following:

a. Completing the Colorado family risk assessment tool, which must include a visit and inspection of the former parent’s home;

b. Reviewing the reasons for the termination of parental rights and determining if the concerns identified have been remedied and do not currently exist or present a safety concern;

c. Conducting the following background checks on the former parent(s) and any other adults eighteen (18) years of age or older in their home and share the results with all parties to the case:

1) Child abuse/and/or neglect records check in every state where any adult residing in the home has lived in the five years preceding the filing of the petition for reinstatement;

2) Fingerprint-based criminal history checks from the Colorado Bureau of Investigation (CBI), or other state background check if the parent lives in another state, and the Federal Bureau of Investigation (FBI);

3) Review the state Judicial Department’s case management system and include in the case record; and, 4) Review the CBI sex offender registry and the national sex offender public website operated by the United States Department of Justice for:

a) Known names and addresses of each adult residing in the home;

b) Address only of the home.

3. A safety assessment shall be completed.

4. Upon the decision to pursue reinstatement of parental rights; only the county department, guardian ad litem, or a child twelve (12) years of age or older may file the petition for reinstatement.

a. The petition for reinstatement of parental rights should be filed in the county that has custody of the child(ren) through the dependency and neglect court case.

b. The petition shall be filed in the dependency and neglect court case where the termination of parental rights occurred for the former parent(s) or in the event that the current open dependency and neglect case is a termination of the adoptive parent’s rights, then the petition shall be filed in that court case, as it grants custody of the child(ren) to the county.

c. If the county is contacted by a former parent inquiring about reinstatement, the county must notify the guardian ad litem (GAL) and child twelve (12) years of age or older within thirty (30) calendar days after the contact and provide them with the name and address of the former parent(s).

d. Once the court sets an initial hearing, the county shall develop and report to the court the following:

1) Whether the former parent(s) has remedied the conditions that led to the termination;

2) Based on the assessment of the former parent, including the outcome of the Colorado family risk assessment tool, the transition plan shall include support or treatment needed for the child(ren) and former parent(s) to help make the reinstatement a success;

3) Whether the former parent(s) can provide a safe and stable home for the child(ren);

4) A family time plan or temporary placement plan with the former parent(s) for up to a six-month trial period where custody remains with the department; this plan will be approved or modified at this initial hearing.

a) Updates about the family time, transition plan, and supports shall be provided at each review hearing and no later than thirty (30) calendar days prior to the expiration of the trial home period.

b) At any point the placement is deemed no longer safe or in the best interest of the child(ren), removal shall be in accordance with procedures outlined in Sections 19-3-401 and 19-3-403, C.R.S.

5) Whether the child(ren) will lose or gain any benefits or services (Medicaid, Chafee, etc.) as a result of the reinstatement being granted.

5. If the court grants the order, the county shall select reinstatement of parental rights as the closure reason, in the state automated case management system.

6. If the court denies the order the county department shall:

a. Arrange for immediate placement of the child(ren), if the child(ren) is still in the former parent’s home;

b. Set a permanency hearing to determine a new permanency goal and plan for the child(ren). 7.301.241 Education Requirements for Children/Youth in Out-of-Home Placement A. Documentation shall be entered into the state automated case management system to address compliance with all requirements in this section, 7.301.241, including designation of responsibilities.

B. County departments shall coordinate with the local public school, school district, the State Charter School Institute, and/or board of cooperative education services (collectively referred to as “education provider” for the purposes of this section) to ensure educational stability for each “student in out-of-home placement” as defined in § 22-32-138(1)(e) and (h), C.R.S. including those attending public pre-school. County departments shall notify “education providers” upon each school-aged child/youth entering or changing out-of-home placement, even if no school change is being considered.

C. Each placement of a child/youth shall take into account the appropriateness of the current educational setting and the proximity to the “school of origin” as defined in § 22-32-138(1)(g), C.R.S. See Section 7.301.24, E.

D. It is presumed to be in a child/youth’s best interest to remain in the “school of origin.” If transportation is necessary to maintain the child/youth in the “school of origin,” this shall be provided in accordance with section 7.301.241, E.

The county shall make a best interest determination prior to any school move resulting from a change in placements unless remaining in the “school of origin” poses a specific, documented threat to the child/youth’s safety. The best interest determination process is as follows:

1. The best interest discussion and determination shall occur as an in-person meeting when warranted and possible. When an in-person meeting is not warranted or not possible, or for participants unable to attend the meeting, the county department shall consult participants by other means, such as phone or email.

2. The county department shall invite the following people to participate in the best interest determination. If a participant is unavailable or cannot be located, the county shall document the various ways in which attempts were made to engage that participant.

a. Child/youth, b. Parents, For purposes of this subsection 7.301.241, the term “parents” includes a natural parent having sole or joint custody, regardless of whether the parent is designated as the primary residential custodian, or a parent allocated parental responsibilities with respect to a child, or an adoptive parent. Parent does not include a person whose parental rights have been terminated pursuant to the provisions of Title 19 of the Colorado Revised Statutes, the parent of an emancipated minor, or the parent of a youth participating in the Foster Youth in Transition program.

c. Caseworker or appropriate designee, d. Guardian ad litem and/or counsel for youth if one is appointed, e. Representative from the “school of origin” who knows the child/youth, as determined by the “education provider,”

f. Educational surrogate parent, if any, and g. Others as relevant and appropriate as determined by the county, which may include but are not limited to future caregiver, court appointed special advocate (CASA), current caregiver, representatives from potential new school, support person for the child/youth.

3. Best interest determination meetings may be incorporated into family engagement meetings. The county department shall protect the family’s confidentiality by including school personnel only in the portion of the meeting regarding the child/youth’s educational needs, unless members consent to their ongoing participation in the meeting.

4. The best interest determination shall address whether it is in the child/youth’s best interests to either:

a. Remain in the same school, or b. Attend another appropriate school.

The potential new school(s) to consider may include any school in which the child/youth may enroll pursuant to state law and “education provider” policy, including but not limited to C.R.S. § 22-1-102 (defining residence of child), C.R.S. § 22-32-116 (defining exception to exclusion of non- residents), or C.R.S. § 22-20-107.5 (defining residence of child who receives special education). The county department need not consider every possible school; rather the county should identify which school or schools they are considering so the attributes of the specific schools can be considered.

If it is determined to be in the child/youth’s best interest to attend a new school, the best interest determination shall also include the date when the child/youth will change schools. The child/youth shall remain in the “school of origin” until this date. It is presumed to be in a child/youth’s best interest to be in the least restrictive environment and to transfer at natural transitions such as the beginning of the school year or academic term.

5. The county department shall make the best interest determination in collaboration with the “education provider” and other participants and in consideration of the following nonexhaustive factors, as relevant:

a. Child/youth’s wishes, b. Child/youth’s safety, c. How the “school of origin” can meet the child/youth’s academic and nonacademic needs (including special education, extra-curricular activities, social, emotional, and other needs). In considering the child/youth’s needs, the county department shall give special weight to whether the child/youth has a meaningful and appropriate relationship with an adult at the “school of origin,”

d. How the potential new school could meet the child/youth’s academic and nonacademic needs, including special education, extra-curricular activities, social, emotional, and other needs, e. How the decision impacts the child/youth’s permanency goal(s), and f. The length of travel and impact on the child/youth.

g. The cost of transportation is not a permissible consideration in determining the child/youth’s best interest.

6. If the county determines that it is not in a child/youth’s best interest to remain in the same school, the “education provider” shall immediately, on the date designated in the best interest determination, enroll the child/youth in a new school, even without records normally required for enrollment, pursuant to the Every Student Succeeds Act, 42 U.S.C. § 675(1)(G)(ii). In order to facilitate transfers at natural academic transitions whenever possible, “immediately” means the date designated in the best interest determination, not necessarily the date the determination is made.

7. The county department shall inform the CHILD/youth, parent(s), guardian ad litem and/or counsel for youth, and educational surrogate parent, if any, of the best interest determination within one business day of making the determination. The notification shall serve as the first day in the dispute resolution time frames described in section 7.301.24, D, 8.

a. Parents of a youth participating in the Foster Youth in transition program are not required to be notified.

8. Disputes regarding best interest determinations shall be handled in a manner that promotes the child/youth’s safety and stability, as follows:

If the parent(s), guardian ad litem, child/youth twelve (12) years of age or older, and/or educational surrogate parent, if any, is a party to an accompanying court case and disagrees with the county department’s best interest determination, he or she must file a motion with the juvenile court to seek judicial resolution. Such a motion must be filed within three business days of the notice of the county’s determination. If the county receives such a motion, the child/youth shall remain in the “school of origin” pending dispute resolution, unless remaining in the school poses a specific, documented threat to the child/youth’s safety. If such parties indicate their agreement to a school move, the county need not delay the move pending the three-day appeal period.

E. County departments and “education providers” shall collaborate to ensure that children in foster care needing transportation to the “school of origin” will promptly receive transportation in a costeffective manner. County departments and “education providers” shall collaborate to develop systems-level transportation plans, including how transportation will be provided, arranged, and funded for the duration of time the child/youth is in out-of-home placement and, if accepted by the family, the remainder of the academic term during which a child/youth exits out-of-home placement. Transportation plans may be developed at the local and/or regional levels.

F. County departments shall document efforts to ensure the child/youth meets the state compulsory attendance requirements.

G. Procedures for special education evaluations when children are in out-of-home care:

1. If a child/youth is suspected to have a disability affecting his or her education, the caseworker shall make a written referral for a special education evaluation to the designated representatives of the child/youth’s “education provider” of jurisdiction, which is the “education provider” where the child is a resident for educational purposes, before a non-emergency placement in a residential child care facility.

2. Upon any placement of a child/youth with a disability or suspected of having a disability into a residential child care facility, the caseworker shall make a verbal notification within five working days and a written notification within fifteen calendar days to the “education provider” of jurisdiction after the placement.

3. Educational costs of placements are not reimbursable to the county department until after notice of the placement is given to the “education provider” of jurisdiction.

4. If the special education evaluation results in a determination that the child/youth is disabled pursuant to section 504 of the Rehabilitation Act and/or the Individuals with Disabilities Education Act, which means that the child/youth qualifies for disability accommodations and/or special education services, the county and “education provider” of jurisdiction shall meet to determine if the educational needs of the child/youth can be met in the placement or the Core Services program.

5. If the child/youth is not eligible for disability accommodations and/or special education services, the county may be responsible for educational costs. 7.301.242 Procedures for Maintaining Education Records [Rev. eff. 4/1/12]

For children/youth in out-of-home placement, the county department shall maintain records within the case file and/or in the fields available in the education section of the automated system that include, but are not limited to, identification of:

A. School name and address at the time of removal from the home.

B. Current school name, address, and telephone number.

C. Grade or classroom designation.

D. Most recent end-of-term grades or other school district approved progress reporting method if grades are not issued.

E. Educational needs including, but not limited to, special education and summaries of the efforts of the county department to address the needs.

F. Educational plans based on individual needs, including an IEP.

G. Educationally based evaluations. 7.301.243 Early Intervention and Supports for Children Birth to Age of 3 in Out-of-Home Placement, Part C, of the Individuals with Disabilities Education Act (IDEA)

A. Documentation of referral, services, and planning shall be recorded in the education section of the automated system.

B. Infants and children under age 3 who may have delays in development or established conditions associated with a disability shall be referred to the local “Child Find” effort. The local “Child Find” may be the School District/Board of Cooperative Educational Services (BOCES), Early Childhood Connections (ECC) organization, or an appropriate community resource for assessment for the identification of needs that may impact the child’s development.

C. The county department shall participate with the school district and/or ECC; or community resource, family, and other pertinent individuals to develop a plan to address identified service and support needs and for transition planning.

7.301.244 COUNTY RESPONSIBILITIES WHEN A CHILD/YOUTH’S TREATMENT NEEDS ARE

MOST APPROPRIATELY MET IN A QUALIFIED RESIDENTIAL TREATMENT PROGRAM

(QRTP) LEVEL OF CARE.

When a child/youth who may need treatment is identified, the county department of human/social services (county department) shall review the child/youth’s treatment options through a county-specific review process. When the county department has custody and believes treatment in a QRTP is in the best interest of the child/youth, the county department shall make a referral for a Qualified Individual to complete an independent assessment. The county department shall hold a Family and Permanency Team Meeting within fourteen (14) calendar days of the acceptance of the referral. If after the county department has held the Family and Permanency Team Meeting and when the Qualified Individual indicates that treatment in a QRTP is warranted, the county department may admit the child/youth to a QRTP.

A. If a county department places a child/youth in a QRTP on an emergency basis, the county department shall make a referral for a Qualified Individual to complete an independent assessment within five (5) calendar days.

B. When a child/youth is in need of respite care, it shall be at the same level of current care or a lower level of care. If the county department wants a child/youth to be in respite care in a QRTP, the county department shall follow the requirements for making a referral for a Qualified Individual to complete an independent assessment.

C. The recommendation of the Qualified Individual shall be documented in the permanency plan of the state automated case management system.

D. The county department shall enter a corresponding record of contact (ROC) note with the following information from the Child and Adolescent Needs and Strengths (CANS) tool which is updated every ninety (90) days: what is the level of treatment recommended for the child/youth, are there any outstanding treatment needs that remain, and are there any notable changes since the last CANS tool was completed.

E. The Family and Permanency Team Meeting may be facilitated and shall be documented in the framework of the state automated case management system. The Family and Permanency Team Meeting shall invite the following attendees (when available):

1. Parents or Legal Guardians;

2. Relatives;

3. Kin;

4. Professionals who are a resource to the family of the child/youth;

5. The youth if age fourteen (14) or older;

6. If the child is age fourteen (14) or older, the team must also include the members of the permanency planning team for the child that are selected by the child in accordance with the Title IV-E case planning requirements (section 475a(c)(1)(B)(i) and (ii) of the family first prevention services act);

7. The Qualified Individual; and, 8. The Guardian ad Litem or Counsel for Youth.

9. If the child is under age fourteen (14) the county department shall consider the appropriateness of their participation in the Family and Permanency Team Meeting.

F. The county department shall share the independent assessment summary with all family participants at the Family and Permanency Team Meeting.

G. If the treatment recommendations made by the Qualified Individual at the time of the independent assessment are not available to the county department, this shall be documented in the state automated case management system and alternative treatment recommendations will be discussed at the Family and Permanency Team Meeting.

H. If the recommendations made by the Qualified Individual are not followed by the county department or are considered not appropriate at the time the independent assessment is completed, the county department shall provide a thorough explanation to support their decision.

I. Prior to release from a QRTP, the county department shall work with the QRTP provider to develop a plan for six (6) months of aftercare services to either be provided by the QRTP provider or by an identified community-based provider that will meet the individual needs of the child/youth and family.

7.301.245 COUNTY RESPONSIBILITIES WHEN A CHILD/YOUTH IS REACHING THEIR

LIFETIME LIMIT IN A QUALIFIED RESIDENTIAL TREATMENT PROGRAM (QRTP)

If a child/youth’s length of treatment in a QRTP is approaching twelve (12) consecutive months; or approaching eighteen (18) non-consecutive months, or the length of treatment for a child who has not reached age thirteen (13) is approaching six (6) consecutive or non-consecutive months; and, the child/youth receiving treatment in a QRTP may need continued treatment beyond the limits defined by the Family First Prevention Services Act (Family First), the county department shall request extended treatment by submitting a length of stay waiver request to the Executive Director of the Colorado Department of Human Services (CDHS):

A. No later than forty-five (45) days prior to the child or youth reaching the applicable length of stay limit as described above, the county department will submit the following documents to the CDHS Executive Director:

1. A letter from the county department’s director or their designee requesting the waiver including details regarding:

a. An explanation of the need for the waiver;

b. The county’s plan during the waiver extension period if granted;

c. An outline of what reasonable efforts were made prior to the waiver request for stepping down the child or youth’s level of out-of-home care from QRTP; and, d. An outline of what reasonable efforts are being made to achieve permanency for the child or youth.

2. A copy of the most recent independent assessment summary;

3. The estimated discharge date from the QRTP;

4. A copy of the most recent 90-day review; and, 5. All Child and Adolescent Needs and Strengths (CANS) tools completed for the child/ youth along with a treatment progress summary.

B. For a child/youth entering a QRTP after the federal maximum length of stay has been reached, these documents need to be received by the CDHS executive director at the completion of the independent assessment process.

C. If the waiver is granted by the CDHS Executive Director for Title IV-E reimbursement, it will continue to be funded in the same manner as the original service authorization. The waiver will expire upon the anticipated discharge date from the QRTP or six (6) months after the date the waiver goes into effect, whichever occurs first. The CDHS Executive Director has the ability to approve the length of stay waiver request in its entirety or with limitations. A new length of stay waiver request must be submitted no later than forty-five (45) days prior to the waiver expiring when an initial length of stay waiver is granted.

D. If the waiver is not granted by the CDHS Executive Director for Title IV-E reimbursement, and the child/youth remains in a QRTP past the child/youth’s lifetime limit, then the county department will be responsible for payment for the child/youth remaining in a QRTP at the CDHS expenditure requirement.

E. The county department shall be responsible for gathering all necessary documentation for submission of the court report, which shall include the Qualified Individual’s final summary report.

F. If a child/youth has exceeded their lifetime limit prior to treatment in a QRTP, an independent assessment would be required and after the Qualified Individual recommendation has approved the QRTP then a waiver request will be required within thirty (30) days of the approved independent assessment summary report.

7.301.3 FAMILY SERVICES PLAN REVIEW AND UPDATES

A continuing reassessment and documentation of the Family Services Plan in relationship to progress to goals shall be done. If a significant change in client service needs occurs, a redetermination of eligibility and/or a reassessment of services shall occur and the Family Services Plan shall be amended, if applicable.

A. The reassessment should be performed jointly with the client and in situations where joint evaluation cannot occur, the reasons shall be documented in the case record.

B. When assessment indicates reunification is appropriate, the treatment/prevention Plan shall be updated to reflect the specific time frame and services necessary for the child to be safely returned to and maintained in the home.

C. The treatment/prevention plan shall be reviewed in conference with the caseworker and the supervisor. Documentation by the caseworker and approval by the supervisor shall be entered in the state automated case management system within 90 calendar days from the initial treatment/prevention plan and then within 90 calendar days from the prior review and thereafter.

The court report, when entered in the state automated case management system, or a six month administrative review of children in out of home placement, may substitute for a 90 day review.

The conference shall address:

1. The Safety needs of the child to include: if a new referral was received how it was managed, and if a new assessment was completed a summary of the outcome;

2. The appropriateness of the child’s current residence and how it meets the child’s needs;

3. Whether the child, parents, family members, and placement providers if applicable, are receiving the specific services mandated by the family services plan, and services are appropriate, time frames are current and progress is being made toward the specific objectives identified in the plan;

a. If a child/youth’s parent is incarcerated, the county department shall communicate or document the efforts to communicate with the parent who is incarcerated and the person designated as the Family Services Coordinator or other designated communications liaison of the facility or jail where the parent is incarcerated regarding the requirements of the court-ordered Family Services Plan.

4. Identification of the barriers hindering progress and how they are being addressed. What strengths are being used to mitigate barriers;

5. Appropriateness of the child’s permanency goal, time frames to achieve permanency and the efforts to finalize a permanent plan;

6. Summary of initial and ongoing family search and engagement efforts and steps taken to develop ongoing support. These efforts shall continue per section 7.304.52, C, 1-4.

D. The following cases are to be set for further review by the county department:

1. All cases in which a child has been placed in four different placements, excluding a return home;

2. All cases in which a child has a current goal of return home for more than twenty four months;

3. All cases in which the child has had a permanency goal of adoption for more than one year and has not been placed in an adoptive home; and, 4. All children who have been returned home and have re- entered care more than twice and have a current plan of return home.

5. All children for whom the permanency goal is another planned permanent living arrangement.

E. if the child/youth is in a qualified residential treatment program (QRTP) or has spent any time during this review period in a QRTP, additional information shall be documented in the comprehensive child welfare information system (CCWIS) as outlined in section 7.705.205-208. 7.302 CHILD WELFARE CHILD CARE [Rev. eff. 4/1/12]

Child Welfare Child Care is a service to maintain children in their own homes or in the least restrictive outof-home care when there are no other child care options available. Child Welfare Child Care is not twenty-four (24) hour care.

Child care services for school-age children during regular school hours must be different from, and cannot be substituted for, educational services that school districts are required to provide under the Colorado Exceptional Children’s Act.

7.302.1 ELIGIBILITY CRITERIA

In addition to meeting eligibility requirements in the General Information and Policies section, the county department shall ensure that there are no other child care options available and the child is eligible for Program Area 4, 5, or 6 as described in this manual. 7.302.2 CHILD CARE ARRANGEMENT AND FAMILY SERVICES PLAN [Rev. eff. 4/1/12]

The county department shall:

A. Complete the relevant sections of the Family Services Plan.

B. Document how the child care plan provides for effective intervention for maintaining children in their own homes or in the least restrictive out-of-home care.

C. Provide the client with information concerning child care services.

D. Have face-to-face or telephone contact with the child and/or family a minimum of once a month, and with the provider a minimum of quarterly when the reason for the child care is child protection. These contacts shall include a discussion of current progress and future direction. If the child is in placement, the contact requirements in Section 7.001.6 (12 CCR 2509-1) shall be used.

E. Assess a client fee when applicable. Refer to Section 3.905, B (9 CCR 2503-1).

F. Develop written criteria to be used to determine when the State set parental fee should be waived.

G. Follow State rules for the Colorado Child Care Assistance Program (CCCAP) as found in rule manual Volume 3 “Income Maintenance”, Section 3.900 et seq. (9 CCR 2503-1).

7.303 CORE SERVICES PROGRAM 7.303.1 DEFINITIONS [Rev. eff. 1/1/15]

The Core Services Program consists of the following services:

A. “Aftercare Services”: any of the Core services provided to prepare a child for reunification with his/her family or other permanent placement and to prevent future out-of-home placement of the B. “County Designed Services”: innovative and/or otherwise unavailable services proposed by a county that meet the goals of the Core Services Program.

C. “Day Treatment”: comprehensive, highly structured services that provide education to children and therapy to children and their families.

D. “Home Based Intervention”: services provided primarily in the home of the client and includes a variety of services which can include therapeutic services, concrete services, collateral services and crisis intervention directed to meet the needs of the child and family. See Section 7.303.14 for service elements of therapeutic, concrete, collateral, and crisis intervention services.

E. “Intensive Family Therapy”: therapeutic intervention typically with all family members to improve family communication, functioning, and relationships.

F. “Life Skills”: services provided primarily in the home that teach household management, effectively accessing community resources, parenting techniques, and family conflict management.

G. “Mental Health Services”: diagnostic and/or therapeutic services to assist in the development of the family services plan, to assess and/or improve family communication, functioning, and relationships.

H. “Sexual Abuse Treatment”: therapeutic intervention designed to address issues and behaviors related to sexual abuse victimization, sexual dysfunction, sexual abuse perpetration, and to prevent further sexual abuse and victimization.

I. “Special Economic Assistance” means emergency financial assistance of not more than $2,000 per family per year in the form of cash and/or vendor payment to purchase hard services. See

Section 7.303.14 for service elements of hard services.

J. “Substance Abuse Treatment Services”: diagnostic and/or therapeutic services to assist in the development of the family service plan, to assess and/or improve family communication, functioning and relationships, and to prevent further abuse of drugs or alcohol. 7.303.11 Program Goals The goals of the Core Services Program are to:

A. Focus on the family strengths by directing intensive services that support and strengthen the family and/or protect the child;

B. Prevent out-of-home placement of the child;

C. Return children in placement to their own home; or D. Unite children with their permanent families.

E. Provide services that protect the child.

“To return children in placement to their own home or to unite children with their permanent families” is defined as return to the home of a parent, an adoptive placement, guardianship, supervised independent living placement, foster-adoption placement or to live with a relative/kin if the goal for the child in the Family Services Plan is to remain in the placement on a permanent basis. 7.303.12 Access County departments must make all of the Core services, except for county designed services, available to any client who meets the criteria for the service as documented in the Family Services Plan. 7.303.13 Program Eligibility [Rev. eff. 1/1/14]

In order to be eligible for the Core Services Program, each child, youth, and family shall:

A. Meet Program Area Three eligibility criteria; or, B. Meet the criteria for Program Area 4, 5, or 6 target group; and, 1. Meet the Colorado out-of-home placement criteria at the time of each placement in any Core Services Program; and/or, 2. Require a more restrictive level of care but may be maintained at a less restrictive out-ofhome placement or in his/her own home with Core Services. 7.303.14 Service Elements Core Services Programs may include any of the following elements of service:

A. “Collateral Services”: teaching families to work with community agencies such as health care, mental health treatment services, substance abuse treatment services, job training, information and referral, advocacy groups, housing assistance agencies, and schools.

B. “Concrete Services”: concentrated assistance in the development and enhancement of parenting skills, stress reduction, problem solving, communication skills, budget and household management and recreational activities.

C. “Crisis Intervention Services”: phone or in-home counseling, medical services, respite or other interventions available on a 24-hour basis.

D. “Diagnostic and Treatment Planning Services”: various evaluations of the child and family to facilitate the development of the Family Services Plan and the move of the child to a permanent E. “Hard Services”: the purchase of services or distribution of cash payments for the following:

- housing funds, including rent, repairs, utilities, or rent deposits - food or money for food - clothing - transportation to include fares, auto repair, auto fuel, auto insurance or bus pass - uncovered medical or dental expenses - appliances, furniture - emergency shelter - employment related expenses, such as tools or dues F. “Therapeutic Services”: interactive parenting, family therapy, support groups, educational groups, problem solving methods, communication skills, and parent-child conflict management. 7.303.15 Service Time Frames A. Services may be provided for up to eighteen (18) months.

B. One or more six month extensions to the initial eighteen months placement are optional if approved by an internal county department administrative review and documentation of approval is in the case record. The in-house review shall include casework or supervisory staff and one or more administrators not providing direct services to the family. 7.303.16 Workload Standards A. Each worker engaged in home based intervention, intensive family therapy, and sexual abuse treatment programs shall have at least two (2) and not more than twelve (12) at risk families depending on the intensity of service needed per family.

B. Life skills shall have staff persons assigned to work no more than twenty (20) families.

C. Supervisory workload ratio shall be six (6) caseworkers per supervisor. Contractors shall provide comparable supervision. 7.303.17 Performance Indicators [Rev. eff. 4/1/12]

Core Services Program success shall be measured by the degree to which the following performance indicators identified in the Family Services Plan are achieved by clients.

A. “Family Conflict Management”: The family shall demonstrate capacity to resolve conflicts and disagreements contributing to child maltreatment, running away, status offenses and delinquent behavior.

B. “Parental Competency”: Parents will show ability to maintain sound relationships with their children and provide care, nutrition, hygiene, discipline, protection, instructions, and supervision.

C. “Household Management Competency”: Parents will be able to provide safe environment for their children through competent household cleaning and maintenance, budgeting and purchasing, and structuring mealtime and families activities.

D. “Resources Access Competency”: Parents will demonstrate ability to obtain help from the community and within the local, state, and federal governments.

E. “Personal and Individual Competency”: Families will show awareness in terms of self-esteem, victim awareness, management of one’s own history of victimization, sex education, peer relationships enhancement establishing appropriate physical and emotional boundaries for themselves and for their children, demonstrating assertive behavior, and assuming responsibility for one’s own behavior.

F. “Academic, Behavioral and Emotional Competency”: Children involved in day treatment settings will demonstrate ability to meet school requirements, to control behavior, and to control and communicate feelings.

G. “Competence in Maintaining Sobriety”: Parents will be able to maintain sobriety and/or develop relapse plans to provide for the care, nutrition, hygiene, discipline, protection, instruction, and supervision of the child(ren). Child(ren) will be able to maintain sobriety and/or develop relapse plans to avoid running away, status offenses, or delinquent behavior.

The county department shall identify the degree to which the client met the treatment goals by entering the appropriate service leave reason on the Department’s automated reporting system when closing the service on the Department’s automated reporting system.

7.303.2 INTEGRATED CARE MANAGEMENT PROGRAM 7.303.21 Definition Integrated Care Management (ICM) allows a county-optional, State-approved plan for the provision of selected child and family services. County ICM plans shall identify specific principles, activities, and program components to improve outcomes for children, youth, and families; to support best practices; to advance selected care management strategies; to improve quality and accountability; and, to provide cost efficient delivery of needed services. 7.303.22 Program Goals The goals of the Integrated Care Management program shall include:

A. More efficient and responsive services systems for children, youth and families.

B. Increased flexibility and collaboration across multiple agencies and funding streams to meet consumer needs and avoid cost shifting between systems.

C. Encouragement and authorization for an integrated services system that incorporates blended funding and administration.

D. Focus on quality and outcome driven services with accountability for an entire array of services that families need.

E. Development of data systems to support these goals and to allow administrators and policy makers to better manage and evaluate. 7.303.23 Availability Integrated Care Management is an optional program for individual county or groups of counties. Counties may elect to participate by operating a State approved Integrated Care Management program. 7.303.24 Program Eligibility County departments shall define program eligibility criteria in the proposed plan, which must include all program components and define how each principle will be implemented. The county programs will be approved by the State Department. 7.303.25 Program Components Each plan must contain the following program components. Counties may operationalize the program components as listed beneath each component or in another manner approved by the State Department.

A. Utilization Management (UM) - A system of inter-agency services review and approval procedures designed to ensure that the services provided to a specific child or family at a given time are cost-effective, clinically appropriate and least restrictive. The goal of utilization management is to provide the most appropriate, least restrictive service that meets the needs of the child and the family. Utilization management may include:

1. Application implemented with any or all of the services used by the county departments.

2. Concurrent review activities that focus on reducing or increasing any level of service and may be conducted by dedicated staff and/or a multi-agency review team.

3. Written UM guidelines including standardized UM processes and criteria for UM that may include definitions for key levels of care.

4. Provider profiling where data is supplementally tracked, differentiating provider performance and competencies.

B. Case Management (CM) - Refers to a process by which the services provided to a specific child or family are tracked and managed to achieve optimum, cost effective outcomes. Case management activities may include:

1. Identification and tracking of selected cases or types of cases.

2. Systematic management approach that integrates tracking and targeting of cases for identified, targeted interventions and outcomes.

3. Varying levels of case management across different providers integrating provider profiling and collaborative activities, such as involving providers in case management activities.

4. Procedures which minimize time between referral and delivery of care, and provide dedicated resources and support for any or all of service referrals.

5. Prevention and early intervention in which the county offers supports before more intensive intervention is needed.

C. Resource Strategies - Involve efforts to organize and manage resources to achieve the goals of the county department paying for care. Resource strategies may include:

1. Contract incentives employing shared risks or performance incentives to influence provider behavior and service delivery.

2. Provider resource structure offering efficiencies and standardized care approaches that promote efficient and appropriate care delivery.

3. Resource blending using collaborative efforts with other child and family serving agencies.

D. Information Management Strategies (IM) - the identification, collection, analysis and use of various types of data to further the county’s mission and goals. IM may include:

1. Tracking information related to service use including identifying service utilization costs, aggregating and reporting.

2. Creating routine reports and IM activities including trend analyses by case type, provider, services category and other variables; or using complex multi-level analyses to identify cost drivers and adjust risks.

E. Collaborative Integration (CI) - Inclusion of consumers and agencies in the community in the development of the agency’s vision, mission and goals and in the implementation of the ICM program. Formal efforts may be directed at coordinating services, integrating care and cooperation between agencies and consumers and may include:

1. Plans for integration, contractual agreements or blending of resources with community agencies.

2. Strategies to utilize formal and informal community based organizations and family support networks to ensure child safety and promote child and family well-being.

3. Plans to have formal inter-agency agreements, Memorandums of Understanding and contracts with community based organizations and a process to engage community partners.

F. Quality Improvement (QI) - Formal organizational processes that emphasize the ongoing improvement of both the process of service delivery and client outcomes through the incorporation of data driven approaches and the institution of systems of monitoring, feedback and organizational learning. QI activities may include:

1. Implementing a formal QI process, which may be narrowly, implemented expanding over time to agency-wide including a written plan and formal process.

2. Implementing a training schedule that trains staff on some aspect of any of the ICM principles or information obtained as a result of use of the principles, such as the outcome of the quality improvement process.

3. Implementing Quality Improvement activities for at least one high cost driver and having dedicated staff for QI activities. 7.303.3 COLLABORATIVE MANAGEMENT PROGRAM [Rev. eff. 8/1/15]

The Collaborative Management Program (CMP) is an optional county program approved by the Department of Human Services for a uniform system for agencies to share resources or to manage and integrate the treatment and services provided to children, youth, and families who would benefit from a multi-system approach to services and service delivery. 7.303.31 Program Goals [Rev. eff. 8/1/15]

The goals of the Collaborative Management Program include:

A. Reducing duplication and fragmentation of services to children, youth, and/or families who would benefit from integrated multi-agency services or approach;

B. Increasing the quality, appropriateness, and effectiveness of services provided to children, youth or families who would benefit from integrated multi-agency services or approach; and, C. Encouraging cost sharing among service providers. 7.303.32 Availability [Rev. eff. 8/1/15]

A. Collaborative Management is an optional program for an individual county or groups of counties.

Counties may elect to participate by entering into a Memorandum of Understanding (MOU) that is designed to promote a collaborative system to coordinate and manage the provision of services to children, youth, and families who would benefit from an integrated multi-system approach to service and service delivery. Counties must use the MOU template provided by the State and developed in conjunction with the Colorado Judicial Districts.

B. The MOU shall be between interested county departments of human/social services and local representatives of each of the following agencies:

1. The local judicial district(s), including probation services;

2. The health department, whether a county, district, or regional health department;

3. The local school district(s);

4. Each comprehensive behavioral health safety net provider as identified by the behavioral health administration;

5. Each behavioral health administrative services organization;

6. The Division of Youth Services;

7. A managed service organization for the provision of treatment of services for alcohol and drug abuse; and, 8. A community domestic abuse program, if representation is available.

C. Counties electing to participate in the MOU may add non-mandatory partners or organizations and are encouraged to include a family member or family advocacy organization, and a youth member or youth advocacy organization.

D. Counties will be provided with guidance/instructions for the completion of the MOU established by the State Department to help in the completion of the MOU process.

E. MOUs must be submitted to the Colorado Department of Human Services on or before May 1st of the fiscal year prior to the MOU agreement year for review and feedback. Completed MOUs, including all signatures, are due on June 30th of the fiscal year prior to the MOU agreement year.

Any MOU received after that date will not be accepted and will result in a loss of funding for the next fiscal year.

F. Reviews of each county’s MOU will be completed by the State Department and will consist of a review and completion of the MOU review checklist. The review checklist consists of the following areas:

1. A list of mandated partners;

2. MOU deadlines;

3. Oversight group documentation;

4. Target population review;

5. Services provided review;

6. Funding sources review;

7. Reinvestment of funds review;

8. Collaborative Management process review;

9. Confidentiality compliance review; and, 10. Review of required signatures.

G. Each Collaborative Management Program that meets the criteria will receive a signed letter of acceptance from the State Department approving the MOU for the next fiscal year within fifteen (15) days of such approval. 7.303.33 Program Components [Rev. eff. 8/1/15]

Each Memorandum of Understanding (MOU) shall contain the following program components.

A. Interagency Oversight Group (IOG)

A system of inter-agency oversight will be developed in the MOU through the creation of an Interagency Oversight Group (IOG). Each IOG must include a local representative of each party to the MOU, each of whom shall be a voting member of the IOG. In addition, the IOG may include advisory members.

1. The MOU shall define the following components of the IOG:

a. Membership requirements;

b. The status of each party as a voting member or advisory member;

c. Procedures for election of officers;

d. Procedures for resolving disputes by a majority vote of voting members; and, e. Procedures for the development of subcommittee groups.

2. These components shall be maintained in each IOG’s by-laws or procedure guide.

3. Process measures shall be identified in the mou annually.

B. Target Population The CMP target population consists of at-risk children and youth ages birth through twenty one (21) years of age and their families who would benefit from a multi-system approach or integrated service plan as defined in the MOU. Each MOU must include the population that will be served through the designated Individualized Service and Support Team (ISST) or multi-system involved team(s) and CMP prevention programs. Children and youth who are at-risk will be determined in accordance with parties to the MOU.

1. An individualized service and support team (ISST) includes two (2) or more system representatives that are present to assist a child/youth/family with developing an integrated service plan directed by family need. The ISST identifies goals and facilitates collaboration and is a family-driven model for service planning. The child/youth/family members are present at and participating in the development of their plan.

2. CMP prevention programs must demonstrate a multi-systemic approach. Programs must demonstrate in the MOU that multiple disciplines were involved in the development or enhancement of the program or that multiple agencies are involved in the delivery of the service.

3. Programs must demonstrate that the program was developed to reduce bifurcated services aimed at the same outcome and demonstrate, if not provided through CMP, the bifurcated approach would bestow a burden to each of the systems. Each MOU must articulate how the joint approach will benefit children, youth, and/or families in their communities.

C. Elements of Collaborative Management Each county/region MOU must establish a collaborative management process that addresses:

1. Risk sharing;

2. Resource pooling;

3. Performance expectations;

4. Outcome monitoring; and, 5. Staff training.

The definitions of each for the elements of Collaborative Management shall be maintained by each IOG’s by-laws or procedure guide and provided as an appendix to the MOU on an annual

basis.

D. Monitoring The Department will monitor at least one CMP per quarter to ensure implementation of the collaborative management program in accordance with statutes, rules, and the MOU.

1. CMP monitoring will include:

a. A review of the IOG process;

b. A review of the by-laws or procedure guide ensuring it includes the elements required in statute and rule; and, c. The accuracy and reliability of county-level program data.

2. A review of prevention programs to ensure that each is in compliance with the definitions outlined under target population in the MOU.

3. A review of the data reporting for all program components and expenditure data.

4. Each county/region must enter all participants served through the CMP program’s target populations: demographics, services, outcomes, and expenditures in the designated data collection system as determined by the Department, so that it can be tracked and monitored. 7.303.34 Reporting [Rev. eff. 8/1/15]

Each IOG must provide an annual report to the State Department that includes:

A. The actual number of children, youth and/or families served through the Individualized Service and Support Team (ISST) or multi-system involved staffing and a description of the recommended services; the outcomes of the services provided, the number, age, race, gender, and, if known, the disability status of the children served; a description of the outcomes for children served; a description of any reduction in duplication or fragmentation of services provided and a description of any significant improvement in outcomes for children, youth and/or families;

B. The actual number of children, youth, and/or families served through the multi-systemic prevention program and the outcomes of the services provided, including a description of any reduction in duplication or fragmentation of services provided and a description of any significant improvement in outcomes for children, youth, and or families;

C. A description of estimated costs of implementing the Collaborative Management Program and any estimated cost-shifting or cost-savings that may have occurred;

D. The number of children and families who were referred to a local Collaborative Management Program and did not receive recommended services, including a description of the services that were recommended but not provided; a description of the barriers to providing such services; and the age, race, gender, and, if known, the disability status of the children;

E. The number of children, by age, served by a local Collaborative Management Program, who were referred by the juvenile justice system (including courts, probation, division of youth services, Colorado Youth Detention Continuum (CYDC), diversion, or law enforcement);

F. The number of children, by age, who were served by a local Collaborative Management Program, who were referred by a county department of human or social services, including referrals through a dependency and neglect case;

G. The number of children, by age, who were served by a local Collaborative Management Program and who identified themselves to the local Collaborative Management Program as:

1. A named victim in a criminal protection order pursuant to Section 18-1-1001 or in a juvenile delinquency or criminal case;

2. A recipient of victim compensation pursuant to Part 4.1 of this title 24; or 3. A protected party in a protection order pursuant to Part 14 of title 13, Section 19-2-707 as it existed prior to its repeal in 2021, or Section 18-1-1001;

H. An accounting of funds that were reinvested in additional services provided to children, youth, and/or families due to cost-savings; and, I. A description of any identified barriers to provide effective services. 7.303.35 Allocation Funding Formula In order to receive collaborative management program (CMP) funds, the county must implement Collaborative Management components and have a signed Collaborative Management MOU accepted by the Colorado Department of Human Services on or before June 30 of the current fiscal year.

A CMP task group, made up of CMP coordinators, CDHS staff, local IOG members, and CMP state agency stakeholders must be formed to review and make proposed changes to the allocation funding formula. In the event that the CMP taskgroup does not reach an agreement on the allocation formula, the Executive Director of the Department of Human Services shall submit the final proposal for the allocation of moneys to the State Board of Human Services. 7.303.36 General Fund Savings and Distribution [Rev. eff. 8/1/15]

County departments must elect to either retain the state general share of the county under-expenditure of the General Fund county child welfare block allocation or participate in surplus distribution for each fiscal year in their MOU. If a county/region chooses to retain the savings realized, they must specify the procedure by which such savings will be reinvested, including to which parties to the MOU such reinvested savings will be available.

The Department, after input from the Child Welfare Allocations Committee, shall develop the method for determining General Fund savings realized as the result of counties’ implementation of a collaborative system of management of multi-agency services provided to children and families related to the funding sources specified in an MOU.

7.303.4 HUMAN TRAFFICKING

A. When the county department of human or social services has reason to believe a child/youth subject to an open assessment or for whom the county agency has responsibility for placement, care or supervision is, or is at risk of being, a victim of human trafficking, the county department shall:

1. screen the child/youth for risk of human trafficking using the state-approved human trafficking screen;

2. determine service needs;

3. Document the details of the human trafficking screen, assessment, and services in the comprehensive child welfare information system;

4. Report immediately, and no later than twenty-four (24) hours from when the county department becomes aware, to the local law enforcement agency; and, 5. Document the details of the report to law enforcement in the comprehensive child welfare information system.

B. If a child/youth who is in the legal custody of the county department of human or social services or for whom the county department of human or social services has authority for placement is missing, then the county department shall:

1. Report immediately and no later than twenty-four (24) hours from when the county department receives notification that the child/youth is missing, to the local law enforcement agency of the child/youth’s last known residence and to the National Center for Missing and Exploited Children (NCMEC). The county department shall document the details of the reports in the comprehensive child welfare information system. The report submitted to law enforcement and NCMEC shall include when reasonably possible:

a. A recent or current photo of the missing youth/child;

b. a description of the child’s or youth’s physical features, such as height, weight, sex, ethnicity, hair color, and eye color; and c. Endangerment information such as pregnancy status, prescription medications, suicidal tendencies, vulnerability for human trafficking, and other health or risk factors.

2. Make reasonable efforts to locate a child/youth who is missing and document those efforts a minimum of once per month in the comprehensive child welfare information system:

a. Efforts shall include regular contact with law enforcement and NCMEC related to efforts to recover the child/youth.

3. Upon confirmation of the return of the child/youth, make reasonable efforts to complete the following activities and document those efforts in the comprehensive child welfare information system:

a. Determine the primary factors that contributed to the child/youth being missing;

b. Determine the child/youth’s experiences while missing, including conducting the human trafficking screen to determine if the child/youth is a possible human trafficking victim; and, c. Respond to factors identified in 7.303.4.B.3.a-b, above, in current and subsequent services.

d. Contact and provide information to the local law enforcement agency and NCMEC related to circumstances of the child or youth’s recovery.

c. If a child/youth for whom the county department of human or social services has responsibility for care or supervision is missing and is believed to be, or is at risk of being, a victim of human trafficking, then the county department shall:

1. Report immediately, and no later than twenty-four (24) hours from when the county department receives notification that the child/youth is missing, to the local law enforcement agency of the child/youth’s last known residence and to NCMEC. The county department shall document the details of the reports in the comprehensive child welfare information system. The report submitted to law enforcement and NCMEC shall include when reasonably possible:

a. A recent or current photo of the missing youth/child;

b. A description of the child’s or youth’s physical features such as height, weight, sex, ethnicity, hair color, and eye color; and c. Endangerment information such as pregnancy status, prescription medications, suicidal tendencies, vulnerability for human trafficking, and other health or risk factors.

2. For as long as a child/youth is under the responsibility of the county department of human or social services for care and supervision, make reasonable efforts to locate a child/youth who is missing and document those efforts once per month in the comprehensive child welfare information system:

a. Efforts shall include regular contact with law enforcement and NCMEC related to efforts to recover the child/youth.

3. Upon confirmation of the return of the child/youth, make reasonable efforts to complete the following activities and document those efforts in the comprehensive child welfare information system:

a. Determine the primary factors that contributed to the child/youth being missing;

b. Determine the child/youth’s experiences while missing, including conducting the human trafficking screen to determine if the child/youth is a possible human trafficking victim; and, c. Respond to factors identified in 7.303.4.c.3.a-b, above, in current and subsequent services.

d. Contact and provide information to the local law enforcement agency and NCMEC related to circumstances of the child or youth’s recovery.

7.304 PLACEMENT SERVICES 7.304.1 DESCRIPTION [Rev. eff. 1/1/16]

A. Placement services are services provided to children in Program Areas 4, 5, and 6 who:

1. Meet the criteria for out-of-home placement and the target group criteria; and, 2. Are placed outside their homes because of a temporary emergency removal by law enforcement, court action, a voluntary placement agreement, or a voluntary services agreement; and, 3. Are in a placement approved by the county department.

B. The range of placement services for children for whom the goal is to return home includes kinship care, foster care homes, specialized group facilities, and residential child care facilities.

C. The range of placement services for children for whom the goal is not to return home includes adoption, kinship care, foster care homes, specialized group facilities, and residential child care facilities.

D. Placement options in this section do not apply to American Indian/Native Alaskan children. Refer to Section 7.309.7 for order of placement preference as required by the Indian Child Welfare Act.

7.304.2 PLACEMENT OPTIONS 7.304.201 Sibling Placement When the child/youth is part of a sibling group and the sibling group is being placed out of the home, it shall be presumed that placement of the entire sibling group in the joint placement is in the best interests of the children/youth, in order to sustain family and/or family like relationships. Such presumption may be rebutted by the county by a preponderance of the evidence that placement of the entire sibling group in the joint placement is not in the best interests of a child/youth or of the children/youth. The county shall make reasonable and continued efforts to locate a joint placement for all of the children/youth in the sibling group unless (1) it is not in the best interests of the children/youth to be placed as a group as determined by the county in consultation with the family, youth, and gal when possible, and (2) these efforts do not unreasonably delay permanency for any child/youth. These efforts depend upon the county’s ability to locate an appropriate, capable, willing, and available joint placement for all of the children/youth in the sibling group. As soon as practicable after making a decision affecting sibling placement, the county department shall notify the gal(s) appointed to the case. Efforts to place siblings as a group shall be documented in the Colorado Child Welfare Information System (CCWIS).

Sibling children/youth in foster and/or kinship care shall have the following rights unless:

1. They are not in the best interests of each sibling regardless of whether the parental rights of one or more of the foster children/youth’s parents have been terminated 2. Youth are in the custody of the division of youth services or a state hospital for persons with mental health disorders who may have different rights based on the rules and regulations where they reside A. To be placed in foster care homes with the child/youth’s siblings, when it is in the best interests of each sibling and when the county department locates an appropriate, capable, willing, and available joint placement for the children/youth siblings, in order to sustain family relationships, B. To be placed in close geographical distance to the child/youth’s siblings in order to promote continuity in the siblings’ relationship;

C. To obtain temporary respite placements together, when possible;

D. To be placed with foster parents, placed with potential adoptive parents, and assigned to child welfare caseworkers who have been provided with training on the importance of sibling relationships;

E. To be notified, as permitted pursuant to state or federal law, about changes in their sibling’s placement, discharge from foster care, catastrophic events, or other circumstances, including but not limited to significant life events as defined by the county department and in consultation with the family, youth and gal when possible. As soon as practicable after making a decision to notify or not notify the sibling, the county department shall notify the gal(s) appointed to the case.

F. To be included in permanency planning discussions or meetings for siblings, if appropriate;

G. To maintain frequent and meaningful contact with the child/youth’s siblings if placement together is not possible;

H. To be actively involved in each other’s lives and share celebrations, if the siblings choose to do so, including but not limited to birthdays, graduations, holidays, school and extracurricular activities, cultural customs in the siblings’ native language, and other milestones;

I. To annually receive contact information for all siblings in foster care, which may include a telephone number, address, social media accounts, and e-mail address, unless a foster parent has requested the foster parent’s identifiable information not be disclosed pursuant to section 19- 1-303 (2.7)(a), C.R.S. (2019) and to receive updated photos of siblings regularly by mail or email, as appropriate;

J. To have more private or less restrictive communication with siblings as compared to communication with others who are not siblings;

K. To be provided with an explanation if contact with a sibling is restricted or denied, as permitted pursuant to state or federal law;

L. Pursuant to section 19-7-203(l), C.R.S., sibling youth in foster care shall have the right to expect that the youth’s guardian ad litem will advocate on behalf of the youth for frequent contact and visits with siblings, unless the guardian ad litem determines through the guardian ad litem’s independent investigation that the contact is not in the best interests of the youth;

M. To have contact with siblings encouraged in any adoptive or guardianship placement; and N. To receive an age-appropriate and developmentally appropriate document that reflects the child/youths primary/preferred language from the department of human services setting forth the rights described in this section:

1. Within thirty days of the date of any placement or any change in placement;

2. On each occasion that a youth’s case plan is modified;

3. At each placement where the youth resides; and 4. On at least an annual basis.

O. To have adult siblings of children/youth in foster care be considered as foster care providers, adoptive parents, and relative custodians for their siblings, if they so choose.

7.304.21 KINSHIP CARE

A. Definitions: Refer to Section 7.000.2 (12 CCR 2509-1) for the definition of “kin” and “non-certified kinship care”. However, these rules for kinship care do not apply to a biological parent as defined in 7.000.2(105) with parental rights intact, guardians, adoptive parents, or current stepparents as defined in 7.000.2(136).

B. Utilizing kinship care 1. Kinship placements and living arrangements:

a) Maintain child(ren)/youth’s meaningful, emotional and cultural ties with family across their lifespan by placing them with family or a person ascribed by the family as having a family-like or prior significant relationship with the child/youth.

b) Minimize the trauma of out-of-home placement.

c) Support and strengthen families’ ability to protect their child(ren)/youth and to provide permanency.

2. The child(ren)/youth shall be eligible for services through program area (PA) 4, 5, or 6 as defined in Section 7.000.1.

a) Kinship care when the county department has legal custody:

1) Shall satisfy out-of-home placement criteria; and/or 2) The county department shall have legal authority for placement as defined in section 7.304.51 and the Children’s Code, Sections 19-1-101 through 19-7-315, C.R.S., through a court order, a dependency and neglect or delinquency action, emergency removal by law enforcement, or an approved voluntary placement, followed by a Petition for Review of Need for Placement (PRNP) in accordance with Section 19-1-115(8), C.R.S.

b) Kinship care living arrangements when the county department does not have legal custody but there is court involvement either through a dependency & neglect or delinquency case:

1) Parent(s)/guardians and kinship caregivers consent to these arrangements; or 2) The court ordered these arrangements.

c) Kinship care living arrangements when the county department does not have legal custody and there is no court involvement:

1) Parent(s)/guardians and kinship caregivers consent to these arrangements.

3. Advisement of services and supports kin may be eligible for:

a) Kinship caregivers shall be advised of the types of services and support available to them through the county department. These services and supports may include, but are not limited to:

1) Family preservation;

2) In-home services and support;

3) Non-certified kinship care reimbursement;

4) Certification for kinship foster care;

5) The Relative Guardianship Assistance Program; and 6) The additional supports listed in section F.3 of these kinship care rules.

b) The family shall be advised of the potential options to make voluntary arrangements for temporary legal custody or guardianship by kin, including supports and services available, with each option for both the short-term and long-term.

C. Kinship care: assessment and decision-making 1. If during an assessment it is discovered that the child(ren)/youth are not living with their parents/guardians but living with kin due to the concerns outlined in the referral, and the living arrangement was made prior to the department’s involvement:

a) If a child welfare case is not opened, the rules for assessment found at 7.104 through 7.104.15 apply.

b) If the assessment transitions into a child welfare case being opened, and the child(ren)/youth remain with kin. The child(ren) /youth are considered to be in kinship care. A removal may or may not be opened dependent on who has legal custody. The rules for kinship care in Section 7.304.21.D-F apply.

c) Kinship caregivers may be eligible for forms of support listed in Section 7.304.21.F.3.

2. If during an assessment or child welfare case, it is determined that the child(ren)/youth are in current or impending danger with their caregiver(s) and the family agrees to a temporary living arrangement with kin through the use of a safety plan:

a) If a child welfare case is not opened, the rules for assessment found at 7.104 through 7.104.15 apply. The child(ren)/youth are not considered to be in out-ofhome care as the arrangements are made through a safety plan.

1) The assessment cannot be closed until a family meeting and one of the following occurs:

(a) The child(ren)/youth have been returned to the care of their caregiver(s);

(b) Documentation is obtained demonstrating that legal authority has been granted to kin (documented in the Comprehensive Child Welfare Information System [CCWIS]); or, (c) A child welfare case has been opened.

b) If the assessment results in a child welfare case being opened, or there is a current open case, and the child(ren)/youth remain with kin, the child(ren)/youth are considered to be in kinship care. A removal must not opened and the rules for kinship care stated in Section 7.304.21.D-F apply. The permanency goal must be identified as return home from kinship care.

c) The kinship caregiver(s) may be eligible for forms of support listed in Section 7.304.21.F.3. Eligibility will be determined on a case-by-case basis.

3. If during an assessment it is determined that the child(ren)/youth are in current or impending danger with their caregiver(s) and the family will not agree to a temporary living arrangement with kin through the use of a safety plan, and the county obtains legal custody:

a) The assessment cannot be closed until a family meeting and one of the following occurs:

1) The child(ren)/youth have been returned to the care of their caregiver(s);

2) Documentation is obtained demonstrating that legal authority has been granted to kin, and that documentation is in the CCWIS; or 3) A child welfare case has been opened.

b) Child(ren)/youth are then considered to be in out-of-home care and a removal is required to be documented in the CCWIS.

c) Kinship caregivers may be eligible for forms of support listed in Section 7.304.21.F.3. Eligibility will be determined on a case-by-case basis.

d) The rules for kinship care stated in Section 7.304.21.D-F apply.

D. Kinship care requirements 1. Whenever considering a kinship placement or living arrangement (as outlined in Section C above), the following must occur and be documented in the CCWIS to ensure the child(ren)/youth are residing with a safe caregiver:

a) Non-fingerprint-based background checks for each adult (18 years and older) living in the home must be completed no more than 90 days prior or at the time of the living arrangement, placement, or change in the child(ren)/youth’s primary caregiver to kin. The background check shall include:

1) The CCWIS to determine whether the relative, kin and any adult in the home has a substantiated finding of child abuse or neglect;

2) The Colorado Courts data access system to determine the status or disposition of any criminal charges;

3) The CBI Sex Offender Registry and the National Sex Offender Public Website operated by the United States Department of Justice to determine whether the relative, kin or any adult in the home is a registered sex offender, including:

(a) Known names and addresses of each adult residing in the home; and (b) Address only of the non-certified kinship care home.

b) Ensure a signed “Original Application to Provide Care” for child(ren)/youth or a state approved, county specific kinship application is initiated. Application must be completed and signed no more than 90 days prior or within 14 days of placement/living arrangement. The state will not approve county-specific applications that add to or create additional burdens for kin or applications that remove any safety requirements from the state-approved form.

c) A safety walk-through of the kinship caregiver’s home using either the state template or state-approved county-specific template completed no more than 60 days prior or at the time of the living arrangement, placement, or change in the child(ren)/youth’s primary caregiver to a kin. The state will not approve countyspecific safety walk-throughs that add to or create additional burdens for kin or safety walk-through forms that remove any safety requirements from the stateapproved form.

2. When an emergency placement is necessary and a prospective relative, kin or any adult that resides in the home is identified, and child(ren)/youth are placed into the temporary custody of the county department of human services by law enforcement or the court, the following actions shall occur prior to placement of child(ren)/youth in the home:

a) The county department shall contact local law enforcement to conduct an initial name-based state and federal criminal history record check (NCIC). The county department shall accept a verbal response for the relative, kin, and any adult who resides in the home. The results regarding each person’s criminal history shall be documented in the CCWIS.

b) The child(ren)/youth shall not be placed with the relative, kin, and any other adult who resides in the home if the initial criminal history record information check (NCIC) reflects one or more convictions of the criminal offenses listed in subsection 7.304.21.D.5.e.

3. Checks for child abuse and neglect records in every state where any adult residing in the home has lived in the five years immediately preceding the date of application shall be initiated no later than fourteen (14) calendar days following the date of becoming aware of the out of state address. Checks shall be documented in the CCWIS.

a) A county department needs to make at least three (3) attempts to obtain the information from other states within forty-five (45) calendar days from the date of becoming aware of the out of state address. If information cannot be received, this needs to be documented in the state automated case management system.

Each attempt needs to be spread out over a period of not less than seven (7) consecutive days.

4. The county department shall complete an assessment to evaluate the non-certified kinship family’s ability to meet the mental, physical, and emotional needs of the child(ren)/youth by addressing and documenting, in the CCWIS, the areas of: safety, parenting skills, potential for permanency, needs of the kinship family, a support system of the kinship family, strengths and any other areas deemed necessary by the county department as it relates to the safety of the child(ren)/youth.

a) The child(ren)/youth’s and parents’ preferences regarding placement must be considered. Whether placement with the kin would hinder reunification shall also be considered. However, a parents objection to placement with a particular relative or kin is not alone sufficient to show that the proposed placement would hinder reunification.

b) The following shall not be considered unless they would threaten the mental, physical, or emotional health or safety of the child(ren)/youth:

1) The size of the home and whether the child(ren)/youth would have a separate room;

2) The socioeconomic status of the relative or kin;

3) The ability of the relative or kin to support the child(ren)/youth’s participation in extracurricular activities;

4) The ordinary bonding and attachment that occurred during time spent in a foster home;

5) The immigration status of the relative or kin; and/or 6) Age or disability of the relative or kin.

5. Fingerprint-based criminal history record information checks from the Colorado Bureau of Investigation (CBI) and the Federal Bureau of Investigation (FBI) shall be conducted for each adult (18 years and older) living in the home. Fingerprints shall be submitted to the designated third-party vendor approved by CBI. The county shall confirm timely submission of fingerprints and document the same in the CCWIS according to the following timeframes:

a) For emergency placements made pursuant to Section 19-3-405, C.R.S., fingerprints shall be submitted within seven (7) calendar days after the child(ren)/youth are placed in the home or no later than fourteen (14) calendar days when documented urgent circumstances exist. Fingerprints completed within ninety (90) days prior to the placement will also be accepted.

b) For safety plans that turn into a case and where there is a change in the child(ren)/youth’s primary caregiver, fingerprints shall be submitted within seven (7) calendar days from the date the county department decides to open the case or no later than fourteen (14) calendar days when documented urgent circumstances exist. The date the county department decides to open a case shall be documented in the assessment closure summary.

1) If a case is already open, the fingerprints shall be submitted within seven (7) calendar days from the date the safety plan was implemented or no later than fourteen (14) calendar days when documented urgent circumstances exist.

c) For family-made arrangements that turn into a case due to the concerns outlined in the referral and the child(ren)/youth remain with the kinship caregiver, fingerprints shall be submitted within seven (7) calendar days from the date the county department decides to open a case or no later than fourteen (14) calendar days when documented urgent circumstances exist. The date the county department decides to open a case shall be documented in the assessment closure summary.

d) For non-emergency placements, fingerprints shall be initiated no more than ninety (90) days prior to the placement or living arrangement.

e) The purpose of the CBI & FBI criminal history checks is to determine if any adult who resides in the home has been convicted of an offense which would preclude placement of the child(ren)/youth in the home pursuant to Section 19-3-406(5), C.R.S. These offenses are:

1) Felony child abuse, as specified in Section 18-6-401, C.R.S.;

2) Murder in the first and second degree, as described in Section 18-3-102 and 18-3-103, C.R.S.; manslaughter, as described in Section 18-3-104, C.R.S.; criminally negligent homicide, as described in Section 18-3-105, C.R.S.; and vehicular homicide, as described in Section 18-3-106, C.R.S.;

3) Kidnapping in the first or second degree, as described in Sections 18-3- 301 and 18-3-302, C.R.S.; or felony false imprisonment, as described in

Section 18-3-303, C.R.S.;

4) Felony crime of violence enhancer, as defined in Section 18-1.3-406 (2)(a)(i), C.R.S., excluding the conviction of escape. If this may be applicable, consider consulting a county attorney or other pertinent staff;

5) An offense involving unlawful sexual behavior, as defined in Section 16- 22-102 (9), C.R.S., including but not limited to sexual exploitation of a child, human trafficking for sexual servitude, and human trafficking of a minor for sexual servitude;

6) A felony, the underlying factual basis of which has been found by the court to include an act of domestic violence, as defined in Section 18-6- 800.3, C.R.S., within the preceding five years;

7) A felony involving physical assault, as described in Section 18-3-202 or 18-3-203, C.R.S., within the preceding five years;

8) A felony drug-related offense within the preceding three years. If the relative or kin has a felony drug-related conviction less than five years prior, any kinship or guardianship assistance payments on behalf of the child or youth must not be made with federal money provided pursuant to Title IV-E of the Federal “Social Security Act”, as amended;

9) A pattern of two or more misdemeanor convictions related to domestic violence, within the preceding five years as defined in Section 18-6-800.3 C.R.S.; or 10) Any offense in any other state, the elements of which are substantially similar to the elements as described in 1) – 9) above.

E. Placement or continued placement/living arrangements 1. When the county has legal authority for placement and in accordance with Section 19-3- 406 (2)(b), C.R.S., if the relative, kin or any adult that resides in the home fails to submit a complete set of fingerprints within 14 calendar days, following must occur:

a) The county department shall notify the parties to the case within seventy-two (72) hours of missing the fourteen (14) calendar day deadline;

b) Any party, including the county department, wanting the child(ren)/ youth to remain in the home shall file a motion within seventy-two (72) hours of receiving notice of the failure to submit fingerprints regarding placement of the child(ren)/youth; and c) If a motion is not filed, or the court orders the removal, the county department or law enforcement shall remove the child(ren)/youth from the physical custody of the relative/kin.

2. When the county has legal authority for placement and in accordance with Section 19-3- 406 (4)(b), C.R.S., if information is found as a result of any background checks, outlined in Section D: kinship care requirements above, of the relative, kin and any adult who lives in the home who has a disqualifying factor, following must occur:

a) The county department shall notify the parties to the case within seventy-two (72) hours of identification of the disqualifying factor;

b) Any party, including the county department, wanting the child(ren)/youth to remain in the home shall file a motion regarding placement of child(ren)/youth within seventy-two (72) hours of notice that a disqualifying factor has been identified. If the county department is supporting the child(ren)/youth remaining in the home, they may file a remediation plan with the court; and c) If a motion is not filed, or the court orders the removal, the county department or law enforcement shall remove the child(ren)/youth from the physical custody of the relative/kin.

3. When there is a child(ren)/youth in a non-court involved case and a fingerprint-based background check is required and a disqualifying factor is identified, the county director or their designee may affirm the living arrangement upon an approved remediation plan as outlined in Section 7.304.21.E.4. See below.

4. If a disqualifying factor as defined in Section 7.000.2.A is identified following the placement/living arrangement of the child(ren)/youth, the department shall evaluate whether disqualifying factors can be mitigated. If concerns can be mitigated, a remediation plan shall be developed to address the concerns within seventy-two (72) hours of identification of the disqualifying factor. The following shall be documented in the CCWIS:

a) Review the circumstances of the placement;

b) Evaluate the vulnerability of the child(ren)/youth, including age and development;

c) Consider the disqualifying criminal convictions including rehabilitation, length of time since conviction, and any impact on child safety;

d) Supports needed by the kinship caregiver(s); and e) Identify alternative solutions to removal of the child(ren)/youth from the placement, and document the solution in the remediation plan including, but not limited to, the family’s current status in the following domains:

1) Risk and safety;

2) Level of functioning;

3) Strengths;

4) Specific areas of concern to be addressed;

5) Services and supports needed; and 6) Changes that must occur to mitigate the concerns.

5. If relatives or kin are interested in certification, the county department shall assess the suitability of relatives or kin in accordance with the kinship foster care certification requirements found at Sections 7.500 and 7.707.

6. Parent(s), children and youth shall be included as part of the planning discussion when considering placement with kin. If the county department believes that an available and willing kin or relative is able to meet the mental, physical, and emotional needs of the child(ren)/youth but any parent, Guardian ad Litem (GAL), or Counsel for Youth (CFY) objects to the placement, the county department shall file a motion requesting the court place the child(ren)/youth with the available kin placement.

7. When removal occurs on an emergency basis and child(ren)/youth are placed with relatives or kin, the relatives or kin have the right to be provisionally certified as a kinship foster care home in accordance with Section 7.500.311.C-D.

8. Substitution of fingerprints for foster care certification:

a) If the county department of human or social services or a child placement agency (when applicable) intends to accept an application for foster care, CBI shall be notified within five (5) calendar days after requesting fingerprint-based criminal

history record information checks in order to prompt flagging and automatic notification to the county department of human or social services or child placement agency when there are new criminal charges; and b) The substitute fingerprint process meets the requirement for an applicant for foster care certification pursuant to Section 26-6-910, C.R.S.

F. Decision making for the care and planning of a child(ren)/youth 1. Parents, relatives and kin shall be encouraged to participate in case planning, whether or not they are the current caregiver. Child(ren)/youth shall also be encouraged to participate in case planning as appropriate to their age and developmental level. Parents and children/youth shall be consulted regarding their preferences for relative and/or kin participation in case planning. Participation may include, but is not limited to the following:

a) Identifying the strengths and needs of the child(ren)/youth and the child(ren)/youth's parent;

b) Identifying and/or providing services and resources that meet the individualized needs of the child(ren)/youth and the child(ren)/youth's parent. The following activities may be provided by relatives and/or kin, but shall not be required:

1) Be considered as the relative or kinship placement with the child/youth pursuant to subsection 3.6.a.iv.d. of this Section;

2) Supervising family time when authorized pursuant to section 19-3-217 C.R.S.;

3) Providing respite care for the child(ren)/youth and having family vacation time with the child(ren)/youth;

4) Providing transportation;

5) Helping maintain the child(ren)/youth's familiar and regular activities, as well as contact with the child(ren)/youth's friends, relatives, and kin, including providing supervision of the child(ren)/youth at family gatherings and events;

6) Participating in the child/youth's family and permanency team if the child/youth is placed in a Qualified Residential Treatment Program;

7) Acting as a support person for the child(ren)/youth, the child(ren)/youth's parent, and the child(ren)/youth's current caregiver, including collaborating with foster parents to support a healthy transition for a child(ren)/youth to family time or placement with a relative or kin, when appropriate; and/or 8) Suggesting other relatives or kin who may be able to participate in the case planning or whom the county department of human or social services, or other social services agency, may consider for the placement of the child(ren)/youth. The county department of human or social services, or other social services agency, shall send a notice to each relative or kin identified by other relatives or kin, unless a relative or kin received the notice earlier in the case or was ruled out as a resource or placement by the court.

2. A relative or kinship caregiver has the right to:

a) Be treated with dignity and respect;

b) Be considered as an important member of the child(ren)/youth’s team;

c) Receive training and support to improve the caregiver’s skills in providing daily care to meet the individualized needs of the child(ren)/youth in their care;

d) Be informed about how to reach after-hours contacts and support; and e) Be informed about available financial assistance and the financial consequences of not pursuing certification as a kinship foster home, including ineligibility for the state's Relative Guardianship Assistance Program.

f) If the sole issue preventing an emergency placement of a child with a relative or kin is a lack of resources, the county department shall use reasonable efforts to assist the relative or kin with obtaining the necessary items within existing available resources.

g) Kinship care providers shall be advised of the types of support available to them through the county department noted in Section 7.304.21.F.3. The information provided, including the date(s) information was provided, shall be documented in the statewide automated child welfare information system.

h) Funding and types of support including:

1) Kinship care may be considered a means of family preservation rather than a placement service;

2) The kinship caregiver(s) may become a kinship foster care home (if eligible); and 3) Other funding and support services, including in-kind or concrete services, can be put into place as mutually agreed upon with the provider.

3. Support and services options a) As part of the assessment process, the county department of human or social services shall determine, with the kinship caregiver(s), which funding options and support services will be necessary to support the placement. If the child(ren)/youth is eligible, at a minimum, the following funding sources shall be considered to support the child(ren)/youth in a kinship care placement:

1) Child support by the absent parent(s). When the county has legal custody, a referral may be made to Child Support Services if the county department finds that a referral is appropriate pursuant to 7.601.712. If a referral is made, the county department must review the case every six (6) months to re-assess the appropriateness of the referral. The county department may consult with the Child Support Services unit during the reassessment;

2) Social Security and/or other death benefits.

3) Supplemental Security Income (SSI);

4) Social Security Disability Insurance (SSDI);

5) Supplemental Nutrition Assistance Program (SNAP);

6) Temporary Assistance to Needy Families (TANF);

7) Tricare or other medical benefits;

8) Medicaid;

9) Core Services, pursuant to Section 7.303;

10) Child Welfare Child Care/Protective Services Child Care;

11) Colorado Child Care Assistance Program;

12) In-kind services or donations;

13) Non-certified kinship care reimbursement;

14) Foster care maintenance payment;

15) Title IV-E or state Relative Guardianship Assistance Program pursuant to

Section 7.311; and 16) Title IV-E or state Adoption Assistance.

b) This decision-making process shall address the needs of the child(ren)/youth, family and kin and focus on how the goals of safety, permanency, and child(ren)/youth well-being can be most effectively achieved for the child(ren)/youth. The department shall work with any relative or kinship caregiver or prospective caregiver to resolve barriers to placement or participation in case planning.

c) The kinship caregiver shall be advised of all support options available.

d) The kinship caregiver shall be advised of any available complaint resolution process.

e) The kinship caregiver shall be advised of training, support and services specific to the needs of kinship care providers in order to meet the needs of the child(ren)/youth in their care.

1) The Reasonable and Prudent Parent Standard: the county department of human or social services or child placement agency shall advise/educate the kinship caregiver on the rights of the child(ren)/youth and how to determine whether an extracurricular, enrichment, cultural, or social activity is consistent with the Reasonable and Prudent Parent Standard, when approving an age or developmentally appropriate activity identified in Section 7.701.200.

4. Permanency planning in kinship care a) When a child(ren)/youth has been placed by the county department into temporary kinship care and reasonable efforts to reunite the child(ren)/youth with the parents are not successful, the county department shall consider permanent placement with the kinship care provider or other appropriate kin. The preferred permanent placement shall be adoption, legal guardianship, or permanent custody.

b) The county shall document all efforts in the Family Services Plan for the child(ren)/youth, including efforts to maintain child(ren)/youth in a relative or kin placement as well as any decisions not to place child(ren)/youth with a relative or kin. Documentation shall include the consideration given to reunification efforts and the child(ren)/youth’s mental, physical, and emotional needs.

7.304.21.1 NON-CERTIFIED KINSHIP CARE REVIEW PROCESS

The process and timing of reviews of non-certified kinship care provider files shall occur in accordance with 12 CCR 2501-1 Section 1.150 through 1.151. Unless otherwise provided herein and is performed utilizing the current review tool accessible via contact with the State Department (Child Welfare).

A. Review schedule and process:

1. Reviews may occur on a 3-year rotation assigned by state staff.

2. Counties that pass with a score of 80% or better will remain on their assigned rotation schedule.

3. Counties that do not pass with a score of 80% or better will be reviewed yearly until they pass with a score of 80% or better. Once passing, counties will resume their previously assigned rotation.

4. If a county fails to pass three (3) consecutive reviews, progressive disciplinary action will be initiated per 12 CCR 2501-1 Section 1.150 through 1.151.

5. Reviews will be performed virtually unless an onsite review is requested by the county and agreed upon by the reviewer(s). If an onsite review is requested, the county is to contact the reviewer at the earliest possible time, but no later than, five (5) state working days from receipt of the notification to schedule the review.

6. The period under review is six (6) months for a large county and one (1) year for mid-size and small counties. The review period will end the previous quarter before the county review. For example, a September review would have a sample period of June through May.

7. The State Department shall conduct a review of a sample of non-certified kinship caregivers for county being reviewed. The sample sizes will be up to 25 providers for large counties (randomized), up to 12 providers for mid-size counties, and up to 5 providers for small counties. For small and mid-size counties, all files will be reviewed up to the maximum sample size.

(a) The samples will be obtained from the comprehensive child welfare information system prescribed by the State.

(b) The samples will be obtained from all kinship providers when the children)/youth are living in a non-certified kinship home, regardless of their length of stay (may include safety plans).

(c) The samples will not include biological parents who have parental rights intact, ICPC cases, kinship foster care homes, or closed cases.

B. Entrance conference:

1. An entrance conference will be offered in accordance with 12 CCR 2501-1 Section 1.151.

C. Scoring:

1. The State Department reviewer shall issue scores for the individual records and an overall score for the county practice.

2. Reviews are scored utilizing the state-approved non-emergency placement, emergency placement, and overall county scoring sheets and can be found at https://cdhs.colorado.gov/our-services/child-and-family-services/child-welfare/childwelfare-forms-and-policies.

3. Scores are based upon the number of applicable points which may vary based on casespecific circumstances.

D. Disputes:

1. If a county department disputes a score and requests to submit additional information in support of its dispute, the county department must submit the additional information by the close of business on the day the score is issued, or at a later time as may be negotiated by the reviewer and the county department. If the documentation is not produced within the specified time, the original score will remain.

2. If a county disputes a score or record, it may follow the appeals process pursuant to 12 CCR 2501-1 Section 1.151.

E. Exit conference:

1. An exit conference will be scheduled with the county department. In most circumstances, the exit conference will be held on the same day as the review, last day of the review, or as negotiated with the reviewer(s).

7.304.3 OUT-OF-HOME PLACEMENT CRITERIA

Not every child at risk needs out-of-home placement. These criteria are designed to provide a decision making model to assist in determining whether Core Service Program services and/or out-of-home placement are indicated. All three criteria must be met unless the youth is eligible for the foster youth transition program as described in 12 CCR 2509-3, 7.203.4.

Criterion 1: The child may be at imminent risk of out-of-home placement, as defined in Section 26-5.3- 102(1)(b), C.R.S., because one or more of the following conditions exist:

A. Abandonment by or incarceration of parents/relatives/caretakers;

B. Abuse/neglect - as defined in the Children's Code;

C. Domestic violence - as defined in Section 18-6-800.3, C.R.S.;

D. Conditions that exist to such a degree for either the child or caretaker so that the caretaker is unable to care for the child:

1. substance abuse; drug exposed infants 2. mental illness 3. disability 4. physical illness 5. homelessness E. Beyond control of parents;

F. Danger to self, others, or community;

G. Infant or young child of teen parent in placement;

H. Delinquency - adjudicated delinquent meeting current out-of-home placement criteria written pursuant to Section 19-2-212, C.R.S.;

I. Relinquishment or termination of parental rights;

J. Child returning home from out-of-home placement or moving to less restrictive level-of-care.

Criterion 2: Before considering placement, an assessment is completed to determine the level of risk. If assessment of risk determines that the child is at imminent risk of out-of-home placement, then child/family strengths are determined, and the appropriate services and/or community supports (reasonable efforts) needed to address the existing Criterion #1 conditions are identified. When these services are not immediately available, or are absent, unsuccessful, or exhausted, placement in the Core Services Program and/or out-of-home may be considered.

Reasonable efforts include the intervention strategies and advocacy efforts used:

A. To identify/locate appropriate parent/relative/caretakers if necessary to prevent out-of-home placement;

B. To assess the parent/relative/caretaker's ability to protect children;

C. To assist the parent/relative/caretaker and/or child in accessing and utilizing the identified services to address the presenting conditions.

Criterion 3: When placement is the best choice of available options/alternatives at this time to reduce risk to the child while continuing reasonable efforts to resolve the conditions which led to imminent risk, then, placement in the Core Services Program and/or out-of-home may occur.

7.304.4 AGE AND RESIDENCY REQUIREMENTS AND PAYMENT RESPONSIBILITY FOR

CHILDREN/YOUTH IN OUT-OF-HOME CARE [Rev. eff. 4/1/13]

A. A child is eligible for placement services on the basis of need from birth to age 18 when the child meets target group eligibility and all three of the placement criteria, regardless of whether the placement is voluntary or court ordered. A youth continues to be eligible for placement services if the court had jurisdiction prior to the 18th birthday or the youth is eligible for and receiving services through the youth in transition program as described in 7.203.4 (12 CCR 2509-3).

B. All children residing or present in the state are eligible for placement services when the criteria in the Target Group sections 7.201, 7.202, and 7.203, the Out-of-Home Placement Criteria section 7.304.3, and the Authority for Placement section 7.304.51, are met.

C. The child's county of residence shall be the county department which has financial and case decision-making responsibility for a child in out-of-home placement shall be the child's county of residence. The child's residence follows the parents' residence unless one or more of the following circumstances exist:

1. When the parent-child legal relationship has been terminated, the child's residence is the county in which the county department has legal custody of the child.

2. When the court has transferred legal custody to a county department and the parent-child legal relationship has not been terminated, the child's residence is that county until the court transfers custody to some other entity, including changes of venue as described in the following section, 7.304.4, E.

3. When a county department has legal custody and the court has also appointed a guardian, the child's residence is that of the county department holding legal custody.

4. When a child is in parental custody, the child's residence is that of the parents, or of the last caretaker parent, unless there is a court order giving custody to one of the parents. In that case, the child's residence is that of the parent with legal custody.

5. When a child is in the legal custody of an individual, the child's residence is that of the individual.

6. When the youth is receiving services through the Foster Youth in Transition Program, the youth’s residence shall be the county in which the youth resides, based on their self attestation. Any changes of jurisdiction for this population shall be determined as described in 7.203.43(A)(4).

D. Residence for school purposes may be determined on other factors, such as the type of facility in which the child is placed or the legal status of the child. See Educational Assessments in the Assessment and Case Planning section.

E. The county department shall transfer financial and service planning, and financial responsibility as follows:

If a parent whose residence is used to determine the county department's financial responsibility for a child in out-of-home placement moves to another Colorado county, the county department shall initiate procedures to transfer the financial responsibility to the new county, unless:

1. The court or the county department finds that the transfer of jurisdiction would be detrimental to the best interest of the child(ren); or, 2. The legal custodian has a history of frequent moves, except when there is evidence of stability in the most recent move, such as a signed lease whose term is six or more months, or there is other firm evidence of the intent to remain in the new residence for six or more months; or, 3. The case is within 3-6 months of resolution; or, 4. The custodial parent is committed to a state mental institute or correctional facility; or, 5. The custodial parent is residing temporarily in the receiving county to receive rehabilitation services, employment training, education, medical care, or shelter services; or, 6. Adjudication has not taken place; or, 7. Change in venue hinders achieving the child's permanency goal; or, 8. The case is an expedited permanency planning case, unless pursuant to Section 19-3- 201(2), C.R.S., wherein it states that is shall be presumed that any transfer of proceedings without good cause shown that results in a delay in the judicial proceedings would be detrimental to the child's best interest. Such presumption may be rebutted in court by preponderance of evidence; or, 9. When parental rights have been terminated for the child(ren); or, 10. If the case involves a juvenile for whom a juvenile delinquency filing has been made, pursuant to Section 19-2-105(1)(b), C.R.S.

F. Each county shall designate a Change of Venue coordinator.

G. When a motion for a Change of Venue has been made by the sending county, the sending county shall mail the Change of Venue motion to all parties and attorneys of record in the case and to the county attorney in the receiving county.

H. Within fifteen (15) calendar days after a court signs an order granting a Change of Venue and transferring jurisdiction, the sending county shall:

1. Provide written case information, if not located in the state automated system, to the designated Change of Venue coordinator in the receiving county which shall include, but need not be limited to:

a. Permanency goals;

b. Target dates related to the case;

c. Evaluations;

d. A current Family Services Plan;

e. Court reports;

f. Dates of placement moves;

g. Progress of the child(ren) in placement;

h. All Title IV-E eligibility determinations; and, i. Recommendations for continuing progress in the case.

2. Update all documentation in the case file and in the state automated system.

3. Provide information, to the extent known, concerning the physical location of the child’s parents, guardians, legal custodians, and relatives.

4. Prepare the case for transfer by:

a. Scheduling a family engagement meeting involving all parties, county department caseworkers and supervisors, and community providers; or, b. Conducting a case staffing between county caseworkers and supervisors in the sending and receiving county departments; or, c. Submitting a written case transfer summary.

5. Forward a complete copy of the case file from the sending county attorney’s office to the receiving county attorney’s office. Privileged attorney-client communications do not need to be included in the transferred case file.

I. The child, family, and foster care provider shall be prepared for the transition by the sending county department.

J. The sending county department is responsible for financial and service planning for the case and for payment of services through the calendar month in which the Change of Venue becomes effective. This date is to be confirmed by the sending county department in writing and there shall be no lapse in financial coverage during this process. If venue does not change, the sending county department retains financial responsibility.

K. The receiving county department shall provide courtesy supervision and available services during this transition. If venue does not change, the sending county department retains financial responsibility.

L. If a child is born while the mother is committed to a state mental institute or correctional facility, the county of residence prior to commitment shall be the county of fiscal responsibility.

M. When a child is placed for adoption, the county department holding legal custody and guardianship shall have fiscal responsibility for the child until the adoption is finalized.

N. If a child needs placement out of the home following finalization of adoption, the child's residence is that of the adoptive parents.

O. Residence related to subsidized adoption is addressed in the Adoption Services section.

7.304.5 SPECIFIC PROCEDURES FOR OUT-OF-HOME PLACEMENT 7.304.51 Authority for Placement The county department shall ensure that a child may enter any out-of-home placement only when:

A. Target group and placement criteria are met; and, B. An emergency is determined to exist and s/he is removed from the home by a law enforcement officer, with or without a court order, or, C. A parent has signed a voluntary placement agreement under conditions established by the county department and according to the Children's Code; or, D. A juvenile court, or a court acting as a juvenile court (including a tribal court), has ordered the child to be placed out of the home and has transferred legal custody to the county department or a social services department of a federally recognized Indian tribe, for placement in a family care home or other child care facility.; OR, E. A youth who is eligible for the Foster Youth in Transition Program as described in 7.203.41 (12 CCR 2509-3) has entered into a voluntary services agreement with the county department. 7.304.52 Family Search and Engagement A. When a child(ren)/youth has been placed in the legal custody of the county department, family search and engagement shall:

1. Be commenced for the noncustodial parent within three (3) working days. The county department must provide notification to the absent parent of the following:

a) The child(ren)/youth has been removed from the home; and, b) The option to participate in the care, treatment, or placement of the child(ren)/youth.

2. Be completed within thirty (30) calendar days for all grandparent(s), other adult relatives, or any identified kin. The county department of human or social services shall provide notification of the following information:

a) The child(ren)/youth has been removed from the home;

b) Options to participate in the care and planning for the child(ren)/youth including other options for contact between the relatives and kin and child(ren)/youth, with the primary goal of reunification; AND c) Information regarding placement of the child(ren)/youth, including:

1) Required background checks;

2) How relatives and kin may request the court review decisions to deny placement based on background checks;

3) Available services and supports, including information regarding the state’s entitlement plans and options as outlined in Section 7.304.21.F.3;

4) Information about kinship foster care certification, including:

(a) The requirements to become certified;

(b) How kinship foster care certification standards differ from traditional foster care standards;

(c) Why certification as a kinship foster home may be denied;

(d) Supports that are available for relatives and kin who are certified;

(e) A description of the relative guardianship assistance program; and (f) A description of the adoption assistance program.

5) Information about non-certified kinship care.

d) The relative or kinship caregiver’s right to intervene with or without an attorney following adjudication. e). Options that may be lost by failing to respond to the notice.

B. The county department shall assure that:

1. Parents are consulted regarding their suggestions for appropriate relative(s) or kinship caregivers.

2. Child(ren)/youth are consulted as appropriate regarding their suggested relative(s) or kinship caregivers.

3. When the court orders a delay in contacting specific relatives for good cause including, but not limited to, domestic or other family violence, then the county department shall discontinue the family search and engagement involving that relative(s) or kin until otherwise authorized by the court.

C. Family search and engagement shall occur for all child(ren)/youth including American Indian/Alaskan Native child(ren)/youth at least every six (6) months throughout the life of the case until the child(ren)/youth has achieved permanency, except as noted in Section 7.304.52.B.3, or when the following conditions exist:

1. A placement is stable with a relative or kin a minimum of six (6) consecutive months; and, 2. The relative or kin has committed to the legal permanence of the child(ren)/youth; and, 3. There is agreement among the parties that the relative or kin is the appropriate permanent option, the juvenile or district court finds it is the appropriate permanency plan, and it is in the best interest of the child(ren)/youth that family search and engagement be discontinued.

4. A non-relative foster care parent without a prior relationship to a youth twelve (12) years of age or older and his/her siblings residing in the same placement commits to the permanency of the child(ren)/youth. In addition, the juvenile or district court adopted a permanency plan of guardianship or Allocation of Parental Responsibilities (APR) and the requirements in Section 7.311.1.C.2 (Relative Guardianship Assistance Program) are met.

D. A family engagement meeting shall occur within thirty (30) calendar days when any of the following conditions exist:

1. The child(ren)/youth is in a family-like permanent setting without the provider expressing formal intent to provide legal permanence at the time that any of the following conditions exist:

a) The child(ren)/youth has been in out-of-home placement fifteen (15) of twentytwo (22) months; or, b) The child(ren)/youth has had two (2) or more unplanned moves within a twelve (12) month period; or, c) The child(ren)/youth is assigned a permanency goal of Other Planned Permanent Living Arrangement (OPPLA).

2. The child(ren)/youth is in out-of-home placement in a non-family-like setting without an approved permanency plan and any of the conditions in Section 7.304.52, D, 1, a-c, exist.

E. 7.304.52 does not apply to youth who are participating in the Foster Youth in Transition Program unless the youth consents and signs all applicable releases of information. The services described in this section shall be offered to these youth.

F. The county shall document all efforts in the Family Services Plan for the child(ren)/youth. Initial and ongoing family search and engagement results shall be reviewed and documented during ninety (90) day supervisory reviews, including documenting that relative(s) and kinship caregivers have been provided notice as required by Section 19-3-403(3.6)(a)(iv), C.R.S. 7.304.53 Court-Related Procedures A. County department staff shall work with the courts in order to best serve families, children, and adults. This includes, but is not limited to:

1. Providing competent and appropriate testimony. When the case involves the Indian Child Welfare Act, testimony shall be provided by a qualified expert witness (see Indian Child Welfare Act, “Definitions”, Section 7.309.1, L).

2. Identifying witnesses and evidence to be presented.

3. Being in compliance with the Indian Child Welfare Act.

4. Working with the legal representative of the county department and all other attorneys involved to serve the best interest of the child(ren) and family.

5. Ensuring that the court is provided names and addresses of parents, foster parents, preadoptive parents, and kin who are providing out of home care for a child in order that the court can inform and allow these individuals an opportunity to be heard at all hearings and reviews involving the child.

B. The county department shall document the following court related procedures in the case file:

1. The child and family’s legal status including custody, guardianship, parental rights, and other judgments issued by the court(s) of jurisdiction. The term “allocation of parental responsibilities” when used by the court shall be interpreted to mean custody for child welfare purposes. The term “allocation of parental responsibilities” shall not be used as a permanency goal.

2. Title IV-E related documents described in Section 7.601.71.

3. The reasonable efforts which have been made to prevent removal of the child from her/his home, the reasonable efforts that have been or will be made to return the child to her/his home, and the reasonable efforts to finalize a permanent plan. The specific actions taken shall be documented and submitted to the court. When the case involves the Indian Child Welfare Act, “active efforts” rather than “reasonable efforts” must be provided (see Indian Child Welfare Act, “Definitions”, Section 7.309.1, A).

When applicable, the county department shall document and submit to the court existing circumstances in which the court may determine that reasonable efforts are not required to prevent a child’s removal from the home or to reunify the child and family. These circumstances are:

a. A court has determined that the parent has subjected the child to aggravated circumstances as specified in Section 19-3-604(1) and (2), C.R.S.

b. A court has determined that the parent has been convicted of:

1) murder or voluntary manslaughter of another child of the parent; or, 2) aiding or abetting, attempting, conspiring, or soliciting to commit murder; or, voluntary manslaughter of another child of the parent; or, 3) felony assault that results in serious injury to the child or another child of the parent.

c. The parental rights of the parent with respect to a sibling have been terminated involuntarily unless the prior sibling termination resulted from a parent delivering a child to a firefighter or a hospital staff member pursuant to the provisions of

Section 19-3-304.5, C.R.S.

d. Youth who are participating in the Foster Youth in Transition program as described in 12 CCR 2509-03, Section 7.203.4, et seq., pursuant to Section 19- 7-307(2), C.R.S.

4. That the court and the parents are notified of any change in placement before the change unless the child is in immediate danger.

5. That a record is kept of all family time and of reasons planned visits did not occur.

6. That the court, the parents, and the child are given written notice ten days before any determination which affects the parent’s family time rights unless the child’s health or well-being is endangered by delaying action or would be endangered if prior notice was given. The caseworker shall keep a copy of this notification in the case record.

7. The treatment plans, including the Family Services Plan and court ordered plan, that have been attempted to return the child to the family home.

8. That the county has requested the court, in its periodic reviews, to make findings regarding the continued necessity and appropriateness of placement, the extent of compliance with the case plan, the extent of progress which has been made toward alleviating or mitigating the causes necessitating the placement, and projecting a likely date by which the child may be returned home or placed in an alternate permanent living arrangement.

C. The county department shall file a dependency and neglect petition when there are protective service issues that either present imminent danger or indicate that the environment is injurious and the case requires court jurisdiction.

D. When protective issues are not significant, county departments may refer children with intellectual, physical, or emotional disabilities to community or home-based services. If homebased or community services are not sufficient or successful, the county department may offer voluntary out-of-home placements for children who meet the criteria. If voluntary out-of-home placements are not offered, the county department shall have a written policy stating that voluntary placements are not provided.

The county department shall ensure that a placement contract is signed before a voluntary placement is made. The county department shall:

1. File a Petition for Review of Need for Placement within 90 calendar days of placement, if the placement is expected to exceed 90 calendar days.

2. Ensure that the child’s parents, guardian, and legal custodian are informed of the substance of the Petition for Review of Need for Placement.

3. File a review report with the court every six months, thereafter, or more frequently, when ordered by the court, until the placement is ended. When an Administrative Review conducted by the Administrative Review Division substitutes for a court review, a summary containing the same information as would be submitted to the court shall be completed and filed in the case record in accordance with 12 CCR 2509-7, Section 7.601.6, B. The county department shall submit this written summary with the Administrative Review findings to the court.

4. Ensure that a court decree giving the county placement and care responsibility is obtained within 180 calendar days of placement. The order must state that continued placement is in the best interests of the child and either that reasonable efforts have been made to reunite the child and family or that the plan is for the child not to return home.

5. Ensure that the permanency planning hearing order for voluntary placements conforms with the requirements discussed under that section.

E. When a child is returned to the home, the county shall request the court to return legal custody of the child to the parent or guardian, except in cases covered by the Interstate Compact for the Placement of Children.

F. When a child is removed from the home, the county department must initiate a request for temporary custody hearing per Sections 19-3-312,19-3-401, and 19-3-403, C.R.S. The Family Services Plan shall be used as an Interim Treatment Plan in Court involved cases, to be available 30 calendar days after the child’s removal from the home or 30 calendar days after filing of the petition, whichever is earlier.

G. The county department shall notify the court of jurisdiction and other parties within 10 calendar days of receipt of a report that a child has run away from placement.

H. Copies of Administrative Review findings shall be filed in the case record and a summary of those findings shall be included in court reports. For those cases in which an Administrative Review substitutes for court reviews, counties shall submit a copy of the actual review findings to the court with the county’s court report.

I. Recommendations to the court regarding out-of-home placement of a child who has been adjudicated a delinquent, shall contain specific facts and reasons supporting the recommendations and the cost of the recommended placement.

J. When a child is temporarily absent from placement because he or she is in detention, psychiatric or medical hospitalization, or on a trial visit home, the placement is considered to be continuous for up to six months for federal review purposes if the county retains legal custody or has placement and care responsibility through a voluntary placement agreement or Petition to Review the Need for Placement. If the child returns to out-of-home placement during this time, a new removal order is not needed. Within the trial home visit time period, when the agency determines it is in the best interest of the child to continue to live in the planned permanent home, the county agency shall request the court to consider relieving the department of custody in these cases.

K. A trial home visit shall occur when it is necessary to assess the child’s or youth’s safety and wellbeing while residing in the planned permanent home. The time period of the trial home visit shall be determined by the agency and reviewed by the court as part of the reunification process prior to the permanent custodial return of the child or youth to the parents or planned caregivers.

1. Trial home visits shall be documented in the State Department’s automated data system.

2. A trial home visit may exceed six months in duration if a court orders a longer trial home visit. If a trial home visit extends beyond six months and has not been authorized by the court or exceeds the time period the court has deemed appropriate, and the child is subsequently returned to foster care, that removal must then be considered a new removal and Title IV-E eligibility must be newly established. Under these circumstances, the judicial determination regarding contrary to the welfare and reasonable efforts to prevent removal are required.

L. Change in Venue procedures are outlined in Section 7.304.4, F, G, and H.

M. When court-ordered, the county department of human or social services shall share a foster care home, kinship foster care home, and/or non-certified kinship care home provider’s reports of fingerprint-based criminal history record information check generated from the Colorado Bureau of Investigation (CBI) and Federal Bureau of Investigation (FBI) with the guardian ad litem, related to the placement of a child and/or youth in out-of-home care.. 7.304.54 Court Procedures Related to Permanency Planning [Rev. eff. 3/1/16]

A. The county department must develop a permanent plan for any child who is in out-of-home placement and is the subject of any court action, including Dependency and Neglect, Delinquency, Petition to Review the Need for Placement, or a Foster Youth in Transition Program case and a concurrent plan for cases filed under Section 19-3-102(2), C.R.S., regarding habitual abuse. The purpose of the plan is to establish treatment needs related to the stated goal for the child and to decide a method to provide a safe, stable, permanent environment for the child as quickly as possible B. The county department shall submit this plan at the permanency court hearing. That hearing must be held before twelve (12) months have elapsed from the date of the child's original out-of-home placement, and shall be held as soon as possible following the dispositional hearing. Following the initial permanency hearing, subsequent permanency hearings must be held every twelve months thereafter while the child remains in out-of-home care. These hearings shall be combined with a periodic review when possible.

C. The county department shall provide the court with documentation of the efforts made by the department to finalize the permanency plan for the child. The county department shall request the court to make a finding (if the evidence so warrants) that the department made reasonable efforts to finalize the permanency plan for the child.

D. Paper reviews, ex parte hearings, agreed orders or other actions or hearings which are not open to the participation of the parents of the child (if appropriate age) and foster parents or preadoptive parents are not permanency hearings.

E. When the court determines that reasonable efforts to return the child home are not required, the county shall request that the permanency hearing be held no later than thirty (30) calendar days after such court determination, unless the requirements of the permanency hearing are fulfilled at the hearing in which such a determination is made.

F. The county department shall ensure and document that a request is made to the court for such a hearing in sufficient time to assure that the hearing is held within the twelve (12) month time frame. Permanency hearings shall be combined with a review hearing when possible.

G. The county department shall include, in the permanency plan, recommendations to the court on either:

1. Returning the child to his/her parent or guardian within the next six months; or, 2. Permanent placement with a relative through adoption; or, 3. Permanent placement with a relative through guardianship or permanent custody; or, 4. Adoption (non-relative); or, 5. Legal guardianship/permanent custody (no-relative); or, 6. Return home through reinstatement of parental rights; or, 7. Other planned permanent living arrangement through emancipation; or, 8. Other planned permanent living arrangement through relative long term foster care; or, 9. Other planned permanent living arrangement through non-relative long term foster care.

H. For permanency goals 8 or 9, the county department shall ensure that the plan contains the name or other identifier, such as the system provider number, if the name of the provider must be kept confidential, of the specific placement and the date that placement shall end.

I. For permanency goals 7, 8, and 9, the following requirements shall apply to the county department of human or social services for purposes of approving the case plan and the case review procedure for youth, except for youth participating in the Foster Youth in Transition Program:

1. At each permanency hearing held with respect to the youth, provide documentation of the intensive, ongoing, and, as of the date of the hearing, unsuccessful efforts made to address the following:

a. Return the youth home;

b. Secure a placement for the youth with a fit and willing relative (including adult siblings), a legal guardian, or an adoptive parent; and, c. Include efforts that utilize search technology (including social media) to find biological family members for the youth.

2. Provide compelling reasons why it continues not to be in the best interests of the youth to return home, be placed for adoption, with a legal guardian, or with a fit and willing relative.

J. The county department shall request that the court order contain specific findings regarding the above goals.

K. The county department shall assure that the permanency hearings determine whether an out-ofstate placement continues to be appropriate and is in the best interest of the child.

L. The county department shall assure that the permanency hearings determine whether the permanency plan includes services for a successful adulthood for a child fourteen years of age or older.

M. Permanency hearings are required to be held if a termination is under appeal, for children placed in a permanent foster home with a specific caregiver, and for children who are free for adoption and are placed in adoptive homes pending the finalization of the adoption.

N. The county department shall file for termination of parental rights no later than the end of the 15th month of placement for any child who has been in foster care under the responsibility of the state for 15 of the last 22 months unless there is a compelling reason submitted to the court identifying why it is in the child’s best interest to not terminate parental rights.

O. The county department shall file for termination of parental rights no later than sixty (60) calendar days after the court determines that the child is an abandoned infant, unless there is a compelling reason submitted to the court identifying why it is in the child’s best interest to not terminate parental rights.

P. The county department shall file for termination of parental rights no later than sixty (60) calendar days after a judicial determination is made that reasonable efforts to reunify the child with the parent are not required, unless there is a compelling reason submitted to the court identifying why it is in the child’s best interest to not terminate parental rights.

Q. The county department shall discuss the purpose and responsibilities of relative guardianship with the parents or legal custodian of a youth or child and the importance of achieving permanency. 7.304.55 Court Procedures Related to Termination of the Parent-Child Legal Relationship A. The county department shall consider termination of the parent-child legal relationship as a part of the permanency planning process. Termination is a court action that permanently divests the child and parent of all legal rights and responsibilities with respect to each other. It does not modify the child’s status as an heir at law, which occurs when there is a final decree of adoption.

Termination of the parent-child legal relationship with both parents frees a child for adoption.

B. When the county department files a petition for dependency and neglect, the petition shall include a statement related to termination of the parent-child legal relationship as required in the Colorado Children’s Code, Section 19-3-502(3)(a), C.R.S..

C. The county department shall give primary consideration to the physical, mental, and emotional conditions and needs of the child when considering filing a motion for termination, and when making any reports and recommendations to the court.

D. The county department shall ensure that the child’s psychological and medical conditions have been evaluated and that the results of those evaluations indicate that termination is in the best interest of the child.

E. The county department shall consider termination of the parent-child legal relationship based on a finding of parental unfitness as outlined in the Colorado Children’s Code, Sections 19-3-604(1)(a) through 19-3-604(1)(c), C.R.S. and 19-5-105 (3.1), C.R.S.

F. The county department shall gather information to present the court with clear and convincing evidence regarding the criteria for termination and evidence beyond a reasonable doubt in the case of children eligible under the Indian Child Welfare Act.

G. In planning for termination of the parent-child legal relationship, the county department shall:

1. Work with the county’s attorney in preparation of the court case.

2. Provide a treatment plan for the court’s approval.

3. Cooperate with any guardian ad litem AND/OR COUNSEL FOR YOUTH for the case.

4. Provide prepared staff to testify at the termination hearing, identify other witnesses, and assist in preparation of witnesses.

5. Keep parents, children, and appropriate interested parties informed regarding hearings and the status of the case.

6. File a motion for termination no less than 30 calendar days before the hearing.

H. Prior to and following termination of the parent-child legal relationship by the court, the county department shall:

1. Consider legal custody or adoption by relatives when in the child’s best interests.

2. Determine resources available for an adoptive placement or alternative permanent plan which best meets the needs of the child.

3. When filing a motion to terminate parental rights, county staff shall begin efforts to recruit, identify, process and approve a qualified adoptive family for the child and document such efforts in the Family Services Plan.

4. Prepare a report for the court to be presented at a hearing scheduled within 90 calendar days following the date of termination. The report shall indicate what disposition of the child’s case has occurred.

I. Permanency hearings are required to be held if a termination is under appeal or if a child is in a pre-adoptive placement following termination.

J. When the county department has legal custody/guardianship following termination of the parentchild legal relationship, the county department shall not close the child’s case until:

1. The child is adopted; or, 2. The child reaches 18 years of age and the court does not continue its jurisdiction; or, 3. The child is emancipated before 18 years of age; or, 4. The court transfers legal custody to another individual or agency; or, 5. The court otherwise terminates the county department’s legal responsibility.

7.304.6 PLACEMENT ACTIVITIES 7.304.61 Pre-Placement Activities A. The child/youth shall have a medical examination before placement or a screening as soon as is reasonably possible after placement. The county department shall assure that the screening is consistent with the Early Periodic Screening Diagnosis and Treatment initial screening described in Section 8.286.01 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10). If a medical, dental, or psychological evaluation is necessary and cannot be covered under Medicaid, third-party insurance, or other sources, the county department may purchase it under program services. See General Information and Policies

section (7.000) and Resources, Reimbursement, and Reporting Section (7.400) of this manual.

B. Prior to the placement of a child/youth in a child placement agency or county foster care home, the placing agency may review the written family assessment, home study, and background checks of the foster parent(s) for use in determining if the home is appropriate for the needs of the child/youth.

C. When the child/youth is part of a sibling group and the sibling group is being placed out of the home, it shall be presumed that placement of the entire sibling group in the joint placement is in the best interests of the children/youth in order to sustain family relationships. Such presumption may be rebutted by the county by a preponderance of the evidence that placement of the entire sibling group in the joint placement is not in the best interests of a child/youth or of the children/youth. The county shall make thorough efforts to locate a joint placement for all of the children/youth in the sibling group unless:

1) It is not in the best interests of the children/youth to be placed as a group and 2) These efforts do not unreasonably delay permanency for any child.

These efforts depend upon the county’s ability to locate an appropriate, capable, willing, and available joint placement for all of the children/youth in the sibling group. Efforts to place siblings as a group shall be documented in the child/youth’s case record.

D. The county department shall share all available information about the child, including relevant social, medical, and educational history, behavior problems, court involvement, family time plans, and other specific characteristics of the child, with the provider before placement. It shall share additional information when obtained. The county department shall inform foster parents of court hearings involving children in care.

E. A child's foster care placement shall not be delayed in order to recruit a same race home when a foster family is available who is of other ethnic or racial identity than that of the child.

F. The county department shall document all pre-placement activities in the case file.

1. an infant that is six (6) months of age or younger must not be placed in a foster care home where any caretaker in the home is not current on influenza and pertussis vaccinations. if the provider is providing care for infant(s) under 6 months of age, the provider must be current on the influenza and pertussis vaccinations. a medical exemption is allowed when an individual has a medical condition that prevents them from receiving a vaccine. a non-medical exemption is allowed when an individual has religious beliefs whose teachings are opposed to immunizations or a personal belief that is opposed to immunizations. if an exemption applies, the provider(s) must provide a written statement detailing the

basis for the applicable exemption to the agency that licenses the provider(s).

G. The county department shall execute the Provider Contract and Agreement with county department certified foster homes and county department sponsored group homes, and the agreement to purchase Child Placement Agency or Residential Child Care Facility services with Child Placement Agencies and Residential Child Care Facilities before placement. The Agreement to Purchase form is child specific and shall be completed for each child placed through a Child Placement Agency or with a Residential Child Care Facility.

1. Placement contracts shall specify the responsibilities of the provider and the county department in the services to be delivered to the child and family in conjunction with the Family Services Plan. The placement contracts shall also require twenty-four (24) hour out-of-home care facilities to have staff present and trained in how to make decisions using the reasonable and prudent parent standard when approving extracurricular, enrichment, cultural, and social activities; and, 2. County departments shall provide twenty-four (24) hour out-of-home care providers with a copy of the policy that identifies activities that providers trained in the reasonable and prudent parent standard may approve, and activities that require county department approval.

H. When a youth is participating in the Foster Youth in Transition Program:

1. With the participating youth’s consent, the youth’s housing may be in any placement approved by the county or the court for which the youth is otherwise eligible, including a supervised independent living arrangement as described in 7.305.2(D), and is the least restrictive option to meet the participating youth’s needs; or 2. If the participating youth needs placement in a qualified residential treatment program, then the placement must follow all of the requirements required for the county to place a child/youth in a qualified residential treatment program. 7.304.62 Placement Activities The county department shall:

A. Give the provider a written record of the child's/youth’s admission to the home at the time of B. Give the provider a written procedure or authorization for obtaining medical care for the child and assure that the provider receives the child's/youth’s state identification number and Medicaid card for Medicaid eligible children in a timely manner.

C. Give the provider a copy of the Family Services Plan for the child/youth at the time of placement or when it is completed following placement.

D. Document the above placement activities in the case file.

E. Add the placement in the Department's automated reporting system prior to the next payroll.

F. Within four weeks of the initial placement, give the provider a complete medical history for the child. The medical history shall contain, to the maximum degree possible, the information listed in the Department of Human Services Health Passport.

G. Provide the child/youth with a full medical examination scheduled within fourteen (14) calendar days after placement and a full dental examination scheduled within eight (8) weeks after placement. The schedule of the appointments shall be documented in the case record. The county department shall maintain the medical and dental information in a record which is kept with the child/youth during placement and upon return home, emancipation, or adoption. The county department shall document that ongoing medical and dental care is provided in a timely manner as defined by the department and by the health care provider. If the child/youth received the required full medical examination at the time of the placement, then the regular schedule of appointments should be maintained in subsequent placements.

If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the medical and dental exams cannot be completed for the child/youth in the required time frame, the medical exam and dental exam must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

H. Document the exceptional circumstances which require an emergency or temporary placement to last longer than sixty (60) calendar days.

I. Except in emergency situations, make subsequent placements according to court order and shall notify all parties to the extent possible.

J. Not move a child from one short-term emergency placement to another unless all reasonable efforts to return the child to the child’s home or to place the child in a more permanent setting have been exhausted and are documented in the Family Services Plan.

K. Not move a child more than twice unless such move results in a permanent placement or is determined to be in the best interests of the child and the reasons for the additional move are documented in the child's Family Services Plan.

L. Notify the guardian ad litem and/or counsel for youth, parent(s) or legal guardian within one (1) business day upon a child/youth’s placement into a foster care home. The Guardian Ad Litem’s AND/OR COUNSEL FOR YOUTH’S contact information shall be provided to the foster parents.

M. If it is in the best interest of each sibling, the county department shall notify the siblings of any child/youth in foster care or kinship care, of sibling placement and changes in sibling placement, catastrophic events, or other circumstances, including but not limited to significant life events, as defined by the county department and in consultation with the family, youth and GAL when N. Provide notice of, and a right to be heard at, any Administrative Review to the child/youth (if age appropriate), foster parents, pre-adoptive parents, or relatives providing care to a child/youth and, upon written request, a written notice of the court hearing, which identifies the following:

1. The child/youth’s current court case number;

2. The date and time of the next court hearing; and, 3. The name of the magistrate or judge and the court division to which the case was assigned.

O. Upon receipt of written notice by a foster parent, employees of State and county departments, or others with the need to know, are prohibited from releasing personally identifying information about a foster parent, other than the first name, to any adult member of the foster child/youth’s family, unless the foster parent subsequently provides written consent for the release of information.

P. Provide at the time of initial placement and at least annually thereafter to the child(ren)/youth contact information for all siblings in foster care, which may include a telephone number, address, social media accounts, and e-mail address, unless a foster parent has requested the foster parent's identifying information not be disclosed, and to receive updated photos of siblings regularly by mail or e-mail, as appropriate.

Q. Refer to Section 7.406.1, F, for the applicable criteria when a child/youth will be absent from the designated out-of-home placement and the county elects to reimburse the provider using the seven (7) day or thirty (30) day policy.

R. Allow out-of-home care providers, who are trained in a reasonable and prudent parent standard, to authorize children and youth to participate in community-based activities without the need for a fingerprint-based criminal record background check for the adult(s) involved in the activities. A decision to allow participation shall be based on trained providers using a reasonable and prudent parent standard, as defined in Section 7.701.200, A (12 CCR 2509-1), and the procedures defined in Section 7.701.200 (12 CCR 2509-8).

S. Respond to issues related to human trafficking as outlined in Section 7.303.4.

T. If a disqualifying factor (refer to Section 7.000.2 (12 CCR 2509-1)) is identified following the placement of a child and/or youth in a non-certified kinship care home, the county department of human or social services shall evaluate the appropriateness of continuing the placement. A plan shall be developed to address the concerns as soon as possible, and the concerns shall be remedied no later than two weeks after the date of placement. The following shall be documented in the state automated case management system in the contact log in the resource section or in the record:

1. The circumstances of the placement;

2. The vulnerability of the child and/or youth, including age and development;

3. Safety issues impacting the child and/or youth;

4. Supports needed by the non-certified kinship caregiver(s);

5. Identify alternative solutions to removal of the child and/or youth from the placement and document the solution in the family service plan including, but not limited to, the family’s current status in the following domains:

a. Risk and safety;

b. Level of functioning;

c. Strengths;

d. Specific concerns to be addressed;

e. Services and supports needed; and, f. Changes that must occur to mitigate the concerns.

6. When the disqualifying factor cannot be mitigated, the alternative solution and plan does not resolve the concerns about appropriateness of the placement, or timeframes are not met, the county department shall remove the child /youth from the placement.

U. Assure that each child or youth in out –of –home care is accompanied to psychiatric appointments by an adult who has knowledge about the daily functioning and behavior of the child or youth, except for youth receiving services through the Foster Youth in Transition Program. 7.304.63 Out of State Placement Activities A. All out-of-state placements for kinship, foster, group, or residential care must comply with the Interstate Compact for the Placement of Children, Section 7.307.

B. County departments must follow federal guidelines and shall not place children out of state who are in care under a placement contract (voluntary placements). Such placements can only be made by a parent or guardian. 7.304.64 Family Time and Supervision A. in all cases where counties have primary responsibility for a child/youth in out-of-home placement, including all types of kinship placements, an appropriate family time plan shall be established and documented in the comprehensive child welfare information system (CCWIS).

The family time plan shall specify:

1. The frequency, location, and duration type of contact by the parents/caregiver(s).

2. The persons that may be present during family time.

3. Method of family time, which shall include if family time should be supervised or unsupervised and the level of supervision and by whom; it is presumed that supervision be conducted by informal supports, when available, and occur in the community, a homelike environment, or other agreed upon location unless the child/youth's safety, or mental, emotional, or physical health requires professional supervision.

4. The child or youth’s opportunity to communicate with the parents, siblings, or other relatives outside of family time.

5. The purpose of the family time.

6. Special considerations or restrictions such as federal or state disability laws.

7. The county department and the court shall consider a parent's preferences when determining supervision, location, and timing of family time.

8. The county department and the court shall consider a child's or youth's preferences when determining supervision, location, and timing of family time, including the child/youth's refusal to participate in the family time.

B. Within thirty (30) days of the child/youth’s removal, the county shall provide the court with family time recommendations that are consistent with the child's or youth's age and developmental needs and best interests. This shall be documented in the comprehensive child welfare information system (CCWIS).

C. Whenever possible, the family time plan shall be developed in collaboration with the family; all family time is to include the maximum contact possible.

D. Child(ren)/youth in out-of-home care shall receive an age-appropriate and developmentally appropriate document from the county department detailing their rights regarding sibling contact:

1. Within thirty days of the date of any placement or any change in placement;

2. On each occasion that a child/youth's case plan is modified;

3. At each placement where the child(ren)/youth resides; and 4. On at least an annual basis.

E. the county department shall include information regarding sibling contact in the family time plan.

The child(ren)/youth shall be consulted about their wishes as to sibling contact. In developing the family time plan, if it is in the best interests of each sibling, the county department shall:

1. Promote frequent contact between siblings in foster care, which may include telephone calls, text messages, social media, video calls, and in-person time;

2. Clarify that sibling contact should not be contingent upon parental contact.

3. Clarify that restriction of sibling contact should not be a consequence for behavioral problems.

4. Ensure that timely and regularly scheduled sibling time are based on individual circumstances and needs of the child(ren)/youth.

F. Sibling contact should occur with sufficient frequency to promote the continuity of the relationships unless:

1. The county department has determined that it is not in the best interests of one or both children/youth or 2. It has been determined in consultation with the county/city attorney and the district attorney that criminal action is pending in any jurisdiction where either sibling is a victim or witness and that such sibling contact may have a detrimental effect upon the prosecution of the pending criminal action, or 3. Contact is not permitted because it would violate a known existing protection order pending in any state.

4. If, in arranging sibling contact, a county department determines that such contact would not be in the best interests of one or both of the siblings, the county department shall deny the request, document its reasons for making the determination in the comprehensive child welfare information system (CCWIS), and provide the siblings with an explanation for the denial, as permitted under state and federal law. as soon as practicable after making a decision affecting sibling contact, the county department shall notify the GAL(s) or counsel for youth (CFY) appointed to the case.

G. The family time plan shall be reviewed and modified on an ongoing basis for the duration of the case and shall be aligned with the families' needs. Any such changes in the family time plan shall be documented in the Child Welfare Information System (CCWIS) and in every court report.

H. Youth participating in the foster youth in transition program are not required to have a family time plan with their parent(s).

I. Family time with parents who are incarcerated 1. In addition to the requirements listed in 7.304.64, The County Department shall:

a. Contact the parent who is incarcerated and the Family Services Coordinator or other designated communications liaison of the facility to determine what options are available for in-person family time, to make reasonable efforts to support inperson family time, and to make reasonable efforts to facilitate family time through audio-visual communication and/or other emerging available technology when in-person family time is not reasonably practicable.

b. Document the efforts to coordinate and facilitate in-person family time or family time through audio-visual communication or other available technology in the CCWIS and in every court report.

7.304.641 RESTRICTING OR SUSPENDING FAMILY TIME

A. Family time is not required if it violates an existing protection order in Colorado or any other state with lawful jurisdiction.

B. If in-person family time is made impossible due to the policies of a facility where a parent is incarcerated or in treatment or if a county department is certain that a parent will not be present for a planned visit based on communication with the parent and child/youth, the county department is not required to transport a child/youth for planned family time.

C. If restricting or suspending ongoing family time is necessary to protect the child’s or youth’s safety or mental, emotional, or physical health, the caseworker shall contact the county attorney to notify the court and request a hearing to determine whether ongoing family time shall be reduced or suspended. This procedure is necessary when any of the following ongoing changes are necessary to protect the child or youth:

1. A change in the level of supervision to a more restrictive level of supervision.

2. A change from in-person to virtual or other forms of contact that are not in-person;

3. A change in the location of supervision to a more restrictive environment.

D. It shall not be necessary for the county department to seek a court order to reduce or suspend family time in the following circumstances:

1. Circumstantial time-limited cancellation of scheduled family time;

a. When allowing the family time to proceed as scheduled would endanger the child’s or youth’s safety or mental, emotional, or physical health at that visit or, b. Unforeseen circumstances such as inclement weather and illness or, c. A parent has consented to or requested cancellation.

2. All parties in a dependency and neglect action have consented in writing, after speaking with their legal representative, to an ongoing alteration to a family time schedule, level of supervision, location of family time, or other terms and conditions of family time.

3. The community supervisor or kin is no longer available or willing to supervise family time, and another community supervisor or informal support has not been identified, but the department or agreed upon third party supervisor is able to supervise the current courtordered frequency and duration of family time.

E. At a hearing when the county department requests a reduction or suspension of family time, the county shall ensure the court has up-to-date information about the status of family time and make relevant information, including the information it is basing the decision to request a reduction or suspension in family time, available to all parties.

F. family time or contact between a child or youth and the child’s or youth’s parent or sibling shall not be limited as a sanction for the child’s or youth’s behavior or as an incentive to change the child’s or youth’s behavior.

G. Family time shall not be reduced or suspended as a sanction for the parent’s failure to comply with court orders or services if the child’s or youth’s safety or mental, emotional, or physical health is not at risk as a result of family time.

H. Any written agreements should be filed with the court or included in the next submitted written court report.

I. When making recommendations to suspend or restrict family time, the caseworker should consider whether modifications to the parent’s treatment plan, if one exists, are necessary to address the issues leading to a reduction in or suspension of family time and shall make recommendations to the court if necessary.

J. In the 90-day review, the county shall update whether the continued reduction in or suspension of family time remains necessary to protect the child’s/ youth’s safety or health and what conditions are necessary for family time to resume.

K. The state, county department, and child placement agencies may not set a universal policy restricting or denying family time. 7.304.65 Administrative Review Definition:

Administrative Review means a review conducted by the Colorado Department of Human Services, Administrative Review Division, that is open to the participation of the parents of the child, the child (if age appropriate, as determined by the caseworker), and the out-of-home care provider, pre-adoptive parents, or relatives/kin who are providing out-of-home care for the child; and conducted by an Administrative Reviewer, who is not responsible for the case management of, or the delivery of services to, either the child or the parents who are the subject of the review. If there is no objection by any party to the action, the court may order that an Administrative Review substitute for a six (6) month periodic review. All attorneys of record must be invited to court ordered Administrative Reviews.

A. The county department shall participate in the statewide Administrative Review system for all children in foster care who meet the criteria for inclusion in the review system.

B. The county department shall provide all required case records, documentation and information to the Administrative Reviewer no later than 8:00 a.m. the day of the scheduled review to allow the reviewer sufficient time to read the case file in its entirety prior to each scheduled review. If the hard copy case record is not available to the reviewer by 8:00 a.m. the day of the scheduled review, case information shall be obtained through the Department’s statewide automated system.

C. The county department shall provide office space for case record review and face-to-face reviews, access to the Department’s statewide automated system, and teleconference capability.

D. The county department shall coordinate, with the Administrative Reviewer, timely scheduling of all initial and subsequent Administrative Reviews.

E. The county department shall invite the following to the administrative reviews, so that these individuals will have a right to be heard, and all invitees shall be encouraged to attend:

1. For out-of-home case reviews, the following shall be invited:

a. Parents, b. The child (if age-appropriate as determined by the caseworker), c. Out-of-home care providers, d. Pre-adoptive parents, e. Relatives/kin who are providing out-of-home care for the child, and, f. Guardian ad Litem and/or counsel for youth.

2. For Foster Youth in Transition reviews, the youth and counsel for youth and guardian ad litem (if applicable) shall be invited to the review and the youth shall be offered the opportunity to invite the following:

a. Parents, b. Out-of-home care providers, c. Pre-adoptive parents, d. Relatives/kin who are providing out-of-home care.

F. If an Administrative Review has been ordered by the court and no objection has been made to the substitution of the Administrative Review for the six (6) month periodic court review, the county department shall also invite to the review all attorneys of record in the case. When an Administrative Review substitutes for a six month periodic court review, the county department shall complete a case summary containing the same information that would be submitted in a court report as required in Section 7.601.6 B, and the county shall submit this written summary with the Administrative Review findings to the court.

G. The county department shall send letters of invitation to all review participants at least two weeks prior to scheduled reviews, and ensure that invited parties are properly documented in the Department’s statewide automated system prior to the time of the review. The parent or Indian custodian and the Indian child’s tribe shall be sent letter(s) of invitation at least two weeks prior to the scheduled review by certified or registered mail with return receipt requested. All other invitations may be sent by electronic mail. Invitations shall include date, time, location, and

purpose of the review. If the case involves an Indian child, the requirements of the pending court proceedings section of the Indian Child Welfare Act of 1978, 25 U.S.C. § 1912(a), and § 19-1- 126, C.R.S.

H. The county department shall encourage all invitees to attend Administrative Reviews (see Section 7.304.661.A, regarding, provider attendance). If an individual is unable to attend, participation by conference call shall be offered.

I. Administrative Reviews shall be held at the county department having custody of the child, irrespective of the location of the child’s placement.

J. Administrative Review Findings 1. Copies of Administrative Review findings shall be maintained in the Department’s statewide automated system and a summary of those findings shall be included in court reports. For those cases in which an Administrative Review substitutes for a six month periodic court review, counties shall submit a copy of the actual review findings to the court with the county’s court report.

2. For all narrative findings that contain “Issues for County Administration”, the county is required to respond to the Administrative Review Division within the time frame specified in the narrative depending on the issue identified.

a. A county response shall be sent to the Administrative Review Division.

b. If the county response is considered sufficient and timely, no further action is taken and the county shall be notified in writing within five (5) working days.

c. If the county’s response is not timely or sufficient, notification will be given to the county and appropriate division(s) representative for further follow up/action.

d. An internal meeting will be held with the appropriate division(s) and their representatives within a maximum of twenty (20) working days to determine next steps and time frames for resolution.

e. If the issues are unresolved, a corrective action process may be pursued.

K. Confidentiality 1. The federal confidentiality requirements at Section 471(a)(8) of the Social Security Act provide safeguards which restrict the use of, or disclosure of, information concerning individuals served by the child welfare agency, and these same rules apply to the Administrative Review process.

2. Audio and/or video recording of Administrative Reviews shall not occur without releases of confidentiality forms signed by all parties to the case prior to recording. 7.304.651 Qualified Residential Treatment Program Placement Reviews Definition:

A Qualified Residential Treatment Program (QRTP) Placement Review means a review conducted by the State Department’s Administrative Review Division (ARD), that is open to the participation of the parents, legal guardian or custodian of each child or youth, the child or youth (if age appropriate as determined by the caseworker), the QRTP staff, and attorneys of record; and conducted by a placement reviewer, who is not responsible for the case management of, or the delivery of services to the child or youth who is subject to the review.

A. The county department shall participate in the QRTP Placement Review for all children in QRTP placements who meet the criteria for inclusion in the review system.

B. Identification of youth eligible for an ARD QRTP Placement Review 1. Children and youth are eligible for a review conducted by the ARD at or before 90 days of placement in a QRTP.

2. For cases that are court involved, all parties to the case must consent to a review by the ARD. If all parties do not consent the review will remain with the courts.

3. The determination that all parties consent that the ARD will review the placement at 90 days must happen no later than the 60 day court review.

4. For cases that are court involved, the county department shall document that each party consented to the QRTP Placement Review to be conducted by the ARD instead of the court. The county department shall document this consent in the Comprehensive Child Welfare Information System.

5. At each subsequent review the county department will ask the parties in attendance if they consent to the next review being conducted by the ARD. County departments will be responsible for seeking consent for any parties who were not at the review no later than 30 days prior to the next review.

6. In instances of a voluntary placement, the ARD shall review the child or youth’s placement no later than 60 days after placement in a QRTP or within 30 days after placement when the qualified individual does not support the QRTP level of care or the child, juvenile, or youth, guardian ad litem and/or counsel for youth, or any party objects to the placement.

C. Scheduling process for ARD QRTP Placement Reviews 1. For cases that are court involved, the county department shall coordinate with the ARD to schedule the review no later than 1 business day after the 60 day court review.

a. Scheduling shall include determination of the following:

i. Day of the review.

ii. Time of the review.

iii. Venue for the review.

2. In instances of a voluntary placement the county will notify the ARD of the need for review no later than two business days after placement and the scheduling process shall commence.

3. If a child or youth leaves the QRTP level of care after a review has been scheduled, the county department must cancel the review and notify the ARD and all parties as soon as D. Invitations 1. The county department shall invite parents, legal guardian or custodian, the child members selected by the child (for children 14 years of age and above), kin, out-of-home care providers, and attorneys of record to the QRTP Placement Review. The county department shall encourage all invitees to attend.

2. The county department shall send letters of invitation to all review participants at least two weeks prior to scheduled reviews, and ensure that invited parties are properly documented in the Comprehensive Child Welfare Information System prior to the time of the review. The parent or Indian custodian and the Indian child’s tribe shall be sent letter(s) of invitation at least two weeks prior to the scheduled review by certified or registered mail with return receipt requested. All other invitations may be sent by electronic mail. Invitations shall include date, time, location, and purpose of the review. If the case involves an Indian child, the requirements of the pending court proceedings

section of the Indian child welfare act applies. 25 U.S.C. § 1912(a) (2020) is hereby incorporated by reference. No later amendments or editions are incorporated. Copies are available for public inspection by contacting the ARD director during regular business hours at Colorado Department of Human Services, Administrative Review Division, 4045 S. Lowell Blvd., Denver, Colorado 80236; or at a state publications depository library.

E. Review process 1. The county department shall submit evidence:

a. Demonstrating that ongoing assessment of the strengths and needs of the child, juvenile, or youth continues to support the determination that the needs of the child, juvenile, or youth cannot be met through placement with a parent, legal guardian, legal custodian, kin caregiver, or in a foster family home; that the placement in a Qualified Residential Treatment Program provides the most effective and appropriate level of care for the child, juvenile, or youth in the least restrictive environment; and that the placement is consistent with the short- and long-term goals for the child, juvenile, or youth as specified in the permanency plan for the child, juvenile, or youth, or as outlined in the family services plan;

b. Documenting the specific treatment or service needs that will be met for the child, juvenile, or youth in the placement and the length of time the child, juvenile, or youth is expected to need treatment or services; and c. Documenting the efforts made by the county department to prepare the child, juvenile, or youth to return home or to be placed with a fit and willing kin caregiver, a legal guardian, legal custodian, or an adoptive parent, or in a foster F. Findings 1. The ARD shall enter copies of Administrative Review findings in the department’s Comprehensive Child Welfare Information System and the county department shall include a summary of those findings in court reports.

2. In the event that the ARD disagrees with the placement of a child in a QRTP, it may result in the placement becoming IV-E non-reimbursable if the child does not step down to a lower level of care within 30 days of the ARD determination.

G. Fiscal sanctions 1. Fiscal sanctions and disallowances may occur as a result of QRTP Placement Review that does not identify placement in a QRTP as the most effective and appropriate level of care for the child, juvenile, or youth. Reimbursement is reduced to the average cost of the determined less restrictive type of available placement, unless the child is court-ordered into the more restrictive placement against the recommendation of the county department.

2. The county department shall move the child, juvenile or youth to a lower level of care within thirty (30) calendar days of the QRTP Placement Review finding in order for reimbursement to be uninterrupted. The county department shall provide the ARD with confirmation of the change in placement.

3. If the county department disagrees with the findings of the ARD’s QRTP Placement Review, the county department may appeal in writing. An appeal must be received by the ARD within three (3) working days of the receipt of written results of the review.

4. Reimbursement is denied from the date of the review if the county department neither corrects the non-compliance nor appeals the review decision within allotted timelines.

H. Confidentiality 1. Federal confidentiality requirements at 42 U.S.C.A. section 5106a(2)(B)(viii) restrict the use of, or disclosure of, information concerning individuals served by the child welfare agency, and these same rules apply to the QRTP Placement Review process.

2. Section 19-1-307, C.R.S. requires that reports of child abuse or neglect and the name and address of any child, family, or informant or any other identifying information contained in such reports shall be confidential and shall not be public information. To the extent QRTP Placement Reviews are incorporated in child abuse and neglect records, they shall be confidential.

3. Audio and/or video recording of QRTP Placement Reviews shall not occur without releases of confidentiality forms signed by all parties to the case prior to recording. 7.304.66 Monitoring of Purchased Services for Out-of-Home Placement and Core Services 7.304.661 Out-of-Home Placement [Rev. eff/ 4/1/12]

A. The county department shall contract with providers for specific services using the stateprescribed contracts. The contract shall specify the responsibilities of the provider and the county for services to be provided to the child and family in conjunction with the Family Services Plan.

The county department shall monitor the services purchased from Residential Child Care Facilities, Child Placement Agencies, Core Service Programs, and all out-of-home providers at least monthly, by face-to-face or telephone contact with the provider. The county department shall contract with providers to submit written quarterly progress reports to the county department and to attend Administrative Reviews in person or by conference call. The county department shall participate in staffing or planning meetings on a regular basis as defined in the case plan. The county shall contract with providers to comply with the county-designated family time plan as specified in the placement agreement.

B. The county department shall reassess the case plan with the provider at least every six months and document progress toward goals, including discharge planning. It shall make necessary modifications to the plan based on mutual treatment planning with the provider.

C. If there are problems or complaints concerning the care or treatment of a child in a purchased Residential Child Care Facility or Child Placement Agency placement, or Core Services Program services, or a report of violations of child care standards, the county department shall report the circumstances to the licensing or certifying authority within 24 hours. If the nature of the complaint involves an allegation of abuse or neglect, a report to the local investigating authority shall be made immediately. 7.304.662 Core Services A. Counties with a state-approved Core Service Program plan may directly provide or purchase Core Services Program.

B. If a Core Service Program is purchased, all state rule requirements shall be followed.

C. When the county purchases Core Services, the county has the responsibility to select contractors who have the skills and resources to deliver the services for which they are contracting. Counties shall monitor all purchase of services contracts to insure that contracted services are delivered.

D. Core Services may be purchased and provided for a child placed out-of-state with written state department approval.

E. County departments shall adhere to state guidelines regarding coding and state reimbursement requirements for provided or purchased services.

F. County Core Service Programs may only be used for a child in out-of-home placement when services are not available through the contract with the out-of-home provider or the county negotiates a lower rate with the provider.

G. Core Service Programs may only be used for clients when the client’s private insurance and/or other funding sources are exhausted, insufficient, or inappropriate.

H. Core Service Programs that have duplicative components cannot be provided/purchase at the same time. 7.304.67 Post-Placement Activities A. The county department shall update the status of the child in the Department’s automated reporting system within seven calendar days following termination of the placement.

B. The county department shall complete a written summary within 30 calendar days after termination of the placement. This summary may be included as part of a court report, six month summary, or case closing summary. The summary shall document that the caseworker has:

1. Discussed with the child and family the goals that have been achieved and not achieved.

2. Established a clear plan for follow-up services if needed.

3. Involved the foster care provider in the evaluation of services, progress, and the child’s further needs.

C. The county department shall follow all required eligibility and documentation procedures to confirm the placement change.

7.304.7 RIGHTS AND RESPONSIBILITIES OF FOSTER PARENTS AND PROVIDERS 7.304.71 Rights of Foster Parents A. The foster parents have a right to a notice of legal status on children in their care and a right to declare their intent to adopt or not to adopt.

B. For a relinquished child, the foster parents may be given custody of a child who has been in their home for more than a year.

C. The court may award guardianship of a child to a foster parent. 7.304.72 Rights of Kinship Care Providers A. Children may be placed with a relative or other suitable person under the legal status of protective supervision.

B. The court may, if in the child's best interests, give preference to a grandparent who is appropriate, capable, willing, and available to care for the child in decisions relating to legal custody and determining where and with whom a child shall live.

C. Evidence of grandparents’ past conduct of any child abuse or neglect shall be considered when the grandparents seek the placement or custody of their grandchildren.

E. When the parent-child relationship is terminated, grandparents, aunts, uncles, brothers, or sisters of a child may request guardianship and legal custody, and the court shall give preference to them if it determines that the placement is in the best interests of the child. 7.304.73 Rights of Denied Foster Parent Applicant [Rev. eff. 4/1/12]

Refer to Section 7.500.351, F, for this information. 7.304.74 Responsibilities of Foster Parents [Rev. eff. 1/1/16]

As the provider, the foster parents shall:

A. Participate with the county department as an active team member in case planning and service delivery, including attendance at staffings and meetings, as specified in each child’s Family Services Plan. The provider’s signature on the Family Services Plan is required for each child placed.

B. Work actively with families of origin as specified in each child’s Family Services Plan.

C. Keep weekly records of each child’s behavior and progress and submit those records monthly to the county department. Copies shall be maintained in the child’s file kept by the provider.

D. Provide written notice to employees of the State Department and county departments or other individuals with a need to know, if the foster parent does not want personally identifiable information provided to adult members of the foster child’s family. Written notice may be subsequently provided to the parties aforementioned for release of personally identifiable information to the foster child’s family; such information shall include the consent to release information, the foster parent’s signature, and the date.

7.305 YOUTH SERVICES

7.305.1 PREPARATION FOR ADULTHOOD

Preparation for adulthood includes programs and services to prepare youth in out-of-home care for the transition to a successful adulthood. Services for all children and youth in out-of-home care should include efforts to build life skills, self-sufficiency competencies, and permanent connections; however, such services with the exception of Chafee are mandatory for youth fourteen (14) years of age and older regardless of their permanency goal.

7.305.2 SPECIFIC PROCEDURES

A. The county department shall assess all youth in foster care who have reached the age of fourteen (14) for services to prepare for adulthood and shall complete the Roadmap to Success part of the Family Services Plan (FSP). This is required regardless of the specified permanency goal of the case plan.

B. The county department's assessment shall include documentation of:

1. The youth's capacity for self-sufficiency and self-support by reviewing daily living skills, in consideration of their age and appropriate developmental expectations/milestones.

2. An evaluation of individual, family, community, and financial support resources available to promote emancipation or semi-independent living.

C. Following assessment, the Roadmap to Success (RTS) shall be developed in consultation with the youth, caseworker, care provider(s), and, at the option of the youth, up to two (2) other significant persons chosen by the youth who are not the foster parent or caseworker for the youth and documented in the FSP in the state automated system. If the county Department of Human or Social Services has good cause to believe an individual selected by the youth will not act in his or her best interest, the planning team may designate another advocate for the youth.

1. The case plan and court report following a staffing or meeting shall describe the services to help the youth transition to successful adulthood, including, but not limited to, ongoing opportunities to engage in age and developmentally appropriate activities and, if the youth is pregnant and/or a parent, the parenting supports provided to the youth.

2. The case plan shall document the rights of the youth to education, health, family time, court participation, the right to stay safe and avoid exploitation, and the right to receive a credit report annually. A signed acknowledgment that the youth was provided a copy of these rights and that they were explained in an age or developmentally appropriate way shall be included in the case plan.

D. A Supervised Independent Living Placement is an out-of-home placement.

1. The county department may utilize a supervised independent living placement for youth at least sixteen (16) years of age through the last day of the month of their twenty-first (21) birthday when the county has placement and care responsibility.

2. Approved supervised independent living placement settings may include an approved college dormitory, transitional living program, an apartment or other private housing, or another age or developmentally appropriate placement 3. The use of a supervised independent living placement for youth ages sixteen (16) up to eighteen (18) may only be utilized after considering the youth’s developmental needs and assets, supports that are available to the youth, and documentation in case notes that all other options have been exhausted.

4. For youth ages sixteen (16) up to eighteen (18), placement in a supervised independent living placement must follow a period in out-of-home care.

5. When the placement is not a college dormitory operated by an institution of higher education, adults residing in the household with the youth shall be required to successfully complete background checks as described in 12 CCR 2509-5.

6. An update to the existing Roadmap to Success (RTS) must be completed, preferably within 30 days prior to, but no later than 30 days after, the start date of the supervised independent living placement.

7. The county department shall establish a written policy for the use of supervised independent living placement. The policy shall address the following:

a. Assessing each youth’s readiness to be successful in a supervised independent living placement, the safety of the placement, the availability of supportive services and resources for youth transitioning into adulthood, any county-specific policies around caseworker contact with the youth, and the process for ongoing review.

b. Supervised independent living placement funds shall be provided to the youth and be sufficient to have their needs met as identified in 12 CCR 2509-8 Sections 7.708.26, 7.708.31, 7.708.41, 7.708.42, 7.708.43, and 7.708.44, as well as having access to a working telephone and internet.

c. Additional supervised independent living placement funds may be provided to the youth as an incentive for progress towards and/or achievement of goals.

d. Decisions to withhold supervised independent living placement funds provided to the youth per section (c) shall not reduce the amount provided per subsection (b) and must be according to defined guidelines found in the county policy.

e. Defined appeal process and notification procedures for youth whose supervised independent living placement funds under subsection (c) are withheld.

f. Defined process for how and when a supervised independent living placement may be terminated. The policy must address potential termination reasons including, but not limited to, concerns for current or impending danger or court case closure.

8. A signed copy of the supervised independent living placement agreement and a signed expectations/acknowledgement that the youth was provided a copy of the county guidelines. These documents shall be explained in an age or developmentally appropriate way and shall be included in the case file.

E. Free Annual Credit Record Report for Youth Fourteen (14) Years of Age and Older in Foster Care The following steps shall be taken:

1. The county department shall obtain free annual credit report information from the three credit reporting agencies designated by the Department for youth who are in foster care and are at least fourteen (14) years of age, and provide the information to the youth and Guardian ad Litem (GAL) and/or counsel for youth;

2. If the youth objects to obtaining the credit report, the county department shall inform the court and request that the court issue an order authorizing the county to obtain the credit report.

3. The county department shall maintain a copy of each credit report in the case record;

4. Should the annual report show evidence of any inaccuracies, the county department shall inform the court of the inaccuracies, refer the youth to a Colorado Department of Human Services approved governmental or non-profit entity to resolve the inaccuracies, and inform the GAL and/or counsel for youth of the referral.

F. The youth, county department caseworker, provider(s), and other representatives of the youth as appropriate, shall jointly develop a detailed, formal emancipation transition plan no more than ninety (90) days prior to the emancipation date of the youth. The plan, signed by all parties, shall include, but need not be limited to, the following:

1. Assurance that the plan meets the specific self-sufficiency/cost of living standard in the county or state where the youth plans to reside.

2. a plan shall be developed with the youth based on the information from the assessment and the youth’s goals.

3. Personalization at the direction of the youth to meet the individual emancipation needs in order to help prevent homelessness.

4. Copies of verifiable vital documents required in Section 7.305.5.

5. Specific options for:

a. Housing, b. Health insurance and health care decision-making information, c. Education, d. Local opportunities for safe mentors, e. Continuing after-care support services, and f. Work force supports and employment services.

6. The plan shall be documented in the State Department’s automated system in the Family Services Plan, and a copy given to the youth free of charge. 7.305.3 NATIONAL YOUTH IN TRANSITION DATABASE (NYTD) [Rev. eff. 11/1/15]

The National Youth in Transition Database (NYTD) is a federal reporting requirement. Information is collected in NYTD about youth in foster care, including sex, race, ethnicity, date of birth, and foster care status. Information is also collected about the outcomes of youth who are in or have exited foster care. 7.305.31 Served Population [Eff. 10/1/10]

The served population consists of youth and children in out-of-home care, regardless of age, receiving independent living services that are paid for or provided by the state or county.

The county department shall enter the following information into various fields of the State’s automated data system:

A. Basic Demographic Information 1. Date of birth;

2. Sex;

3. Race;

4. Hispanic/Latino ethnicity.

B. Youth/Child Characteristics 1. Adjudicated delinquent;

2. Out-of-home status;

3. Federally-recognized tribe;

4. Educational level;

5. Special education.

C. Independent Living Services 1. Independent living needs assessment;

2. Academic support;

3. Post-secondary educational support;

4. Career preparation;

5. Employment programs or vocational training;

6. Budget and financial management;

7. Housing education and home management training;

8. Health education and risk prevention;

9. Family support and healthy marriage education;

10. Mentoring;

11. Supervised independent living;

12. “Room and board” financial assistance;

13. Educational financial assistance; and, 14. Other financial assistance. 7.305.32 Baseline Population [Eff. 10/1/10]

The “Baseline Population” consists of any youth who is in out-of-home placement, for even one day, and that has reached age seventeen (17) as of October 1, 2010 through September 30, 2011, and every third year thereafter.

The county department shall assure that surveys for the “Baseline Population” are completed within fortyfive (45) days of the youth turning age seventeen (17). 7.305.33 Follow-Up Population [Rev. eff. 11/1/15]

The “Follow-Up Population” consists of young people who were in the baseline population at age seventeen (17) who reach age nineteen (19) or age twenty-one (21) during the six-month survey period and who appear in the survey population or sample indicated in the Trails NYTD screen.

For youth open in a case and who are in the “Follow-Up Population”, the county department or Division of Youth Services shall assure that the “follow-up surveys” are completed by the youth within the six (6) month period to which they are assigned.

For youth who have discharged from care who are in the “follow-up population”, the county department or Division of Youth Services shall assist the Division of Child Welfare in locating and engaging youth to complete the survey during the period to which they are assigned. 7.305.34 [Eff. 10/1/10]

When a youth in either the Baseline or Follow-Up population is unable to participate, the county shall document the reason in the State’s automated system. The reasons that shall be given are:

A. Youth declined participation;

B. Parent declined on behalf of the youth;

C. Youth is incapacitated;

D. Youth is incarcerated;

E. Runaway/missing youth;

F. Unable to locate the youth;

G. Youth has died.

7.305.4 CHAFEE PROGRAM – TITLE IV-E INDEPENDENT LIVING GRANT INITIATIVE

The purpose of the Chafee Program is to provide age or developmentally appropriate services and resources to support a successful transition to adulthood for eligible current and former foster youth.

These services are voluntary and complement the youth’s own efforts towards self-sufficiency. The services shall supplement existing independent living resources and programs in county departments, residential child care facilities and child placement agencies, and by federal statute, shall not replace or duplicate existing services. Chafee Program funds shall not be used for room and board for a youth under eighteen (18) years of participating as child in open child welfare case. See section 7.305.42 for eligibility requirements. 7.305.41 County Responsibilities [Rev. eff. 11/1/15]

A. The designated host county department or program shall submit a county plan for State approval.

B. The county department or program shall comply in format, content, and time lines with the instructions for Chafee Program plans as published by the State Department in an agency letter which will also contain required instructions for program and financial reporting.

C. The county department or program shall administer the State approved plan in accordance with provisions of the plan.

D. Funds shall be used exclusively for the purposes specified in the plan.

E. Chafee programs must submit amendments to approved plans when the county or program is proposing to add or delete a service to the plan. The program shall submit amendments TO the plan with signature from agency designee for approval to the State Department no less than thirty (30) business days before the amendment is to be effective. Written approval will be provided by the state department within thirty (30) business days after submission of the updated changes.

F. The county department must consider the following factors, in the prioritization of Chafee services on an individual basis:

1. Transfer of Chafee services from another county, provider, or state;

2. Risk or history of homelessness;

3. Risk or history of human trafficking or exploitation;

4. Youth has discharged from an out-of-home placement or exited from an eligible placement through the division of youth services after attaining age eighteen (18);

5. In an out-of-home placement at age sixteen (16) up to twenty-one (21) years of age;

6. Remaining eligible populations.

G. Chafee referral requirements:

1. Referrals for youth in care:

A. Approved program referral form, B. Copy of Roadmap to Success signed by youth and caseworker (or DYS case plan), and C. Documented proof of citizenship or legal presence.

2. Self-referrals and youth who are no longer in care:

A. Program referral form (to be filled out with the youth), B. Verification of Chafee eligibility, and C. Documented proof of citizenship or legal presence. 7.305.42 Eligibility Effective October 1, 2020, eligibility for the Chafee program will align with the standards put forth in the John H. Chafee Foster Care Program for Successful Transition to Adulthood section of the Social Security Act [SSA section 477. [42 U.S.C. 677](a)] and all federal guidance that pertains to that section. 7.305.43 Colorado Fostering Success Voucher Program The purpose of the Colorado Fostering Success Voucher Program is to provide rental assistance vouchers to recipients along with age, developmentally, and culturally appropriate case management.

A. Colorado Fostering Success Voucher Program youth/participant eligibility 1. In order to be eligible for the Colorado Fostering Success Voucher Program, youth must:

A. Be at least 18 years of age but less than 26 years of age;

b. Reside in Colorado;

c. Be currently experiencing homelessness or be at imminent risk of homelessness, as defined by the Department’s Foster Youth Successful Transition to Adulthood Grant Program Advisory Board described in section 19-7-314(3), C.R.S., and have voluntarily agreed to participate in services offered and provided by a case management agency;

i. The definition of imminent risk of homelessness established by the Foster Youth Successful Transition to Adulthood Grant Program Advisory Board shall provide the flexibility necessary to meet the unique needs of this population and shall ensure that a youth's participation in programs intended to support a successful transition to adulthood shall not exclude or prohibit a youth’s ability to access the program.

d. Have income that does not exceed a level determined pursuant to section 19-7- 314.5(2)(b)(v), C.R.S.; and e. Meet one of the following foster care (as defined by section 19-1-103(66), C.R.S.) eligibility requirements:

i. Was in foster care on or after their 14th birthday; or ii. Was in noncertified kinship care (as defined by section 19-1-103(102), C.R.S.) on or after their 14th birthday and adjudicated dependent and neglected pursuant to article 3 of title 19; or iii. Turned 18 years of age when the youth was a named child or youth in a dependency and neglect case.

f. Voucher recipients must continue to participate in case management services provided by the case management agency in order to remain eligible for the rental assistance voucher.

g. The state Department of Human Services will work in partnership with the Colorado Department of Local Affairs and the Foster Youth Successful Transition to Adulthood Grant Program Advisory Board described in section 19-7-314(3), C.R.S. to develop an appeals process for program applications that are denied due to eligibility.

B. Case management agency eligibility and application process 1. Organizations that are eligible to apply for the Colorado Foster Success Voucher Program must be:

A. A current grant recipient of the Foster Youth Successful Transition to Adulthood Grant Program; or b. Currently operating a Chafee Foster Care Program for Successful Transition to Adulthood Program in Colorado.

C. Case management requirements for case management agencies 1. Case management service providers shall follow the Chafee and/or Colorado Foster Youth Successful Transition to Adulthood State Grant Program plan submitted to and approved by the Department.

A. A case management agency shall make reasonable efforts to engage a youth in case management activities and to support the youth with coming into compliance with voucher requirements prior to terminating the voucher or case management services. 7.305.5 Vital Life Documents Prior to Emancipation A. All youth in foster care who have reached the age of eighteen (18), and who have been in foster care at least six (6) months, shall be provided with the following documents no more than ninety (90) days prior to the emancipation date of the youth, unless there is no record of the youth’s birth or the identity of the youth cannot be established, in which case the basis for this shall be documented in the State automated system:

1. A certified birth certificate or, when applicable, an alien registration card (green card);

2. Tribal affiliation information for American Indian/Alaskan Native youth (see section 7.309.21, A and B);

3. A Social Security card;

4. A state identification card or a state driver’s license;

5. A Health Passport and other pertinent health-related records, to include health care decision-making information, and health insurance information; and, 6. Educational records (see Section 7.301.242).

7. Official documentation to prove the youth was in out-of-home placement.

B. For all male youth with a permanency goal of “Other Planned Permanent Living Arrangement”, the county shall facilitate registration for the Selective Service System. 7.306 Adoption Services The county department shall ensure that adoption services are provided as a service on the continuum of protective services to children. All children/youth who are unable to return to their own home should be considered for adoption. Proceeding with termination of parental rights implies that the county department will actively pursue adoption as the permanent plan for the child(ren)/youth. 7.306.1 Pre-Adoption Services 7.306.11 The Evaluation of Child/Youth’s Needs The county department shall assess the child/youth’s readiness for adoption.

A. The county department shall make thorough efforts to place siblings together in the adoptive family and document such efforts in the Family Services Plan. When the child/youth is part of a sibling group and the sibling group is being placed out of the home, it shall be presumed that placement of the entire sibling group in the joint placement is in the best interests of the children/youth in order to sustain family relationships. Such presumption may be rebutted by the county department by a preponderance of evidence that placement of the entire sibling group in the joint placement is not in the best interests and the needs of a child/youth or of the children/youth.

B. If the current caregiver is an approved adoptive resource for the identified child/youth, the worker will complete the Colorado Adoption Resource Registry (CARR) exclusion form and send the form to the state’s adoption unit.

C. Conduct an ongoing comprehensive search of the child(ren)/youth’s record for possible permanent placement(s) or other permanent connections unless the child/youth meets the family search and engagement exclusion criteria in section 7.304.52.C (12 CCR 2509-4). Any possible resources should be interviewed/contacted as to their willingness and/or availability as a placement for the child/youth.

D. Available resources for adoption shall be assessed and a recruitment plan developed if there is no adoptive family identified. Recruitment efforts begin when the permanency goal becomes adoption and should use all resources available. The county department shall document, in the Family Services Plan, efforts to recruit and locate a permanent home for any child/youth whose parental rights have been terminated and who is in the guardianship of the county department with the right to consent to adoption.

E. A child/youth’s best interests and special needs shall be the primary consideration in determining 7.306.12 Child And Family Study Within 90 calendar days following relinquishment or termination of the parent-child relationship, the family

history and medical information shall be collected and documented in the state prescribed child and family study.

A. Information shall include, but not be limited to:

1. Birth certificate 2. Legal custody documents 3. Record of placements, including previous adoption(s) if applicable 4. Emotional, physical, medical, psychological, trauma, and developmental evaluations.

B. Information in the record should be updated when changes occur or additional information is available that would affect the child/youth’s readiness for adoption.

C. The child and family study shall be updated annually from the date of the initial child and family study until the child/youth achieves permanency. 7.306.13 Colorado Adoption Resource Registry (CARR)

The county department shall submit either an initial child/youth referral form for recruitment services or a request for exclusion from the CARR, 90 calendar days following relinquishment or termination of parentchild relationship.

A. Referral to the Colorado Adoption Resource Registry 1. If no adoptive home has been found for the child/youth within 90 calendar days following relinquishment or termination of the parent-child relationship.

2. Following a disruption of an adoptive placement before legal finalization the child/youth shall be listed or excluded within 90 calendar days from the date of the disruption.

3. Registration with the CARR will be sent to the state adoption specialist or the state contracted service provider.

B. Exclusion from the CARR The county department may decide that the best interest of the child/youth will not be served by a CARR photo listing. The county department shall determine the reason for the exclusion from listing and send the request for exclusion to the state department. The county department shall use the following criteria for determining reasons for exclusion:

1. If an approved family has been identified as an adoptive home for a child/youth. If the child/youth has not moved into the adoptive placement within 90 calendar days of termination of parental rights, the county department shall photo list the child/youth with the CARR. If there is a compelling reason that the county department and the State Department agree is appropriate for delaying filing of the adoption petition, this reason is to be submitted to the state review team by the county department. If the compelling reason for delaying filing the petition is approved, the state review team will review the foster care placement until such time as the petition to adopt is filed or the child/youth is photo listed with the CARR.

2. The child/youth is:

a. One whose court-approved and court-ordered permanency goal is legal guardianship or other planned permanent living arrangement.

b. Placed with a relative or a relative is being considered as a placement resource for the child/youth (adoption or foster care). All relatives who are providing care for a child/youth who is legally free for adoption shall be counseled by a professional who is knowledgeable about permanency options regarding the importance of permanency through adoption, guardianship, or permanent custody. When a relative is being considered, the placement shall be made 90 calendar days from the date the child/youth is legally free for adoption unless there is a documented extenuating circumstance in the case record.

c. The CARR exclusion will be considered and approved or denied by the State Department. The following are conditions that are not necessarily appropriate for denying any child/youth the possibility of a permanent placement or a permanent connection in his/her life.

1) Placement in a residential child care facility, detention or corrective center, or mental hospital, and placement is not indicated by the treatment plan for the child/youth.

2) In therapy and adoptive placement is not indicated by the treatment plan for the child/youth. the county department shall provide the review team with documentation that a therapist and others (e.g., guardians ad litem) have determined that it would not be in the child(ren)/youth’s best interest to recruit an adoptive home.

3) A child/youth who is still being evaluated by specialists. The county department shall photo list the child(ren)/youth with the Colorado Adoption Resource Registry if the evaluation is not completed within 90 calendar days of termination of parental rights.

4) A child/youth who is twelve (12) years or older and is refusing adoption.

The child/youth shall be counseled by a professional who is knowledgeable about adoption and permanency for teens, recognizing that their consent is still required to proceed with an adoption. 7.306.14 Selection of an Adoptive Family for a Child/Youth A. The county department shall use all resources available to find an adoptive family home for the child/youth. Unless it is in the best interest of the child/youth, the county department shall not deny or delay the placement of a child/youth for adoption when an approved prospective adoptive family is available outside of the county department or state. If a family with an approved home assessment from another county department or state requests a fair hearing, it shall be provided to the family.

B. The county department shall comply with the Indian Child Welfare Act in placing any eligible Native American child/youth. See Indian Child Welfare Act of 1978, 25 U.S.C. sections 1901 - 1963 (2019), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Department of Justice, http://www.ssa.gov/op_home/comp2/f095-608.html. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Children Youth and Families, 1575 Sherman St Denver, Colorado 80203, during regular business hours.

C. An adoptive placement shall not be delayed or denied solely because the prospective adoptive family is of another race, color, or national origin than that of the child/youth.

D. Race, color, and national origin can only be considered in extraordinary circumstances. 7.306.2 Adoption Placement Services The county department shall complete the following most recent, approved, state prescribed documents and reports:

A. As soon as the county department has identified a prospective adoptive family, the county department shall conduct a face-to-face presentation interview with the prospective adoptive parent(s) within 90 days of termination of parental rights. If the adoptive resource is a two-parent family, both parents shall be present for the interview.

If attending a face-to-face presentation will create an undue hardship for the prospective adoptive family, the presentation meeting may be conducted via phone or video conference chat to accommodate the prospective family during the presentation.

1. The guardian ad litem and/or counsel for youth shall be invited to attend the presentation interview.

2. The county department shall provide the prospective adoptive parent(s) with the child and family study and any supplemental information (example: medical records, educational records, etc). All documentation provided to the prospective adoptive parents will be redacted to remove all identifying information.

3. The presentation shall be audio-recorded. Two copies of the recording shall be made.

a. One copy shall be kept with the child/youth file until the adoption is finalized, at which time it will be placed in the sealed file.

b. The second copy shall be provided to the prospective adoptive family.

B. If requested by the prospective adoptive family or deemed necessary by the county department, the prospective adoptive family shall have a minimum of 48 business hours to review all of the written and audio information in order to make an informed decision before any further steps are made toward finalizing the adoption.

C. All of the information provided shall be documented on the state’s approved form (entitled “information sharing acknowledgement”), signed by the family, then placed in the child/youth’s record until the adoption is finalized, at which time it will be placed in the sealed file.

D. If the family decides at a later time not to move forward with adoption or maintain a permanent relationship with the child/youth, the county department will request all information provided to the prospective adoptive family must be returned to the county department. 7.306.21 Adoption Placement Activities The county department shall complete the following most recent approved prescribed documents and reports:

A. The Adoption Placement Agreement, at the time the child/youth is legally free and placed in the home.

B. The information sharing form, at the time a child/youth is legally free for adoption and placed in the home. When a child in an adoptive placement whose adoption is not finalized has a name change, and case and client I.D. number(s) change entered into the department’s statewide automated system, the county department shall provide the following information to the administrative reviewer: the child’s biological name, trails case and client I.D. numbers, and the new name, and new trails case and client I.D. numbers.

C. The county department shall request that the court finalize the adoption when the child/youth to be adopted has been in the prospective adoptive home for at least six months prior to the filing of the petition to adopt. If adoption is requested to be expedited prior to six months of the child/youth being in the prospective adoptive home, the county department may request finalization of the adoption if all parties are in agreement. Written documentation of these requests shall be in the case file.

D. The county department shall file a motion with the court to close the hearing to the public when all parties have consented and when it is in the best interests of the child/youth who is the subject of the adoption hearing.

E. When a child/youth is placed for adoption into another Colorado county department, the county department of residence where the child/youth is placed shall open Medicaid when the child/youth is receiving subsidized adoption assistance. The placing county department shall send written notification to the resident county department to expedite timely opening of the Medicaid benefits.

7.306.3 POST-PLACEMENT SERVICES

Following placement in the adoptive home, the county department shall:

A. Provide services to the child/youth and the adoptive parents to integrate the child/youth into the B. Re-review the information sharing acknowledgment form with the adoptive parent(s); all parties identified on the form shall date and initial it before the finalization of the adoption.

C. Inform the family of the legal procedure for adoption, and complete and submit all documents to the court regarding the adoptive placement as required by the Colorado Children’s Code (C.R.S. 19-1-107). 7.306.31 Adoption Placement Disruption The county with custody of the child/youth shall formulate an appropriate SMART (specific, measurable, achievable, result focused and relevant, and time limited) plan if the adoptive placement disrupts prior to finalization. 7.306.32 Post Finalization of Adoption Adoption assistance is a post-placement service (see adoption assistance services, section 7.306.4).

A. At the time the county department changes the child/youth’s status from foster care to adoption, the case in the Comprehensive Child Welfare Information System (CCWIS) shall be closed in the child/youth’s birth name and opened under the new adoptive name. In addition, a new state identification number shall be reissued in the child/youth’s adoptive name.

B. When a child/youth is placed for adoption into another Colorado county department, the county department of residence where the child/youth is placed shall open Medicaid when the child/youth is receiving subsidized adoption assistance. The placing county department shall send written notification to the resident county department to expedite timely opening of the Medicaid benefits. 7.306.4 Adoption Assistance Services Colorado operates two adoption assistance programs: the Title IV-E program and the state and countyonly (non-Title IV-E) program.

A. Applicable to Both Programs:

1. The federal government participates in adoption assistance agreements on behalf of children/youth who meet the eligibility criteria for the Title IV-E adoption assistance program.

2. The state and county departments participate in adoption assistance agreements on behalf of children/youth who are not eligible for the Title IV-E program.

3. Prospective adoptive parents must be informed of the adoption assistance program.

Adoption assistance is a program that provides assistance to adoptive parent(s) in certain defined and limited ways to provide for the needs of an eligible adopted child/youth.

Adoption assistance is intended to help or remove financial or other barriers to the adoption of eligible Colorado children/youth with identified needs by providing assistance to the parent(s) in caring for and raising the child/youth.

a. The county department may make adoption assistance payments and/or provide Medicaid or medical assistance at the time of adoptive placement, continue them after the adoption has been finalized and continue them until the adopted child/youth has reached the age of eighteen (18). As defined in section 7.306.54, adoption assistance may continue to the 21st birthday. In situations where adoption assistance continues through the 21st birthday of the adoptee, adoption Medicaid will still continue through the end of the month of the 21st birthday.

b. The determination for expiration of the agreement must be made and documented in the original negotiation and noted in the original paperwork for the adoption assistance agreement. The county department shall extend the adoption assistance agreement upon the approaching expiration date if the youth meets criteria for extension per section 7.306.54 and the extension is requested by the adoptive parent(s).

c. The county department must determine that in each case a reasonable, but unsuccessful, effort to place the child/youth for adoption without adoption assistance has been made before negotiating adoption assistance, unless the best interests of the child/youth would not be served by such an effort.

Reasonable effort requires listing with the Colorado Adoption Resource Registry (CARR) and may include presentation in the media and consultation with the state. Exceptions to the requirement:

1) The current caregiver will be given priority as the prospective adoptive family, when appropriate.

2) In situations where it would be against the best interests of the child/youth, due to such factors as:

a. The existence of significant emotional ties with the prospective adoptive parents while in their care as a foster child/youth, or b. Adoption by a kinship caregiver c. The eligible child/youth is being placed by a birth parent with designated adoptive parents through a non-profit child placement agency.

d. Eligible child or youth means a child or youth who meets the medical and disability requirements for federal supplemental security income or is a child or youth with one or more specific factors or conditions that would make it reasonable to conclude that a child or youth cannot be adopted without providing benefits to assist in the adoption. Such factors may include but are not limited to:

1) A physical disability, that has been documented by a qualified licensed professional such as hearing, vision, or physical impairment; neurological conditions; disfiguring defects; metabolic disorder; a child or youth infected with the human immunodeficiency virus; or heart defects;

2) A mental, intellectual, or developmental disability that has been documented by a qualified licensed professional, such as a perceptual, speech, or language disability or any disability that results in educational delays or significant learning difficulties;

3) An emotional handicap, such as post-traumatic stress disorder, bipolar disorder, or other mental health disorder that has been documented by a qualified licensed professional;

4) Hereditary factors that have been documented by a qualified licensed professional;

5) An educational disability that qualifies for section 504 of the federal rehabilitation act of 1973, or special education services;

6) Factors that place a child or youth in a “high-risk” category, such as being drug- or alcohol-exposed in utero;

7) Other conditions that act as a barrier to the child’s/youth’s adoption, including but not limited to, a healthy child or youth over seven years of age or a sibling group that should remain intact and medical conditions that are likely to require further treatment; or, 8) Ethnic background or membership in a minority group which may be difficult to place.

e. The county department shall not use an income eligibility requirement (income means test) for the prospective adoptive parent(s) in determining eligibility for adoption assistance. Instead, the particular agreement that is negotiated shall be based on the child/youth’s current and anticipated needs and the family circumstances.

f. Available public programs for which the child/youth is eligible shall be used first to address the child’s/youth’s needs before an adoption assistance agreement is negotiated.

g. The county department may authorize the following types of adoption assistance agreements:

1) “Long-Term Adoption Assistance Agreement” means to partially meet a child’s/youth’s daily needs unless the adoptive family’s or child’s/youth’s circumstances change or the agreement terminates as outlined in the termination of adoption assistance, section 7.306.48, of the adoption assistance agreement rules and as cited in C.R.S. § 26-7-109. A longterm agreement is made when the family’s financial situation and/or the child’s/youth's needs are unlikely to change or when a child’s/youth’s needs take an excessive toll on the family’s financial resources.

2) “Time-Limited Adoption Assistance Agreement” means to partially meet the everyday needs of the child/youth for a specified period. Agreement partially covers unmet needs that are time limited.

3) “Dormant” or “Medicaid Only Adoption Assistance Agreement” means there is no adoption assistance payment provided at the time of the agreement. County departments shall document for the child’s/youth’s eligibility in the services record and in the Comprehensive Child Welfare Information System (CCWIS) that the potential need for financial adoption assistance exists and may need to be activated at a future time.

4. If the child/youth is legally available for adoption and reunited with their birth parent(s), the child/youth is not eligible for adoption assistance.

5. Medicaid is available to all Colorado children/youth who have an adoption assistance agreement.

6. Families who adopt children/youth who meet the criteria for adoption assistance are eligible for non-recurring adoption expenses.

7. Case services payments may be part of an adoption assistance agreement; these payments can be made directly to the service providers or to the adoptive parent(s).

B. Target Groups for Adoption Assistance Agreements:

1. Children/youth who meet the eligibility criteria to participate in one of Colorado’s adoption assistance programs and whose identified needs are a barrier to their adoption are legally available for adoption and are in the custody of a county department and the county has guardianship of the child/youth with the right to consent for adoption; or, 2. Children/youth who are in the custody of a relative, tribe, person to whom custody of the child/youth has been given by proper order of a dependency and neglect court, or licensed non-profit child placement agency and meet the eligibility criteria to participate in one of Colorado’s adoption assistance programs; and, 3. The county department, licensed non-profit child placement agency, tribe, person to whom custody of the child/youth has been given by proper order of a dependency and neglect court, or relative requesting the adoption assistance agreement is financially responsible for the care of the child/youth.

C. County Requirements for Adoption Assistance:

1. The county department shall obtain and document the diagnoses and prognoses of the child’s/youth’s needs that are barriers to the adoption.

2. The documentation shall include specific eligibility factors used to determine eligibility factors as outlined in section 7.306.4 A.

A. Placement history B. Eligible child/youth: if the county department determines that the child/youth is an eligible child/youth, with needs for whom services will be purchased, it must confirm the identified needs by a second opinion of a qualified licensed professional who is outside the department.

C. Other appropriate reports 3. The county department shall determine the child’s/youth’s Title IV-E status for adoption assistance in the Comprehensive Child Welfare Information System (CCWIS) prior to adoption finalization and no later than the calendar month the adoption petition is filed.

4. The county department shall ensure that all parties sign the adoption assistance agreement before the adoption is finalized.

5. At the time that the family is matched for adoption of a child/youth who is potentially eligible for adoption assistance benefits, the prospective adoptive family should be informed in writing, with the following information:

a. The availability of benefits, with an explanation of the differences between these benefits and foster care maintenance payments;

b. The availability of reimbursement for non-recurring expenses incurred in the adoption of an eligible child/youth not to exceed the federal limit;

c. The availability of mental health services through the state Medicaid assistance program or other programs;

d. The federal adoption tax credit for an individual who is adopting or is considering adopting a child/youth in foster care or through a nonprofit child placement agency;

e. Notice of the general right to request a negotiating meeting;

f. Notice of the general right to bring to the adoption assistance negotiation process:

1. Parties who possess relevant information about a child/youth’s history and needs, including the child’s guardian ad litem or the family’s advocate; and 2. Legal representation for a child/youth or prospective adoptive family.

g. Notice of the right to an administrative appeal and be represented by legal counsel, at the prospective adoptive parent’s expense.

h. The Colorado Adoption Assistance Negotiation Worksheet must be provided to all participants 5 business days prior to the negotiation meeting. 7.306.41 Title IV-E Adoption Assistance Program A. Pathways to Eligibility Title IV-E adoption assistance services may be provided to children/youth whose needs are a barrier to their adoption, who are legally available for adoption, and meet one of the following pathways:

1. A child/youth was removed from a specified relative by a court order that contains the requirements in Section 7.601.71.

a. For the purposes of Title IV-E adoption assistance only, there is no requirement for a “reasonable efforts” judicial determination at the time of the initial removal.

b. The Federal Applicable Child Criteria (delinking) allows for Title IV-E adoption assistance to child(ren)/youth who are two or turn two in the federal fiscal year in which the adoption is finalized.

c. For Title IV-E funding to be an option in adoption assistance a removal must have been entered and an initial Title IV-E foster care determination must have been entered into the CCWIS system.

2. Have Social Security Income (SSI) eligibility.

a. This factor must be met at any time prior to finalization of the adoption.

b. If eligible, the child/youth may simultaneously receive SSI and Title IV-E adoption assistance payments.

c. If a child/youth is SSI eligible, there are no requirements for the Federal Applicable Child Criteria or the statement regarding efforts to place the child/youth without adoption assistance.

3. Are IV-E eligible in a previous adoption and the adoptive parents have relinquished, had their parental rights terminated, or died and the child/youth are placed in a subsequent adoptive placement, then the child/youth retain Title IV-E eligibility for adoption assistance in their new adoptive placement. Additional requirements for this pathway to eligibility include:

a. A new determination regarding the child/youth’s continuing needs.

b. Completion of a new adoption assistance agreement with the new prospective adoptive parent(s).

c. If the previous adoptive parent(s) is(are) deceased, a copy of the death certificate must be provided.

4. Is in mutual foster care placement with a county department.

a. The child must be placed with their teen parent; and, b. The foster care payment included both the child and the teen parent.

5. Is in foster care by voluntary placement agreement with a county department (a tribe or another public agency with which the state/county has a Title IV-E agreement). The child/youth must meet the requirement outlined in section 7.601.71.

a. There must have been at least one Title IV-E foster care maintenance payment made on behalf of the child/youth under the voluntary placement agreement.

b. Under this factor, there is no specified amount of time that the child/youth must have been in foster care under the voluntary placement agreement.

6. A child/youth who was voluntarily relinquished to a public or private licensed non-profit agency must meet the requirements in section 7.601.71.F., and:

a. A petition was filed in court to place the child/youth outside of the home within six months of the time the child/youth lived with the relinquishing parent; and, b. A subsequent order was issued which included findings that it is in the best interest of the child/youth to be placed out of the home; and, c. Legal orders placing the child/youth in the custody of a public or private licensed non-profit child placement agency with authority to consent to the child/youth’s adoption;

d. The agency must provide documentation of the efforts the agency made to place the child/youth for adoption without an adoption assistance agreement, except as provided in section 7.306.4.A.3.C., when the child/youth meets the Federal Applicable Child Criteria.

7. If the child/youth does not meet the Federal Applicable Child Criteria, has identified needs, and if they are between the ages of 2 and 18 years in the Federal Fiscal Year in which the adoption assistance agreement is signed by all parties, the child/youth will become categorically eligible for Title IV-E adoption assistance (delinking). A child/youth still must meet removal requirements of section 7.601.71. This requirement is in effect during the period of January 1, 2018, through June 30,2024. This includes children/youth who turn two during the current federal fiscal year in which they are adopted.

8. County Departments of Human/Social Services shall continue the adoption assistance agreement if the extension is requested by the adoptive parent(s) and claim Title IV-E funds for youth 18 years of age through the 21st birthday (adoption Medicaid will still continue through the end of the month of the 21st birthday) when one of the following criteria is met:

a. The county shall document in the record that the youth is enrolled full-time in high school or vocational training and is making progress in the program; or completing secondary education; or is enrolled in a program leading to an equivalent credential; or, b. Enrolled in an institution that provides postsecondary or vocational education (section 7.306.54); or, c. A youth who is identified in the original adoption assistance agreement as having an intellectual and or developmental disability or a physical handicap, is between the age of 18-21, and continues to live at home, may continue to be eligible for the adoption assistance program as long as these disabilities were identified and documented in the original agreement paperwork or is genetic in nature; or, d. Participation in a program or activity designed to promote or remove barriers to employment; or, e. Employed for at least eighty hours per month.

9. After a child/youth has been determined eligible for Title IV-E adoption assistance payments and/or Title IV-E Medicaid benefits, Title IV-E eligibility continues as long as there is an adoption assistance agreement in effect as outlined below:

a. The child/youth meet the requirements regardless of the family’s state of residence.

b. Eligibility may continue even though no payments or Medicaid benefit is currently paid; therefore, maintaining the potential Title IV-E benefits if needed later.

c. Until the expiration of the original agreement unless all parties to the agreement are in concurrence in a subsequent written and signed document.

10. The county shall obtain annual documentation of school attendance or reasons for inability to attend. The documentation must demonstrate that each child/youth who is eligible for adoption assistance and who has attained the minimum age for compulsory school attendance is:

a. Enrolled or in the process of enrolling in an institution that provides elementary or secondary education, or, b. Instructed in elementary or secondary education at home in accordance with the home school statute, or, c. In an independent study elementary or secondary education program in accordance with statute, and which is administered by the local school, school district, or Board of Cooperative Education (BOCES), or, d. Incapable of attending school on a full-time basis due to the medical condition of the youth or child. The reasons shall be supported by regularly updated information in the educational plan maintained by the school, school district, or Boards of Cooperative Educational Services (BOCES).

B. Out-of-Home Placement of a Child/Youth Who is in the Custody of the County While Receiving Adoption Assistance 1. Title IV-E eligibility must be determined when a child/youth is dually placed in foster care and adoption assistance. The child/youth does not automatically retain the Title IV-E eligibility while in foster care and out of home placement.

2. The State prescribed form must be completed using the adoptive parent(s)’ income.

3. The child/youth, upon returning to the adoptive parent(s)’ home, continues to be eligible for the Title IV-E adoption assistance agreement.

4. If the adoptive family does not reside in the state of Colorado this does not apply.

C. Assessment of Parental Fees for Placement Out of the Home for Children/Youth Receiving Title IV-E Adoption Assistance:

1. If the adoptive parent(s) are receiving Title IV-E adoption assistance and the child/youth is under the custody of the department and placed in out-of-home for a duration of over thirty (30) calendar days, the department and the family have two options:

a. To assess a parental fee (child support) from the family not to exceed the amount of the adoption assistance payment they are receiving under their adoption assistance agreement; or, b. To execute an amended agreement, which would reduce the adoption assistance payment to $0 and place it on Medicaid-only status until such time that the child/youth returns to the custody of the parent(s).

2. The parental fee will not be discontinued because the child/youth returns to the home of the adoptive parents for holidays or visits while the child/youth is under the custody of the department.

3. During the time the adoption assistance payment is in Medicaid-only status, the parent(s) will not be assessed a parental share fee for the child/youth’s out-of-home placement.

D. Eligibility Determination for Medicaid in Title IV-E Adoption Assistance 1. Children/youth with an effective adoption assistance agreement are eligible for Medicaid in the state they reside. See Medical Resources section, 7.402 Medicaid for children/youth covered by the Interstate Compact on Adoptions and Medical Assistance (ICAMA).

2. An adoption assistance payment is not required to extend Medicaid coverage.

3. Colorado is a member of the Interstate Compact to Adoption and Medicaid Assistance (ICAMA). Procedures for completing and complying with the compact are in the Medical Resources section, Children Moving from Colorado (Section 7.420.3, B.).

4. Medicaid eligibility shall be continued for IV-E eligible children/youth who are out of the home for more than thirty (30) calendar days unless it is determined that they are eligible for Medicaid under another program by completing the State approved form.

5. Medicaid eligibility for all children/youth receiving Medicaid shall be re-determined yearly only if the child/youth continues to be eligible for Medicaid. This can be done by completing the State prescribed form or completing a form letter that the children/youth continue to be eligible for Medicaid. This form letter shall be sent to the other states by the county department to ensure continuation of Medicaid for a child/youth who is residing out of state.

6. Upon verification that Medicaid has been opened by the receiving state, the county department will ensure Colorado Medicaid is closed.

E. County Process for Title IV-E Adoption Assistance Agreements 1. Determine and document a child’s/youth’s identified needs and eligibility for adoption 2. Denial of assistance based solely on a means test of the adoptive family is not allowed and must not be substituted for the agreement.

a. The circumstances of the family, as defined in C.R.S. § 26-7-102(5), should be considered in negotiating the adoption assistance agreement. “Circumstances of the family” is defined as the capacity of the family, including but not limited to financial capacity, to meet the anticipated needs of the eligible child or youth. The county is entitled to request and receive financial information regarding the family, including assets, liabilities, and insurance benefits in negotiating the initial agreement and any subsequent increases in adoption assistance but may not be used as the sole factor.

3. The adoption assistance agreement shall be established in accordance with the state’s written policy and is consistent with state and federal regulations. The policy shall outline the criteria used for determining the amount of adoption assistance.

a. County departments shall use the Colorado Adoption Assistance Negotiation Worksheet with the potential adoptive family for all adoption assistance determinations and negotiations.

1. If adoptive parent(s) choose(s) to refuse all adoption assistance including monthly cash assistance, Medicaid, and/or case services, they must sign the permanent refusal of adoption assistance form.

2. If adoption parent(s) request a Medicaid only adoption assistance agreement and/or non-recurring adoption expenses they may choose to decline completing the Adoption Assistance Negotiation Worksheet and sign the request for Medicaid only adoption assistance form. However, they still must sign an adoption assistance agreement.

b. County departments shall adopt the policies and procedures outlined in the State of Colorado’s adoption assistance policy. A copy of the written policy shall be provided to adoptive parent(s) at least 5 business days prior to a negotiation meeting.

4. It is not permissible for a county to include a statement in the adoption assistance agreement that IV-E adoption assistance payments and/or services are subject to the appropriation of state funds.

5. The county department shall make a good faith effort to negotiate an adoption assistance agreement with the adoptive parent(s). The county shall base the negotiation on the current and anticipated needs of the child/youth and the circumstances of the adoptive parent(s).

a. A good faith negotiation means to deal honestly and fairly with one another.

There must be a discussion between the county department and the adoptive parent(s).

b. At the negotiation meeting, the county department will explain all aspects of the program and the agreed-upon amount of assistance which considers the needs of the child/youth.

c. If the parties cannot come to an agreement, the county department shall establish the adoption assistance amount. If the family disagrees with the decision, a fair hearing can be requested.

6. Negotiate with the adoptive parents to request the amount that is needed by the family to meet the child’s/youth’s needs. This may be less than the amount for which the child/youth qualifies.

7. The county may negotiate up to the monthly foster care rate in appropriate cases. The amount shall be no more than the rate that is being paid for the child’s/youth’s current out-of-home care or that would have been paid if the child/youth were in paid out-of-home care today. The monthly respite care payment that is provided under the foster care program is not a benefit under the adoption assistance program. If the county and the prospective adoptive family do not agree to an amount, the county shall make an offer.

The adoptive family may reject that offer and take the matter to a fair hearing.

8. If a child/youth with mental, intellectual or developmental disability that is documented and defined by a licensed medical professional is receiving an allowance in addition to the foster care payment at the time the child/youth is placed for adoption, the allowance may continue under the adoption assistance program if the child/youth continues to meet the criteria outlined in “Child with Adoption assistance” Section 7.306.4, A.

9. County departments who pay more than the child’s/youth’s foster care rate or in the event that the child/youth is not in foster care, the rate that would have been paid based on the child’s/youth’s original or amended adoption assistance agreement shall reimburse the state for ninety percent (90%) of the payment that is over the foster care rate.

10. Use the State prescribed forms to document the negotiated agreement for IV-E adoption assistance and attach supporting documentation.

11. Complete and sign the adoption assistance agreement form specifying:

a. The dollar amount of any adoption assistance and a summary of case services agreed upon being provided, if applicable.

b. The duration date of the agreement:

1. Until the adopted child/youth reaches the age of 18 years; or, 2. Up to 21 years in the case of a child/youth who has a physical, intellectual or developmental disability; or, a. The county shall document in the record that the youth is enrolled full-time in high school or vocational training and is making progress in the program or completing secondary education or is enrolled in a program leading to an equivalent credential.

b. Enrolled in an institution that provides postsecondary or vocational education.

c. A youth who is identified in the original adoption assistance agreement has an intellectual and or developmental disability or a physical handicap, is between the age of 18-21, and continues to live at home, may continue to be eligible for the adoption assistance program as long as these disabilities were identified;

d. Participating in a program or activity designed to promote or remove barriers to employment; or, e. Employed for at least eighty hours per month.

3. On a case-by-case basis, the duration of an agreement may be sooner 4. The services and dates of services that are covered by an effective adoption assistance agreement.

5. Any reimbursement for non-recurring expenses incurred by or on behalf of the adoptive parent(s) in connection with the adoption.

c. That the adoption assistance agreement must be signed and dated by all parties prior to the effective date of the agreement and before the adoption is finalized. If the county fails to completely execute the initial adoption assistance agreement prior to the effective date and prior to the finalization of the adoption, the assistance payment will become non-reimbursable by the State and IV-E moneys.

12. The adoption assistance agreement must be reviewed at least every three years. The county department shall provide written notice of the upcoming review to the adoptive a. The agreement may be adjusted after a good-faith negotiation and with the concurrence of the adoptive family. An adjustment is reviewable through the b. Benefits provided through the program must be continued if the adoptive parent(s) leave the state of Colorado with the adopted child or youth (for additional information regarding state-to-state Medicaid services see section 7.402.4 Medicaid for children and youth covered by the Interstate Compact on Adoptions and Medical Assistance (ICAMA)).

13. The county or adoptive family may request to renegotiate an existing adoption assistance agreement at any based on changes in the needs of the adopted child or youth or in the circumstances of the family related to the original eligibility criteria known and documented at the time of the finalization of the adoption.

a. Any new agreement must include the circumstances under which the county department may suspend adoption assistance payments.

b. The agreement may be adjusted after a good faith negotiation and with the concurrence of the adoptive family. An adjustment is reviewable through the F. There are situations after finalization when adoptive parents can request a state level fair hearing before an Administrative Law Judge concerning the adopted child’s/youth’s eligibility for adoption assistance benefits or the amount of those benefits. These situations include but are not limited to:

1. Relevant facts regarding the child/youth that were known and not presented to the adoptive parent(s) prior to the finalization of the adoption.

2. Denial of assistance based upon a means test of the adoptive family.

3. Erroneous determination that a child/youth is ineligible for adoption assistance.

4. Denial of a request for a change in payment level due to a change in the child/youth’s needs and/or in the adoptive parent(s)’ circumstances.

5. Failure by the county or non-profit child placement agency to advise the adoptive parent(s) about the availability of adoption assistance for children/youth who have been identified with special needs.

6. Decrease in the amount of adoption assistance without the concurrence of the adoptive parent(s) (for Title IV-E adoption assistance agreements, only). 7.306.42 Non-Title IV-E Adoption Assistance A. Pathways to Eligibility The following are ways to become eligible for non-Title IV-E adoption assistance:

1. The county department has guardianship of the person(s) (children/youth) with the

authority to consent to adoption.

2. The county department or non-profit child placement agency has guardianship of the person (children/youth) with the right to consent to adoption, but the current caregiver has physical custody of the children/youth.

3. The child(ren)/youth is not a citizen or a qualified citizen but is being adopted by a U.S. citizen or qualified citizen.

4. A person has custody of a child/youth given by proper order of a dependency and neglect court.

5. The child/youth was not Title IV-E eligible in foster care and does not meet the Federal Applicable Child Criteria (delinking).

6. All county departments of human/social services and Title IV-E eligibility staff are required to determine children and youth eligible for Title IV-E adoption assistance, if the following applies:

a. The child or youth was in the custody of relatives or kin at the time of termination of parental rights in a dependency and neglect action; and/or, b. The child or youth was in the care or custody of a public or licensed private nonprofit child placement agency or Indian tribal organization pursuant to:

1. An involuntary removal of the child or youth from the home in accordance with a judicial determination to the effect that continuation in the home would be contrary to the welfare of the child or youth; or, 2. A voluntary placement agreement or voluntary relinquishment; and, 3. The termination of parental rights/relinquishment orders contain the judicial determination to the effect that the county department/Indian tribal organization has guardianship of the child or youth to consent to that child or youth’s adoption; and the child or youth has been determined by the county, pursuant to section 7.306.4. a. d. to be an eligible child or youth.

B. Foster Care Placement of a Child/Youth Under an Adoption Assistance Agreement 1. The State prescribed form must be completed to determine Title IV-E eligibility using the adoptive parent(s)’ income.

2. The child/youth, upon returning to the adoptive parent(s)’ home, returns to the previous non-IV-E adoption assistance agreement.

C. Eligibility Determination for Medicaid in Non-Title IV-E Eligible 1. Colorado children/youth who are eligible for an adoption assistance agreement, but are not Title IV-E are eligible for Medicaid in Colorado or reciprocal states, only.

2. An adoption assistance payment is not required to extend Medicaid coverage.

3. Medicaid eligibility may or may not be continued for non-IV-E eligible children/youth who are out of the home for more than thirty (30) calendar days.

4. Medicaid eligibility for all children/youth receiving Medicaid shall be redetermined yearly only if the child/youth continues to be eligible for Medicaid. This can be done by completing the State prescribed form.

D. Non-Title IV-E Adoption Assistance Payments 1. Determine and document a child’s/youth’s identified needs and eligibility for adoption 2. Denial of assistance based solely on a means test of the adoptive family is not allowed and must not be substituted for the agreement.

3. The adoption assistance agreement shall be established in accordance with the State’s written policy.

a. County departments shall use the Colorado Adoption Assistance Negotiation Worksheet with the potential adoptive family for all adoption assistance determinations and negotiations.

1. If adoptive parent(s) choose to refuse all adoption assistance including monthly cash assistance, Medicaid, and/or case services, they must sign the permanent refusal of adoption assistance form.

2. If adoptive parent(s) request a Medicaid only adoption assistance agreement and/or non-recurring adoption expenses they may choose to decline completing the Adoption Assistance Negotiation Worksheet and sign the request for Medicaid only adoption assistance form. However, they still must sign an adoption assistance agreement.

b. County departments shall adopt the policies and procedures outlined in the State of Colorado’s adoption assistance policy. a copy of the written policy shall be provided to adoptive parent(s) at least 5 business days prior to a negotiation meeting.

4. Make a good faith effort to negotiate an adoption assistance agreement with the adoptive parent(s). The county shall base the negotiation on the current and anticipated needs of the child/youth and the circumstances of the adoptive parent(s). If the parties cannot come to an agreement, the county department shall establish the adoption assistance amount. If the family disagrees with the decision, a fair hearing can be requested.

5. The monthly respite care payment that is provided under the foster care program is not a benefit under the adoption assistance program.

6. If a child/youth with physical, mental, intellectual and developmental disabilities is receiving an allowance in addition to the foster care payment at the time the child/youth is placed for adoption, the allowance may continue under the adoption assistance program if the child/youth continues to meet the criteria outlined in “Child with Adoption assistance”, Section 7.306.4.A.e.d.

7. County departments who pay more than the county’s foster care rate or in the event that the child/youth is not in foster care, the rate that would have been paid based on the child’s/youth’s original or amended adoption assistance agreement shall reimburse the State for ninety percent (90%) of the payment that is over the foster care rate.

8. Use the State prescribed forms to document the negotiated agreement for non-Title IV-E adoption assistance and attach supporting documentation.

9. Complete and sign the Adoption assistance Agreement form specifying:

a. The dollar amount of the adoption assistance being provided, if applicable.

b. Duration of the agreement:

1. In non-Title IV-E adoption assistance agreements, duration is decided by the State’s written policy, according to the identified needs of the child/youth and family circumstances. The county department shall extend the adoption assistance agreement upon the approaching expiration date if the youth meets criteria for extension and the extension is requested by the adoptive parent(s). As defined in section 7.306.54, adoption assistance may continue to the 21st birthday. In situations where adoption assistance continues through the 21st birthday, adoption Medicaid will still continue through the end of the month of the 21st birthday.

2. On a case-by-case basis, the duration of an agreement may be sooner 3. The adoption assistance agreement must be reviewed at least every three years. The county department shall provide written notice of the upcoming review to the adoptive family.

a. Any new agreement must include the circumstances under which the county department may suspend subsidy payments.

b. The agreement may be adjusted after good faith negotiation and with the written concurrence of the adoptive family. An adjustment is reviewable through the administrative law process upon the request of the family. Any party may request a review of the agreement prior to the three-year mandatory review if changes occur in the needs of the adoptive child/youth or in the circumstances of the family.

c. Benefits provided through the program must be continued if the adoptive parents leave the state of Colorado with the adoptive child or youth.

d. The services and dates that are covered by an effective adoption e. Any reimbursement for non-recurring adoption expenses incurred by or on behalf of the adoptive parent in connection with the adoption.

f. That the adoption assistance agreement must be signed and dated by all parties prior to the effective date of the agreement and before the adoption is finalized. If the county fails to completely execute the initial adoption assistance agreement prior to the effective data and prior to the finalization of the adoption, the assistance payment will become non-reimbursable by the State.

10. The adoption assistance agreement must be reviewed at least every three years. The county department shall provide written notice of the upcoming review to the adoptive a. Any new agreement must include the circumstances under which the county department may suspend adoption assistance payments.

b. The agreement may be adjusted after good faith negotiation and with the written cconcurrence of the adoptive family. An adjustment is reviewable through the c. Benefits provided through the program must be continued if the adoptive parent(s) leaves the state of Colorado with the adopted child or youth.

11. The county or adoptive family may at any time negotiate changes to an existing adoption assistance agreement based on information related to the child’s/youth’s current and/or anticipated needs or the family’s circumstances. 7.306.43 Review Of Eligibility For All Ongoing Adoption Assistance Agreements The state department will conduct reviews of county departments’ adoption assistance programs as follows:

A. The county shall review the current adoption assistance agreement every three (3) years.

1. The county department shall initiate the written notice of the review for adoption assistance sixty (60) days prior to the three-year anniversary of the agreement.

2. The adoptive family may request a review of the agreement prior to the three-year review if changes in the needs of the child/youth or family circumstances occur.

3. The adoptive parents may request a review of the adoption assistance agreement if changes in the needs of the child/youth or family circumstances occur. Any changes in the agreement must be related to the original barriers identified at the time the decision was made that adoption assistance was needed or to the child’s/youth's needs that are genetic in nature, regardless of whether those needs were identified prior to adoption.

B. The county shall annually review documentation of school attendance or reasons for inability to attend. The documentation must demonstrate that each child/youth who is eligible for adoption assistance and who has attained the minimum age for compulsory school attendance is:

1. Enrolled (or in the process of enrolling) in an institution that provides elementary or secondary education, or, 2. Instructed in elementary or secondary education at home in accordance with the homeschool statute, or, 3. In an independent study elementary or secondary education program in accordance with statute, and which is administered by the local school, school district, or board of cooperative education (BOCES), or, 4. Incapable of attending school on a full-time basis due to the medical condition of the child/youth. The reasons shall be supported by regularly updated information in the educational plan maintained by the school, school district, or BOCES. 7.306.44 Social Security Benefits for Children/Youth in Adoptive Placement A. The county department shall inform adoptive parents of the potential eligibility for social security benefits of any child/youth placed with them for adoption.

B. In cases where the child/youth is eligible for both Supplemental Security Income (SSI) and Title IV-E adoption assistance, the prospective adoptive parents may make application for both programs and the child/youth, if eligible, may receive benefits from both programs. In considering the most appropriate choice of programs and deciding whether to make application for one or both, the prospective adoptive parents should be made aware of the differences between SSI and the adoption assistance program by the county department of human/social services.

C. When a child/youth is receiving Supplemental Security Income prior to adoption, the adoptive parent(s) can seek a monthly adoption assistance payment from the county department of human/social services up to the foster care maintenance payment that has been paid or would have been paid if the eligible child or youth had been in foster care at the time of the eligible child or youth’s adoption. In cases where the child/youth is eligible for both Supplemental Security Income (SSI) and Title IV-E adoption assistance the adoptive parent(s) cannot receive more than the maximum foster care rate. Nothing in this paragraph shall limit the county department of human/social services from providing case services when a child/youth is SSI eligible. 7.306.45 Accepting and Processing Applications for Adoption Assistance from Child Placement Agencies and Prospective Adoptive Parents Seeking a Private Adoption A. Colorado non-profit licensed adoption agencies can access adoption assistance if the child/youth is in their custody and meets Title IV-E eligibility, as outlined in section.7.601.7. Prospective adoptive parent(s) can also access adoption assistance in a private adoption if the child/youth is determined to be eligible for Social Security Income or is in their custody through a court order of a dependency and neglect court, such as guardianship or allocation of parental responsibilities, and meets Title IV-E eligibility as outlined in section 7.601.7. The adoption assistance application, whether being made by a licensed adoption agency or prospective adoptive parent(s), should be made in the first instance to the Colorado Division of Child Welfare.

1. Upon receipt of the complete application, the Colorado Division of Child Welfare shall determine the overall eligibility of the child/youth. If the Division of Child Welfare determines there is an eligible child/youth, within ten (10) business days the Colorado Division of Child Welfare shall request financial Title IV-E eligibility from the county department of human/social services where the prospective adoptive family resides. The county department shall send verification of that determination to the Colorado Division of Child Welfare. Such determination by the county department shall be made within ten (10) business days.

2. Upon receipt of financial Title IV-E eligibility from the county department, the Colorado Division of Child Welfare Adoption Administrator shall provide the formal Title IV-E determination letter to the applicant within fourteen (14) business days. The Colorado Division of Child Welfare Adoption Administrator shall send the required documents to the Colorado county department of human/social services within fourteen (14) business days and the county department will start the adoption negotiation process with the prospective adoptive parents.

3. If the child/youth is determined to be non-Title IV-E eligible, the Colorado Division of Child Welfare Adoption Administrator will provide the adoptive family and county department of human/social services a denial letter of adoption assistance. If the child/youth is determined to be non-Title IV-E eligible, the family may consult with the county department on other services for which they or the child/youth may be eligible. It is at the discretion of the Colorado county department of human/social services if they choose to provide adoption assistance as all assistance, would be solely funded by the county. The provision of medical insurance for these children/youth can only occur through commercial insurance plans solely paid through county only funds. The only path for these child(ren)/youth is that the family meets Medicaid income parameters, or the child(ren)/youth meets waiver, or children and disabilities buy-in parameters.

4. If it is determined that the child/youth is not eligible for Title IV-E adoption assistance, the Colorado Division of Child Welfare Adoption Administrator shall inform all parties in writing the basis for the denial and their right to appeal the state’s decision.

B. If the child/youth is being placed in the state of Colorado with a prospective adoptive family working with a Colorado non-profit adoption agency, the Colorado Department of Human Services will process and approve adoption assistance funded by Colorado county departments if the child/youth meets the following criteria:

1. Have Social Security Income (SSI) eligibility; or, 2. If the child/youth meets the Federal Applicable Child Criteria (delinking), has identified needs, and meets the requirements in the federal fiscal year in which the adoption is finalized, the child/youth will become categorically eligible for Title IV-E adoption C. If the child/youth is being placed out of the state of Colorado by a Colorado non-profit adoption agency, it is at the discretion of the other state to process and fund adoption assistance.

D. After the county department approves the adoption assistance and finalization has occurred, it shall open the case on the Comprehensive Child Welfare Information System (CCWIS).

E. Approved adoption assistance payments will begin on the date of adoption finalization. The child placement agency or the prospective adoptive parents, whichever is applicable, is responsible for any costs before the initiation of the adoption assistance agreement and prior to finalization.

F. Adoption assistance available to the eligible child/youth are:

1. Medicaid (Title XIX).

2. Adoption assistance payment.

3. Non-recurring adoption expenses.

4. Adoption case services.

G. Before finalization of the adoption, the child placement agency that arranged the adoption, if applicable, retains responsibility for continued services to the adoptive family should they be requested.

H. The county department shall terminate adoption assistance payments and eligibility for Medicaid as outlined in termination of adoption assistance (section 7.306.59). 7.306.46 Reinstatement of Adoption Assistance A. Adoption assistance agreements may be reinstated if the services requested relate to the child’s/youth's identified needs or family circumstances.

B. When adoptive parents have relinquished, have had their parental rights terminated, or have died and the child/youth is placed in a subsequent adoptive placement, then the child/youth retains Title IV-E eligibility for adoption assistance in their new adoptive placement. The only determination that must be made for adoption assistance eligibility prior to the finalization of the subsequent adoption is whether the child/youth is a child/youth with one or more specific factors or conditions as set forth in Colorado Revised Statutes section 26-7-102(8). 7.306.47 Suspension of Adoption Assistance 1. The county department may suspend the payment of adoption assistance available when contact with the adoptive family cannot be established and the county department cannot establish that the adoptive parent is providing any support, which includes financial support as determined by the Title IV-E agency.

2. Prior to suspension, the county department shall provide notice to the adoptive parent(s) of intent to suspend adoption assistance payments at least ten days prior to suspension and shall include in the notice:

a. A statement of the county department's intent to suspend adoption assistance payments, as well as the reasons and legal basis for the intended suspension;

b. A description of the adoptive parent(s)' right to request a fair hearing pursuant to 45 C.F.R. § 205.10; “(current through May 3, 2023) can be found in the Code of Federal Regulations. No later amendments or editions are incorporated. The Code of Federal Regulations are available at no cost from the U.S. Health Resources and Services Administration, Office of Communications 5600 FISHERS LANE, ROCKVILLE, MD 20857 or at https://www.ecfr.gov/. The regulations are also available for public inspection and copying by contacting the Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado 80203 during regular business hours.”

c. A description of the circumstances under which adoption assistance must be continued if a hearing is requested; and d. The circumstances under which a suspension may be reversed without a fair hearing.

3. When the adoption assistance payment is suspended, the eligible child or youth remains Title IV-E eligible, the Title IV-E agreement remains in effect, and the eligible child or youth remains eligible for, and in receipt of, medical assistance. 7.306.48 Termination of Adoption Assistance Agreement 1. The county department shall terminate the payment of adoption assistance available when any of the following situations occur:

a. The child or youth reaches eighteen (18) years of age; except that, in cases where the county department has determined that the youth meets eligibility for extension of the adoption assistance agreement which warrants continued assistance, the payment of adoption assistance shall continue until the child or youth reaches twenty-one (21) years of age;

b. The adoptive parent or parents are no longer legally responsible for the support of the child or youth;

c. The child or youth is no longer receiving support from the adoptive family, which includes financial support as determined by the Title IV-E agency, or d. The county department certifies the death, marriage, or enrollment in military service of the child or youth.

2. Adoptive parents who receive adoption assistance shall keep the county department that is administering the program informed of circumstances that would make them ineligible to continue to receive adoption assistance.

7.306.5 INSTRUCTIONS FOR REIMBURSEMENT OF ADOPTION ASSISTANCE SERVICES 7.306.51 Medical Payments in Adoption Assistance Agreements 7.306.511 General Provisions A. Adoption assistance agreement payments are made directly to adoptive parents for a service already received or to a vendor for treatment of a physical or developmental disabilities or emotional disturbance. An adoption assistance agreement shall relate directly to the barrier or barriers identified at the time the initial agreement is approved, as not otherwise covered by Medicaid.

B. Adoption assistance agreements are not available for treatment of any physical or developmental disability or emotional disturbance diagnosed after finalization of the adoption.

C. Adoption assistance agreements may be used to supplement any other available resource such as an adoptive family’s private insurance that pays part but not all for the child’s treatment (physical, mental, and emotional).

D. Adoption assistance agreements can only be used for Medicaid cases if the service requested would not be covered under the State Medicaid Plan (as evidenced by an eligibility coverage decision) and relates to the direct barrier/need identified at the time the child is placed for adoption. Please refer to C.C.R..2505-10 8.000 - 8.6000 (June 30, 2020) for more information about eligibility coverage plans. These regulations are available at no cost from the Colorado Secretary of State, 1700 Broadway, Denver, Co 80290 or at https://www.sos.state.co.us/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Community Partnerships, 1575 Sherman St, Denver, Co 80203, during regular business hours. 7.306.52 Reimbursable and Non-Reimbursable Adoption Assistance Case Services Prior to the negotiation meeting, the county department shall provide the adoptive family’s contact information to a representative of the Accountable Care Collaborative (ACC) and request that they contact the family within 72 business hours to discuss Medicaid covered and non-covered services. An ACC representative may be present during the negotiation meeting at the invitation of the adoptive family or the county department. The ACC representative will act as a neutral party strictly for the purposes of providing information regarding services that are covered by Medicaid.

The county department shall provide access to the Colorado Medicaid member handbook, either electronically or in hard copy. This handbook is also available at no cost from Health First Colorado, Colorado’s Medicaid program, 1570 Grant Street, Denver, Co 80203 or at https://www.healthfirstcolorado.com/benefits-services/ this handbook is available for public inspection and copying at the Colorado Department of Human Services, Office of Community Partnerships, 1575 Sherman St, Denver co 80203, during regular business hours.

Case services are a type of purchased program services that support a case plan for children/youth in out-of home placement or an adoption assistance agreement.

Case services are provided to meet a child/youth special needs identified when the child is placed for adoption and which are not covered by the adoption assistance or Medicaid. assistance agreements.

Adoptive families may request reimbursement, all or in part, for non-Medicaid covered services to support the health and well- being of an eligible child or youth, and considering the circumstances of the family as defined in C.R.S. 26-7-102(5).

Such services may be reimbursed if:

1. Documented and recommended or prescribed by a medical, dental, mental health and/or educational professional, or other qualified professional based upon education, professional experience, certification, or licensure.

2. Designed to appropriately meet the needs of the eligible child or youth that would otherwise be a barrier to adoption.

Such requested services may include but not be limited to, child care, tutoring in coordination with school services in order to achieve age appropriate grade level academic competency or therapies, such as animal-assisted therapy, or therapeutically recommended prosocial or recreational activities. Funding for such services shall be negotiated in good faith by the parties, giving consideration to the circumstances of the adoptive family pursuant to C.R.S. 26-7-102 (5). In no case will the county reimburse for such services when they are available at no cost, provided through another reasonably accessible public program or covered by the adoptive family’s private insurance. provided, however, that the decision to add the child on the adoptive family’s private insurance shall be at the adoptive family’s sole election.

If the child/youth is placed in an adoptive home in a state other than Colorado at the time of finalization, the county department representative from Colorado will contact the family’s Interstate Compact on the Placement Child (ICPC) case manager in the receiving state to gather and provide the necessary information for the adopting parents to have the opportunity to contact a Medicaid liaison in the receiving state to attend the negotiation meeting to discuss Medicaid coverage in the receiving state post-adoption; and to gather post-adoption services information provided in the receiving state.

To be eligible for case services in an adoption assistance agreement, the State prescribed form outlining the agreement must be in place and the case open in the Comprehensive Child Welfare Information system as an adoption assistance case. 7.306.53 Non-Recurring Adoption Expenses A. Reimbursement for the following non-recurring adoption expenses, not to exceed the federal allowed amount per child/youth, is available to parents adopting an eligible child/youth:

Reimbursement for non-recurring adoption expenses, pursuant to 42 U.S.C. 673 (a) (6) (a) includes reasonable and necessary adoption fees, court costs, attorney fees (including attorney’s fees in connection with representing parents seeking adoption assistance for an eligible child/youth) and other expenses (including advocate fees in connection with representing parents seeking adoption assistance for an eligible child/youth) that are directly related to the legal adoption of an eligible child or youth. “Other Expenses” are defined as the costs of adoption incurred by or on behalf of the adoptive parents and for which they carry the ultimate liability for payment, including the adoption study, health and psychological examinations, supervision of the placement prior to adoption, transportation and the reasonable costs of lodging and food for the child or youth and/or the adoptive parents when necessary to complete the adoption process.

The federal allowed amount per child/youth is set forth under 42 U.S.C. § 673 (2019). This federal statutory provision is available at no cost from the U.S. Health & Human Services, Administration for Children & Families 330 C Street, S.W., Washington, D.C. 20201 or at https://www.acf.hhs.gov/cb. This federal statutory provision is also available for public inspection and copying at the Colorado Department of Human Services, Office of Community Partnerships, 1575 Sherman St, Denver, Co 80203, during regular business hours. 7.306.54 Continuing Adoption Assistance Agreements Beyond Eighteen Years Of Age County Departments of Human/Social Services may claim title IV-E funds for youth 18 years of age through the month of the twenty first birthday when one of the following criteria is met:

A. The county shall document in the record that the youth is enrolled full-time in high school or vocational training and is making progress in the program; or completing secondary education or is enrolled in a program leading to an equivalent credential.

B. Enrolled in an institution that provides postsecondary or vocational education.

C. A youth who is identified in the original adoption assistance agreement has an intellectual and or developmental disability or a physically handicap, is between the age of 18-21, and continues to live at home, may continue to be eligible for the adoption assistance program as long as these disabilities were identified and documented in the original agreement paperwork or is genetic in nature.

D. Participating in a program or activity designed to promote or remove barriers to employment; or E. Employed for at least eighty hours per month 7.306.55 Post Adoption Services The county that signed the initial adoption assistance agreement is responsible for maintaining or renegotiating the agreement post adoption subject to the agreement being terminated pursuant to C.R.S.

section 26-7-109. The county of residence of the adoptive parents following the adoption will not be responsible for the renegotiation of such agreement.

If an adoptive family wishes to renegotiate an existing agreement, they must contact the county that provided the initial adoption assistance, regardless of the county, state or country of residence. Any renegotiation of services and benefits can be requested at any time by the adoptive family and will be based upon the needs of the eligible child/youth and the circumstances of the adoptive family.

If additional support is needed, the family may seek services from the county of residence. The county of residence, in consultation with the county that signed the initial adoption assistance agreement, shall make reasonable efforts to locate and connect the adoptive family with appropriate and accessible service providers. 7.306.56 Adoption Records A. The county department shall maintain a record for the child/youth in its custody who is approved for adoptive placement. It shall ensure that all documentation related to the child/youth’s adoption is in the record. The following must be included, but is not limited to:

1. Court order issued at the time of initial removal;

2. Voluntary placement agreement, if applicable;

3. order for termination of parental rights or order for relinquishment of parental rights;

4. Child/youth and family study;

5. Adoptive family’s application;

6. Adoptive family’s home study and any updates, as necessary;

7. Documentation of the child/youth’s special needs (7.306.4, A, 3, D, 1-5).

8. Documentation of child/youth’s tribal affiliation, if applicable;

9. Time and date-stamped petition for adoption;

10. Final decree of adoption.

B. Upon completion of legal adoption, the county department shall close the case in the CCWIS system within 30 calendar days, unless the child receives adoption assistance.

C. Within 90 calendar days of the date of finalization of the adoption, the county will send to state basic data on the family and children/youth for entry in the statewide database using the state’s approved form. This information shall be supported and reflect what is in the CCWIS system.

D. In adoption assistance cases, the county department shall maintain a separate record to include the following items, as long as the adoption assistance agreement is in effect for the child/youth and family. Upon termination of this adoption assistance agreement, the record shall be closed immediately.

1. Current adoptive home study and any necessary updates;

2. Child/youth’s summary and application for adoption assistance;

3. Initial adoption assistance agreement;

4. Court order issued at time of initial removal;

5. Voluntary placement agreement, if applicable;

6. Subsequent order on review for need of placement, if applicable;

7. Review of adoption assistance agreement and three year reviews of need for adoption assistance or any amendments of the original adoption assistance agreement;

8. Adoption assistance title iv-e eligibility determination form;

9. Title IV-E foster care eligibility determination form;

10. Title IV-E redetermination of eligibility determination form(s);

11. A copy of the social security income eligibility notification;

12. Petition to adopt time and date-stamped by the court;

13. Final adoption decree;

14. Orders terminating parental rights;

15. Appeal petition of the termination and final order resolving appeal of the termination;

16. Indian Child Welfare cases, if known tribal affiliation;

17. Documentation of the child/youth’s special needs (7.306.4, A, 3, D, 1-5);

18. Motion to court to expedite the date of the final hearing, if applicable.

E. County departments providing adoption assistance to children/youth from private non-profit adoption agencies or relatives shall maintain, in a secure location at the county, the records containing the adoption assistance information listed in subsection D, above.

F. County departments providing a subsequent adoption assistance agreement to children/youth whose previous adoption was dissolved shall maintain, in a secure location at the county department, the records containing the adoption assistance information listed in subsection d, above. additional required information includes:

1. New documentation assessing and identifying the child/youth’s continuing special needs;

2. All of the adoption assistance forms and documentation from the previous adoptive G. County departments providing an adoption assistance agreement to children/youth who were in foster care with the teen parent/s, shall maintain, in a secure location at the county department, their records containing the adoption assistance information listed in subsection D, above.

Additional required information must include proof of foster care payment made that includes both the child/youth and his/her teen parent. 7.306.57 state monitoring/sanction process of adoption assistance programs in counties The state department will conduct reviews of county departments’ adoption assistance programs as follows:

A. The state will randomly select cases from the county’s adoption assistance caseload.

B. The passing threshold will be issued in a memo to county departments and updated at least every three years by the state department. Each county will be given three opportunities to pass the review before a fiscal sanction is established.

1. Counties passing the initial review will be reviewed again in three years.

2. If the county fails the initial review, a second review will be conducted in the following year.

3. If the county fails the second review, a third review will be conducted in the following year.

C. At each review, the county will be given an opportunity to provide information to the state department that will enable the case that is out of compliance to pass the review.

D. At each review, the state department will offer the county failing the review technical assistance based on issues identified during the review and will require it to develop a program improvement plan.

E. If the county fails all three reviews, the reviewed cases that are out of compliance, as determined by the memo regarding the monitoring tool, may be converted to county-only funding from the time of the third review and throughout the duration of the adoption assistance agreement.

7.306.6 RIGHT TO APPEAL

A. When the county department or state department denies an application for adoption assistance, or reduces, suspends or terminates the assistance agreement, the applicant or recipient shall have a right to appeal. For purpose of an appeal arising from the state or county’s denial of an application for adoption assistance reduction, suspension or termination of an adoption assistance agreement only, the procedures for appeal and state level fair hearing and that are set forth in 9 CCR 2503-8 § 3.850 shall be followed.

B. When a family who has been denied Title IV-E Subsidized Adoption benefits requests a state level Fair Hearing, it is the responsibility of the Administrative Law Judge to determine whether the applicant or recipient was wrongly denied eligibility or whether the amount of the assistance was determined correctly. (See Section 7.306.41, E, for fair hearing circumstances.)

C. The adoptive parents have the burden of proving extenuating circumstances and adoption assistance eligibility at a state level fair hearing. The state, county departments and or/its designee can provide factual information to assist the family in establishing eligibility for Title IV-E adoption assistance.

D. When either state or federal law requires or results in a reduction or deletion of services, a hearing need not be granted.

7.307 INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN (ICPC)

The purpose of the Interstate Compact on the Placement of Children is to ensure timely placements of children across state lines in the least restrictive and appropriate settings in the 50 states, District of Columbia, and the U.S. Virgin Islands. The sending and receiving state authorities shall have sufficient background information to make informed decisions concerning a proposed placement, to arrange for the provision of services to the child as needed, and to designate where planning, financial, and jurisdictional responsibility for the child lies. 7.307.1 USE AND OBSERVANCE OF THE COMPACT [Rev. eff. 4/1/12]

County departments, other Colorado licensed placement agencies, and when applicable, individual residents, shall follow all rules, regulations, and procedures of the Interstate Compact on the Placement of Children, as stated in Section 24-60-1801, 1802, C.R.S., and Section 19-1-115, C.R.S. Regulations I through XI are on file at the Colorado Department of Human Services, Interstate Compact Office, Child Welfare, 2nd Floor, 1575 Sherman Street, Denver, Colorado 80203-1714. Regulation I was amended on April 18, 2010. Regulation II was amended on April 30-May 1, 2011. Regulation III was amended on April 30-May1, 2011. Regulation IV was amended on April 29–May 2, 2001. Regulation V was amended in April 2002. Regulation VI was amended on April 29-May 2, 2001. Regulation VII was amended on April 30-May 1, 2011. Regulation VIII was amended on April 30-May 3, 2000. Regulation IX was amended in April 2002. Regulation X was amended in April 2002. Regulation XI was adopted on April 18, 2010.

These regulations are adopted pursuant to Article VII of the Interstate Compact on the Placement of Children by action of the Association of Administrators of the Interstate Compact on the Placement of Children at its annual meeting. The information incorporated here by reference may be examined at the Department of Human Services as indicated above, at any county department of social services, or at any state publications depository library.

7.307.2 DEFINITION OF “SENDING AGENCIES”

The Interstate Compact defines the persons and agencies who, when they place a child from one state into another state, shall follow Interstate Compact on the Placement of Children procedures. These persons and agencies are all called “sending agencies,” and include the following:

A. A state in the United States, the District of Columbia or the U.S. Virgin Islands, or any officer or employee of a state in the United States, the District of Columbia, or the U.S. Virgin Islands.

B. A subdivision of a state in the United States, the District of Columbia or the U.S. Virgin Islands, or any officer or employee of the subdivision.

C. A court of a state in the United States, the District of Columbia, or the U.S. Virgin Islands.

D. Any person, corporation, association, or charitable agency of a state in the United States, the District of Columbia, or the U.S. Virgin Islands.

7.307.3 AGENCY-MADE PLACEMENTS 7.307.31 Interstate Compact on the Placement of Children Initiation Procedures Compact procedures shall be initiated for children who are considered for placement out-of-state for:

A. Adoption; or B. Homes of parents or relatives; or C. Foster, group, or residential child care; and D. Where the sending agency, such as a county department or the Court, holds legal custody or legal jurisdiction. 7.307.32 Interstate Compact on the Placement of Children Procedures The county department director shall be the Compact Liaison in each Colorado county. At each director’s discretion, duties of the Liaison may be delegated to staff within the county department. It is recommended that the designated liaison be at the Child Welfare Supervisor level or above. The director shall notify, in writing, the Deputy Compact Administrator of the name, title, and phone number of this designee who shall perform the day-to-day functions of the Interstate Compact on the Placement of Children Liaison and be available for Colorado and other state Interstate Compact on the Placement of Children offices to contact for assistance with Compact related situations in that county.

Interstate Compact on the Placement of Children procedures shall be followed when a child is:

A. In the custody of a county department or under the jurisdiction of a court in one state and is considered for placement with his or her parents, relatives, non-relatives, foster parents, adoptive parents, or into residential or group care in another state.

B. Under the jurisdiction of a county department, court, or private placement agency moves with his or her parents, relatives, foster parents, or prospective adoptive parents out-of-state.

C. An adjudicated delinquent ordered by the court into a non-public institution out-of-state.

D. An adjudicated delinquent who is not on probation or parole and is considered for placement with parents, relatives, foster parents, or prospective adoptive parents out-of-state.

E. To be placed for adoption out-of-state.

F. In the custody of a county department or under the protection of the court and has fled out-ofstate and the local departments in both the sending and receiving states agree it may be in the child’s best interest to remain in the site the child has chosen, pending the outcome of the home study.

G. In the custody of a county department or under court jurisdiction and has been taken out of state or been coerced to leave the state without the court’s consent; however, before ordering the child’s return, the court agrees to a home study being done to determine the status of the child’s living arrangement out of state to determine if the child should be permitted to stay there.

H. In runaway status from another state and is taken into protective custody by a county department that subsequently learns that neither the parents nor any known relatives will grant the child access to their homes. In this situation, the county department shall file a Dependency and Neglect Petition on behalf of the child to enable the department to explore other relative placement possibilities out of state.

7.307.4 DIRECT PLACEMENTS OUT OF STATE BY PARENTS OR NON-AGENCY GUARDIANS

A. Interstate Compact on the Placement of Children procedures shall be initiated for children who are being considered for placement out of state by parents, guardians, or relatives, into facilities not designated as medical or educational in nature when a child is considered for placement 1. Out of state with a person other than a parent, step- parent, adult brother or sister, adult aunt or uncle, or grandparent.

2. Out of state into a foster home, adoptive home, group home, residential facility or nonpublic institutional setting.

3. With an out of state non-relative or non-agency guardian.

B. The parent or guardian shall contact the local Colorado county department or the Colorado Interstate Compact on the Placement of Children state office to request information and to be provided with copies of the Interstate Compact on the Placement of Children Request to Place Child (100-A). The parent or non-agency guardian is considered to be the “sending agency” in this situation. The parent or guardian will forward the Interstate Compact on the Placement of Children request to the Colorado state Interstate Compact on the Placement of Children office which will forward the documents to the receiving state Interstate Compact on the Placement of Children office.

7.307.5 REQUIREMENTS 7.307.51 Requirements When Colorado is the Sending State [Emer. Rule eff. 10/1/06; Perm.

Rule eff. 12/1/2006]

The county department must determine, within fourteen (14) calendar days upon receipt of the home study report conducted by the receiving state, whether the placement is appropriate for the child.

The county department or licensed child placement agency holding legal custody or maintaining courtordered protective supervision and considering placement of a dependent child into any site out-of-state shall:

A. Submit information required by the state.

B. Send a referral packet to the Deputy Compact Administrator in the receiving state and enter information from Forms 100-A and 100-B in the Child Welfare Automated Tracking System (see

Section 7.307.7 on “Reporting requirements).

C. Complete and submit the Change of Status Form (100-B) to the receiving state.

D. Not be a party to sending or allowing a child to be taken across the state line without the “prior permission” of the receiving state Interstate Compact on the Placement of Children Administrator or his or her designated staff. Prior permission is defined as either permission or denial being granted on the 100-A or on a facsimile of the 100-A.

E. Continue to have financial responsibility for the support and maintenance of the child during the out-of-state placement unless the placement is with a parent or a care-provider who assumes financial responsibility for the child.

F. Be financially responsible for the return of the child if the placement disrupts and the decision is made to return the child.

G. Send quarterly progress report form to the out-of-state foster care provider on the state designated form.

H. Retain legal custody or the child remains under the court’s jurisdiction; and, I. Not agree to dismissal of the Petition or termination of local court jurisdiction without one of the following four conditions being met:

1. The child has been adopted.

2. The child has become self supporting or legally emancipated.

3. The child is 18 or older.

4. A minimum six month period of supervision has elapsed from date of Interstate Compact on the Placement of Children approval and the receiving state Interstate Compact on the Placement of Children Administrator or his/her designee has granted permission for dismissal of the Petition or termination of court jurisdiction. 7.307.52 Requirements When Colorado is the Receiving State [Rev. eff. 4/1/12]

When Colorado is the receiving state of an Interstate Compact on the Placement of Children Request for Placement, all such requests shall be sent by the sending state directly to the correct county department or to the Colorado Deputy Compact Administrator who shall forward the request packet to the correct county department or licensed Child Placement Agency.

A. Upon receipt, the county department Interstate Compact on the Placement of Children liaison or designee shall review the request for compliance with the Compact and all relevant Colorado and federal laws, and take appropriate action.

B. The county department staff or licensed Child Placement Agency staff assigned to the Interstate Compact on the Placement of Children cases shall:

1. Complete a home study within sixty (60) calendar days of receipt of the request from the sending state.

2. Provide protective services and supervision of the placement according to the treatment plan and case plan set up by the county department or court in the sending state.

3. Provide written progress reports as required.

4. Make determinations and recommendations to the sending agency for dismissal or continuation of the legal custody and jurisdiction in the sending state.

5. Provide services, including protective services, to families and children covered by the Interstate Compact on the Placement of Children and other approved Interstate or intercountry placements as are provided to other similar placement cases that are the responsibility of a county department.

C. These cases shall be subject to the same contact requirements as other Program Area 4, 5 or 6 cases. If circumstances prohibit such contact, the county department shall document exceptions to the minimum requirements on the alternative agency contact agreement with a signature of approval from the county department administrator or county director. Case contacts shall be documented in the State Department’s automated system.

D. Requests for placement received from other states shall be opened as Program Area 6 in the State Department’s automated system.

E. The receiving state (Colorado) may close its Interstate Compact on the Placement of Children case when one of the following conditions have been met:

1. The child has been adopted.

2. The child has become self supporting or legally emancipated.

3. The child has become eighteen (18) years of age.

4. The Colorado county liaison or state Interstate Compact on the Placement of Children Administrator has granted permission for dismissal of the petition or termination of court jurisdiction.

7.307.6 INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN (ICPC) EXPEDITED

PLACEMENT DECISION [Rev. eff. 10/1/13]

To fulfill its obligations under Interstate Compact on the Placement of Children, interstate cases must be processed in a time frame and manner comparable to intrastate cases and intrastate hardship cases.

The expedited placement is designed to eliminate delays in the placement of children in appropriate family homes across state lines.

A. All cases of expedited placement decision require an expedited placement decision court order.

B. In addition, an expedited placement decision can only be made when the placement of the child is with a parent, step-parent, adult brother or sister, adult uncle or aunt, grandparent, or his/her guardian. 7.307.61 Definition of an Expedited Placement Decision [Eff. 10/1/13]

“Expedited placement decision” means an approval or denial of a placement resource made by the receiving state within twenty (20) business days after receipt of a complete request from the sending state. 7.307.62 Sending State Expedited Placement Decision Court Order Findings [Rev. eff. 10/1/13]

A. A valid expedited placement decision court order from the sending state shall contain an express finding that one or more of the following circumstances applies to a particular case and sets forth the facts on which the court bases its finding:

The proposed placement resource is a relative as specified in 7.307.6, B, and either:

1. The child is four (4) years old or younger and his/her sibling(s) if being placed in the same home; or, 2. The child is in an emergency placement, or, 3. The court finds that the child or any child in the sibling group has a substantial relationship with the proposed placement resource.

B. In cases where the sending state court is not itself the sending agency, it is the responsibility of the sending agency to keep the court, which issued the priority order, informed of the status of the priority request. 7.307.63 County Department Processing of Sending State Expedited Placement Request [Eff. 10/1/13]

The county staff shall obtain a copy of the sending state’s court order of expedited placement decision.

County staff will ensure that the order sets forth the factual basis for a finding that an expedited placement decision applies to the child in question, whether the request includes a request for a provisional approval of the prospective placement and a factual basis for the request.

The county department shall also obtain a signed written statement by the assigned case manager in the sending state that affirms the following conditions are met:

A. The child must be placed with a parent, step-parent, adult (as defined by the laws of the receiving state) brother or sister, adult uncle or aunt, grandparent, or his/her guardian.

B. The relative or guardian is interested in being a placement resource and willing to cooperate with the ICPC process.

C. The name and correct address, all available telephone numbers, other contact information of the placement resource, and the date of birth and Social Security Numbers of all adults in the home.

D. Number and type of rooms in the residence of the placement resource to accommodate the child under consideration and the number of people, including children, who will be residing in the home.

E. Proof of sufficient financial resources or explanation for how children will be fed, clothed and cared for.

F. Acknowledgement that a criminal records and child abuse history check will be completed on any persons eighteen (18) years of age and older residing in the home.

G. Based upon current information known to the sending agency, it is unaware of any fact that would prohibit the child being placed with the placement resource and that it has completed and is prepared to send all required paperwork to the sending state ICPC office. 7.307.64 Expedited Placement Decision Requirements When Colorado is the Sending State [Rev. eff. 10/1/13]

A. The county department holding legal custody and considering placement of a dependent child into any site out-of-state shall complete an Interstate Compact on the Placement of Children request as outlined in Section 7.307.51 of these rules. The Interstate Compact on the Placement of Children referral packet shall include a valid expedited placement decision court order.

B. There are specific time frames in processing expedited placement decision requests.

1. Time periods in these procedures may be modified with a written agreement between the court which made the expedited order, the sending agency, the Colorado Interstate Compact on the Placement of Children county liaison and the receiving state Compact Administrator. Any such modifications shall apply only to the single case to which it is addressed.

2. The court sends a copy of its signed order for expedited placement decision to the sending agency within two (2) business days of the hearing or consideration of the request.

3. Within three (3) business days of receipt of the expedited placement decision court order, the county caseworker shall transmit the signed court order, completed forms, and supporting documentation to the Interstate Compact on the Placement of Children county liaison.

4. Within two (2) business days after receipt of the expedited placement decision request, the Interstate Compact on the Placement of Children county liaison shall transmit the complete expedited placement decision request and its accompanying documentation by overnight mailing to the receiving state Compact Administrator together with a notice form that the request is entitled to expedited processing. 7.307.65 Expedited Placement Decision Requirements When Colorado is the Receiving State [Rev. eff. 10/1/13]

A. Within two (2) business days after receipt of a complete expedited placement decision referral packet from the sending state, the Interstate Compact on the Placement of Children county liaison shall forward the referral to the county caseworker.

B. Within fifteen (15) business days, the county caseworker shall forward the completed home study to the Interstate Compact on the Placement of Children county liaison.

C. Within three (3) business days after receipt of the home study, the Interstate Compact on the Placement of Children (ICPC) county liaison shall approve or deny the placement and provide the home study report to the sending state by expedited transmission.

D. A county department is authorized to consent to the sending state’s request to relinquish jurisdiction if the placement is approved with a parent from whom the child was not removed.

7.307.7 REPORTING

All cases provided Interstate Compact on the Placement of Children services shall be opened by the Colorado county departments on the Department’s automated reporting system.

7.307.8 OTHER TYPES OF PLACEMENTS - CHILD MOVING OUT-OF-STATE WITH FOSTER

PARENTS

When it is decided that a child should accompany his/her foster parents who are relocating out-of-state, the county department shall initiate Interstate Compact on the Placement of Children procedures to secure prior approval, whenever possible, for the placement from the receiving state.

7.307.9 EXCLUSION

Native American children placed by tribal authorities may be excluded or placed through Interstate Compact on the Placement of Children procedures at the choice of the tribal court.

7.308 RELINQUISHMENT COUNSELING SERVICES

If the child meets the target group requirements of Program Area 4, 5, or 6, county departments shall assure that relinquishment counseling services are provided:

A. To parents considering relinquishment.

B. To the child when twelve years of age or older, if appropriate.

C. When court-ordered.

7.308.1 COUNSELING AND REFERRAL ACTIVITIES

The county department shall assure that:

A. Relinquishment counseling, referral services, and legal activities are provided in accordance with

Section 19-5-103, C.R.S.

B. If the child is an eligible Native American child, the parents are informed of the provisions of the Indian Child Welfare Act, or any tribal-state agreement with their tribe, and the requirements for notifying tribal authorities.

7.308.2 COURT ACTIVITIES

The county department shall assure that an affidavit is prepared and submitted to the court that includes the elements described in Section 19-5-103(1)(b)(II), C.R.S.

7.308.3 CONTACTS, RECORDS, AND DOCUMENTS

The county department shall maintain a case file which includes court documents. The county department shall maintain the closed adoption records in a secure location at the county. See Adoption Records,

Section 7.306.34.

7.308.4 CONFIDENTIALITY OF CONTACTS AND RECORDS

The county department shall respect the confidential nature of the counseling and maintain confidentiality of all records and papers with respect to the relinquishment following the filing of a Petition for Relinquishment in that such records and papers are open to inspection only upon order of the court. The record shall show the parent’s preference about future communications from the child.

7.309 INDIAN CHILD WELFARE ACT (ICWA) OF 1978

The Indian Child Welfare Act (ICWA) of 1978 is federal legislation that establishes standards for the placement of Indian children in foster care or adoptive homes. Regulations effective on December 12, 2016 were created for the substantive legal requirements of ICWA and updated federal guidelines were also adopted at that time to clarify best practices in implementing ICWA and its regulations. All rights and privileges afforded to parents and children in any other section of this manual are applicable to rights and privileges for Indian parent(s), Indian custodian(s), and children under jurisdiction of county departments.

Indian Tribes are not subject to rules related to ICWA as they have Tribal sovereignty.

7.309.1 DEFINITIONS

A. Active Efforts - Affirmative, active, thorough, and timely efforts intended primarily to maintain or reunite an Indian child with his or her family. Active efforts shall involve assisting the parent(s) or Indian custodian(s) through the steps of a case plan and accessing or developing the resources necessary to satisfy the case plan to the maximum extent possible. Active efforts should be provided in a manner consistent with the prevailing social and cultural conditions of the Indian child’s Tribe and should be conducted in partnership with the Indian child and the Indian child’s parent(s), extended family members, Indian custodian and Tribe. Active efforts may include:

1. Conducting a comprehensive assessment of the circumstances of the Indian child’s family, with a focus on safe reunification as the most desirable goal;

2. Identifying appropriate cultural services and helping the parent(s) to overcome barriers, including actively assisting the parent(s) in obtaining such services;

3. Identifying, notifying, and inviting representatives of the Indian child’s Tribe to participate in providing support and services to the Indian child’s family and in family meetings, permanency planning and resolution of placement issues;

4. Conducting a diligent search or intensive family finding for the Indian child’s extended family members, and contacting and consulting with extended family members to provide family structure and support for the Indian child and the Indian child’s parent(s);

5. Offering and employing all available and culturally appropriate family preservation strategies and facilitating the use of remedial and rehabilitative services provided by the child’s Tribe;

6. Taking steps to keep siblings together whenever possible;

7. Supporting regular visits with parent(s) or Indian custodian(s) in the most natural setting possible as well as trial home visits of the Indian child during any period of removal, consistent with the need to ensure the health, safety, and welfare of the child;

8. Identifying community resources including housing, financial, transportation, mental health, substance abuse, and peer support services and actively assisting the Indian child’s parent(s) or, when appropriate, the child’s family in utilizing and accessing those resources;

9. Monitoring progress and participation in services;

10. Considering alternative ways to address the needs of the Indian child’s parent(s) and, where appropriate, the family, if the optimum services do not exist or are not available;

11. Providing post-reunification services and monitoring.

B. Child Custody Proceedings - Any action other than an emergency proceeding that may culminate into one of the following outcomes: foster care placement, termination of parental rights, preadoptive placement, or adoptive placement.

C. Continued Custody – Physical or legal custody that the parent(s) or Indian custodian(s) has or had at any point in the past and may be applicable by Tribal law or custom.

D. Domicile – For a parent(s) or Indian custodian(s), the place at which a person has been physically present and that the person regards as home; a person’s fixed principal and permanent home, to which that person intends to return and remain indefinitely even though the person may be currently residing elsewhere.

E. Emergency Placement - Child(ren) must be in imminent danger of moderate to severe physical damage or harm with clear and convincing evidence available to be presented before the court .

Emergency placement may not last longer than thirty (30) days.

F. Emergency Proceeding- Includes any court action that involves an emergency removal or emergency placement of an Indian child.

G. Existing Indian Exception – repealed.

H. Indian Custodian(s) - Any Indian who has legal custody of an Indian child under Tribal law, custom, or by state law, including those situations when the parent(s) has transferred temporary physical care, custody, and control to another individual.

I. Indian Foster Home – A foster home in which one or more of the foster parent(s) is a member/citizen of a federally recognized Indian Tribe, or who is an Alaska native and a member of a regional corporation.

J. Involuntary Proceeding – A child custody proceeding in which the parent does not consent of his or her free will to the foster care, pre-adoptive, or adoptive placement or termination of parental rights. This includes parental consent under threat of removal by a court or county department.

K. Indian Tribe - Any Indian Tribe, band, nation, or other organized group federally recognized as eligible for the services provided to Indians including Alaskan native villages.

L. Qualified Expert Witness - An individual who is qualified to testify regarding whether the child’s continued custody by the parent(s) or Indian custodian(s) is likely to result in serious emotional or physical harm to the child and is qualified to testify as to prevailing social and cultural standards of the Indian child’s Tribe. A person may be designated by the Indian child’s Tribe as being qualified to testify to the prevailing social and cultural standards of the Indian child’s Tribe. The court or any party may request the assistance of the Indian child’s Tribe or the Bureau of Indian Affairs (BIA) in locating persons qualified to serve as expert witnesses. The case worker regularly assigned to the Indian child may not serve as a qualified expert witness in child-custody proceedings concerning the child.

M. Tribal Court - A court with jurisdiction over child custody proceedings and which is either a court of Indian offenses, a court established and operated under the code or custom of an Indian Tribe, or any other administrative body of a Tribe which is vested with authority over child custody proceedings.

N. Tribal Sovereignty – Refers to Tribe’s rights to govern themselves, define their own membership, manage Tribal property, and regulate Tribal business and domestic relations; it further recognizes the existence of a government-to-government relationship between such Tribes and the federal government.

O. Status Offense - An offense that would not be considered criminal if committed by an adult, and are prohibited only because of a person’s status as a minor, such as truancy. If an Indian child is being removed because he or she committed a status offense, then ICWA applies.

7.309.2 DETERMINATION OF ELIGIBILITY - INDIAN CHILD WELFARE ACT

Indian children served under the ICWA shall meet the following criteria for eligibility:

A. The Indian child must be:

1. unmarried;

2. under eighteen (18) years of age; and either, 3. a member or citizen of an Indian Tribe; or, 4. eligible for membership or citizenship in an Indian Tribe and the biological child of a member/citizen of an Indian Tribe.

B. If the child-custody proceeding extends beyond an Indian child’s eighteenth (18th) birthday, ICWA continues to apply.

7.309.3 NOTIFICATION PROCEDURES - INDIAN CHILD WELFARE ACT 7.309.31 Notification Requirements - Indian Child Welfare Act A. The county department shall notify the parent(s), Indian custodian(s) and any potential Tribe or Tribal court of jurisdiction that an Indian child is in need of placement or if a petition for termination of the parent-child legal relationship has been filed with the court, when the parties have reason to know that an Indian child is involved, except in an emergency placement. The county department shall ask each participant in the case if they know or have reason to know that a child is an Indian child in any of the following:

1. Any involuntary placement of a Indian child; or 2. Any voluntary placement of any Indian child for foster care or petition for relinquishment as provided in the Tribal-State agreement under ICWA.

B. Notice is necessary to ensure that parent(s), Indian custodian(s), and Tribes have the opportunity to participate in the proceeding. Notice shall be sent by registered or certified mail with return receipt requested, of the pending child-custody proceeding and their right to intervene. The following information shall be provided as part of this notice:

1. Identifying information for the child, including name, birthdate and birthplace;

2. Parent(s)’ names, including any known maiden or former names or aliases, birthplaces and birthdates and Tribal enrollment numbers or as much information as known;

3. If known, the names, birthdates, birthplaces and Tribal enrollment information of other direct lineal ancestors of the child, such as grandparent(s);

4. The name of each Indian Tribe in which the child is a member/citizen or may be eligible for membership/citizenship if a biological parent is a member/citizen;

5. A copy of the petition initiating the child-custody proceeding and a description of the potential legal consequences of the proceeding and if a hearing has been scheduled, information on the date, time and location of the hearing;

6. The name of the petitioner and the names and addresses of the petitioner’s attorney;

7. Rights of any parent or Indian custodian(s) of the child to intervene in the proceedings;

8. The Indian Tribe’s right to intervene at any time in a state-court proceeding for the foster care placement of or termination of parental rights to an Indian child;

9. The rights that if the child’s parent(s) or Indian custodian(s) is unable to afford counsel based on determination of indigency by the court, the parent(s) or Indian custodian(s) has the right to court-appointed counsel;

10. The right to be granted, upon request, up to twenty (20) additional days to prepare for the child-custody proceedings;

11. The right of the parent(s) or Indian custodian(s) and the Indian child’s Tribe to petition the court for transfer of the foster care placement or termination of the parental rights proceeding to the Tribal court;

12. The mailing addresses and telephone numbers of the court and information related to all parties; and 13. The potential legal consequences of the child custody proceedings on the future parental and custodial right.

C. Copies of these notices shall be sent to each of the following:

1. The Tribe where the child may be a member/citizen, or eligible for membership/citizenship; and 2. The child’s parent(s) and if applicable the child’s Indian custodian(s).

D. If the identity or location of the child’s parent(s), the child’s Indian custodian(s), or the Tribes in which the Indian child is a member/citizen or eligible for membership/citizenship cannot be ascertained, but there is reason to know the child is an Indian child, notices of the child custody proceeding shall be sent to the Bureau of Indian Affairs (BIA) regional director to establish Tribal identity.

E. Notice for the Colorado regional director shall be sent to the following address:

Albuquerque Regional Director Bureau of Indian Affairs 1001 Indian School Road, NW Albuquerque, NM 87104 F. The BIA will not make a determination of Tribal membership/citizenship but may, in some instances, be able to identify Tribes to contact.

G. Notice may also be sent via personal service or electronically, but such alternative methods do not replace the requirement for notice to be sent by registered or certified mail with return receipt requested.

H. The county department shall exercise due diligence to:

1. Identify the Tribe;

2. Work with the Tribe to verify whether the child is a citizen/member or their biological parent is a citizen/member and the child is eligible for citizenship/membership; and, 3. Treat the child as an Indian child, unless and until the court determines that the child is not an Indian child. 7.309.32 Initial Notification - Involuntary Placements - Indian Child Welfare Act A. The county department shall give notice in involuntary placements by telephone or via email within 48 hours, followed by registered or certified mail with return receipt requested, to the parent(s), Indian Custodian(s), if applicable, and the child’s Tribe.

B. The county department shall observe the following timelines (except for emergency placements) before a judicial request for placement can be made. The county department shall wait at least 10 working days after receiving the return receipt of notice before proceeding with a judicial request when the notice has been sent to:

1. The parent(s) or Indian Custodian(s). If the parent(s) or Indian Custodian(s) requests time to prepare for the proceeding, the county department shall petition the court to set the hearing no earlier than 30 calendar days after receipt of notice.

2. The Tribe. If the Tribe requests time to prepare for the proceeding, the county department shall petition the court to set the hearing no earlier than 30 calendar days after receipt of notice. 7.309.33 Initial Notification - Voluntary Placements - Indian Child Welfare Act A. The county department shall give notice to the Tribe, when a placement is voluntary or a relinquishment is contemplated, in the same manner as noted immediately above, or according to the Tribal-State Agreement if the child is a member/citizen of the Ute Mountain Ute or enrolled or eligible for enrollment in the Southern Ute Indian Tribe.

B. The county department shall file a Petition for the Review of Need of Placement by the 90th day of out of-home care as outlined in Court Related Procedures, Section 7.304.53.

C. The county department shall follow step B. outlined in Section “Initial Notification-Involuntary Placements” when the child is placed due to a voluntary relinquishment.

7.309.34 EMERGENCY PROCEEDINGS – INDIAN CHILD WELFARE ACT

A. Emergency proceedings can only be used if it is necessary to prevent imminent danger of physical harm to the child. The county department shall petition the court to terminate the emergency proceeding immediately when the removal or placement is no longer necessary to prevent imminent danger of harm to the child. An emergency proceeding can be terminated by one or more of the following actions:

1. Returning the child to the parent(s) or Indian custodian(s);

2. Transfer of the child to the jurisdiction of the appropriate Indian Tribe; or, 3. Initiation of a child-custody proceeding subject to the provisions of ICWA.

B. Active efforts shall be applied in emergency placements when possible.

C. Emergency placements regarding an Indian child shall not be continued for more than 30 days unless the court makes one of the following determinations:

1. Returning the child to the parent(s) or Indian custodian(s) would subject the child to imminent physical harm;

2. The court has been unable to transfer the proceeding to the jurisdiction of the appropriate Indian Tribe; or, 3. It has not been possible to initiate a child custody proceeding.

7.309.4 TRANSFER OF JURISDICTION FROM STATE COURT TO TRIBAL COURT

A. Upon the Tribe’s petition for transfer of jurisdiction, the county department shall carry out the transfer to the Tribe within five (5) working days, unless either parent or the Indian Custodian(s) objects to a transfer; where the Tribal court declines the transfer; or the court determines there is good cause not to transfer jurisdiction. A county department shall not request a good cause determination based on the following:

1. The child custody proceeding is in the advanced stages, if the parent(s), Indian custodian(s), or Indian child’s Tribe did not receive notice of the proceeding until an advance stage;

2. Prior proceedings involving the child for which no petition to transfer was filed;

3. Predictions of whether the transfer could result in a change in the placement of the child;

4. The Indian child’s perceived cultural connections with the Tribe or reservation;

5. Consideration of any perceived inadequacy of judicial systems;

6. Consideration of the perceived socioeconomic conditions within a Tribe or reservation; or, 7. Consideration of bonding or attachment that resulted from time spent in a non-preferred placement that was made in violation of ICWA.

B. The county department shall prepare child(ren) for legal transfer to the Tribal court of jurisdiction as appropriate to their age. Such preparation shall include:

1. Information about reasons for the transfer and its timing. 2 Involvement of the child in the plans for transfer (see Pre-Placement Activities, Section 7.304.61).

C. The county department shall coordinate plans for the transfer of the child(ren) with the Tribal agency responsible for accepting custody of the child(ren) prior to the transfer.

D. The county department shall expeditiously provide a complete copy of its file(s) concerning the Indian child(ren) to the Indian child’s Tribe.

7.309.5 FOSTER CARE AND PRE-ADOPTIVE PLACEMENTS - INDIAN CHILD WELFARE ACT

The county department shall make every effort to make placements:

A. In the most appropriate, least restrictive setting, that most approximates a family and best meets the needs of the child, taking into consideration:

1. Sibling attachment;

2. The Indian child’s special needs (if any); and, B. Within a reasonable distance to the child’s home, extended family, or siblings.

C. The parent or Indian custodian may withdraw consent to voluntary foster care placement at any time and have the Indian child returned to them as soon as practical.

7.309.6 ORDER OF PREFERENCE - INDIAN CHILD WELFARE ACT (FOSTER CARE AND

PREADOPTIVE PLACEMENT)

The county department shall place eligible Indian children for foster care or pre-adoptive placement according to the following order of preference. It shall do so, unless the child’s Tribe has established another order, or unless it has good cause to the contrary, as documented in the child’s record.

A. For Out-of-Home Care/Pre-Adoptive Placement:

The county department shall engage the Tribe at the earliest possible opportunity to not hinder the Tribes’ ability and options regarding placement preference in foster care or pre-adoptive placements. Under ICWA the county department shall use the following order of preference unless the Indian child’s Tribe has identified a different placement preference than the following 1. Member of child’s extended family;

2. Foster home licensed/certified, approved or specified by the Indian child’s Tribe;

3. Indian foster home licensed/certified, approved or specified by an authorized non-Indian

authority; or 4. Institution for children approved by an Indian Tribe or operated by an Indian organization which has programs suitable to meet the needs of Indian children.

B. The county department shall not depart from placement preference based on the socioeconomic status of any placement relative to another placement or based on the ordinary bonding or attachment that results from time spent in a non-preferred placement that was made in violation of ICWA.

C. The following are the only actions considered good cause to deviate from placement preferences:

1. Request from the parent(s);

2. Request from the child;

3. Sibling attachment; or, 4. Extraordinary physical, mental or emotional needs of the child; or, 5. The unavailability of a suitable preferred placement.

D. The county department shall follow a different order of preference if one is established by the Tribe, so long as the placement is the most appropriate and least restrictive setting to meet the child’s needs. Where appropriate, the preference of the Indian child or parent(s) shall be considered. If a consenting parent has a desire for anonymity, the county department shall give weight to such desire in applying the preferences.

7.309.7 PLACEMENTS INVOLVING STATUS OFFENSES- INDIAN CHILD WELFARE ACT

A. ICWA includes requirements that apply whenever an Indian child is the subject of a proceeding involving status offenses if any part of that proceeding results in the need for out-of-home placement for the child, including a foster care, pre-adoptive, or adoptive placement or termination of parental rights.

B. The county department shall ensure that the consent signed by the parent(s)/Indian Custodian(s) shall contain all of the following:

1. Name and birth date of child.

2. Name of child’s Tribe.

3. Child’s enrollment number or other indication of membership/citizenship in the Tribe.

4. Name, address and Tribal enrollment number of consenting parent(s)/custodian(s).

5. Name and address of prospective parent(s), if known, for substitute care placements.

6. Name and address of person or agency through whom placement arranged, if any, or adoptive placements. 7.309.8 Involuntary Termination of Parent-Child Relationship - Indian Child Welfare Act When terminating the parent-child legal relationship of a child under ICWA, the county department shall provide the court of jurisdiction with evidence beyond a reasonable doubt, including testimony of qualified expert witness. (See section 7.309. 1). 7.309.81 Relinquishment of Child for Adoption A. A voluntary relinquishment of an Indian child may be done in a state court when the parent(s) chooses to file a relinquishment petition under Colorado statutes.

B. The county department shall not petition the court for relinquishment before 10 days after the child’s birth.

C. The county department shall follow the procedure outlined for court ordered placement in the “Initial Notification - Involuntary Placements” section. If the child is from either Ute Mountain Ute or Southern Ute Indian Tribe, the county department shall comply with the Tribal-State Agreement.

D. The county department shall not accept voluntary consent for foster or adoptive care unless all of these conditions are met:

1. The consent is voluntary and obtained free of fraud or duress;

2. The consent is in writing and recorded before a judge; and, 3. The consent is accompanied by the judge’s certificate ensuring that terms and consequences of the consent were fully explained in:

a. Detail and fully understood by the parent(s) or Indian custodian(s).

b. English or interpreted into a language understood by the parent(s) or Indian custodian(s).

E. Withdrawal of consent may apply to relinquishment of parental rights. In these situations the parent(s) or Indian custodian(s) may withdraw consent for any reason at any time prior to the entry of the final decree of relinquishment and have the child returned.

7.309.82 ORDER OF PREFERENCE - INDIAN CHILD WELFARE ACT, ADOPTION

A. The county department shall make placements of eligible Indian children for adoption according to the following order of preference, unless there is good cause to the contrary as determined by the court, or where the Indian child’s Tribe has not established a different order of preference.

Preference shall be given in descending order, as listed below:

1. A member of the child’s extended family;

2. Other members of the Indian child’s Tribe; or 3. Other Indian families.

B. The county department shall also consider, when appropriate, the placement preference of the Indian child or Indian child’s parent(s).

7.309.83 DOCUMENTATION– INDIAN CHILD WELFARE ACT

A. The county department shall document all active efforts, notice provided, and departures from placement preferences in the state automated case management system.

B. The county department shall maintain records evidencing the efforts to comply with placement preference. These records shall be made available at any time upon the request of the BIA or the Indian child’s Tribe. Efforts to comply shall include documentation by the county department to search diligently for placement which falls within the preference of the act.

C. The county department bears the burden of proving by clear and convincing evidence that there is good cause to depart from placement preference, and the court’s determination of good cause shall be made on the record and in writing and maintained by the county department.

D. The county department shall maintain records of every voluntary or involuntary foster-care, preadoptive and adoptive placement of an Indian child and make the records available within fourteen (14) days upon request of the secretary of the BIA or the Indian child’s Tribe. The record shall contain, at a minimum, the petition or complaint, all substantive orders entered in the childcustody proceeding, the complete record of the placement determination, and if the placement departs from the placement preferences, detailed documentation of the efforts to comply with the placement preference. 7.309.84 Disrupted or Changed Placement - Foster Care or Adoption - Indian Child Welfare Act Notice to Parent(s) and the Tribe A. When a final decree of adoption of an Indian child has been vacated or set aside or the adoptive parent(s) has voluntarily consented to the termination of his or her parental rights to the child, the county department shall notify the child’s parent(s), Indian Custodian(s), and Tribe of jurisdiction within 10 working days. These parties may petition for return of custody and the court shall grant such petition unless there is a showing that such return of custody is not in the best interests of the child. (See Order of Preference, Section 7.309.83.) This notice shall inform the recipient of her or his right to petition for return of custody of the child. The Tribe shall also be notified of changes or disruptions in adoptive placements.

B. Notice shall be sent by registered or certified mail with return receipt requested to the parent(s), Indian custodian(s) and the Tribe whenever a final decree of adoption has been vacated.

7.309.85 ADOPTION DECREE

A. The county department shall provide notice of any voluntary or involuntary adoption of an Indian child to the BIA within 30 days of the final decree, to the following address:

Bureau of Indian Affairs, Chief Division of Human Services 1849 C Street NW., Mail Stop 4513 MIB Washington DC 20240 B. The following information shall be included, in an envelope marked “confidential”:

1. Birth name and birthdate of the Indian child, and Tribal affiliation and name of the Indian child after adoption;

2. Names and addresses of the biological parent(s);

3. Names and addresses of the adoptive parent(s);

4. Names and contact information for any agency having files or information relating to the adoption;

5. Any affidavit signed by the biological parent or parents asking that their identity remain confidential; and 6. Any information relating to Tribal membership/citizenship or eligibility for Tribal membership/citizenship of the adopted child.

7.310 FAMILY STABILITY SERVICES (FSS)

A. Family Stability Services shall be provided within context of a support plan. The Family Services Plan or other existing plan may be utilized if it meets minimum qualifications; otherwise, the State shall provide a format for the support plan. The support plan shall identify at a minimum:

1. Family strengths;

2. Family’s unique needs;

3. Appropriate service and supports based on strengths and needs; and, 4. Family generated goal(s) within service time frames.

B. The program goals of FSS are to assist in the provision of appropriate and necessary short-term services to help stabilize families in order to:

1. Preserve the family unit, including kin and adoptive families; or, 2. Reintegrate children with their families, including adoptive families.

7.310.1 DEFINITIONS

Family Stabilization Services consists of the following services areas:

A. “Respite Care”: a service to provide temporary care to children who are not in an out-of-home placement through the county departments of social/human services and to their families who request a short break in parenting in order to stabilize family environment. Respite may occur outside of the home and in the home settings for less than 24 hours. The family may choose appropriate respite care providers including, but not limited to, kin, friends and licensed providers depending on the needs of the family and available resources.

B. “In-home Services”: short-term, solution-focused services provided to children who are not in an out-of-home placement through the county departments and to their families, based on their unique needs in order to strengthen the home environment so that children do not need a higher level of intervention or out-of-home placement.

C. “Reintegration Services”: transition services to assist children and families to reintegrate following an out-of-home placement. Service elements would prepare children and their families for successful reunification.

7.310.2 PROGRAM ELIGIBILITY

A. County departments may make available Family Stability Services, subject to available resources, to families who meet the eligibility criteria. These services shall be provided through contracts or service agreements with private or nonprofit organizations or entities whenever B. In order to be eligible for the Family Stability Services:

1. Each family shall be in need of services to stabilize the home environment; or have been reunited with the child(ren) following an out-of-home placement.

2. Each family must also:

a. Voluntarily request such services; and, b. Have utilized existing resources or existing services, which have not met the family’s needs; and, c. Have the potential to stabilize the family environment.

7.310.3 SERVICE ELEMENTS

Family stability services may include, but are not limited to, the following array of services in order to address the diverse needs of the family:

A. Crisis Intervention: Crisis services such as phone or in-home counseling, crisis counseling, respite care (less than 24 hour) or acute interventions aimed at alleviating the crisis.

B. Family Support Services: Family strengthening services such as parent education, family group conferencing, tutoring, mentoring, life skills training, home visitation, mediation, conflict resolution, family advocacy, support groups, recreational activities and linkages to other community resources.

C. Therapeutic Services: These services could include individual and family counseling, aftercare treatment, multi-systemic therapy, case management, and other therapeutic interventions.

7.310.4 SERVICE TIME FRAMES

Service time frames shall be outlined in the support plan.

A. Respite services must be less than 24 hours of continuous care and may be provided up to three (3) months. Respite services should be provided within 24 hours of identification of the need.

B. In-Home services may be provided up to three (3) months. The family should be linked to organized and/or natural supports within the community within one (1) week of the identification of the need.

C. Reintegration services may be provided up to three (3) months. The family should be linked to therapeutic services within one (1) week of identification of the need.

D. Extensions to the initial provision of service are optional; if a review process is described in the county Family Stability Services plan and the support plan indicates that the family will benefit from an extension of services in order to stabilize the home environment.

7.310.5 WORKLOAD STANDARDS

Workload standards shall be determined by the local county department and/or by community-based agencies and outlined in the county Family Stability Services plan. 7.310.6 PERFORMANCE INDICATORS [Rev. eff. 4/1/12]

Family Stability Services’ success shall be measured by the degree to which the following performance indicators, as identified in the support plan, are achieved by clients:

A. Crisis Intervention The family has improved family interactions and has demonstrated the ability to alleviate a crisis.

B. Family Support Services The family has created and has shown its ability to utilize an informal or/and formal support system within the community that is readily accessible during stressful family situations to enable the members to remain safely together.

C. Therapeutic Services The family has identified its strengths and demonstrated an increased capacity to advocate for itself and manage the day-to-day stressors of working as a family unit. 7.311 RELATIVE GUARDIANSHIP ASSISTANCE PROGRAM [Rev eff. 12/1/12]

The Relative Guardianship Assistance Program provides assistance to a relative guardian in a defined and limited manner so that permanency is achieved for an eligible youth or child. Relative guardianship assistance is intended to help or remove financial or other barriers for a relative guardian, as defined in

Section 7.311.1, of a Colorado youth or child by providing assistance to the relative guardian to care for and raise the youth or child. The Relative Guardianship Assistance Program elements are as follows:

A. Reunification and adoption efforts must have been exhausted and those goals have been ruled out based on individualized needs.

B. The program is most appropriate for older youth who choose not to be adopted and who want to maintain familial ties while living safely and achieving permanency with a relative guardian.

C. The program shall not supplant diligent reunification or adoption efforts.

D. Youth who are twelve (12) years and older and who refuse adoption shall receive ongoing counseling by a professional who is knowledgeable about adoption and permanency issues.

E. All requirements of this section relate solely to the Relative Guardianship Assistance Program and excludes any other type of guardianship. 7.311.1 ELIGIBILITY REQUIREMENTS [Rev. eff. 1/1/16]

Eligibility requirements for the prospective relative guardian and youth and/or child must be documented in the Family Services Plan in the child welfare case management system and are as follows, including the definition specific to relationships for a kinship foster home in § 19-1-103 (71.3), C.R.S.:

A. For the purpose of the Relative Guardianship Assistance Program, a relative is defined as:

1. An adult who is related to the youth or child in the fifth (5th) degree of kinship;

2. Related to the youth or child through marriage or adoption;

3. A person ascribed by the family as having a family-like relationship; or, 4. An individual that had a prior significant relationship with the youth or child.

B. The most recent removal occurred through a court order, or a voluntary placement agreement and subsequent court order for authority for placement that includes a judicial determination that continuation in the home would be contrary to the welfare of the youth or child; and, C. The prospective relative guardian was the:

1. Relative foster care parent for the youth or child for a minimum of six (6) consecutive months while the youth or child resided in the home, excluding breaks in full certification due to provisional or probationary certificates being issued, or other adverse action taken regarding the certificate or, 2. Non-relative foster care parent for a minimum of twelve (12) consecutive months while the youth resided in the home, excluding breaks in full certification due to any adverse action taken regarding the certificate if all of the following requirements are met:

a. The youth is twelve (12) years of age or older; and, b. The youth consents to guardianship or allocation of parental responsibilities (apr) with the foster parent; and, c. The dependency and neglect court finds that the youth has a substantial psychological tie to the foster parent and it would be seriously detrimental to the emotional well-being of the youth to remove the youth from the foster parent’s care as referenced in § 19-3-702 (5) (a) (III) and (5) (b), C.R.S.; and, d. the dependency and neglect court makes a finding pursuant to § 19-3-702 (5) (a)

(III), C.R.S., that the foster parent is unable to adopt the youth because of exceptional circumstances, which do not include unwillingness to accept legal responsibility for the youth, but is willing and capable of providing the child with a stable and permanent environment; and, e. In the case of the sibling(s) of a child meeting the requirements in (a-d) residing in the same foster care home, the siblings must meet the requirements in (c-d).

D. Reunification and adoption are not appropriate permanency goal options for the youth or child;

E. The youth or child demonstrates a strong attachment to the relative; and, F. Youth who are age twelve (12) or older are consulted about their expressed wishes to be placed in a relative guardianship (refer to Section 7.311.2, A); and, G. The prospective relative guardian has a strong commitment to caring for the youth or child permanently; and, H. The reason why permanent placement with a prospective relative guardian and receipt of a relative guardianship assistance payment is in the best interests of the youth or child.

7.311.2 COUNTY DEPARTMENT RESPONSIBILITIES

The county Department of Human or Social Services shall assess and demonstrate the youth or child's appropriateness for the Relative Guardianship Assistance Program.

Documentation in the Family Services Plan in the State automated case management system shall include:

A. Efforts to discuss adoption with the kinship foster care parent as the more permanent option for the youth and/or child and the reasons that the prospective relative guardian is unwilling to adopt.

The goal of the discussion shall be to assure that the prospective guardian makes a fully informed decision regarding the permanency options that are available. The discussion shall include, but not be limited to, the following areas:

1. The legal differences between termination of parental rights for adoption and the transfer of guardianship;

2. The relationship with the birth or custodial family; and, 3. Family time with the birth or custodial family and sibling as outlined in 7.304.64, 7.304.641, and section 7.311.21, B.

B. The prospective relative guardian understands the significance of permanency through guardianship and the importance in continuing to be a permanent family after the youth or child exits the relative guardianship assistance program.

C. Efforts to discuss the relative guardianship assistance arrangement with the parents or legal custodians of the youth or child, and if it was not discussed with the parents, provide the reasons why the efforts were not made.

D. If relinquishment or termination of parental rights occurred for the youth or child, how the requirements in Section 7.306 are met to assure that concerted efforts to achieve adoption were made and documented. When the goal of adoption is ruled out, the requirements in Section 7.306.14, B, 2 (Colorado Adoption Resource Registry) shall be met. 7.311.21 Placement with Siblings [Rev. eff. 1/1/16]

In addition to requirements in Section 7.301.24, the county Department of Human or Social Services shall document:

A. The efforts to place siblings together in the kinship foster care home.

B. The ongoing efforts to facilitate placement together and the efforts to maintain frequent Family Time and ongoing connections for siblings that live apart. 7.311.22 Inclusion of Siblings in a Relative Guardianship Assistance Agreement [Eff. 2/1/10]

A. Sibling(s) of a youth or child who meet all other requirements identified in Section 7.311.1 except the Title IV-E eligibility may be included in the same relative guardianship assistance agreement when there is agreement by the sibling(s) of the youth or child, prospective relative guardian, and the county department that the arrangement is in the best interests of the sibling(s) of the youth or child. This may occur on or at a later date than the youth or child who is Title IV-E eligible, and B. Relative guardianship assistance payments may be made on behalf of each sibling in the same relative guardianship assistance agreement. 7.311.3 RELATIVE GUARDIANSHIP ASSISTANCE RECORDS [Eff. 2/1/10]

A. Information in the record shall be updated when changes occur or additional information is available.

B. Upon termination of the Relative Guardianship Assistance Agreement the record shall be closed. 7.311.4 BENEFITS [Eff. 2/1/10]

Social/Supplemental Security benefits for a youth or child in a Relative Guardianship Assistance Agreement:

A. The county department shall inform the prospective relative guardian of the potential eligibility for Social/Supplemental Security benefits for any youth or child placed with them.

B. When a youth or child is eligible for Social/Supplemental Security benefits and is receiving relative guardianship assistance, the relative guardian must inform the agency of the receipt of these benefits. 7.311.41 Legal Residence of the Youth or Child in a Relative Guardianship Assistance Agreement for Medicaid [Eff. 2/1/10]

A. Following the court appointment of relative guardianship, if the youth or child resides in a different county than the county in which the relative guardianship was granted in Colorado, the county of residence where the youth or child is placed shall open Medicaid benefits.

B. The placing county department shall send written notification to the resident county to expedite timely opening of the Medicaid benefits. 7.311.42 For Chafee Foster Care Independence Program Services, see Section 7.305.4. [Eff. 2/1/10] 7.311.5 RELATIVE GUARDIANSHIP ASSISTANCE PROGRAM SERVICES [Rev. eff. 12/1/12]

A. The Relative Guardianship Assistance Program includes Title IV-E and a state and county-only (non Title IV-E) program.

1. The federal government participates in relative guardianship assistance agreements for youth and children who meet the eligibility criteria for the Title IV-E relative guardianship assistance program.

2. The state and county participate in relative guardianship assistance agreements for youth and children who are not eligible for the Title IV-E program.

B. The Relative Guardianship Assistance Program provides assistance to a relative guardian in a defined and limited manner so that permanency is achieved for an eligible youth or child where reunification and adoption are not appropriate goals. The following requirements are applicable to both programs:

1. The county department may make relative guardianship assistance payments and/or provide Medicaid or medical assistance following the appointment of the relative guardian by the probate court or the approval of an allocation of parental responsibilities (APR) by a juvenile or district court and continue the assistance until the youth has reached eighteen (18) years of age.

2. The determination for expiration of the agreement must be made and documented in the original negotiation and noted in the original documents for the relative guardianship 3. The county department must determine that in each case a reasonable, but unsuccessful, effort to place the youth or child for adoption has been made before negotiating relative guardianship assistance, unless the best interests of the youth or child would not be served by such an effort.

4. The county department may not use an income eligibility requirement (income means test) for the prospective relative guardian in determining eligibility for relative guardianship assistance.

5. The relative guardianship assistance agreement that is negotiated shall be based on the needs of the youth or child and the relative guardian’s circumstances.

6. Public community-based programs or services that the youth or child is eligible for shall be accessed first to address the needs of the youth or child before a relative guardianship assistance agreement is negotiated.

7. The county department may authorize the following types of relative guardianship assistance agreements:

a. A “long-term relative guardianship assistance agreement” is intended to partially meet the daily needs of a youth or child indefinitely. A long-term agreement is made when the relative guardian’s financial situation is a barrier to achievement of relative guardianship and where it is unlikely to change. It may also occur when the needs of the youth or child creates an excessive hardship on the relative guardian’s financial and emotional resources. This type of monthly payment may continue until the circumstances change for the youth, child or the relative guardian, or the agreement terminates as outlined in the relative guardianship assistance agreement.

b. A “time-limited relative guardianship assistance agreement” is intended to partially meet the daily needs of the youth or child for a specified period. Funds may be used for start-up costs for items that the youth or child placed in relative guardianship may not have, such as sufficient clothing. The agreement partially covers unmet needs that are time-limited and non-renewable.

c. A “core” relative guardianship assistance agreement (Title IV-E only) means there is a minimum monthly assistance payment of at least ten dollars ($10) and Medicaid provided. County departments shall document any specific needs that may occur in the future for the youth or child in the services record and in the State Department’s automated system. The agreement identifies a potential need for increased financial relative guardianship assistance that may be activated at a future time.

d. A “dormant relative guardianship assistance agreement” (non-Title IV-E only) means there is no relative assistance payment provided. County departments shall document any specific needs that may occur in the future for the youth or child in the services record and in the State automated system. The agreement identifies a potential need for financial relative guardianship assistance that may be activated at a future time. Medicaid benefits may be accessed (refer to

Section 7.311.62, B).

8. If the youth or child is reunited with the parent(s), previous legal custodian, or is adopted, eligibility for relative guardianship assistance is terminated.

9. A relative guardian who meets the criteria for relative guardianship assistance are eligible for non-recurring relative guardianship assistance expenses.

10. The contact requirements in Section 7.001.6 shall be met prior to court appointment of relative guardianship. The contacts shall be documented in the State Department’s automated system.

11. Case services payments may be part of the relative guardianship assistance agreement; these payments may be made directly to the providers of service or to the appointed relative guardian.

C. Applicable Groups for Relative Guardianship Assistance 1. Youth or children who are in the custody of the county department.

2. The county department requesting the assistance agreement is financially responsible for the care of the youth or child.

D. County Department Requirements for Relative Guardianship Assistance 1. While the Relative Guardianship Assistance agreement is in effect, a combined record for each youth or child and the relative guardian shall be maintained.

A combined record shall contain documentation about each youth or child and the relative guardian, which is relevant to the guardianship assistance agreement including, but not limited to, application, Structured Analysis Family Evaluation (SAFE) home study and applicable update(s) related to the relative guardianship, medical records, placement

history, specific needs requiring purchase of services, confirmation of second opinions of professionals outside of the county department (licensed social worker, doctor, psychologist, or mental health specialist), annual school reports, and other applicable reports or evaluations.

2. The county department shall prepare the documentation necessary for the youth or child for relative guardianship assistance on the State Department’s prescribed form no later than one calendar month prior to the court appointment of the relative guardianship.

3. The county department shall review the information on the State Department’s prescribed form with the relative kinship guardian. All parties shall date, sign, and initial the document before the court appoints the relative guardian.

4. The county department shall enter the legal relative guardianship information for each youth or child into the State Department’s automated system within thirty (30) calendar days following the date that the court appoints the relative guardian. The eligibility determination shall be completed in the Title IV-E module within forty-five (45) calendar days following the date that the court appoints the relative guardian. 7.311.51 Provision of Services [Eff. 2/1/10]

Following the court appointment of the relative guardianship, the county department shall provide services to the youth or child and the relative guardian family as addressed in the guardianship assistance agreement to assure stability of permanency. This does not preclude providing additional services based on current or temporary circumstances including, but not limited to, core services. 7.311.6 RELATIVE GUARDIANSHIP ASSISTANCE AGREEMENT SERVICES [Rev. eff. 12/1/12]

A. The county department may make relative guardianship assistance payments and/or provide Medicaid or medical assistance at the time the relative guardianship is appointed by the court and continue the payments until the youth reaches the age of eighteen (18).

B. The expiration of the agreement must be determined and documented in the original negotiation and noted in the original paperwork for the relative guardianship assistance agreement.

C. The county department shall not use an income eligibility requirement (income means test) for the prospective relative guardian in determining eligibility for relative guardianship assistance.

D. The relative guardianship assistance agreement shall be negotiated in good faith and based upon the needs of the youth or child and circumstances of the relative guardian.

E. Public community-based programs or services that the youth or child is eligible for shall be accessed first to address the needs of the youth or child before a relative guardianship assistance agreement is negotiated.

F. If the youth or child is reunited with the birth parent(s) or legal custodians, the youth or child is not eligible for relative guardianship assistance.

G. Relative guardians of youth or children who meet the criteria for relative guardianship assistance are eligible for non-recurring relative guardianship expenses.

H. Relative guardianship assistance services may be provided for youth and children who meet the requirements, and:

1. The payment may not exceed the foster care reimbursement.

2. A binding relative Guardianship Assistance Agreement shall be negotiated and a copy provided to the relative guardian.

3. The relative guardian may renegotiate the agreement if the needs of the youth or child, or the circumstances of the relative guardian, change.

I. The amount of the assistance agreement and the manner that the payments will be provided shall be documented on the State prescribed forms. 7.311.61 Title IV-E Relative Guardianship Assistance [Rev. eff. 11/1/15]

A. When a successor guardian is not identified in the original assistance agreement (or in an addendum to the assistance agreement dated prior to incapacitation or death of the relative guardian) and the relative guardianship is removed or an allocation of parental responsibilities is modified, the youth or child and the subsequent relative guardian must meet all Relative Guardianship Assistance Program eligibility requirements, including:

1. A new determination regarding the continuing needs of the youth or child;

2. Completion of a new relative guardianship assistance agreement with the new relative guardian; and/or, 3. If the previous relative guardian is deceased, a copy of the death certificate must be B. After a youth or child has been determined eligible for Title IV-E relative guardianship assistance payments and/or Title IV-E Medicaid benefits, Title IV-E eligibility continues while there is a relative guardianship assistance agreement in effect:

1. Eligibility continues as long as the youth or child meets the requirements regardless of the relative guardian’s state of residence.

2. Title IV-E relative guardianship assistance benefits and/or Title IV-E Medicaid benefits must continue until the expiration of the original agreement unless all parties to the agreement are in concurrence. This includes, but is not limited to, a situation where the relative guardian fails to complete and return paperwork related to the three-year review of the assistance agreement.

3. If the previous relative guardian is deceased, a copy of the death certificate must be C. Eligibility Determination for Medicaid in Title IV-E Relative Guardianship Assistance 1. A youth or child who is eligible to receive a Title IV-E payment is categorically eligible for Medicaid. A relative guardianship assistance payment is required to extend Medicaid coverage.

2. Medicaid eligibility shall continue for Title IV-E eligible youth and children who are out of the home for more than thirty calendar days unless it is determined that they are eligible for Medicaid under another program by completing the State Department’s prescribed form (see county responsibility, Section 7.402.2).

3. Medicaid eligibility for the youth or child shall be re-determined annually only if the youth or child continues to be eligible for Medicaid. Complete the State Department’s prescribed form or a form letter stating that the youth or child continues to be eligible for Medicaid. This document shall be sent to other states by the county department to ensure continuation of Medicaid for a youth or child who is residing out of state. 7.311.62 State-County Relative Guardianship Assistance (Non-Title IV-E) [Rev. eff. 11/1/15]

A. Non-Title IV-E relative guardianship assistance services may be provided to a youth or child who does not meet eligibility criteria as determined in the Title IV-E module, and:

1. The youth or child was not Title IV-E eligible in foster care.

2. The youth or child was placed in foster care with the county department through a court order or a voluntary placement agreement with the county; and, a. There was no subsequent petition with the court and a court order within 180 days of living with the specified relative that includes “best interest” or “contrary to the welfare language; or, b. There was no foster care payment made while in care under the voluntary placement agreement.

B. Medicaid Eligibility Determination for Non-Title IV-E Relative Guardianship Assistance 1. Youth and children who are eligible for a relative guardianship assistance agreement, but are not Title IV-E eligible may be eligible for:

a. Medicaid through other categories of assistance; and/or, b. Temporary Assistance for Needy Families (TANF).

2. Medicaid eligibility may be continued when the youth or child is in out-of-home care for thirty (30) calendar days, depending on the county department’s policy.

3. Medicaid eligibility shall be redetermined annually only when the youth or child continues to be eligible for Medicaid. This shall be completed on the State Department’s prescribed form.

C. When a successor guardian is not identified in the original assistance agreement (or in an addendum to the assistance agreement dated prior to incapacitation or death of the relative guardian) and the relative guardianship is removed or an allocation of parental responsibilities is modified, the youth or child and the subsequent relative guardian must meet all Relative Guardianship Assistance Program eligibility requirements, including:

1. A new determination regarding the continuing needs of the youth or child; and, 2. Completion of a new relative guardianship assistance agreement with the new relative guardian; and/or, 3. If the previous relative guardian is deceased, a copy of the death certificate must be 7.311.63 Negotiation of Relative Guardianship Assistance Agreements [Rev. eff. 12/1/12]

A. The county department shall:

1. Establish a policy regarding the criteria used for calculating the relative guardianship assistance agreements. The agreements shall be established in accordance with the written policy.

2. Determine specific needs of the youth or child and eligibility for relative guardianship 3. Utilize financial information regarding the relative guardian’s family including assets, liabilities and insurance benefits in negotiating the initial agreement, and any subsequent increases in relative guardianship assistance.

4. Not include a statement in the relative guardianship assistance agreement that Title IV-E relative guardianship assistance payments and/or services are subject to the appropriation of state funds.

5. Make a good faith effort to negotiate a relative guardianship assistance agreement with the relative guardian and base the negotiation on the needs of the youth and child and the circumstances of the relative guardian. If the parties cannot agree, the county department shall establish the amount. If the relative disagrees with the decision, a fair hearing may be requested.

6. Negotiate with the relative guardian the amount that is needed by the relative guardian to meet the needs of the youth or child. This may be less than the amount for which the youth or child qualifies.

7. Establish a maximum rate that may be provided to a relative guardian; the rate cannot exceed the current foster care maintenance rate that was reimbursed for the out-of-home care of the youth, or that would have been reimbursed if the youth or child was currently in out-of-home care. The monthly respite care payment that is provided in the foster care rate is not a benefit under the relative guardianship assistance program.

8. Identify additional services and assistance that the youth or child will be eligible for and the procedures for applying for the services.

9. Use the State Department’s prescribed forms to document the negotiated agreement for Title IV-E or non-Title IV-E relative guardianship assistance, and attach supporting documentation.

10. Complete and sign the relative guardianship assistance agreement form specifying:

a. The dollar amount of the relative guardianship assistance being provided, if applicable.

b. The duration dates of the agreement:

1) Until the youth or child in relative guardianship reaches the age of eighteen (18) years, or, 2) On a case-by-case basis, the duration of the agreement may be sooner c. The services and dates of services that are covered by the relative guardianship d. The relative guardianship assistance agreement must be signed and dated by all parties prior to the effective date of the agreement, which is the date that the court appoints relative guardianship. If the county department fails to completely execute the relative guardianship assistance agreement prior to the date the relative guardianship is appointed, the assistance payment will become nonreimbursable by the state and Title IV-E funds.

11. Review the agreement every three (3) years from the date of the initial agreement.

a. Any change in the relative guardianship assistance agreement shall be related to the original needs, identified at the time the decision was made that relative guardianship assistance was needed.

b. A Title IV-E relative guardianship assistance agreement shall not be changed without the concurrence of all parties. The only exception is if there is a reduction or increase in the foster care maintenance payment rate. In that circumstance the state may adjust the relative guardianship assistance payment without the relative guardian’s agreement.

c. Any change in a non-Title IV-E relative guardianship assistance agreement must be related to the specific needs of the youth or child, the relative guardian’s circumstances, and the county department’s policy.

The county department shall negotiate with the relative guardian that when the youth or child is in out-of-home care or committed to the Division of Youth Services for more than thirty (30) days, the assistance payment shall be suspended until the youth or child returns to the relative guardian’s home.

d. After the court appoints the relative guardianship, the county department shall not include additional needs for the relative guardianship assistance payment that are not directly related to the original identified needs of the youth or child, or unless the needs are based on a genetic relationship to the original needs.

e. The county department or a relative guardian may renegotiate an existing relative guardianship assistance agreement if the needs of the youth or child change and the information is related to the original needs that were identified or the family’s circumstances.

12. For Title IV-E relative guardianship assistance agreements, there are situations after the relative guardianship appointment by the court where the guardian can request a state level fair hearing before an Administrative Law Judge (ALJ) concerning the eligibility of the youth or child or relative guardianship assistance benefits or the amount of those benefits. The situations include, but are not limited to:

a. Relevant facts regarding the youth or child that were known and not presented to the relative guardians prior to the court appointment of relative guardianship.

b. Denial of assistance based upon a means test of the relative guardian.

c. Guardians’ belief that an erroneous determination was made finding a youth or child ineligible for relative guardianship assistance.

d. Denial of a request for a change in assistance payment rate due to a change in circumstances for the relative guardian.

e. Decrease in the amount of relative guardianship assistance without the agreement of the relative guardian except as previously noted in Section 7.311.63, A, 11, b. 7.311.64 Successor Guardian [Eff. 11/1/15]

A. A successor guardian may be identified in the original Relative Guardianship Assistance Agreement or in an addendum to the assistance agreement dated prior to incapacitation or death of the relative guardian for continuity of relationship and permanency, and to prevent re-entry into foster care for a youth or child, due to incapacitation or death of the original guardian.

1. Incapacitation means the relative guardian is substantially unable to perform the duties of a legal guardian for the youth or child(ren) named in the Relative Guardianship Assistance Agreement. Substantial inability to provide care may be due to a physically debilitating illness, disease, or injury; or a mental impairment resulting in substantial inability to understand the nature and consequences of decisions concerning the care of the youth or child.

2. The eligibility of a successor guardian at the time of incapacitation or death requires all of the following conditions:

a. The successor guardian must meet requirements applicable to foster care providers for fingerprint-based criminal background checks through the Colorado Bureau of Investigation (CBI) and Federal Bureau of Investigation (FBI) at the time of incapacitation or death;

b. All other adults residing in the home must meet requirements applicable to foster care providers for fingerprint-based criminal background checks through CBI and FBI at the time of incapacitation or death;

c. The successor guardian and all adults (eighteen years and older) residing in the home are not registered sex offenders;

d. The successor guardian has knowledge about the needs of the youth or child in the relative guardianship assistance agreement; and, e. The successor guardian is committed to raise the youth or child.

3. Responsibilities of a successor guardian at the time of incapacitation or death of the original guardian and following appointment of guardianship include the following:

The successor guardian must:

a. Notify the county department with financial responsibility for the Relative Guardianship Assistance Agreement about the incapacitation or death of the original guardian;

b. Submit completed documentation of fingerprint-based CBI and FBI results;

c. Identify all adults living in the home and their dates of residences for the preceding five (5) years;

d. Petition the probate court for guardianship or petition the juvenile or district court with jurisdiction for an allocation of parent responsibilities of the youth or child as soon as possible;

e. Collaborate with the county department with financial responsibility to complete a Relative Guardianship Assistance Agreement commensurate with the current agreement and based upon the needs of the youth or child and the circumstances of the successor guardian;

f. Notify the county department of any significant changes that affect the terms of the assistance agreement;

g. Submit required reports to the court; and, h. Provide annual verification of school attendance for the child(ren) or youth included in the assistance agreement.

4. Responsibilities of the county department include the following:

a. Upon notification of the incapacitation or death of a relative guardian, the county department shall suspend relative guardianship assistance payments and services identified in the original assistance agreement effective the date of incapacitation or death, until the successor guardian has attained guardianship of the youth or child through the probate court or an allocation of parental responsibilities through the juvenile or district court.

b. The county department shall review the current CBI and FBI fingerprint-based

history provided by the successor guardian and for all adults (eighteen years and older residing in the home).

c. The county department shall request and review child abuse/neglect records in each state where the successor guardian and all adults (eighteen years and older) living in the home have resided in the five (5) years preceding the date of notification of incapacitation or death of the original guardian.

d. The county department shall complete national and CBI sex offender registry checks using the state prescribed procedures for the successor guardian and all adults (eighteen years and older) living in the home.

e. Upon determination that the prospective successor guardian meets requirements, the county department shall collaborate to provide commensurate assistance and services identified in the original Relative Guardianship Assistance Agreement and based upon the needs of the youth or child and the circumstances of the successor guardian.

f. The assistance agreement shall be signed by all appropriate parties prior to the date the court awards guardianship. The relative guardianship assistance is effective the date of guardianship. 7.311.7 MEDICAL PAYMENTS IN RELATIVE GUARDIANSHIP ASSISTANCE AGREEMENTS [Rev.

eff. 12/1/12]

A. Medical payments in relative guardianship assistance agreements may be used to supplement any other available resource such as a relative guardian’s private insurance that pays part but not all of the treatment (physical, mental, and emotional) for the youth or child.

1. Payments are made directly to relative guardians for a service already received or to a vendor for the treatment of physical, developmental disabilities, or an emotional disturbance.

2. Shall relate directly to the barrier(s) identified at the time the initial agreement is approved.

B. The payments are not available for treatment of any physical, developmental disability, or emotional disturbance diagnosed after the court appointment of the relative guardianship.

C. The payments may only be used for Medicaid cases if the service requested is a service that is not covered under the state Medicaid plan and relates to a need identified at the time the youth or child is placed in relative guardianship.

D. The payments for medical services shall reflect the reasonable costs of those services in the community where the youth or child resides. 7.311.71 Reimbursable and Non-Reimbursable Relative Guardianship Assistance Case Services [Rev. eff. 12/1/12]

Case services are a type of purchased program services that support a case plan for youth and children in relative guardianship assistance.

Case services are provided to meet the special needs of a youth or child that were identified when the youth or child is placed into a relative guardianship and which are not covered by the relative guardianship assistance or Medicaid assistance agreements.

For eligibility for case services in a relative guardianship assistance agreement, the State Department’s prescribed form outlining the agreement must be in place and the case open in the State Department’s automated system as relative guardianship assistance case.

A. Medical 1. Orthodontia a. Cosmetic reasons - not reimbursable.

b. Special needs directly related to the reason for which the youth or child was classified as special needs, e.g. cleft palate or injury related to an abuse will be reimbursable.

2. Eye Glasses a. Eyeglasses are not reimbursable using case services funds because Medicaid pays for one (1) pair of glasses per year.

b. Payment for additional eye glasses during the year or contacts related to the special needs of the youth or child that were identified at the time of the initial relative guardianship assistance agreement are reimbursable.

3. Medication a. Routine medication that is not related to the special needs of the youth or child not reimbursable.

b. If related to the special needs of a youth or child - reimbursable. The medication must be prescribed by a licensed physician and related to the special need identified at the time the youth or child was approved for relative guardianship 4. Special Therapies - Speech, Occupational, and Physical a. If not available through other community and family resources - reimbursable.

Youth and school-age children should receive these services through the education system.

b. When these services are available in hospitals and clinics – not reimbursable because Medicaid covers these costs.

5. Special Medical Equipment Special medical needs/equipment prescribed by a physician may be reimbursable. For a youth or child who is severely physically challenged; special exceptions should not exceed two thousand dollars ($2,000) without a supervisor’s written authorization.

B. Psychological Services 1. Time-limited out-patient therapy for a youth or child living in a state that does not accept Medicaid for this service - reimbursable if related to the special needs of the youth or child and a written plan is obtained from the service provider which contains:

a. Diagnosis.

b. Prognosis.

c. Length of service.

d. Individuals who will be seen during the therapy.

e. A cap on the amount of money to be spent for the psychological exam or therapy.

f. Frequency of contact (i.e., once a week, twice a month, etc.).

g. Type of therapy being provided (i.e., individual, group, family, etc.).

2. If time-limited out-patient therapy is available using Medicaid – not reimbursable.

3. Day treatment - not reimbursable because Medicaid provides for this service.

4. Residential child care facility - not reimbursable because Medicaid provides for this service.

5. In-patient psychiatric hospitalization - not reimbursable because Medicaid provides this service. (Children who are Medicaid eligible may receive some in-patient psychiatric services under the Medicaid program.)

C. Education Costs 1. Tutoring - not reimbursable. Education systems are required to provide all youth and children with special needs a free appropriate public education.

2. School tuition - not reimbursable. There will be no reimbursement for tuition expenses through the relative guardianship assistance program. If the relative guardian chooses the youth or child to remain in a current private school placement, this is an expense for which the relative guardian is responsible.

D. Respite and Day Care 1. Respite care - reimbursable.

2. Day care - not reimbursable.

E. Other Relative Guardianship Assistance Case Services Relative guardianship assistance case services for youth and children who are Title IV-E or non- Title IV-E may be provided for a specified time to provide needed services. It is required that these time-limited services/funds are clearly provided on a case-by-case basis. This requirement must be clearly documented in the agreement.

F. To be eligible for case services in a relative guardianship, the State Department’s prescribed form outlining the agreement must be in place and the case opened in the State Department’s automated system as a relative guardianship assistance case following the court appointment of relative guardianship. 7.311.72 Non-Recurring Relative Guardianship Expenses [Rev. eff. 12/1/12]

A. The relative guardian shall be reimbursed for the total costs of non-recurring expenses associated with obtaining relative guardianship, not to exceed two thousand dollars ($2,000) per youth or child in order to facilitate achievement of the guardianship for:

1. Legal fees, 2. Fees for relative guardianship, or 3. Other expenses related to the relative guardianship of the youth or child, such as the cost of the SAFE home study and a SAFE update related to the prospective relative guardianship completed by the county department.

B. The county department shall determine if the reimbursements requested by the prospective relative guardian are non-recurring expenses.

C. Documentation for non-recurring relative guardianship expenses:

1. The county department shall use the State Department’s prescribed form prior to the court appointing the relative guardianship.

2. The prospective relative guardian shall provide evidence of the needs of the youth or 3. Provide an itemized statement of the expenses to be reimbursed within one (1) year from the date of the probate court appointment of the relative guardianship or the date that the juvenile or district court approved an allocation of parental responsibilities.

7.311.8 ACCEPTING AND PROCESSING APPLICATIONS FOR RELATIVE GUARDIANSHIP

ASSISTANCE FROM KINSHIP FOSTER CARE PARENTS WHO ARE CERTIFIED BY CHILD

PLACEMENT AGENCIES [Rev. eff. 1/1/16]

A. Colorado licensed child placement agencies may certify kinship foster care homes only upon written request from the county department of human or social services with responsibility for the care and custody of the youth or child.

B. The county department will use the same procedures for all prospective relative guardians.

C. The child placement agency that certified the prospective relative guardian retains responsibility for services to the relative guardian prior to the court appointment of the relative guardianship. 7.311.81 Review of Eligibility for All Ongoing Relative Guardianship Assistance Agreements [Rev. eff. 12/1/12]

A. The county department shall initiate the written notice of the review for relative guardianship assistance sixty (60) days prior to the three (3) year anniversary of the agreement.

B. The relative guardian may request a review of the agreement prior to the three-year review if changes in the needs of the child or family circumstances occur.

C. Any changes in the needs of the youth or child shall relate to the original barrier(s), identified at the time the decision was made that relative guardianship assistance was needed. The county department shall not include additional needs for relative guardianship assistance payments after the court appointment of the guardianship unless genetic in nature.

D. The county department shall review school attendance annually.

Relative guardianship assistance files must contain documentation of school attendance or reasons for the inability to attend. Documentation must be updated annually to assure that each youth and child who is eligible for relative guardianship assistance and who has attained the minimum age for compulsory school attendance is:

1. Enrolled (or in the process of enrolling) an elementary or secondary education institution, 2. Instructed in elementary or secondary education at home in accordance with the home school statute, 3. In an independent study elementary or secondary education program in accordance with statute, and which is administered by the local school, school district, or Board of Cooperative Education (BOCES), or 4. Incapable of attending school on a full-time basis due to the medical condition of the youth or child. The reasons shall be supported by regularly updated information in the educational plan maintained by the school, school district, or BOCES. 7.311.82 Procedures for Relative Guardianship Assistance Payment When a Youth or Child is in Out-of-Home Care or Committed to the Division of Youth Services [Rev. eff. 12/1/12]

A. Medicaid eligibility shall continue for Title IV-E eligible youth or children who are out of the home for more than thirty (30) calendar days unless it is determined that they are eligible for Medicaid under another program by completing the State Prescribed form (see County Responsibility,

Section 7.402.2).

B. When a youth or child with a non-Title IV-E relative guardianship assistance agreement is placed in out-of-home care for more than thirty (30) days, the county department shall discontinue the relative guardianship assistance payment until the youth or child returns to the relative guardian’s home. This includes a commitment to the Division of Youth Services.

C. When non-Title IV-E eligible youth or child resides outside of Colorado with the relative guardian who has a relative guardianship assistance agreement and the youth or child is in out-of-home placement longer than thirty (30) calendar days, the relative guardianship assistance payment and relative guardianship case services shall be discontinued. A state/county non-Title IV-E agreement may only be resumed when the youth or child is returned home and the out-of-home placement has been discontinued on the State Department’s automated system. 7.311.9 TERMINATION OF RELATIVE GUARDIANSHIP ASSISTANCE AGREEMENTS [Eff. 2/1/10]

The county department shall terminate relative guardianship assistance agreements when the:

a. Relative guardian requests that payments end; or, B. Youth reaches age eighteen (18); or, C. The county department determines the relative guardian is no longer legally responsible for the support of the youth or child; or, D. Youth or child is no longer receiving any support from the relative guardian; or, E. County of responsibility verifies the death or marriage of a youth or child. 7.311.91 Reinstatement [Rev. eff. 11/1/10]

A. Reinstatement of the original relative guardianship assistance agreement is prohibited when the relative guardian who was appointed by the court no longer has guardianship of the youth or B. Reinstatement of payments related to the needs of a youth or child that were identified at the time of the original Relative Guardianship Assistance Agreement is allowed for a:

1. Youth or child that is non-Title IV-E eligible.

2. Youth or child that is Title IV-E eligible. 7.311.92 Right to Appeal [Rev. eff. 12/1/12]

A. If the county department denies an application for relative guardianship assistance, or reduces or terminates the assistance payment, the applicant or recipient has the right to appeal. Using procedures outlined in Section 3.850 (9 CCR 2503-1).

B. When a family who has been denied Title IV-E relative guardianship assistance requests a state level fair hearing, it is the responsibility of the Administrative Law Judge to determine whether the applicant or recipient was wrongly denied eligibility or whether the amount of the relative guardianship assistance agreement was determined correctly (see Section 7.306.41, E).

C. The relative guardian has the burden of proving extenuating circumstances and relative guardianship assistance eligibility at a state level fair hearing. The state and/or its designee can provide factual information to assist the family in establishing eligibility for Title IV-E relative guardianship assistance.

D. When either state or federal law requires or results in a reduction or deletion of services, a hearing shall not be granted. 7.311.93 State Monitoring/Progressive Discipline Process of Relative Guardianship Assistance Programs in County Departments [Eff. 2/1/10]

A. Monitoring shall be conducted annually with county departments by the State Department using a risk-based approach by reviewing the number and nature of complaints received from consumers, advocates, or the general public.

B. The department will conduct monitoring in the same manner contained in Section 7.306.43. _________________________________________________________________________ Editor’s Notes

History

Rule 7.304.21 D.2.f.4 emer. rule eff. 08/03/2007.

Rules 7.301.1-22, 7.301.231 eff. 09/01/2007.

Rule 7.304.21 eff. 10/30/2007.

Rule 7.301.1 emer. rule eff. 08/01/2008.

Rule 7.301.1 eff. 10/01/2008.

Rule 7.304.64 eff. 11/01/2008.

Rule 7.304.62 eff. 01/01/2009.

Rules 7.306.11-7.306.14, 7.306.2, 7.306.22-7.306.31, 7.306.34, 7.306.4-7.306.6 eff. 02/01/2009.

Rules 7.302, 7.302.2 eff. 04/01/2009. Rules 7.302.7-7.302.32 repealed eff. 04/01/2009.

Rules 7.305; 7.305.1; 7.305.5 eff. 05/01/2009.

Rule 7.304.52 emer. rule eff. 08/07/2009.

Rule 7.304.52 eff. 11/01/2009.

Rule 7.306.35 emer. rule eff. 11/06/2009.

Rules 7.301.24, 7.301.241-7.301.242, 7.304.21 D, 7.304.52 C-D, 7.304.54 P, 7.304.55 F, 7.304.74 D, 7.305.2-7.305.42, 7.306.35, 7.306.41 A, B7-D, 7.306.53, 7.306.56-7.306.57, 7.311 eff. 02/01/2010.

Rules 7.304.54 A-F; 7.304.62 G-H, N; 7.304.65; 7.306.21 E eff. 07/01/2010.

Rules 7.311.1, 7.311.2, 7.311.5 B7-D5, 7.311.6 H -7.311.61, 7.311.72, 7.311.82, 7.311.91 emer. rules eff. 08/06/2010.

Rules 7.301.24, 7.305.3-7.305.34, 7.305.42 emer. rules eff. 10/01/2010.

Rules 7.301.24, 7.305.3-7.305.34, 7.305.42, 7.311.1, 7.311.2, 7.311.5 B7-D5, 7.311.6 H, 7.311.61, 7.311.72, 7.311.82, 7.311.91 eff. 11/01/2010.

Rules 7.304.4, 7.304.53, 7.306.11, 7.306.15, 7.306.16 eff. 03/02/2011.

Rules 7.305.2 E, 7.305.5 eff. 08/01/2011.

Rules 7.301.242, 7.302, 7.302.2, 7.303.17, 7.304.21, 7.304.661, 7.304.73-.74, 7.305.1, 7.305.4, 7.305.42, 7.307.1, 7.307.52, 7.307.6, 7.307.61-.64, 7.310.6, 7.311.5, 7.311.61-.62 eff. 04/01/2012.

Rules 7.300.1, 7.304.52 eff. 05/01/2012.

Rules 7.304.62 L-P, 7.305.2 E-F, 7.305.4, 7.305.42 A-B eff. 07/01/2012.

Rules 7.305.4-7.305.4 C, 7.311-7.311.1, 7.311.5, 7.311.6-7.311.63, 7.311.7-7.311.72, 7.311.81-82, 7.311.92 emer. rules eff. 09/07/2012.

Rules 7.301.24 Q.1, 7.305.4-7.305.4 C, 7.306.4, 7.306.41 B.7-8, 7.311-7.311.1, 7.311.5, 7.311.6- 7.311.63, 7.311.7-7.311.72, 7.311.81-82, 7.311.92 eff. 12/01/2012.

Rule 7.304.4 H eff. 04/01/2013.

Rule 7.307.6 eff. 10/01/2013.

Rules 7.303.11-7.303.13 eff. 01/01/2014.

Rules 7.301.22, 7.305.2, 7.305.2 E eff. 07/01/2014.

Rules 7.301.1-7.301.21, 7.301.231, 7.303-7.303.1 eff. 01/01/2015.

Rules 7.301.24, 7.303.3 eff. 08/01/2015.

Rules 7.301.21, 7.301.24, 7.301.24 K-N.1, 7.303.4, 7.304.21, 7.304.21 D-D.2, 7.304.52, 7.304.54, 7.304.54 I-Q, 7.304.61, 7.304.61 G, 7.304.62, 7.304.62 P-Q, 7.305.1-7.305.3, 7.305.33, 7.305.4, 7.305.41, 7.305.41 F, 7.305.42-.43, 7.305.5 A, 7.311.61-.62, 7.311.64 eff. 11/01/2015.

Rules 7.304.1, 7.304.21, 7.304.52, 7.304.53, 7.304.61, 7.304.62, 7.304.74, 7.306.14, 7.311.1, 7.311.2, 7.311.21, 7.311.8 eff. 01/01/2016.

Rules 7.301.24, 7.304.54 eff. 03/01/2016.

Rules 7.303.4, 7.304.52 C.3-4, 7.311.1, 7.311.5 B.1, 7.311.61 A, 7.311.61 B.3, 7.311.62 C, 7.311.64 A, 7.311.72 C.3 eff. 10/01/2016.

Rule 7.304.21 eff. 01/01/2017.

Rules 7.300.1, 7.301.2, 7.301.21, 7.301.23, 7.301.24, 7.301.241, 7.301.242 eff. 02/01/2017.

Rules 7.304.53 A.1, 7.309 eff. 07/01/2017.

Rules 7.304.62 S, 7.305.2 D, 7.305.2 F eff. 10/01/2017.

Rules 7.303.32 B.6, 7.304.21 E.2.f.3, 7.305.33, 7.305.41 F.3, 7.305.42 A, 7.311.63 A.11.c, 7.311.82 B eff. 12/01/2017.

Rules 7.301.3 E, 7.304.21 E.2.f.4, 7.309.31 E eff. 02/01/2018.

Rules 7.304.21 D.6.b.2, 7.304.21 E.2.f, 7.304.52 A.2, 7.304.53 D.3, 7.304.662 eff. 12/01/2018.

Rules 7.301.21 C, 7.305, 7.305.2 C, 7.305.42 A, 7.305.42 C.2 eff. 03/15/2019.

Rules 7.301.24 E, 7.301.241 eff. 03/30/2019.

Rules 7.304.65 F-G eff. 09/01/2019.

Rules 7.301.21, 7.301.23, 7.301.231, 7.301.3 eff. 01/01/2020.

Rules 7.306-7.306.32 eff. 01/30/2020.

Rules 7.301.24 A, 7.301.24 B, 7.301.24 K, 7.304.201, 7.304.61 C, 7.304.62 L-U, 7.304.64, 7.306.11 A eff. 06/01/2020.

Rule 7.304.62 A-G emer. rules eff. 06/12/2020.

Rule 7.304.62 A-G eff. 09/01/2020.

Rule 7.306.5, 7.306.6 eff. 09/30/2020. Rules 7.306.43, 7.306.57-59 repealed eff. 09/30/2020.

Rules 7.301.241 D, 7.303.11, 7.304.54 L, 7.305.1, 7.305.2, 7.305.4, 7.305.41, 7.305.42, 7.305.5 A eff. 12/01/2020. Rule 7.305.43 repealed eff. 12/01/2020.

Rules 7.304.201, 7.304.21 C.5, 7.304.21 D.7, 7.304.64 eff. 03/02/2021.

Rule 7.304.651 eff. 11/30/2021.

Rules 7.301.2, 7.301.23 A, 7.301.24 M, 7.301.24 R.7, 7.304.1 A.2, 7.304.3, 7.304.4 A, 7.304.4 C.6, 7.304.51 E, 7.304.52 E-F, 7.304.54 I, 7.304.61 B, 7.304.61 H, 7.304.62 L, 7.304.62 U, 7.304.64 I, 7.305.2 D.1 eff. 12/30/2021.

Rules 7.301.24 S.4.a-c, 7.301.241 D.1-2.f, 7.301.241 D.7-8, 7.304.53 M, 7.304.55 G, 7.304.62 L, 7.304.65 E, 7.304.651 B.6, 7.304.651 D.1, 7.305.2 E.1, 7.306.2 A.1 eff. 03/02/2023.

Rules 7.304.21 E.3.a.1, 7.304.61 F.1 eff. 06/01/2023.

Rules 7.306.4-7.306.48; repealed rules 7.306.34, 7.306.57 eff. 07/30/2023.

Rules 7.301.22, 7.301.24, 7.301.241, 7.303.4, 7.304.53, 7.304.65, 7.305.2 eff. 07/31/2023.

Rule 7.305.43 eff. 01/01/2024.

Rules 7.301.244, 7.301.245 eff. 04/01/2024.

Rules 7.301.22 B.2, 7.301.24 B.(1), 7.301.24 K, 7.301.24 S, 7.304.53 B.5)-6), 7.304.61 D, 7.304.64, 7.304.65, 7.304.661 A, 7.304.72, 7.305.2 C, 7.306.57, 7.311.2 A.3, 7.311.21 B eff. 06/01/2024.

Rules 7.303.32-7.303.35 eff. 06/30/2024.

Rules 7.301.22 B.3, 7.301.3 C, 7.304.201 2, 7.304.64 I eff. 12/01/2024.

Rule 7.303.4 eff. 01/01/2025.

Rules 7.304.21, 7.304.21.1, 7.304.52 eff. 07/01/2025.

Annotations

Rule 7.306.35 (adopted 12/04/2009) was not extended by Senate Bill 11-078 and therefore expired 05/15/2011.

##### **12 CCR 2509-5** Resources, Reimbursement, Reporting, and Provider Requirements {#sec-12-ccr-2509-5 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-5}

DEPARTMENT OF HUMAN SERVICES

RESOURCES, REIMBURSEMENT, REPORTING, AND PROVIDER REQUIREMENTS

12 CCR 2509-5 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 7.401 RESOURCES 7.401.1 CORE SERVICES PROGRAM PLANS 7.401.11 Commissions A. The governing body of each county or governing boards of groups of counties or city and county shall establish a Family Preservation Commission in accordance with Section 26-5.5-106, C.R.S.

B. During the term of appointment, commission members shall not participate in Commission discussion or decision making in those situations where there is a conflict of interest or the appearance of a conflict of interest, between commission membership interest and the members' private or agency representative interest. 7.401.12 Plan Procedures A. A county(ies) department of social services' proposed Core Services Program plan shall be subject to preliminary approval by the state department prior to submittal to the State Board of Human Services. The State Board of Human Services shall approve the plan prior to implementation.

B. The county department shall comply in format, content, and time lines with the Instructions for Core Services Program Plans as published by the state department. The Agency Letter will also contain required instructions for program and financial reporting.

C. If a county finds that it cannot comply with Core staff qualifications requirements in rules, the county may request alternative staff qualifications. This request must be submitted to the Department of Human Services, Division of Child Welfare Services, in accordance with the process outlined in Section 7.000.7, Q, 5.

D. State Board of Human Services' approval of a county's Core Services Program Plan confers on the plan, state rule authority for program administration and reimbursement. The county department's responsibility is to administer the plan in accordance with provisions of the plan and other supporting state rules.

E. County department(s) Core Services Plan shall be approved for a period of no longer than three (3) years except that proposed county designed services shall be approved annually.

F. County departments must submit amendments to approved plans when the county is proposing to add an additional service to the plan. The county department shall submit amendments of the Core Services Program Plan to the state department no less than 30 working days before the State Board meeting in the month the amendment is to be effective.

7.401.2 EARLY INTERVENTION AND PREVENTION PROGRAM PLANS 7.401.21 Plan Procedures [Rev. eff. 1/1/14]

County department(s) of social/human services' proposed Early Intervention and Prevention Program Plan shall be included in and follow the prescribed format of the Core Services Program Plan as outlined in Section 7.401.12.

7.401.3 INTEGRATED CARE MANAGEMENT PROGRAM PLANS

A. County department(s) of social/human services proposed Integrated Care Management program plan shall be subject to approval by the State Department.

B. The county department(s) shall comply in format, content and time lines with the instruction for Integrated Care Management program plans as published by the State Department, as found in

Section 7.303.2 (12 CCR 2509-4).

C. The county department(s) shall submit amendments to approved plans when the county is proposing to modify how program components are being implemented.

7.401.4 FAMILY STABILITY SERVICES PLANS 7.401.41 Plan Procedures A. County department(s) of social/human services' proposed Family Stability Services plan shall be subject to approval by the State Department.

B. County department(s)' Family Stability Services plan shall be approved for a period of no longer than three (3) years.

C. The county department(s) shall comply in format, content, and time lines with the instruction for Family Stability Services plans pursuant to guidelines established by the State Department and issued in an agency letter.

D. County department(s) shall submit amendments to approved plans when the county proposes to modify the plan.

7.402 MEDICAL RESOURCES

7.402.1 PROVISION OF SERVICES

Subject to certain income and resource limitations, medical assistance through the Colorado Medicaid program must be provided to certain children and youth receiving child welfare services as follows:

A. Children and youth for whom the county department is assuming full or partial financial responsibility.

1. Children and youth in foster care, including those who are in supervised independent living placement situations subsequent to being in foster care;

2. Youth committed to the Department of Human Services, Division of Youth Services, who are placed in a non-secure community based residential facility or in supervised independent living placement situations;

3. Children and youth who have a current, signed subsidized adoption agreement;

4. Children and youth receiving Core services who otherwise would be in foster care;

5. Children and youth in subsidized adoption, including adoption placements out of state, who are IV-E eligible or where the state option is in effect until the receiving state can provide Medicaid;

6. Children and youth from Colorado placed in an out of state out-of-home placement by a Colorado county. IV-E eligible children receive Colorado Medicaid until the receiving state can provide Medicaid;

7. Children and youth eligible for Supplemental Security Income, even if they are not receiving cash benefits, who are placed in an out of state foster care setting until the receiving state can provide Medicaid.

8. Children and youth who are eligible for the Relative Guardianship Assistance Program, including relative guardianship assistance placements out of state who are Title IV-E eligible, until the receiving state can provide Medicaid.

B. Certain children and youth from other states who are placed in Colorado by that state.

1. Children and youth eligible for adoption assistance placed in Colorado by another state;

2. Children and youth placed in an out-of-home placement in Colorado by another state;

3. Children and youth who are eligible for Supplemental Security Income placed in an outof-home placement in Colorado by another state.

4. Children and youth who are eligible for Relative Guardianship Assistance placed in Colorado by another state and who are Title IV-E eligible.

C. Children and youth who are receiving child welfare services, living in their own home or the home of a designated relative, and the county department is not assuming full or partial financial responsibility for their care, may be eligible for coverage under other Colorado Medicaid programs for families and children.

D. Adoption assistance youth who emancipated from foster care or adoption assistance at age eighteen (18) or after and are under age twenty-one (21), and for whom the state made foster care or adoption assistance payments in the month the youth turned eighteen (18) years of age.

E. A child who has an acceptable non-citizen status as defined in 10 CCR 2505-10 Section 8.100.3.G and is in the custody of DHS is eligible for Colorado Medicaid and no longer need to meet the five-year waiting period to be eligible for Medicaid.

F. Beginning January 1, 2014, former Colorado foster care youth, who were under the State’s or Tribe’s responsibility, when they emancipated from foster care at age eighteen (18) or after, and who were enrolled in Medicaid (IV-E or non-IV-E) under Colorado’s Medicaid State Plan at the time of their emancipation, and are under age twenty-six (26); are eligible for Colorado’s Former Foster Care Medicaid. Eligible placement types include the following:

• Kinship family foster care • Non certified kinship care • Foster home care • Group home and group center care • Children’s Habilitation Residential Program (CHRP)

• Residential Child Care Facilities • Supervised Independent Living Placement programs • Youth committed to the Division of Youth Services, living in one of the above, non-secure placements.

G. Youth for whom the county had placement authority or custody on or after the youth’s 18th birthday. 7.402.2 COUNTY DEPARTMENT RESPONSIBILITY [Eff. 02/01/2009]

The county department shall be responsible for determining eligibility for Colorado Medicaid. For children for whom the county department is assuming full or partial financial responsibility through an out-of-home placement or Core services, the county department shall:

A. Determine Medicaid eligibility at the time the child enters out-of-home placement or begins receiving Core services.

B. Determine if a child entering out-of-home care is covered by medical insurance and notify the Department of Health Care Policy and Financing of such coverage in the manner prescribed by the Division of Third Party Resources.

C. Determine eligibility in the manner prescribed by the state Department of Human Services.

D. For children in out-of-home placement, consider income and resource limitations as set forth in

Section 8.101 through 8.104 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10), considering the child as a household of one.

E. For children receiving Core services and residing with the custodial parent(s), consider income and resource limitations as set forth in Section 8.101 through 8.104 of the Department of Health Care Policy and Financing's Medical Assistance manual (10 CCR 2505-10), considering income and resources of the family unit. Medicaid eligibility determination for children receiving Core services is required only if it appears the household income or resources will not preclude eligibility.

F. Enroll the child using the appropriate data system no later than 90 calendar days after assuming full or partial responsibility for the child.

For children voluntarily placed in out-of-home care who were Medicaid eligible prior to placement, the caseworker shall coordinate Medicaid coverage with the eligibility technician. If it appears that the out-of-home placement will last longer than 90 calendar days, the child shall be enrolled in child welfare Medicaid.

G. Re-determine eligibility for Medicaid at such time as may be required.

H. For children receiving adoption assistance from a Colorado county when the child is being placed into another county in Colorado, the county of residence where the child is placed shall be responsible for opening the Medicaid case.

I. Discontinue Medicaid eligibility on the date the child is removed from the out-of-home placement and the county department is no longer assuming full or partial financial responsibility for the child.

J. Discontinue Medicaid when an adoption is finalized, unless the child is receiving adoption assistance and/or otherwise entitled to continued Medicaid coverage.

K. Develop another plan to meet the child's medical needs when a child for whom the county department is assuming full or partial financial responsibility through an out-of-home placement is ineligible for Medicaid. If the child is ineligible because of personal income, that income shall first be applied to the provision of medical care, either by the direct purchase of medical care or by the purchase of medical insurance.

L. Determine Medicaid eligibility for foster care or adoption assistance youth who emancipated from foster care or adoption assistance at age eighteen (18) or after and are under age twenty-one (21), and for whom the state made foster care payments or adoption assistance payments in the month the youth turned age eighteen. Enter the determination into the state automated system within ninety (90) days of the determination.

7.402.3 MEDICAID FOR CHILDREN COVERED BY THE INTERSTATE COMPACT ON THE

PLACEMENT OF CHILDREN [Rev. eff. 4/1/12]

A. Children moving to Colorado:

1. The county department shall establish eligibility for Medicaid for IV-E eligible children moving from another state into Colorado for out-of-home care when the state or origin provides verification of IV-E eligibility. The letter of verification shall contain the date of discontinuation of medical assistance from the state of origin.

2. If the child is placed with a parent, it is the responsibility of the parent to provide financial support and medical coverage or to apply for medical assistance in the county where he/she resides regardless of the child being determined Title IV-E eligible or not Title IV-E eligible by the state of origin.

3. Medicaid eligibility in Colorado shall begin the month following the discontinuation of medical assistance by the state of origin.

4. Medical assistance for children who are not IV-E eligible and who are moving to Colorado for out-of-home care is the responsibility of the state of origin.

B. Children moving from Colorado:

1. The county department shall establish eligibility for Medicaid for IV-E eligible children moving to another state from Colorado for out-of-home care. The county department shall provide the receiving state verification of IV-E eligibility and notification of the last date of Medicaid coverage under Colorado Medicaid.

2. Children from Colorado who are not IV-E eligible and who move to another state for outof-home placement must have a plan for medical assistance in place prior to placement out of state.

3. If the child is placed with a parent, it is the responsibility of the parent to provide financial support and medical coverage or to apply for medical assistance in the new state where he/she resides regardless of the child being determined Title IV-E eligible or not Title IV-E eligible by the county department of human/social services.

4. The county department shall provide the Interstate Compact on Adoption and Medical Assistance (ICAMA) forms and a copy of the adoption assistance agreement to the receiving state within the same month when the change from foster care to adoption occurs.

7.402.4 MEDICAID FOR CHILDREN AND YOUTH COVERED BY THE INTERSTATE COMPACT ON

ADOPTIONS AND MEDICAL ASSISTANCE (ICAMA) [Rev. eff. 12/1/12]

A. Children and youth moving to Colorado 1. The county department shall establish eligibility for Medicaid for children and youth moving from another state into Colorado who have a current adoption assistance agreement or a Title IV-E Guardianship Assistance Agreement in effect from the state of origin. The state of origin shall provide completed Interstate Compact on Adoptions and Medical Assistance forms and a copy of the current adoption assistance agreement or the Guardianship Assistance Agreement. The letter of verification shall contain the date of discontinuation of medical assistance from the state of origin.

2. Medicaid eligibility in Colorado shall begin the month following the discontinuation of medical assistance by the state of origin B. Children and youth moving from Colorado 1. IV-E Adoption Assistance For children and youth who have a current adoption assistance agreement who are moving out of state, the county department shall provide the state adoptions program staff with duplicate copies of the completed ICAMA forms and a copy of the current adoption assistance agreement.

2. For children and youth who have a current Relative Guardianship Assistance Agreement who are moving out of state, the county department shall provide the state adoptions program staff with duplicate copies of the completed ICAMA forms and a copy of the current assistance agreement.

3. Non-Title IV-E Adoption Assistance a. For children and youth who are moving to a reciprocal state and have a current adoption assistance agreement, the county department shall provide the State adoptions program staff with duplicate copies of the completed ICAMA forms and a copy of the current adoption assistance agreement.

b. For children and youth who are moving to a state that is not reciprocal with Colorado’s non-Title IV-E Medicaid, the county shall provide medical insurance for the child or youth. This arrangement shall be negotiated with the family as to how the insurance will be provided. 7.403 SPECIAL NEEDS DETERMINATION [Rev. eff. 5/1/12]

The special needs allowance is an additional resource that can be used to increase the level of income a child can have and still be eligible for Medicaid.

A. In order to be eligible for the special needs allowance, as outlined in the Need Standard in the Income Maintenance staff manual (9 CCR 2503-1), the family must meet the following criteria:

Criterion #1:

The child may be at imminent risk of out-of-home placement because one or more of the following conditions exist:

1. Abandonment by or incarceration of parents/relatives/caretakers;

2. Abuse/neglect - as defined in the Children's Code;

3. Domestic violence - as defined in Section 18-6-800.3, C.R.S.;

4. Conditions that exist to such a degree for either the child or caretaker so that the caretaker is unable to care for the child:

a. Substance abuse; drug exposed infants b. Mental illness c. Disability d. Physical illness e. Homelessness 5. Beyond control of parents;

6. Danger to self, others, or community;

7. Infant or young child of teen parent in placement;

8. Delinquency - adjudicated delinquent meeting current out-of-home placement criteria written pursuant to Section 19-2-907 and 19-2-212, C.R.S.;

9. Relinquishment or termination of parental rights;

10. Child returning home from out-of-home placement or moving to less restrictive level-of- Criterion #2:

The county department has custody of the child and the child is receiving court-ordered services.

B. Children in out-of-home placement who would meet IV-E eligibility, except that their income exceeds 185 percent of the Colorado Works needs standard, can be eligible for Medicaid if:

1. They meet the special needs criteria; and, 2. They are deprived of parental support and have less than $1000 in resources; and, 3. Their income is less than 185 percent of the combination of the needs standard and the maintenance cost of the placement.

C. For children in out-of-home placement who are not Title IV-E eligible and whose income exceeds the need standard can be Medicaid eligible if:

1. They meet the special needs criteria; and, 2. Their income is less than the maintenance cost of the placement. If the special needs allowance is the same as the maintenance cost of placement in the facility in which the child is placed, then deprivation of parental support is not required.

D. The county shall meet all other reporting requirements for children in placement who are determined eligible for Medicaid under the special needs allowance.

E. For children in their own homes or receiving Core Services Program:

1. Special needs criteria must be met and the child must be in the custody of the county department and receiving court-ordered services.

2. There must be deprivation of parental support and the family must have incurred an additional expenditure for items included in the Colorado Works need standard due to the special problems of the child or family.

3. The special needs allowance must be related to one of the following components of the need standard:

a. Shelter b. Utilities c. Food d. Clothing e. Personal needs f. Educational expenses g. Household supplies 4. The inclusion of the special needs allowance could make a family that currently has income in excess of the Colorado Works need standard eligible for Colorado Works and Medicaid. They must meet other Colorado Works program requirements.

5. The county department Colorado Works section shall compute the special needs allowance. The services section shall develop the service plan and verify those items which may be included in the special needs allowance. The costs of these items shall be reasonable and needed as a result of child or family problems, and be for the purpose of maintaining the child in the home and avoiding out-of-home placement.

F. The county department shall obtain prior authorization for the inclusion of the special needs allowance from the Office of Self Sufficiency at the state department.

G. The county department shall maintain the authorization from the Office of Self-Sufficiency and receipts verifying expenditures in the assistance payments case record.

H. The county department services section shall notify the assistance payments section when the child or family is no longer eligible for a special needs allowance.

I. The county department shall document in the case record how the special needs requirements are met. The county director shall approve the determination of Medicaid.

7.404 FEES

A. Fees shall be determined and collected as applicable for the following services in each program area:

1. Child Welfare Child Care.

2. Foster care.

3. Adoptive studies.

4. Core Services Program services as defined in the state approved Core Services Program plan.

5. Medical care paid by the county that is not reimbursed by the state.

6. Other services, such as case services, or custody evaluations.

B. When both foster care and Core Services Program Services are simultaneously being provided or purchased, the foster care fee schedule shall be applied to the cost of both programs.

C. Categories excluded from fee collection:

1. Colorado Works categories, except for Supplemental Security Income eligible children in foster care and whose parents are not Colorado Works recipients.

2. Individuals whose income is deemed to a Colorado Works household.

3. Adoptive families who have an approved but inactive adoption assistance agreement and the child is in out-of-home placement.

4. Youth participating in the Foster Youth in Transition Program and their parents.

D. Once the amount of fee is determined, the full amount is to be paid up to the cost of services.

E. Fees shall be determined for adoptive families as follows:

1. Adoptive families who have an approved Colorado non-Title IV-E adoption assistance agreement, but are currently not receiving adoption assistance payments and the child is in out-of-home placement, are excluded from fee collection.

2. Adoptive families living out of Colorado who have an approved non-Title IV-E adoption assistance agreement whose child is in out-of-home care and the family is being charged a placement fee may request continuation of the adoption assistance payments to assist in the cost associated with the child's out-of-home placement. The plan for the child shall be reunification with the family.

3. Adoptive families who have an approved Colorado non-Title IV-E adoption assistance agreement and the child is in out-of-home placement shall be assessed a placement fee not to exceed the amount of the adoption assistance payment they are receiving under their adoption assistance agreement.

4. Adoptive families who have an approved Title IV-E adoption assistance agreement and the child is in out-of-home placement shall be assessed a fee not to exceed the amount of the adoption assistance payment they are receiving under their adoption assistance agreement.

F. If a family is receiving purchased services the fees shall be distributed in the following priority:

1. Medical costs for non-Medicaid eligible children 2. Foster care 3. Core Services Program Services 4. Child Welfare Child Care 5. Other services 7.404.1 CHILD WELFARE CHILD CARE PARENTAL FEE SCHEDULE Counties will be notified of the State set parental fee schedule via a yearly Agency Letter from the Division of Child Care. The State set parental fee schedule is based on an approved formula that can be found in rule manual Volume 3 “Income Maintenance” , Section 3.905, B (9 CCR 2503-1).

7.404.2 FEES FOR FOSTER CARE

A. The county department shall assess the family the required fee as determined from an application of the child support guidelines in state statute. The fee will be based on the guidelines for all fees assessed after the effective date of the rule.

B. The county department or designee shall collect a fee from the legally responsible custodial parent(s). All fees must be established using the Colorado child support guidelines to determine the amount to be ordered. County staff shall not deviate from the guidelines. The fee shall be established either by the court or by the county department pursuant to the Administrative Procedure for Child Support Establishment and Enforcement, Title 26, Article 13.5, C.R.S.

C. When the county department petitions the court for legal custody or for Review of Need for Placement, the county department shall include a statement regarding both parents' gross income, including a worksheet to calculate the fee according to the child support guidelines, in the social study for the court to consider in ordering the fee to be paid. The county department shall submit a guideline worksheet to the court.

D. When a fee is being established for a foster care case and either paternity cannot be established or the absent parent cannot be located, minimum wage is imputed to the absent parent to determine the fee paid by the custodial parent, only if there is no economic reliable evidence of the absent parent's income or income history.

E. In cases where both parents are not in the home, the foster care fee shall be calculated using child support guidelines as follows:

1. Calculate the mother's and father's income in the appropriate columns on the Sole Physical Custody Worksheet A.

2. Insert the number of birth and adoptive children in the home, not in placement, on line 1- C of the child support guideline worksheet in both the mother and father.

3. Calculate the remainder of Worksheet A to determine each parent's foster care fee amount.

F. In cases where both parents reside in the same home, separate orders are required for each custodial parent to reflect their foster care fee amount. Even though both parents reside in the same home, the foster care fee shall be calculated using the same method as used when both parents are not in the home.

G. As a result of using child support guidelines, the Department will claim Federal Financial Participation for all activities associated with the establishment and collection of foster care fees, only for new cases or old cases that are reviewed and have the fee set under the guidelines. In addition:

1. Foster care fee collections set under guidelines shall be reported to IV-D as child support collections.

2. Activities related to foster care fee establishment under the child support guidelines can be considered a IV-D activity and staff can be billed to IV-D.

3. Foster care fee collections based on fees set under the old fee schedule shall not be reported to IV-D as child support guidelines.

7.404.3 CHILD'S INCOME

A. For non-IV-E children, income and other funds, including fees and child support, received by or on behalf of the child, which are more than the amount needed to meet his/her monthly needs, shall be kept by the county treasurer in a special account or trust fund, or, with the concurrence of the county treasurer, a trust account may be established with the county director as the trustee.

See the Finance Manual (11 CCR 2508-1) Such excess funds may be used to meet the child's other needs, such as medical care.

B. For IV-E foster care children, the county department shall handle payment according to Volume V, Disbursement of Support Collections. All other income is handled the same as for non-IV-E children.

C. When a child in foster care has income earned from her/his employment, the county department shall consider the following:

1. Income is not a consideration in determining eligibility for foster care.

2. Full-time student - when a foster child is in school full-time, or would be, except for scheduled vacation. The child need not contribute toward the cost of her/his foster care.

3. Part-time student:

a. When a child in foster care is a part-time student and employed part-time (less than 30 hours per week), earned income is not considered.

b. When the child is employed full-time, the child's own income shall be considered in determining a foster care fee. The guidelines permit the court to consider the child's income in setting the award against the parents.

D. When a child is in a placement under IV-E Foster Care (Title IV-E) and has income, the county department shall refer the case to the Income Maintenance Division for determination of continuing eligibility for IV-E Foster Care. See the Income Maintenance manual Section on Eligibility for Temporary Assistance to Needy Families (9 CCR 2503-1).

E. When a youth is participating in the Foster Youth in Transition Program, the youth's housing is fully or partially funded through foster care maintenance payments, in addition to any other housing assistance the youth is eligible to receive. Any expectations for the youth to contribute to the youth's own expenses must be determined by requirements in 7.416.2. 7.404.4 Child Support A. When a child with an absent parent is eligible for Medicaid and the child is placed out of the home, the county department may complete the “Information Concerning Absent Parent Form”

(CSE-10), and the cws-3a as specified by the state department, and refer the case to the county child support services unit, if a referral is made, the county department must review the case every 6 months to reassess the appropriateness of the referral. the county department may consult with the child support services unit during the reassessment.

B. he child shall remain eligible for foster care whether either parent cooperates with the child support unit.

C. when a child is not eligible for iv-e foster care, the county department may apply for child support services, using the “application for child support services” (case-6), if the county department finds that a referral is appropriate; see section 7.601.712 (12 CCR 2509-7). if a referral is made, the county department must review the case every 6 months to reassess the appropriateness of the referral. the county department may consult with the child support services unit during the reassessment.

D. . in referring the case to the county child support services unit, the county department must include the “information concerning absent parent” (case-10).

E. the county department may refer foster care cases to child support services (iv-d) for collection of the foster care fee if the amount of the foster care fee is based on the child support guidelines and the amount stated in the court order and if the county department finds that a referral is appropriate; see section 7.601.712 (12 CR 2509-7). if a referral is made, the county department must review the case every 6 months to reassess the appropriateness of the referral. the county department may consult with the child support services unit during the reassessment.

F. the county department shall notify the custodial parent of the availability of child support services.

G. the Colorado state department of human services has paid a one-time iv-d application fee of $20 on behalf of all children in foster care.

7.405 REIMBURSEMENT 7.405.1 GENERAL [Rev. eff. 4/1/12]

The county department shall be reimbursed for child welfare services when State program and fiscal requirements are met. Reimbursement shall be eighty percent (80%) of the approved allowable cost, within the available allocation. The county department shall be reimbursed ninety percent (90%) of the amounts expended for adoption and relative guardianship assistance when state program and fiscal requirements are met.

7.405.2 GENERAL REIMBURSEMENT REQUIREMENTS

In order to be eligible for state reimbursement the county department shall:

A. Determine the eligibility of a child for a target group, re-determine the eligibility at required intervals, and maintain an open case record for the period of time for which reimbursement is requested.

B. Determine the categorical or funding source status of the child.

C. Prepare a Family Services Plan according to requirements.

D. Report the eligibility and funding source findings accurately in the Department's automated reporting systems.

7.406 GENERAL REIMBURSEMENT FOR CHILD WELFARE SERVICES

7.406.1 THE STATE REIMBURSES WHEN

A. The county's case record contains required program documentation. For out-of-home placement, documentation shall include the requirements listed under Section 7.304.51 (12 CCR 2509-4),

Authority for Placement.

B. Care is provided after the case is open and before the case is closed.

C. The child is with a provider in possession of a valid certificate or license, when one is required.

D. Placement is with an in-state Residential Child Care Facility or Child Placement Agency on the state approved vendor list or with out of state placement providers as approved through the Interstate Compact on the Placement of Children.

E. A youth over eighteen (18) years of age is in placement only when the court had jurisdiction before the 18th birthday and the court orders out- of-home placement or the youth meets eligibility criteria for the Foster Youth in Transition Program and has an active voluntary services agreement.

F. A child is absent from an out-of-home placement and the county department elects to reimburse the provider during the absence period for the placement for one of the following reasons:

1. The absence does not exceed seven days per absence, with only one (1) seven-day total reimbursement within thirty (30) calendar days for the following reasons:

a. The child has run away, b. Trial home visit, c. Trial provider visit, d. Child in detention; or, e. The child has been kidnapped.

2. Thirty (30) calendar day absences are allowed for the following reasons:

a. Respite (unless care is being provided and it violates Section 7.708.31.1 C, (12 CCR 2509-8) and causes a foster care home to be over capacity); or, b. The absence occurs during the first thirty (30) days of a hospitalization.

3. For children enrolled in the Children's Habilitation Residential Program Waiver (CHRP), the county may continue payment of the equivalent of the maximum federal Supplemental Security Income benefit during all absences.

G. The out-of-home placement duration for a voluntary Title IV-E child/youth does not exceed 180 calendar days when the county department has filed for a petition to review the need for placement, or petition to open a foster youth in transition case by the 90th calendar day and the county has a correctly worded court order issued, based on the request of the petition to review the need for placement; see Court-Related Procedures, Section 7.304.53 (12 CCR 2509-4).

H. The county department reports an out-of-home or Core Services Program care placement in the Department's automated reporting system within ninety (90) calendar days of its beginning. The State reimburses for retroactive payments not greater than the current and two (2) preceding months.

I. The county department places children in out-of-home care within the provider's licensed or certified capacity or if the licensed/certified capacity is exceeded with the placement of a sibling group. The county shall document that there are no other appropriate placements available.

J. A child is in a Child Placement Agency or Residential Child Care Facility within Colorado for longer than ten (10) working days and an agreement to purchase Child Placement Agency or Residential Child Care Facility services is completed for the child.

K. A child is in a Child Placement Agency or Residential Child Care Facility within Colorado for less than ten (10) working days and the facility has an emergency shelter contract with a county department.

L. Out-of-home placement occurs in facilities holding current certificates or licenses, including kinship foster care placement.

M. Children are placed in Child Placement Agencies and Residential Child Care Facilities outside of Colorado according to the rules for out of state placement and Interstate Compact on the Placement of Children.

N. Respite care is paid to providers of foster care homes. This includes county department or child placement agency foster care homes, or adoptive homes receiving a foster care payment and kinship family foster care providers. It does not include foster homes that provide receiving home O. The child enters care (first day) but not for the last day in care.

P. The child is placed and removed on the same day.

Q. The state reimburses for supervised independent living placements as described in 12 CCR 2509-04; 7.305.2(D) for youth aged sixteen (16) through the end of the month of the youth’s twenty-first (21st) birthday, when the county has placement and care responsibility.

R. Child Welfare Child Care program criteria are met.

S. The Core Services Program is operated within applicable state rules and within the provisions of the county or multi-county state approved Core Services Plan and in accordance with the requirements governing the specific funding streams used.

T. Client travel costs for out-of-state placement and supervision activities are related to out-of-home placements approved through the Interstate Compact county liaison and the receiving state Interstate Compact on the Placement of Children office. Staff travel costs are reimbursed through county administration.

U. Payments for out-of-home care and rate adjustments are pro-rated using the foster care daily rate in the State Department's automated reporting system.

V. The developmental disability rate for children placed in foster care homes, kinship foster care homes, receiving home care, specialized group facilities, specialized foster care in county certified foster care homes, and homes in which a subsidized adoption maintenance payment is made.

W. Clothing is authorized to be purchased for a child/youth in out-of-home care. The state reimburses retroactive clothing payments not greater than the current and two preceding months.

X. The child is in out-of-home care and the county department lists a child who is available for adoption with the Colorado Adoption Resource Registry within ninety (90) calendar days following:

1. The date of relinquishment or termination of the parent-child relationship, or 2. The date of placement into out-of-home care following an adoption dissolution.

Y. The child is in out-of-home care, the county department requests and the State approves an exclusion from Colorado Adoption Resource Registry listing for a child who is available for adoption within ninety (90) calendar days following:

1. The date of relinquishment or termination of the parent-child relationship; or, 2. The date of placement into foster care following an adoption dissolution.

Z. A Colorado Adoption Resource Registry exclusion is approved by the state because the county finds an adoptive home, reimbursement for out-of-home care is limited to six months from the date the state department receives the request for exclusion.

AA. Costs are billed for the current and two (2) preceding months.

BB. The Early intervention and Prevention Program is operated within applicable state rules and within the provision of the county or multi- county state approved services plan.

CC. A child/youth with intellectual or developmental disabilities has been placed in a locked residential setting for treatment and the county has obtained a court order of legal imposition of disability pursuant to Section 27-10.5-110, C.R.S.

DD. A county department pays incentives to a consortium for meeting or exceeding agreed to outcomes.

EE. A county department may pay a consortium, if the consortium's outcome measures meet or exceed the agreed to standard.

FF. A county department purchases Transition Program services provided by a RCCF that is on the approved State RCCF vendor list. In no case shall the rate for transition services exceed the RCCF rate approved by the county department.

GG. Placement of a child in a provisionally certified foster care home that is fully certified within ninety (90) calendar days from the date of the application.

HH. If required by section 24-76.5-101, -102, OR -103 a county department shall document the lawful presence of children age eighteen (18) and over receiving services other than those excluded from the definition of a federal public benefit, state and local public benefits as those terms are defined at Section 24-76.5-102, C.R.S., or services excluded from this requirement as defined at

section 24-76.5-103, C.R.S.

II. A county department pays a provider at or above the state-established base anchor rates. A county that negotiates provider rates shall use a request for proposal process, a draft of which shall be submitted to the Department, no later than March 1 of each calendar year. The Department shall approve or deny the draft proposal no later than April 1 of each calendar year.

The request for proposal shall include the following:

1. The county department of human/social services’ policy for:

a. Determining the time frames for negotiation or re-negotiation of rates, services and outcomes; and, b. Actions to be taken if services are not delivered or outcomes are not met.

2. The Department shall evaluate request for proposals submitted by county departments of human/social services using the following criteria:

a. Consideration of whether the county used an approved request for proposal process including, but not limited to, competitive bidding and negotiations;

b. Consideration of performance outcomes and whether they are tied to financial incentives.

JJ. Reasonable travel is provided to the school where the child is enrolled prior to out-of-home placement.

KK. Reasonable costs are provided for liability insurance for a child.

LL. Adoption Assistance and Relative Guardianship Assistance Program payments are made in compliance with requirements.

MM. Case services are authorized in adoption assistance agreements and relative guardianship assistance agreements.

NN. Non-recurring expenses are authorized for adoption assistance and relative guardianship assistance agreements.

OO. A child/youth is placed at the IDD facility, as described in 7.424.13, with the approval of the State Department. The approved placement period is the duration of treatment, as stated in the most recent approval letter from the State Department, and thirty (30) days after the completion of treatment/discharge date.

PP. A county department makes foster care maintenance payments for children/youth placed with parents in a licensed residential family-based treatment facility for substance abuse in accordance with federal and state program and fiscal requirements. Reimbursement shall be eighty percent (80%) of the approved allowable cost, within the available allocation.

7.406.2 THE STATE DEPARTMENT SHALL NOT REIMBURSE

A. Out-of-home placements for a child in Colorado who is in the custody of another state. The county shall bill the other state for reimbursement.

B. Receiving home or shelter care placements that exceed 90 consecutive days.

C. Out-of-home placements of children who do not meet the requirements of Section 7.304.51,

Authority for Placement.

D. Out-of-home care in public child care institutions accommodating more than twenty-five (25) children.

E. Placements of children under the age of six (6) years in a specialized group facility or residential child care facility, except for children with documented exceptional needs which can be met only by the specifically identified facility. Documentation in the child's Family Services Plan shall include a description of the services available in that facility to address the child's specific needs.

F. Placements of children under the age of twelve (12) years in a specialized group facility or residential child care facility that exceed sixty (60) calendar days unless the child has documented special treatment needs that cannot be met in a foster care home. Documentation in the Family Services Plan shall include a description of the services available in that facility to address the child's specific needs.

G. Placements in a specialized group home with a capacity in excess of ten (10) children unless there is written approval by the placing caseworker's supervisor. Such approval shall be based upon written documentation in the Family Services Plan that the child's needs can be met only by the specifically identified facility. The documentation shall include a description of the services available in that facility to address the child's needs.

H. Services provided by Residential Child Care Facilities or Child Placement Agencies which are reimbursable from other funding sources.

I. Respite care allowance paid to specialized group home or centers or for independent living.

J. Out-of-home care for the period of non-compliance with state rules in Section 7.306.14, Colorado Adoption Resource Registry (CARR) listing and exclusion requirements.

K. Out-of-home care if the county department does not forward the Colorado Adoption Resource Registry photo listing to the State Department within thirty (30) calendar days following the State's notification of Colorado Adoption Resource Registry exclusion denial. Reimbursement is not authorized for the period of non-compliance from the date the profile is due until the profile is received by the State.

L. Placement of a child in a foster home if that placement will result in more than six foster children in that foster home, or a total of ten children (foster and non-foster), or more than two children under two years of age, except in those instances in which the placement of a sibling group in a foster home would exceed the limits. If the placement of a sibling group results in exceeding the above limits, no other children can be placed in the home.

M. Placement of a child in a foster home, if that placement will result in more than two (2) children enrolled in the Children's Habilitation Residential Program (CHRP) waiver funding or more than two (2) foster children and one (1) child enrolled in the CHRP waiver, unless there has been prior written approval by the CHRP waiver administrator. Placements of three (3) children enrolled in the CHRP waiver may be made if the agency can demonstrate to the CHRP waiver administrator that the provider has sufficient knowledge, experience, and supports to safely meet the needs of all of the children in the home. In any case, no more than three (3) children enrolled in the CHRP waiver and no (0) non-CHRP children will be placed in one (1) foster home. Any placement resulting in three (3) CHRP children placed in a foster home must have prior approval by the CHRP waiver administrator.

FOSTER CARE HOME (COUNTY OR CPA) MAXIMUM CAPACITY

CHRP Non-CHRP Total Children 1 2 3 2 0 2 3 0 3 N. Placement of a child in a specialized group facility if that placement will result in more than eight (8) children and one (1) child enrolled in the Children's Habilitation Residential Program (CHRP) funding or five (5) foster children and two (2) children enrolled in the CHRP waiver, unless there has been prior written approval by the CHRP waiver administrator. If Placement of a child in a Specialized Group Center will result in more than three (3) children enrolled in the CHRP waiver, then the total number of children paced in that Specialized Group Center will not exceed a maximum of six (6) total children. Placements of more than three (3) children enrolled in the CHRP waiver may be made if the agency can demonstrate to the CHRP waiver administrator that the provider has sufficient knowledge, experience, and supports to safely meet the needs of all of the children in the home.

SPECIALIZED GROUP FACILITY MAXIMUM CAPACITY

CHRP Non-CHRP Total Children 1 8 9 2 5 7 O. Placements of children enrolled in the Children's Habilitation Residential Program (CHRP) waiver when the county is not in compliance with rules contained in the Department of Health Care Policy and Financing's Medical Assistance Manual at Section 8.508 (10 CCR 2505-10).

P. Placement of child in a foster home, if the foster parent(s) have not completed twelve (12) hours of foster parent core training. If a child is already in the home, the placement shall not be disrupted, but no additional children shall be placed until the training is completed.

Q. For “child specific” or kinship foster care placements exceeding ninety (90) calendar days in a provisional status from the date of application.

R. For children that do not have a diagnosis of developmental disability as defined in Section 27- 10.5, C.R.S., and who are placed with a service agency that has been approved through Developmental Disabilities Services.

S. For children placed in locked facilities through county departments, except as outlined in Section 7.406.1, CC.

T. For consortium fees, if the consortium is not registered with the State Department.

U. Placement of a child in a provisionally certified foster care home that is not fully certified within ninety (90) calendar days from the date of the application.

V. Placement of a child living in a foster care home with his/her parent(s), including in kinship foster W. For costs incurred when a child/youth, who is in the custody of the county department of human/social services, and remains in placement at the IDD facility, as defined in 7.424.5, after the end of the approved placement period. The approved placement period is the duration of treatment, as stated in the most recent approval letter from the State Department, and thirty (30) days after the completion of treatment/discharge date.

7.407 ADMINISTRATIVE REVIEW FINDINGS, FISCAL SANCTIONS, APPEALS, AND

DISALLOWANCES [Rev. eff. 1/1/16]

A. Fiscal sanctions and disallowances occur as a result of Administrative Review findings of noncompliance in three areas:

1. Title IV-E foster care eligibility or ineligibility has not been determined. Reimbursement is reduced by the amount of Title IV-E funds not earned.

2. Level of care of the placement is too restrictive. Reimbursement is reduced to the average cost of the determined less restrictive type of available placement, unless the child is court-ordered into the more restrictive placement against the recommendation of the county department.

3. Requirements for state reimbursement at Section 7.406.2 are not met.

B. The county shall correct the area of non-compliance or initiate court proceedings to correct the non-compliance within thirty (30) calendar days in order for reimbursement to be uninterrupted.

The county department shall provide the Administrative Review Division with a copy of the motion to the court or the written request for special action by the court. Within 30 calendar days following the court hearing, the county must submit to the Administrative Review Division a copy of the county's court report documenting the county's agreement with the Administrative Review findings and a copy of the resulting order of the court.

C. If the county department disagrees with the findings, the county department may appeal in writing the denial of reimbursement. An appeal must be received by the Administrative Review Division within fifteen (15) working days of the receipt of written results of the review.

D. Reimbursement is denied from the date of the review if the county neither corrects the noncompliance nor appeals the review decision within allotted timelines. 7.408 REIMBURSABLE DUAL PAYMENTS AND DUAL PLACEMENTS [Rev. eff. 1/1/16]

A. The state reimburses for simultaneous placements in foster care homes, kinship foster care homes, specialized group facilities, or residential child care and receiving home or shelter care.

B. The state reimburses for simultaneous placements in state-approved transition or home-based programs and foster care home, specialized group facility care, receiving home care, shelter care, residential child care, independent living, kinship foster care, or subsidized adoption.

C. The state reimburses for subsidized adoption and a simultaneous placement in any out-of-home care when the child has been determined to be Title IV-E eligible in his/her adoptive placement as evidenced by having a signed Title IV-E subsidized adoption agreement.

D. The state reimburses for more than one Core Services Program service at a time when Core Services Program rules are met.

E. The state reimburses for simultaneous placements in out-of-home care and Core services provided/purchased when Core Services Program rules are met.

F. The state reimburses for the independent living allowance to a youth and a simultaneous payment to a Residential Child Care Facility or Child Placement Agency supervising the independent living placement.

G. The state reimburses for foster care and child care when the provider is dually certified for both types of placements except when it is the same child at the same time with the same provider.

7.409 OUT OF STATE FOSTER CARE PLACEMENTS

The state reimburses for out of state foster care placements at the other state's rate when:

A. The county department complies with the Interstate Compact on the Placement of Children; and, B. The provider is licensed, certified, or approved in the other state; or, C. The provider, originally a Colorado home, is licensed, certified or approved within 90 calendar days after moving from Colorado; and, D. The required provider, client, and rate information is entered into the Department's automated reporting system. 7.410 CASE SERVICE PAYMENTS FOR CHILDREN PLACED IN OUT-OF-HOME CARE [Rev. eff. 4/1/12]

Case services are a type of purchased program services that support a case plan for children in out-ofhome placement, adoption assistance, or a Relative Guardianship Assistance agreement.

A. The State reimburses for a one time physical, dental and psychological examination for individual eligible children in out-of-home care per Section 7.607.3, B, 2 (12 CCR 2509-7).

B. The State reimburses county departments for client transportation as a case service from out-ofhome care funds when travel is necessary:

1. For children in out-of-home care to receive services specified in the Family Services Plan that are directly related to visitation and reunification.

2. To return runaways, who are in county department custody, to their Colorado home county.

3. To facilitate a permanent plan through the Interstate Compact on the Placement of Children.

C. The State does not reimburse for transportation when the:

Child is eligible for Medicaid and the transportation is to enable him/her to secure medical benefits.

D. The State reimburses county departments for case services provided to children placed by provider consortiums/networks when such services are not a part of either room and board or Medicaid treatment/case management services.

E. The State reimburses county departments for other case services provided to children in out-ofhome placement when such services are not a part of either room and board or Medicaid treatment or case management services.

7.411 REIMBURSEMENT FOR RESERVED SPACE

A. The State reimburses for out-of-home placement space as provided in a contract for services, outcomes, or as is negotiated through a contract for reserved space.

B. Reimbursement for reserved space is reduced by placements from any county.

7.412 REIMBURSEMENT FOR ADJUSTMENTS OF STATE-APPROVED RATES

A. The State reimburses for county negotiated out-of-state rates that exceed Colorado's rates or the other state's rate for the same type of care only with state approval of the placement.

B. The State approves reimbursement for educational costs of a child placed in group or residential child care facility care or day treatment only when the educational assessment results in a finding that the child is not educationally handicapped. (See Case Planning and Assessment section, 7.301.241, for discussion of educational assessment.)

7.413 REIMBURSEMENT FOR SUBSIDIZED ADOPTION

A. The state reimburses for services specified in a valid adoption subsidy agreement that the county department approved and reviews every three years and that satisfies adoption subsidy program criteria. The three year review is documented in writing on the appropriate form.

B. The maximum subsidized adoption reimbursement is the child maintenance rate, the county negotiated rate, plus the special need rate for an age group, if appropriate. The county shall negotiate a Title IV-E adoption assistance subsidy with the adoptive parents and may negotiate a state and county only adoption assistance agreement with the subsidized adoptive parents for a rate for the age group and should review this rate every three years. The current rate will be documented on the three year review form. See Section 7.203.2 for additional guidelines.

7.414 REIMBURSEMENT FOR CORE SERVICES PROGRAM

A. The state shall reimburse counties for expenditures in approved Core Services Program Plans to include the following:

1. Salaries, fringe and operating costs directly related to the Core Service funded FTE positions;

2. Rent and utilities for facilities which are for the sole and separate use of a Core Services Program;

3. Contracted services authorized by an approved Core Services Program Plan and contained in a written contract between the individual contractor and the county department; contractors must perform as an independent business entity;

4. Program services purchased from an agency as outlined in an approved Core Services Program Plan when a written contractual agreement exists between the provider agency and the county department;

5. Capital expenditures on items that are for the appropriate, necessary and justifiable use of the approved Core service;

6. Consultation, training, and staff development for county Core service staff when necessary for the delivery of a Core service;

7. Program expenses such as training supplies, films, or publications necessary for the delivery of Core Services Program services;

8. Travel and per-diem expenses directly related to program delivery or administration;

9. Travel for children in out-of-home care or their parents is allowed if part of an approved Core Services Plan;

10. Space guarantees necessary to maintain program availability not to exceed 50 percent capacity of a facility. Space guarantees up to 100 percent capacity of a facility may be paid for no more than three months when initiating a new program.

B. Core Services Program Care expenditures not reimbursable by the state include:

1. Contractual program services such as child care services and physical exams;

2. Foster care costs for placement in facilities operating under the supervision of the county department, for placement in residential child care facilities or child placement agencies on the state approved vendor list or for supervised independent living placement funds;

3. Those expenditures that may be reimbursed by some other source;

4. Other expenditures not permitted by the fiscal rules or procedures.

C. Any expenditure other than those defined in this section as reimbursable shall be nonreimbursable unless specifically identified in an approved Core Services Program Plan.

D. The county department shall only be reimbursed for the current (month being paid) and two months preceding.

E. The county department shall only purchase services from facilities other than those on the state department's vendor list, if the approved Core Services Program Plan provides for the expenditure.

F. The county department shall meet all State fiscal reporting requirements before being reimbursed for expenditures in its plan. The State may withhold or reduce reimbursement to counties for expenditures not in compliance with programs as described in the approved Core Services Program Plan.

G. County departments assessing fees for Core Services shall set these fees and the method of computation in their Core Services plans for consideration of the State Board of Human Services. 7.415 REPORTING [Rev. eff. 1/1/14]

A. The county department shall make timely and accurate reports in all applicable automated reporting systems operated by the state. The reporting of placements and placement changes in the automated reporting systems operated by the state shall be made prior to the next payroll.

B. The county department shall report client prevention, intervention, referral, assessment, service, case and placement information in the automated reporting systems operated by the state when one or more of the following occurs:

1. The county department provides Program Area 3 services directly, through another division or through a community agency; or, 2. The county department opens a case and determines the target group eligibility or redetermines a change in target group eligibility; or, 3. The child is in out-of-home or Core Services care and the funding source is determined or changes; or, 4. An out-of-home, relative, adoption assistance, Relative Guardianship Assistance, or Core Services care placement is made, the placement changes or ends, or a change in the level or nature of a payment must be authorized; or, 5. A court orders a change in the custody of a child or other legal action occurs; or, 6. The State Department's automated system special consideration codes are relevant; or, 7. The child is legally free for adoption; or, 8. The child is placed for adoption and gets a new identity (name, household number, State ID); or, 9. The child is in Colorado from another state for Interstate Compact on the Placement of Children supervision or Medicaid only; or, 10. Within thirty (30) calendar days of a decision to close.

C. The county department shall report confirmed incidents of abuse and neglect in the State Department’s automated system.

D. The county department shall report the Medicaid eligibility status of children out-of-home or in subsidized adoption using the FCS-100 system, when a child has:

1. Eligibility for Medicaid and in out-of-home care or subsidized adoption; or, 2. Categorical status or medical resource code changes; or, 3. Changes from one placement to another; or, 4. Been placed for adoption and gets a new identity (name, household number, State ID); or, 5. Eligibility for an in-state medical effective span; and, 6. Is in Colorado from another state and receiving Medicaid only (COBRA).

E. The county department shall leave a case open on the Department's automated system for each child with a current subsidized adoption agreement. When the subsidized adoption agreement is terminated, the county shall close the child's case on the State Department's automated system and the FCS-100, if applicable.

F. For purposes of reporting and maintaining confidentiality in the State Department's automated system and other systems, the county department shall create a new adoptive identity (name, household number, state ID) different from the birth identity when the adoption of the child has been finalized, except in the following circumstances:

1. The name or identity of the child is not changed in the adoptive home. The birth name and birth state identification number is maintained.

2. The child is adopted by relatives and the name or identity is not changed after the adoption. The relative(s) is the caretaker(s) of the child in the birth case.

G. The county department shall consider siblings and their parents or legal caretakers as one household unit. When parental legal rights are terminated or relinquished, the new household unit may be an individual child or all siblings, depending upon whether the case plan is to place the siblings separately or together.

H. The county department shall obtain Social Security Numbers for children and enter them into the State Department's automated system.

I. The county department shall provide information when requested by the state for special studies.

7.416 REIMBURSEMENT FOR THE CHAFEE PROGRAM

7.416.1 REIMBURSEMENT FOR THE CHAFEE PROGRAM

A. The Chafee Program provides supplemental services that assist youth to successfully transition to adulthood for youth who are eligible through section 7.305.42. The state shall reimburse counties or programs for expenditures in approved Chafee plans to include the following:

1. Salaries, fringe, and operating costs directly related to the county- or program- funded positions;

2. Contracted services authorized by an approved program plan and contained in a written contract between the individual contractor and the county department. Contractors must perform as an independent business entity;

3. Program services purchased from an agency as outlined in an approved Chafee Foster Care Independence Program plan when a written contractual agreement exists between the provider agency and the county department;

4. Consultation, training, and staff development for Chafee Program service staff when necessary for the delivery of the Chafee Program;

5. Travel and per-diem expenses directly related to program delivery; and, 6. Room and board costs for young adults, ages 18 to 23, who were in out-of-home care on or after their 18th birthday.

B. Chafee Program expenditures not reimbursable by the state include:

1. Expenditures used to supplant, duplicate, or replace existing child welfare funds; and, 2. Other expenditures not permitted by the fiscal rules or procedures.

C. Any expenditure other than those defined in this section as reimbursable shall be nonreimbursable unless specifically identified in a state approved Chafee Program plan.

D. The county departments shall meet all state fiscal reporting requirements for expenditures in its plan. The state may withhold or reduce reimbursement to counties for expenditures not in compliance with the Chafee Program plan.

E. Youth Direct Services - County departments of social services may be reimbursed at 100% for directly funded services up to a maximum amount in each state fiscal year.

1. The amount shall be determined by the county departments of social services with approval by the state.

2. Youth Direct Services shall be used according to federal guidelines (Public Law No. 106- 169) as incentives for completing goals in the plan for transition to independent living and other expenditures that will assist youth to emancipate and for which no other funding sources exist.

a. Amounts up to $100 shall be documented in the case notes.

b. Amounts of $100 or greater shall be documented in the Chafee plan that is created with the youth.

7.416.2 REIMBURSEMENT FOR SUPERVISED INDEPENDENT LIVING PLACEMENT

This is paid according to the rate negotiated by the county department. The rate may be the State established child maintenance rate or may be the rate negotiated by the county department that ensures the youth has sufficient resources to meet their basic needs and any contribution the youth is required to make shall be based on:

A. The presumption that ability to pay aligns with standards established by the federal department of housing and urban development housing choice or similar voucher programs. Any variance shall be based on the needs of the youth and:

1. The need to gradually reduce payments in a manner that reduces potential negative impacts associated with a sudden reduction in public benefits; this reduction shall not begin more than 120 days prior to the projected end of payments.

2. The need to provide stable support to the youth should the youth’s income change rapidly or unexpectedly.

3. Any variance and the reason for the variance shall be documented in the comprehensive child welfare information system.

7.417 REIMBURSEMENT REQUIREMENTS 7.417.1 COUNTY FOSTER CARE HOME PROVIDER REQUIREMENTS [Rev. eff. 1/1/16]

County providers include foster care homes, receiving homes, and kinship foster care homes. County providers are reimbursed by the county department of human or social services according to the procedures in this manual.

A. Facilities must be certified in order for the county department to be reimbursed by the state.

B. The pay period for foster care is the calendar month. The foster facilities are reimbursed for the day in which the child is placed in the home, but are not reimbursed for the day the child leaves it, unless the child was placed and removed on the same day.

C. All certified facilities shall sign and use the relevant provider contract when they are certified and recertified.

D. When a child is placed, the information shall be entered on the child placement log by the county department and the provider, and copies of the updated log shall be maintained in the provider file and by the provider in the facility.

E. County departments shall evaluate receiving homes. Homes shall be evaluated after the first six months of operation and annually thereafter.

1. An evaluation shall include, but not be limited to, the following information:

a. Date of evaluation;

b. Name of home;

c. County department identification number;

d. Licensed capacity;

e. Average number of children in residence for the last six (6) months;

f. Personnel, including the number of full time staff;

g. Direct care services.

2. The evaluator shall review an operating statement and financial records to determine if the home is maintaining records and files of revenue and expenditures. The operating statement shall be used to justify payments.

3. Any incorrect payments to the home due to omission, error, fraud, or embezzlement shall be recovered from the home by deduction from subsequent payments.

4. The evaluator shall discuss and review the evaluation with the home staff and obtain the signature of the operators.

5. A home having an unsatisfactory evaluation will require re-evaluation for continuing use.

If it is determined that the use of the home should be continued, the supervising agency will contract for improved performance. If after sixty (60) calendar days the unsatisfactory components have continued, the supervising agency shall terminate use of the home.

6. If the staff of the home does not agree with the evaluation, an attempt shall be made to resolve the dispute within fifteen (15) working days by informal county grievance procedures, as determined by each county.

7.417.2 STATE LICENSED PROVIDER REQUIREMENTS

The State licenses providers including Child Placement Agencies and Residential Child Care Facilities.

State licensed providers are reimbursed by the county department according to procedures in this manual.

A. In addition to the minimum standards required by licensing, Residential Child Care Facilities and Child Placement Agencies must be included on state department established approved vendor lists in order for the county department to receive state reimbursement for purchased residential care and treatment services from such providers. These lists contain the names of providers who have requested approval and have been approved by the state department to enter into purchase agreements for care and treatment of children placed in a Residential Child Care Facility or Child Placement Agency by a county department.

B. Providers may request to be added to the approved vendor lists by following the review process as published by the Child Welfare Division. In the event that a provider adds a new population to be served or a new program to the current menu of service, the provider may request to have the new program added to the provider list by following the review process.

C. If the facility provides its own educational program, that program must be approved by the Colorado Department of Education and documentation of such approval must be provided.

D. The pay period for foster care is the calendar month. See Section 7.417.1, B.

E. Each provider shall allow representatives of the state or federal agencies who have an interest in monitoring and evaluating a program to have access to such records and information as may be necessary to achieve those purposes authorized by state or federal law.

F. The reimbursement rate agreed upon by provider and the county department shall be neither retroactively increased to reflect unforeseen service costs nor retroactively decreased.

G. The reimbursement rate for child maintenance agreed upon between the CPA and the county department shall be paid to the CPA foster parents for the care of the child. 7.417.3 EMERGENCY SHELTER REIMBURSEMENT REQUIREMENTS [Rev. eff. 4/1/12]

Reimbursement restrictions exist for facilities such as foster home, receiving homes and shelter facilities used as emergency shelter.

A. Reimbursement for care is limited to ninety (90) consecutive days.

B. For stays in care beyond sixty (60) calendar days, the county department shall document in the child's record information which:

1. Indicates the county department has a specific plan for the child's living arrangements;

2. Specifies the reasons for the extension from 60 to a maximum of 90 calendar days; and, 3. Verifies that the extension will prevent additional temporary foster care placements until the plan can be implemented. 7.417.4 KINSHIP FOSTER CARE HOME PROVIDER REIMBURSEMENT REQUIREMENTS [Rev. eff. 1/1/16]

A. Kinship foster care providers for Title IV-E eligible children shall receive the same reimbursement as non-relative foster care providers.

B. Kinship foster care providers may elect not to receive a money payment and may follow the grievance process for foster care providers when there is disagreement about such reimbursement rate.

C. A child in the care of his/her parents is not considered to be living in a foster home and, therefore, is ineligible for foster care maintenance payments, including kinship care payments.

D. Title IV-E reimbursable foster care payments may only be made to kin who are defined as an adult who is not a parent, but who is in one of the following groups:

1. Any blood relative, including those of half- blood, and including first cousins, nephews or nieces, and persons of preceding generations as denoted by prefixes of grand, great, or great- great.

2. Stepfather, stepmother, stepbrother, and stepsister.

3. Persons who legally adopt a child or his/her parent, as well as the natural and other legally adopted children of such persons, and other relatives of the adoptive parents in accordance with state law.

4. Spouses of any persons named in the above groups even after the marriage is terminated by death or divorce.

7.417.5 NON-CERTIFIED KINSHIP CAREGIVER REIMBURSEMENT REQUIREMENTS

A. Non-certified kinship caregivers are eligible to receive thirty (30) percent of the reimbursement rate of foster care providers for state fiscal years 2025 and 2026. Beginning in the state fiscal year 2026-2027, non-certified kinship caregivers are eligible to receive fifty (50) percent of the reimbursement rate of foster care providers based on the age of the child or youth receiving care.

B. Non-certified kinship care reimbursement can only be made to non-certified kin as defined in 12 CCR 2509-1 Section 7.000.2, providing non-certified kinship care, as defined in 12 CCR 2509-1

Section 7.000.2.

1. Non-certified kinship caregivers are ineligible for reimbursement if the biological parent lives in the kinship caregiver’s home. For purposes of this rule, “living in the home” means regularly lives, shares common areas, and sleeps in the non-certified kinship home. An individual who is living, sharing common areas, and sleeping in the noncertified kinship home temporarily for more than two consecutive weeks is considered a household member.

2. Biological parents whose rights have been terminated are not eligible for reimbursement regardless of whether reinstatement of rights is being considered.

3. For youth in a foster youth in transition case and residing with a non-certified kinship caregiver, reimbursement would be paid through their supervised independent living placement or through non-certified kinship care reimbursement.

C. Reimbursement shall be paid to non-certified kinship caregivers caring for a child/youth involved in a child welfare case, regardless of who has legal custody of the child/youth.

D. Non-certified kinship care reimbursement will be terminated when the kinship caregiver becomes certified, the child(ren)/youth moves from the home, the child welfare case closes, or the kinship caregiver requests the reimbursement be terminated.

E. To receive non-certified kinship care reimbursement, kinship caregivers must complete and sign the state-approved forms including but not limited to the reimbursement agreement and the financial assistance document and complete fingerprint-based criminal history checks.

1. A payment certification shall be prepared and signed by the kinship caregiver monthly using the Colorado Department of Human Services prescribed form. These forms are due in the county departments of social/human services by the end of the month in which care was given. These forms shall be kept on file and available for audit. 7.417.6 MONTHLY PROVIDER BILLING [Eff. 5/1/12]

A certification shall be prepared and signed by the provider monthly and used by the county business office to verify the days the children are in the facility. This shall be done using the Colorado Department of Human Services prescribed form. These forms are due in the county departments of social/human services by the end of the month in which care was given. These forms shall be kept on file and available for audit.

7.418 PROVIDER REIMBURSEMENT RATE COMPONENTS

For purposes of maximizing Colorado's federal funding, reimbursement rates are made up of three primary components:

A. Child maintenance, which can include a difficulty of care amount;

B. Administrative maintenance, which can include a direct child care allowance;

C. Services and administrative services.

Provider type will determine which of these three components will be included in the reimbursement rate. 7.418.1 CHILD MAINTENANCE [Rev. eff. 2/1/10]

A. The Department shall utilize the most current and available United States Department of Agriculture (USDA) Expenditures on Children by Families Report to determine child maintenance.

This report is available at no cost from the U.S. Department of Agriculture, Center for Nutrition Policy and Promotion 1400 Independence Avenue, S.W., Washington D.C. 20250 or at https://www.fns.usda.gov/. The report is also available for public inspection and copying at the Colorado Department of Human Services, Office of Children, Youth, and Families, 1575 Sherman St, Denver, CO 80203, during regular business hours. The child maintenance rate used for a child, age birth through 20, in out of home placement shall be determined based on the report’s defined annual household expenditures on a child by single-parent families, overall U.S. (beforetax) income per year at the lowest income tier listed, and then averaged over the life of the child, birth through age 17. The rate does not include education, medical, and child care costs as these costs may be paid for with other sources and were not included in the rate methodology.

B. The categories of annual household expenditures considered and their descriptions are as follows:

1. Housing expenses: consist of shelter (mortgage payments, property taxes, or rent; maintenance and repairs; and insurance), utilities (gas, electricity, fuel, cell/telephone, and water), and house furnishings and equipment (furniture, floor coverings, major appliances, and small appliances). Mortgage payments include principal and interest payments;

2. Food expenses: consist of food and non-alcoholic beverages purchased at grocery, convenience and specialty stores, including purchases with supplemental nutrition assistance program benefits; dining at restaurants; and household expenditures on school meals;

3. Transportation expenses: consist of the monthly payments on vehicle loans, down payments, gasoline and motor oil, maintenance and repairs, insurance, and public transportation (including airline fares);

4. Clothing expenses: consist of children’s apparel such diapers, shirts, pants, dresses, and suits; footwear; and clothing services such as dry cleaning, alterations, and repair;

5. Miscellaneous expenses: consist of personal care items (haircuts, toothbrushes, etc.), entertainment (portable media players, sports equipment, televisions, computers, etc.), and reading materials (non-school books, magazines, etc.).

C. Child maintenance may include a difficulty of care assessment amount. A difficulty of care assessment must be completed by the county department in conjunction with the provider.

D. A child maintenance payment is required to be paid to the direct care provider where the child is in residence.

E. Subject to available funding, the Department will make increases or decreases to the child maintenance rate in accordance with the United States Department of Agriculture (USDA)

Expenditures on Children by Families Report. This report is available at no cost from the U.S.

Department of Agriculture, Center for Nutrition Policy and Promotion 1400 Independence Avenue, S.W., Washington D.C. 20250 or at https://www.fns.usda.gov/. The report is also available for public inspection and copying at the Colorado Department of Human Services, Office of Children, Youth, and Families, 1575 Sherman St, Denver, CO 80203, during regular business hours.

7.418.2 ADMINISTRATIVE MAINTENANCE

Administrative maintenance are components which are necessary for overall care of the child. Following is a description of the types of activities which may be included in this component along with the facility types which are eligible to have this component built into the rate.

A. “Support staff” responsible for building maintenance, janitorial, housekeeping, laundry, food preparation functions, and transportation.

B. “Direct child care staff” are responsible for implementing the treatment plan in the daily living situation, creating a therapeutic milieu and helping CHILDREN/YOUTH learn satisfactory ways of coping with the daily living process.

C. “Administration” are the staff responsible for the overall direction of the organization. This includes accounting, general record keeping, business management, budgeting, community relations, and clerical functions. This does not include hours spent in fund raising or clinical records management.

D. “Administrative overhead” is a fixed allowance for costs associated with the overall direction of the facility including, but not limited to: accounting, general record keeping, business management, budgeting, community relations, clerical functions, leased office equipment, and supplies necessary to conduct the administrative function.

E. “Support overhead” is an allowance for space, supplies, and other items related to building maintenance, janitorial, housekeeping, laundry, and food preparation services.

F. “Provider types” eligible for administrative maintenance reimbursement are:

1. “Receiving Homes” are only eligible for the direct child care component. The direct child care allowance may have the following elements:

• surrogate parents for supervising the children administrative participation in staff development • assuring the county department of emergency care for children on a 24-hour

basis • the direct care staff shall be no less than one paid full- time equivalent staff 2. “Specialized Group Facility” - all components of administrative maintenance may apply.

3. “Child Placement Agency” (CPA) - all components of administrative maintenance may apply.

4. “Residential Child Care Facility” (RCCF) - all components of administrative maintenance may apply.

7.418.3 SERVICES AND ADMINISTRATIVE SERVICES

Services and administrative services are components that may be included in the rate to cover the cost of providing services and/or treatment for the child as identified in the Family Services Plan. The following activities are to be considered when developing a rate for a child in a facility:

A. Foster parent payment which is in addition to the child maintenance payment and is not for difficulty of care of the child.

B. Educational liaison staff are responsible for coordinating the educational needs of a child between the facility and public/private school and in obtaining public or private educational services for a child.

C. Recreation staff are responsible for planning, organizing, and leading recreational activities.

D. Direct therapy staff are responsible for those activities which occur between a professional (Bachelors Degree or above in the mental health profession) staff member, and the child and/or child's family which are based upon a specific treatment plan and are aimed at making changes in the child/family maladaptive behavior, intra- psychic conflict, or development impediments.

Direct therapy includes the ongoing evaluative function which is part of a therapist's role. Speech therapy is included in this category.

E. Other treatment staff (individuals with at least a Bachelor of Arts in a mental health discipline qualify as treatment personnel) are responsible for the treatment of the child or family, including:

1. “Evaluation services” are formal activities which are directed toward an understanding or diagnosing of the reasons for a child or family's maladaptive functioning. The evaluation may extend beyond the child and family to other important persons in the child's life, community institutions, and the evaluation of records or other written information that pertains to the child. Evaluations result in a written report or other documentation related to this function. Evaluation includes intake evaluation which results in a decision to accept or not accept a child into the facility's program.

2. “Treatment supervision” is the function of supervising treatment activities of staff members. This function may include conducting staff training.

3. “Treatment liaison” are those child-related activities that are directed toward the state and county departments of social services, court, medical providers, and other community agencies that serve to further the care and treatment which the child receives from the providers. Such activities may involve information sharing, coordination of programs, and interagency problem-solving resulting from the child's behavior.

4. “Medical services” are those activities that are directed toward prevention or elimination of physical illness or dysfunction, such as physical therapy or other services not reimbursable under Medicaid.

5. “Recreational allowance” is an amount for the recreational activities of the children in a facility.

6. “Transportation” is for mileage, vehicle rental, vehicle depreciation, maintenance, insurance, parking charges, licenses, registration fees, tires, gas, oil, public transportation, and other expenses pertaining to travel, including client travel.

F. Services and administrative services components shall only be included in the rates of child Placement Agencies and Residential Child Care Facilities. 7.418.31 Operating an Out-of-Home Placement Provider Consortium [Rev. eff. 4/1/12]

An out of home provider consortium is defined at Section 26-6-102, C.R.S., as a “group of service providers that are formally organized and managed to achieve the goals of the county, group of counties, or mental health agency contracting for additional services other than treatment-related or child maintenance services”.

A. Each consortium shall be registered with the State Department providing information as follows:

1. Name of consortium 2. At a minimum: name, address, telephone, and e- mail of the members of the consortium/board of directors.

3. Legal status of the consortium as established by the Secretary of State.

4. The purpose of the consortium and the population to be served.

5. Contact person: Director of consortium, name and address.

6. Liability insurance carrier for the consortium.

B. Each consortium shall file an annual report with the State Department, depicting the activities of the consortium that includes:

1. Information regarding contracts held.

2. Outcome data/studies.

3. Data on children involved.

4. Complaint and resolution process.

5. Description of the justification for different rates charged to different counties.

C. Each consortium:

1. Shall cooperate with the State Department, counties and other entities in seeking the maximum federal fiscal reimbursement for children participating in consortium services.

2. May enter into contracts with county departments for additional services and outcomes, in addition to treatment and maintenance, to be provided to children in care.

3. Shall include planned outcomes achieved on behalf of a child along with the consequence for not achieving the outcome in contracts.

4. Shall develop and implement corrective action plan with either the State Department or county departments when performance fails to meet contracted expectations.

7.419 RESIDENTIAL CHILD CARE FACILITY (RCCF)PROVIDING MENTAL HEALTH SERVICES

RATE SETTING [Rev. eff. 1/1/12]

A. New Residential Child Care Facility (RCCF) Provider Rate Setting A new Residential Child Care Facility shall receive a per diem rate (child maintenance, administrative maintenance, and services) equal to the most recent weighted average rate. This per diem rate shall remain in effect until new rates are established for all providers.

1. A new Residential Child Care Facility means a facility not previously licensed as a RCCF or a facility that has been licensed as a RCCF.

2. RCCF's that have been previously licensed as a RCCF and have undergone a transfer of ownership are not considered new facilities.

3. New facilities shall be treated as established facilities for rate determination purposes at the next round of rate setting.

B. A provider wishing to appeal that the provider rate was not established in accordance with these rules may appeal to the Department of Personnel and Administration, Office of Administrative Courts (OAC), within thirty (30) calendar days from issuance of the notice letter according to the State Administrative Procedure Act. At such a hearing, the Administrative Law Judge’s decision will be limited to determine whether RCCF provider rates were established in accordance with these rules.

7.420 RATES FOR CHILDREN OR YOUTH WITH DEVELOPMENTAL OR PHYSICAL DISABILITIES [Rev. eff. 1/1/16]

The rate for professional services for children/youth with developmental or physical disabilities, and not enrolled in the Children’s Habilitation Residential Program (CHRP) waiver, may be established at a higher level than foster care rates for foster care homes, kinship foster care homes, receiving homes, and specialized group facilities due to the additional care needed. The county department of human or social services shall consider the additional needs of the child/youth to determine the appropriate rate in accordance with the following criteria:

A. The need for a foster care rate for professional services shall be determined by a physician that the child requires more than the normal amount of care, treatment, and training due to developmental disabilities.

B. In addition, foster care parents may need relief in some cases to provide the necessary 24-hour care. At the time a child with developmental disabilities or physical handicap in need of an additional allowance is placed, the county department and the provider shall enter into a contract (SS-22). The effective date of the contract is the date the child is placed.

7.421 INDEPENDENT AUDIT

All providers are required to have a yearly independent audit performed by a certified public accountant who has no connection with the organization either in fact or in appearance. The audit will be based on the previous fiscal year's financial activity. For both profit and non- profit facilities, the audited statements shall be prepared in accordance with current generally accepted accounting principles (GAAP) and generally accepted auditing standards (GAAS) as promulgated by the American Institute of Certified Public Accountants and other appropriate authoritative bodies. The independent audit report shall include supplemental information schedules as required by the Department. These supplemental information schedules shall be in a format specified by the Department and contain the financial information required by the Department. This independent audit will be used to verify the total revenues and expenditures reported on the Residential Child Care Facility and Child Placement Agency cost report. If discrepancies exist between the totals in the Residential Child Care Facility and Child Placement Agency cost report and the independent audit, the discrepancies shall be reconciled such that an auditor can express an unqualified opinion.

7.422 FAMILY STABILITY SERVICES

7.422.1 REIMBURSEMENT FOR FAMILY STABILITY SERVICES

A. Counties shall be reimbursed when Family Stability Services is operated within applicable State rules and within the provision of the county or multi-county State-approved services plan.

B. Counties shall be reimbursed for expenditures in approved Family Stability Services plans which include the following:

1. Contracted or agreed upon services authorized by an approved Family Stability Services plan and contained in a written contract between the individual contractor and the county department; such contractors must perform as an independent business entity;

2. Program services purchased from an agency as outlined in an approved Family Stability Services plan when a written contract exists between the provider agency and the county department;

3. Program services that might have been reimbursed from another source, but those funds have been exhausted;

4. Reimbursement for respite care is limited to less than 24 hours of continuous care;

5. Salaries, fringe and operating costs directly related to Family Stability Services;

6. Travel and per diem expenses directly related to program delivery or administration.

C. Any expenditure other than those defined in this section as reimbursable shall be nonreimbursable unless specifically identified in an approved Family Stability Services plan.

D. The county department shall meet all State fiscal reporting requirements before being reimbursed for expenditures in its plan. The State may withhold or reduce reimbursement to counties for expenditures not in compliance with the Family Stability Services plan.

E. The county department assessing fees for Family Stability Services may set these fees and the method of computation in their Family Stability Services plan.

F. The county department shall only be reimbursed for the current month (month being paid) and two preceding months.

7.422.2 REPORTING

A. The county department shall make timely and accurate reports in all applicable automated systems operated by the State.

B. The county department(s) shall comply in format, content, and time lines with the instruction for Family Stability Services program and financial report as published by the State Department in an agency letter.

C. The county department shall provide information when requested by the State for special studies and reports.

7.423 TITLE IV-E INCENTIVE FUNDING FOR THE COMPLETION OF TIMELY INTERSTATE HOME

STUDIES

The State Department shall reimburse a county department of social/human services for the Title IV-E incentive funding received from the federal government for the county's completion of timely interstate home studies. The reimbursement to the county will be distributed annually. The county shall only receive the amount of incentive funding earned that was reimbursed to the state in federal Title IV-E funding.

The interstate home study is considered timely when the home study is completed and returned to the sending state within thirty (30) calendar days of a request from the other state.

7.424 INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FACILITIES (IDD FACILTIES) AND

ACUTE RESIDENTIAL FACILITIES

7.424.1 INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FACILITIES

The State Department shall contract with licensed Colorado residential facilities to provide short-term stabilization, treatment, and services to children/youth identified with intellectual and developmental disabilities, and who are experiencing acute and severe behaviors.

7.424.11 REFERRAL AND ELIGIBILITY

A. The county department of human/social services shall make the referral to the State Department using the state approved application.

B. The State Department shall determine whether referrals meet eligibility requirements for services in the IDD facility.

C. A primary indicator for placement in the IDD facility is an intellectual and/or developmental disability or an autism spectrum disorder. “Intellectual and developmental disability” means a disability that manifests before the person reaches twenty-two years of age, that constitutes a substantial disability to the affected person, and that is attributable to developmental disability or related conditions, which include cerebral palsy, epilepsy, autism, or other neurological conditions when those conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with developmental disability.

D. Other indicators for placement may include but are not limited to:

1. The child/youth is currently experiencing acute and severe behaviors, which may include but are not limited to: high levels of aggression and/or self-harming behaviors, emotional distress, impulsive behaviors, and/or other emotional, behavioral, or psychological issues; and, 2. Previous placements have been unsuccessful or alternative placements, specifically within the state of Colorado, are not available for the child/youth.

E. Child/youth who meet criteria for a mental health hold or detainment by law enforcement are not appropriate for admission.

7.424.12 APPEALS PROCESS FOR DENIED ELIGIBILITY

A. A county department of human/social services may submit a request for an appeal of denied initial or continued eligibility to the Division of Child Welfare 24 Hour Appeal Panel within fifteen (15) business days of the denial.

B. Decisions on appeals shall be communicated to the county department of human/social services no later than seven (7) business days of receipt of the request.

C. If the county department of human/social services is aggrieved by the decision of the Child Welfare 24 Hour Appeal Panel, the county department of human/social services may request an administrative hearing pursuant to 7.701.13.d.4.a.

D. Decisions by the administrative law judge are considered final and are not subject to further judicial review.

E. While the continuing eligibility of a child/youth is under appeal, the child/youth may remain in placement at the IDD facility. If the appeal is denied, the county department of human/social services may be responsible for the costs incurred for continuing the placement of the child/youth after thirty (30) days beyond the discharge date.

7.424.13 ADMISSION TO THE IDD FACILITY

A. The State Department, in collaboration with the IDD facility, shall determine if and/or when a referred child/youth shall be admitted to the IDD facility.

B. Upon acceptance of the child/youth into the IDD facility, the State Department shall issue an approval letter to include the date of admission, which shall be determined in collaboration with the county department of human/social services and the IDD facility and shall be approved by the State Department.

C. In the event that there is a waitlist for admission to the IDD facility, the county department of human/social services shall place the eligible and approved child/youth on the agreed upon admission date or forfeit admission, which may result in the child/youth returning to the IDD facility waitlist.

D. Children/youth in the care or custody of county human/social services departments shall be prioritized for admission into the IDD facility.

E. Children/youth who have previously been discharged from the facility shall be prioritized for readmission, according to the needs of the child/youth.

7.424.14 EMERGENCY ADMISSION

The State Department may hold open up to three (3) beds at the IDD facility to be used for emergency placements. Criteria for emergency admission may include but are not limited to:

A. The child/youth is on the waitlist and experiences an unexpected crisis; or, B. The child/youth is determined, by the county department of human/social services, to be unsafe in their current setting; or, C. The child/youth is to be discharged from a more restricted setting, including but not limited to a hospital or detention setting; or, D. The child/youth experiences an imminent placement disruption unrelated to the child’s/youth’s status or situation; or, E. The child/youth is unexpectedly discharged from current placement.

7.424.15 DISCHARGE

A. The duration of treatment at the IDD facility shall be determined at the time of admission by the State Department in collaboration with the IDD facility, county department of human/social services, child/youth, family of child/youth, and the child’s/youth’s permanency team.

B. Criteria for determining duration of treatment at the IDD facility may include but are not limited to the assessment of the child’s/youth’s needs, goals of the child/youth, goals of the family (when applicable), expected time to achieve stabilization, criteria for transition, transition needs, and plan for permanency.

C. Within fourteen (14) calendar days of admission, the State Department shall issue an approval letter to include the duration of the child’s/youth’s treatment and the expected date by which the child/youth will be discharged from the IDD facility.

D. The duration of treatment shall be reviewed by the State Department, the IDD facility, and the county department of human/social services, in collaboration with the child/youth, family of the child/youth (when applicable), and the child’s/youth’s permanency team, no more than every thirty (30) days after the date of admission and may be subject to change based upon the progress and needs of the child/youth.

E. In the event the State Department determines a change to the duration of treatment, a revised approval letter will be issued.

F. Criteria for discharge 1. The child/youth has met the goals and objectives in the individual child’s/youth’s plan, as determined by the IDD facility, in consultation with the State Department and the county department of human/social services; or, 2. The child's behavior has become such that significant safety issues for themselves and/or others at the facility and the treatment team at the facility can no longer effectively provide treatment for the child and the child can no longer be safely maintained in the facility without a higher level of intervention. The facility will consult with the State Department and the placing authority to develop an ongoing plan for the child; or, 3. A viable placement option in a lower level of care is identified and available; or, 4. The child’s/youth’s family is ready and able to care for the child/youth; and, 5. A transition plan is in place to include identified services to support the placement option or family in caring for the child/youth.

G. The county department of human/social services retains the right to remove the child/youth from the program any time prior to the discharge date specified in the most recent approval letter.

7.424.16 COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES RESPONSIBILITIES

A. The county department of human/social services shall participate in initial and ongoing monthly staffings, treatment planning, and discharge planning for each child/youth placed at the IDD facility by the county department of human/social services.

B. Permanency planning shall occur in accordance with 7.301.2.

7.424.17 REIMBURSEMENT

When the child/youth is placed by a county department of human/ social services the State Department shall reimburse one hundred percent (100%) of the placement costs, up to thirty (30) days beyond the discharge date as defined in the most recent approval letter.

7.424.18 QUALITY ASSURANCE

The licensee that holds the IDD facility contract is subject to the rules and regulations found at 7.701, 7.705, 7.706, 7.714, and 7.719.

7.424.2 ACUTE RESIDENTIAL FACILITIES

The State Department shall contract with licensed providers for the delivery of services to children and youth whose behavioral or mental health needs require services and treatment in a residential facility.

7.424.21 REFERRAL AND ELIGIBILITY

A. The county department of human/social services shall make the referral to the State Department using the state approved application.

B. The State Department shall determine whether referrals meet eligibility requirements for services in the acute residential facilities.

C. The primary indicators for placement in an acute residential program are:

1. A serious emotional disturbance, includes, with respect to a child, any child who has a serious emotional disorder, a serious behavioral disorder, or a serious mental disorder.

2. An intellectual and/or developmental disability or an autism spectrum disorder.

“Intellectual and developmental disability” means a disability that manifests before the person reaches twenty-two years of age, that constitutes a substantial disability to the affected person, and that is attributable to an intellectual and developmental disability or related conditions, including Prader-Willi syndrome, cerebral palsy, epilepsy, autism, or other neurological conditions when the condition or conditions result in impairment of general intellectual functioning or adaptive behavior similar to that of a person with an intellectual and developmental disability.

D. Other indicators for placement may include but are not limited to:

1. The child/youth is currently experiencing acute and severe behaviors, which may include but are not limited to: high levels of aggression and/or self-harming behaviors, emotional distress, impulsive behaviors, and/or other emotional, behavioral, or psychological issues; and, 2. The child/youth is exhibiting intensive behaviors that have not been manageable in lowerlevels of care or existing facilities in Colorado or has met discharge criteria from hospitalization and alternative placements, specifically within the state of Colorado, are not available for the child/youth.

E. Children/youth who meet criteria for detainment by law enforcement are not appropriate for admission.

F. To be eligible for admission to a qualified residential treatment program (QRTP) the child must be determined to be appropriate for placement in a qrtp through the independent assesssment process by a qualified individual in accordance with 19-1-115(4)(e)(i), c.r.s.

G. To be eligible for admission to a psychiatric residential treatment facility (PRTF) the child must be certified to need PRTF level of care by an independent team in accordance with 10 ccr 2505-10 § 8.765.4.a.

7.424.22 APPEALS PROCESS FOR DENIED ELIGIBILITY

A. A county department of human/social services may submit a request for an appeal of denied initial or continued eligibility to the Division Of Child Welfare 24 Hour Appeal Panel within fifteen (15) business days of the denial.

B. Decisions on appeals shall be communicated to the county department of human/social services no later than seven (7) business days of receipt of the request.

C. If the county department of human/social services is aggrieved by the decision of the Child Welfare 24 Hour Appeal Panel, the county department of human/social services may request an administrative hearing pursuant to 7.701.13.d.4.a.

D. While the continuing eligibility of a child/youth is under appeal, the child/youth may remain in placement at the acute residential facility. If the appeal is denied, the county department of human/social services may be responsible for the costs incurred for continuing the placement of the child/youth after thirty (30) days beyond the discharge date.

7.424.23 ADMISSION TO AN ACUTE RESIDENTIAL FACILITY

A. The State Department, in consultation with the acute residential facilities, shall determine if and/or when a referred child/youth who has been deemed eligible for the program(s) shall be admitted to an acute residential facility. Admission of a child shall be in keeping with the stated purpose of the child care facility and shall be limited to those children for whom the facility is qualified by staff, program, equipment, and needs of children already in residence to provide care deemed necessary. Care must be provided in the least restrictive, most appropriate setting in order to meet the child's needs.

B. Upon acceptance of the child/youth into the acute residential facility, the State Department shall issue an approval letter to include the date of admission, which shall be determined in collaboration with the county department of human/social services and the acute residential facility, and shall be approved by the State Department.

C. In the event that there is a waitlist for admission to the acute residential facility, the county department of human/social services shall place the eligible and approved child/youth on the agreed upon admission date or forfeit admission, which may result in the child/youth returning to the acute residential facility waitlist.

7.424.24 DISCHARGE

A. The eligible period of placement at the acute residential facility shall be determined at the time of admission by the State Department in collaboration with the acute residential facility, county department of human/social services, child/youth, family of child/youth, and the child’s/youth’s permanency team.

B. Criteria for determining the eligibility period of placement at the acute residential facility may include but are not limited to the assessment of the child’s/youth’s needs, goals of the child/youth, goals of the family (when applicable), expected time to achieve stabilization, criteria for transition, transition needs, and plan for permanency.

C. Within fourteen (14) calendar days of admission, the State Department shall issue an approval letter to include the duration of the child’s/youth’s treatment and the expected date by which the child/youth will be discharged from the acute residential facility.

D. The duration of treatment shall be reviewed by the State Department, the acute residential facility, and the county department of human/social services, in collaboration with the child/youth, family of the child/youth (when applicable), and the child’s/youth’s permanency team, no more than every thirty (30) days after the date of admission and may be subject to change based upon the progress and needs of the child/youth.

E. In the event the State Department determines a change to the duration of treatment, a revised approval letter will be issued.

F. Criteria for discharge 1. The child/youth has met the goals and objectives in the individual child’s/youth’s plan, as determined by the acute residential facility, in consultation with the State Department and the county department of human/social services; or, 2. The child's behavior has become such that it presents significant safety issues for themselves and/or others at the facility, the treatment team at the facility can no longer effectively provide treatment for the child, and the child can no longer be safely maintained in the facility without a higher level of intervention. The facility will consult with the State Department and the placing authority to develop an ongoing plan for the child; or, 3. A viable placement option in a lower level of care is identified and available; or, 4. The child’s/youth’s family is ready and able to care for the child/youth; and, 5. A transition plan is in place to include identified services to support the placement option or family in caring for the child/youth.

G. The facility, county department of human/social services, child’s permanency team, placement option, and acute residential program administrator shall participate in discharge planning to ensure continuity of care and appropriate transition planning.

H. The county department of human/social services retains the right to remove the child/youth from the program any time prior to the discharge date specified in the most recent approval letter.

7.424.25 COUNTY DEPARTMENT OF HUMAN/SOCIAL SERVICES RESPONSIBILITIES

A. The county department of human/social services shall participate in initial and ongoing monthly staffings, treatment planning, and discharge planning for each child/youth placed at the acute residential facility by the county department of human/social services.

B. Permanency planning shall occur in accordance with 7.301.2.

7.424.26 REIMBURSEMENT

When the child/youth is placed at the acute residential facility, the State Department shall reimburse the provider one hundred percent (100%) of the placement costs, up to thirty (30) days beyond the discharge date as defined in the most recent approval letter. The Department will not reimburse for costs incurred when a county department of human services continues the placement of a child or youth at the acute residential facility after the end of the approved placement period. County departments of human services must contract directly with the facility by completing an ss-23a.

7.424.27 QUALITY ASSURANCE

A licensee that holds an acute residential facility contract is subject to the rules and regulations found at 7.701, 7.705, 7.706, 7.714, and 7.719.

7.425 CHILD WELFARE PREVENTION AND INTERVENTION SERVICES CASH FUND

7.425.1 ALLOCATIONS FROM THE CASH FUND

A. The General Assembly has created a “Child Welfare Prevention and Intervention Cash Fund,” referred to as the “Fund.” Within the Fund, there are two accounts: the “Small-and Medium-Sized” cash fund account and “The All-Counties” cash fund account. Section 26-5-104(7), C.R.S.

B. Small-and medium-sized county departments of human or social services may apply to the state department for funds from the “Small-And Medium-Sized” cash fund account.

C. All county departments of human or social services may apply to the state department for funds from the “All-Counties” cash fund account, regardless of size.

D. The application process for both the “Small-And Medium-Sized” cash fund account and the “All- Counties” cash fund account will be developed in collaboration with county departments of human or social services.

E. If the General Assembly makes a direct appropriation from the state’s general fund to the Fund, that money shall be credited to the All-Counties cash fund account. The state department, in consultation with the counties, shall determine the allocation of any general fund monies credited to the All-Counties cash fund account. State general fund monies credited to the All-Counties cash fund account can be allocated to all counties, regardless of size. Section 26-5-104(7)(a)(III), C.R.S.

F. Monies allocated from each of the accounts in the Fund must be used to increase the capacity of local child welfare prevention and intervention services and must be used by county departments of human or social services for the delivery of child welfare prevention and intervention services that have been approved by the state department.

G. From July 1, 2019 through June 30, 2020 the department shall first prioritize those prevention and intervention services specified in the state’s Title IV-E Waiver Demonstration Project as outlined in Section 26-5-105.4, C.R.S. ________________________________________________________________________ Editor’s Notes

History

Rule 7.419 emer. rule eff. 07/01/2007.

Rule 7.406.2 eff. 07/30/2007.

Rule 7.419 eff. 09/30/2007.

Rules 7.402.1, 7.402.2 emer. rules eff. 12/07/2007.

Rules 7.405.1, 7.406.1, 7.417, 7.423 emer. rules eff. 01/01/2008.

Rules 7.402.1, 7.402.2 eff. 01/30/2008.

Rules 7.405.1, 7.406.1, 7.417, 7.423 eff. 03/01/2008.

Rules 7.402.1, 7.402.2 emer. rules eff. 07/11/2008.

Rules 7.402.1, 7.402.2 eff. 10/01/2008.

Rule 7.406.1 eff. 01/01/2009.

Rules 7.402.1-702.4, 7.404 eff. 02/01/2009.

Rules 7.404, 7.406.1 eff. 04/01/2009.

Rules 7.406.1(MM-QQ), 7.418.1(A) eff. 02/01/2010.

Rule 7.407 eff. 07/01/2010.

Rules 7.406.2(A)-(K), 7.417.6, 7.419 eff. 01/01/2012.

Rules 7.402.3, 7.405.1, 7.406.1, 7.408, 7.410, 7.415, 7.417.1, 7.417.3 - 7.417.4, 7.418.31, 7.420 eff. 04/01/2012.

Rules 7.403, 7.417.6 eff. 05/01/2012.

Rules 7.402.1, 7.402.4 emer. rules eff. 09/07/2012.

Rules 7.402.1, 7.402.4 eff. 12/01/2012.

Rules 7.401.21, 7.406.1(S)-(W), 7.415 eff. 01/01/2014.

Rules 7.406.1, 7.406.2, 7.407, 7.408, 7.417.1, 7.417.4, 7.420 eff. 01/01/2016.

Rule 7.402.1 eff. 10/01/2017.

Rule 7.402.1 A.2 eff. 12/01/2017.

Rule 7.407 A.3 eff. 12/01/2018.

Rules 7.402.2 G-H, 7.402.3 A.1, 7.405.1, 7.406.1 II, OO-PP, 7.406.2 L, W, 7.407 A, 7.418.1, 7.418.2 B, 7.424-7.425.1 E eff. 10/01/2019.

Rule 7.425.1 eff. 01/01/2020.

Rules 7.402.1 A.1-2, 7.402.1 F, 7.406.1 Q, 7.414 B.2, 7.416, 7.416.2 eff. 12/01/2020.

Rules 7.406.1 OO, 7.424 emer. rules eff. 11/01/2021.

Rules 7.402.1 D, 7.402.1 G, 7.404 C.4, 7.404.3 E, 7.406.1 E, 7.406.1 G, 7.406.1 HH, 7.406.1 OO, 7.410 A, 7.416.2, 7.424 eff. 12/30/2021.

Rule 7.404.4 eff. 06/01/2023.

Rules 7.406.1, 7.416.1 eff. 07/31/2023.

Rule 7.417.5 eff. 07/01/2025.

##### **12 CCR 2509-6** Resource Development {#sec-12-ccr-2509-6 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-6}

DEPARTMENT OF HUMAN SERVICES

RESOURCE DEVELOPMENT

12 CCR 2509-6 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 7.500.1 MISSION STATEMENT To develop and coordinate the external resources necessary to fulfill the objectives of the county human/social services programs. 7.500.11 Target Groups Target groups served by this program area are the individuals who will be serving the department's clients in such roles as foster or kinship foster parents for children/youth or adults or child care providers or adoptive parents.

7.500.2 ASSESSMENT OF FOSTER CARE HOMES AND ADOPTIVE HOMES

A. The family assessment must be completed using the Structured Analysis Family Evaluation (SAFE™) home study. The SAFE™ assessment must be completed by using all tools and processes required by the SAFE™ protocol. Persons completing the home studies must be qualified and must complete the required two (2) day SAFE™ training prior to completing the assessment. The SAFE™ assessment must be completed prior to certification of a foster parent or adoptive parent.

A SAFE™ refresher training is required every three (3) years from the date of the initial SAFE™ training received or previous refresher training. This includes home study practitioners and their supervisors.

1. The SAFE™ practitioner must conduct a minimum of one (1) joint interview with a couple or all applicants, one (1) individual interview with each adult member of the household, and an age/developmentally appropriate interview with each child/youth residing in the home. A minimum of two (2) interviews is required with a single applicant.

2. Interview Requirements The original SAFE™ assessment must include the date, person interviewed, length of interview (hours and minutes), location of each interview, and must be documented in the SAFE™ assessment. If the certifying agency proposes having interviews conducted outside of the residence, an applicant must be consulted and be in agreement. the conversation must be documented in the SAFE™ assessment.

a. A minimum of two interviews must be completed in the applicant’s home on separate days.

b. The second interview, and any subsequent interviews of the adults must not be completed until at least three (3) calendar days after the previous interview.

3. The SAFE™ practitioner must document the applicant’s relationship with the county department of human/social services, including a discussion about the applicant’s ability and willingness to work with the child welfare system, court, guardian ad litem (GAL), legal parent/legal custodian, and others in the child’s/youth’s life.

4. The signature page of the SAFE™ assessment must be signed and dated by the person completing the assessment and supervisor/designee. The applicant must sign the SAFE™ assessment/update section indicating the individual read and reviewed the final draft of the assessment. All signatures must be dated prior to or on the date of the issuance of the foster care home certificate.

5. The county department must complete a search of the Comprehensive Child Welfare Information System (CCWIS), Colorado Bureau of Investigation (CBI), Federal Bureau of Investigation (FBI), and the Colorado court case management system at the State Judicial Department.

a. Prior to full certification of a foster care home, there shall be a review and documentation in the applicant’s provider record:

1) A background check for each adult living in the home for the following:

a) Child abuse/neglect records check in every state where the adult has resided in the five (5) years immediately preceding the date of application for each adult (eighteen (18) years and older) living in the home.

b) A fingerprint-based criminal history record information check of CBI and FBI records:

i. A new FBI fingerprint-based criminal history information record must be completed every five (5) years from the original fingerprint date as required in Section 7.701.33.D.5.

c) A comparison search on the court case management system at the State Judicial Department, using the name and date of birth with available criminal history information for each adult eighteen (18) years and older living in the home. This search must be completed regardless of whether the CBI and FBI fingerprint

history confirms or does not confirm a criminal history. These checks are valid for one year prior to certification.

d) The CBI sex offender registry and national sex offender public website (NSOPW) operated by the United States Department of Justice by:

i. Known names, nicknames, also known as (AKA), and addresses of each adult residing in the foster care home.

Checks must be completed prior to each recertification.

ii. Address only of the foster care home, including a copy of the map from the respective database to confirm that the address of the foster care home has been checked.

iii. Sex offender checks must be completed prior to each recertification.

2) Complete SAFE™ reference letters with signatures;

3) Health information including a health assessment completed by a physician, doctor of osteopathic medicine, physician assistant, or a nurse practitioner for each individual living in the home;

4) The review of existing agency case records, including the CCWIS, for prior foster care home certifications or denials; and, 5) Assessments of any concerns raised from the application and/or other sources of information.

6) The results of the face-to-face interviews with all members of the household.

b. The Colorado Department of Human Services Original Application to care for Children and Youth expires one year from the date of applicant(s) signature(s) if the foster care home is not certified.

c. FBI fingerprint-based criminal history record information checks shall be initiated for all prospective foster and adoptive parents and each adult eighteen (18) years and older living in the foster care home. The FBI reports shall be made available to the county department of human/social services submitting the request for information.

1) Following review of FBI information, the findings may only be identified in the home study as eligible, not eligible, meets criteria, does not meet criteria, or inconclusive.

d. All CBI and FBI fingerprint-based criminal history record information reports, including court dispositions, if applicable, and results from the five-year child abuse and/or neglect checks shall remain confidential in the county department records.

e. A county department shall not place a child and/or youth in the foster care home if the foster parent or any adult eighteen (18) years of age or older who resides in the home:

1) Is a registered sex offender, or, 2) Has a finding of child abuse and/or neglect in the CCWIS or another state’s child abuse and neglect registry, unless it is determined following a review of the finding that the placement is safe.

6. Kinship Foster Care a. Assessment includes the applicant’s ability to provide a permanent home through adoption, guardianship, or permanent custody. also included are the ability to meet the individualized needs of the specified child(ren)/youth, the relationship with birth parents/legal custodians and extended family members as it impacts the applicant’s ability to care for the child(ren)/youth, and their ability to set boundaries with the birth parents/legal custodian to maintain safety for the child(ren)/youth.

b. Applicants are not prevented from fostering if they are not able to provide a permanent home. when completing the assessment. Section 7.708, Rules Regulating Foster Care Homes shall apply to all applicants.

7. When there is a significant change in the composition of the household, an update must be completed on the update template or written in a word document. The update must be completed within 45 calendar days from the date the county department becomes aware of the change. Expectations for time frames for completing background checks is located in 7.500.2 A.11.b.5.

When the change occurs 45 calendar days or less from the expiration date of the certificate, the change may be addressed in the SAFE™ update. The addendum needs to be signed by all parties. these changes may include but are not limited to:

a. New individuals that are eighteen (18) years of age or older, living in the foster care home (including results of the background checks);

b. When a household member moves out of the foster care home;

c. The age, gender, gender identity, and/or special characteristics of the child(ren)/youth that will be considered for the foster care home has changed. A re-evaluation of the foster care home will be completed and the assessment revised;

d. New location of the foster care home;

e. Marital/domestic relationship; or, f. Health issues, incapacitation, or death of a foster parent or household member.

8. SAFE™ Requirements When Certification Status Changes.

a. A full SAFE™ assessment is required when a foster care home was closed longer than 365 days.

b. When the foster care home was closed less than 365 days, a comprehensive update is required to identify new relevant information. All relevant domains and/or any gaps in content from the original home study and subsequent updates, as well as the completion of new update questionnaires, must be included.

1) When all historic SAFE™ documents, are not available, a full SAFE™ assessment must be completed.

9. Other Requirements a. Assessment of the ability of the applicant(s) to foster and/or adopt a child/youth and to preserve continuity of the child's/youth’s identity in a positive and affirming manner. Factors should include, but are not limited to, consideration of the child's/youth’s sexual orientation, gender identity and expression, racial and ethnic identity, family, community, neighborhood, faith or religious beliefs, school activities, friends, and the child's/youth’s and family's primary language.

Documentation of the assessment of this requirement shall be in the case file.

b. The application for foster care or adoption shall be denied for reasons listed in

Section 7.500.312.D and may be denied for reasons listed in Section 7.500.312.E. If the applicant has ever been denied as a prospective foster and/or adoptive parent, the SAFE™ assessment must address the reason for the denial and any resolution of disagreements concerning the decision.

c. As part of the assessment, the agency must:

1) Complete a minimum of one joint face-to-face interview with a couple, one individual face-to-face interview with each adult member of the household, and, if applicable, one individual face-to-face interview with any person considering a second parent adoption of the child(ren)/youth, and an age/developmentally appropriate face-to-face interview with all children/youth residing in the home. For single applicants, a minimum of two interviews will be required.

2) Complete at least one face-to-face interview in the applicant's home.

3) Complete an on-site inspection for foster care homes to determine compliance with the Rules and Regulations for Foster Care Homes,

Section 7.708. Approval of local zoning, health, or fire departments must be documented in the foster care home file when the situation warrants.

4) Complete interviews over a period of not less than three (3) consecutive days.

5) Complete an annual SAFE™ update. This shall include at least one visit in the foster care home and a review of the current medical status. any child abuse/neglect assessments completed during the previous year shall be discussed with the applicant(s).

If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the medical exams for the foster parent(s), other children, and other adults residing in the home cannot be completed for the child/youth in the required time frame, the medical exam(s) must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

d. The application and medical records must be reviewed; any issues that are identified will be discussed with the applicant. No physical examination shall be required of any person who in good faith relies upon spiritual means or prayer in the free exercise of religion to prevent or cure a disease unless there is a reason to believe the individual’s physical condition is such that the person would be unable to care for a child/youth.

e. The county department shall not complete a foster care home or adoptive home assessment on a member of its own staff. The worker should check with the supervisor for county policies and procedures regarding completing assessments on county staff.

f. Water, if from any source other than a regular municipal water supply, shall be tested for compliance with water quality requirements.

g. A current photograph taken within one (1) year of the foster family shall be requested and maintained in the provider record.

h. Pursuant to Section 19-1-130, C.R.S., a service provider means the State Department of Human Services, a county department of human or social services, or a child placement agency. This includes a contractor or subcontractor that provides placement-related services on a service provider's behalf.

1) A service provider shall provide placement related services in a manner that is culturally responsive to the complex social identity of the individual receiving such services. complex social identities include but are not limited to race, ethnicity, nationality, age, religion, sex, sexual orientation, gender identity, gender expression, socioeconomic status, physical or cognitive ability, language, beliefs, values, behavior patterns, and customs.

None of these characteristics may be used to cause the delay or denial of an out-of-home placement of a child or youth, unless the delay or denial of the placement is not detrimental to the health or welfare of the child or youth.

2) The county department of human/social services must not deny any person the opportunity to become a foster or an adoptive parent solely on the basis of a real or perceived disability, race, creed, religion, color, sex, sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or any communicable disease, including HIV, of the person or a member of the person's household; and, a) Any denial to care for a specific child or youth that includes one of the factors above as the basis for the denial must be documented, must have a clear connection to the ability to meet the needs of the child/youth, and the denial to care must not be detrimental to the health or welfare of the child or youth; or, 3) The county department of human/social services must not delay or deny the placement of a child or youth for adoption or into foster care on the

basis of a real or perceived disability, race, creed, religion, color, sex, sexual orientation, gender identity, gender expression, national origin, ancestry, or any communicable disease, including HIV, of the child or youth, unless the delay or denial of the placement is not detrimental to the health or welfare of the child or youth.

10. Additional Requirements Based on the recommendation of the SAFE™ assessment practitioner and in conjunction with the applicant’s completion of the SAFE™ Compatibility Inventory, list characteristics of child(ren)/youth that the foster parent(s) are approved to provide care and/or can best serve. These include but are not limited to age, race, sexual orientation, gender identity or expression, and specific needs (such as medical, physical, and emotional). Information obtained from the compatibility inventory must indicate competencies in parenting, their areas of interest, as well as training or coaching needed to increase skills. This must be in compliance with Section 7.500.2.A.9.h above. These characteristics must be discussed in the recommendations in the SAFE™ assessment. The information must be evaluated and summarized and attached to the SAFE™ questionnaires.

At a minimum, the SAFE™ Compatibility Inventory must be completed with each applicant at initial certification and then every other year thereafter. It is encouraged that someone with knowledge about the child/youth being considered for placement in a foster care home complete the child/youth inventory.

11. Assessment Update a. If there are changes in the age and/or special characteristics of the child(ren)/youth that the county will consider for placement with the foster parent(s), a re-evaluation of the family will be completed and the assessment revised.

b. For any individual eighteen (18) years of age or older entering the home with the intent of residing in the home or providing care in the home, there shall be documentation in the provider record of a review of the following:

1) Child abuse or neglect records check in every state where the adult has resided in the previous five (5) years.

2) A fingerprint-based criminal history record information check completed for the CBI and FBI, and, 3) A comparison search in the court case management system at the State Judicial Department, Using the name and date of birth with available criminal history information. the purpose is to determine any crime(s) for which the adult residing in the home was arrested or convicted and the disposition. This search must be completed regardless of whether the CBI and FBI fingerprint history confirms or does not confirm a criminal

history.

4) CBI sex offender and NSOPW sex offender checks, including known names, nicknames, AKAs, addresses, and a map of the location from the respective database to confirm that the address of the foster care home was checked.

5) If a new individual eighteen (18) years of age or older is visiting or living in the foster care or kinship foster care home and intends to stay thirty (30) consecutive days or longer, the following must be completed no later than the time frames listed below from the date the county department of human/social services learned that the adult was in the foster care home.

a) Within 24 hours, the county must complete CBI and NSOPW sex offender registry checks and document the information into the provider record in the CCWIS and foster care home record.

b) Within 24 hours, a Colorado child abuse/neglect check and a check in the State Judicial database must be completed and documented in the provider record in the CCWIS and the foster care home record.

c) Within seven (7) business days, the county must request child abuse and neglect records in all other states where the adult has resided in the past five (5) years. Document the requests in the provider record in the CCWIS. Document all responses in the CCWIS and foster care record.

d) Within thirty (30) calendar days, a CBI and FBI fingerprint based criminal history record check must be submitted. documentation, including the dates of the CBI and FBI checks, must be entered into the provider record in the CCWIS. Documentation must indicate the results were reviewed and the county department of human/social services did not have concerns. This may be a record of contact (ROC) note. The hard copy records must be located in the foster care home record.

12. At any time after the placement of a child/youth, the placing agency may review the SAFE™ assessment, updates, and all background checks of the foster parent except except the FBI criminal history record information report, unless the applicant authorizes it in writing.

13. County departments of human/social services are required to share approved adoptive home studies between counties if there is a child(ren)/youth whom the foster parent(s) wants to be considered for possible placement. The foster parent(s) shall make a request in writing providing the name of the county department or child placement agency, address, and name of the person who is to receive the home assessment, and appropriate documents. When the county department or child placement agency that completed the home assessment receives the written request, the written home assessment and appropriate documents shall be sent to the other county within five (5) working days at no cost to the foster parent(s). The county receiving the home assessment shall notify the foster parent(s) within five (5) working days that the county department has received the information.

The county department placing the child/youth for adoption will be responsible for postplacement supervision until the adoption is finalized, unless otherwise negotiated in the placement agreement between the county and the child placement agency.

14. A child placement agency shall share the SAFE™ assessment with the county department when a child placement agency foster parent wants to be considered for a possible adoptive placement.

a. The foster parent shall make a written request to the child placement agency, identifying the county department, and the name, and address of the county contact that is to receive the SAFE™ assessment and appropriate documents.

b. When the child placement agency receives the written request, the SAFE™ assessment and appropriate documents shall be sent to the identified county department within five (5) working days.

c. The county department receiving the SAFE™ assessment shall notify the prospective adoptive parent(s) within five (5) working days that the county department has received the information.

d. The county department placing the child/youth for adoption will be responsible for post-placement supervision until the adoption is finalized, unless otherwise negotiated in the placement agreement between the county and the child placement agency.

15. Post-Adoptive Services and Connections The applicant’s ability and willingness to assist with possible post-adoptive questions and concerns of the child/youth should be assessed, including, but not limited to:

a. Questions about the birth family;

b. Locating and obtaining non-identifying information about the birth family;

c. Search and possible reunification of the child/youth with the birth family; and, d. Willingness to assist the child/youth who was adopted with counseling, if needed, regarding issues related to adoption.

7.500.3 CHILDREN'S/YOUTH’S RESOURCES

A. Resources for children/youth to be developed by the county department of human/social services are non-relative foster care homes, kinship foster care homes, receiving homes if applicable, and adoption resources.

B. A diligent recruitment plan shall be submitted to the Division of Child Welfare with the content, format, and time frames prescribed. The county department shall implement the plan and demonstrate good faith efforts and due diligence to recruit and retain families that reflect the diverse communities and identities of all children/youth served by the child welfare agency.

C. Facilities for children/youth shall be certified, and shall meet necessary local requirements and hold local permits, as applicable. In order to support youth with an independent living stipend, a foster care home may provide a home for a youth that previously resided in foster care in the home on or before the youth’s eighteenth (18th) birthday. The youth shall occupy a bedroom alone. The foster care home may accept a negotiated portion of the independent living stipend.

Negotiation shall include the youth, caseworker, and foster parent(s).

D. The county department of human/social services shall audit all current foster care files annually to verify that all required information is present in the file. Following the annual audit, the county department shall attest in writing that all the required information is present.

E. The county department of human/social services shall develop resources for the twenty-four (24) hour out-of-home care of children/youth who otherwise would be inappropriately placed in jail or detention.

F. A foster care home or receiving home certified by the county department of human/social services shall receive children/youth only from a county department, and the certifying county shall approve each placement.

G. The county department of human/social services shall maintain a directory of current, accurate information to identify all available placements. The directory shall include available vacancies, licensed or certified capacity, ages, and gender identity of children/youth accepted by the foster care home, or facility, a description of the level of care which the foster care home or facility can provide, and any special services that are provided.

H. Care of children/youth in foster care homes when care is also provided for adults with intellectual and developmental disabilities 1. The foster care home shall meet all certification and recertification requirements in

Section 7.500.

2. The capacity of the foster care home when adults with intellectual and developmental disabilities are also in care shall not exceed a total of four (4) persons requiring care through the foster care system and/or the adult intellectual and developmental disabilities system.

a. When a youth in foster care turns eighteen (18) years of age and is eligible for the adult residential system through the Department of Health Care Policy & Financing (HCPF), the youth shall be considered an adult receiving care for the

purpose of capacity. If the county or State Department of human/social services has legal responsibility for the care and placement of the youth turning eighteen (18) years of age, the individual will be considered a child for the purpose of capacity.

b. Children/youth in foster care and who are enrolled in the Children’s Habilitation Residential Program (CHRP), may live in the foster care home with a combined maximum of three (3) individuals receiving a Home and Community-based Services (HCBS) Waiver. This may include one (1) HCBS-CHRP client and two (2) HCBS-persons with developmental disabilities (DD) OR HCBS-Supported Living Services (SLS) Waiver participants, or two (2) HCBS-CHRP participants and one (1) HCBS-DD or HCBS-SLS Waiver participants living in the same foster care home.

c. All children/youth in foster care, children/youth under eighteen (18) living in the home who are not in foster care, and all adults being cared for through the adult intellectual and developmental disabilities system cannot exceed a combined capacity of ten (10).

3. When a youth in foster care in the home turns eighteen (18) years of age (18), if the youth is eligible for the adult residential system, background checks in Section 7.500.2.A.5.a.1, must be completed on the youth and a SAFE™ update must be completed as identified in Section 7.500.A.7. 7.500.31 Foster Care Homes Foster care homes must be certified by county departments of human/social services, Child Placement Agencies or a federally recognized tribe with a foster care program.

A. A foster care home provides temporary care for children/youth who must live outside their own homes and are in need of protection and/or supervision, including those children/youth with physical or developmental disabilities when target group eligibility and out-of-home placement criteria are met. Receiving homes are a type of foster care home which provide temporary care of children/youth.

B. Foster parents shall be recruited who demonstrate a genuine interest in and knowledge of children/youth and a concern for their care and well-being. A county department of human/social services shall recruit within its own county and may recruit in adjacent counties.

C. Within five (5) working days after initial inquiry, the case worker shall discuss with the prospective applicant(s) general information regarding foster care requirements and the date of the upcoming orientation/information meeting.

D. An orientation/information meeting shall be held to discuss the application and certification process for prospective foster parent applicants within six (6) weeks after the initial inquiry. the orientation/information meeting may be completed individually.

E. A foster care home must be certified and pursuant to an application for certification, the county department of human/social services shall assess a foster care home; except:

1. A staff member of a county department of human/social services shall not be certified to operate a foster care home by the county department of human/social services in which the individual is employed due to conflict of interest. A waiver can be filed if there is an undue hardship which creates a substantial and unnecessary burden on the applicant, the family, community served, or the rule is too stringently applied.

2. A staff member of a county department of human/social services may be certified by another county, but may not receive children/youth placed by the county in which the individual is employed.

3. No county department of human/social services shall certify a foster care home of a relative of any staff member of the Child Welfare Division or unit. If the foster care home is certified by another county department, the referring county department may place children/youth in the foster care home upon written agreement of the two (2) county department directors or designees.

4. If a relative of a staff member of the county, who is not an employee of the county Child Welfare Division or unit applies to be a foster care home for the county department, then the application shall be reviewed by the county department director or designee to determine whether a conflict of interest exists and the director or designee shall provide written approval or denial and the justification for the decision. The documentation shall be attached to the application.

F. A county department of human/social services may receive an application for certification and complete a SAFE™ assessment for an applicant living in an adjacent county only after the county director of the adjacent county or designee gives approval for the other county department to complete the SAFE™ assessment and issue the certificate. County departments may only certify a foster home in a nonadjacent county with the written permission of both county directors or their designees.

G. Lawful presence in the United States is not required to operate a foster care home. The county department of human/social services shall not verify an applicant’s lawful presence to approve an application to operate a foster care home.

H. A county department of human/social services shall not accept an application to operate a foster care home from an individual who is currently certified by a child placement agency to operate a foster care home until that individual has terminated the certification by the child placement agency.

I. Reference checks for the applicant and all adults residing in the home:

Any application accepted by the county department of human/social services for an individual(s) or couple who wishes to be certified to operate a foster care home shall be on the department’s approved form.

Each adult shall sign a release of information; and, the county department of human/social services from whom the certification is sought shall conduct a reference check of each adult residing in the home by contacting all of the child placement agencies and county departments identified before issuing the certificate for the foster care home. This should include and is not limited to:

1. The names and addresses of child placement agencies and county departments where the applicant previously applied or was certified, information about prior or current licensing for child care at the time of the application, the agency that issued the certificate or license, and the type of care the certificate or license authorized.

J. No director or staff member of a county department of human/social services or child placement agency shall contact or recruit foster care homes currently certified by another county department or child placement agency for the purpose of becoming a foster care home.

K. A county director or the designee may take the following actions for prospective or current kinship foster care home providers. Decisions shall be made case-by-case and the safety and well-being of a child/youth placed in the foster care home shall not be compromised, the county director or the designee may:

1. Waive non-safety certification standards for kinship foster care providers referenced in 7.708.7 (12 CCR 2509-8);

2. Require special conditions for certification that address the safety or well-being needs for a child/youth;

3. Limit or restrict a certificate; and/or, 4. Require a written agreement for compliance that addresses safety and well-being needs for a child/youth. 7.500.311 Training In addition to twenty-seven hours of pre-certification training, which includes twelve hours of core training, each foster parent shall be certified in First Aid or the equivalent, and CPR for the ages of the children and/or youth in placement.

A. Training, Colorado Bureau of Investigation (CBI), Federal Bureau of Investigation (FBI), and Five- Year Child Abuse and Neglect Records Check Requirements.

1. Prior to the placement of a child and/or youth, initial training shall be provided through the statewide core curriculum, county department of human/social services, licensed Colorado child placement agency, or an organization approved by the Division of Child Welfare (DCW).

a. Each applicant shall complete twelve hours of core training. Core training shall include, at a minimum, the following content areas:

1) General overview of foster care;

2) Administrative rules, laws, and legal issues;

3) The impact of child abuse and neglect on child development;

4) Parenting and family dynamics;

5) Key concepts of child growth and development;

6) Addressing child/youth behaviors;

7) Importance of the team approach;

8) Cultural responsiveness identified in Section 7.701 (12 CCR 2509-8), including individual differences, such as race, ethnicity, sexual orientation, gender identity and expression, ableism, and culture;

9) Discipline;

10) Effects of fostering on the foster family;

11) The importance of maintaining meaningful relationships between children/youth and their parents or legal guardians, including regular visitation;

12) Reasonable and prudent parent standard;

13) Trauma-informed care as specified in Section 7.701.400;

14) Medication administration;

15) Health issues in foster care, including health services available to children and youth in foster care;

16) The right of a child or youth in foster care to have fair and equal access to all available services, placement, care, treatment, and benefits, and to not be subjected to discrimination or harassment on the basis of actual or perceived disability, race, creed, religion, color, sex, sexual orientation, gender identity, gender expression, national origin, ancestry, or any communicable disease, including HIV, of the child or youth;

17) The rights of siblings in foster care, located in § 19-7-203, C.R.S.; and, 18) Understanding the role of a Child Welfare Education Liaison, as described in § 22-32-138(2), C.R.S.

b. In addition to twenty-seven hours of pre-certification training, which includes twelve hours of core training, each foster parent shall be certified in First Aid and CPR for the ages of the children and/or youth in placement. Initial CPR training must be completed in a classroom with manual demonstration of resuscitation.

Individuals in the direct medical or emergency responder field may have CPR and First Aid waived if their immediate supervisor affirms that the applicant is a medical professional that performs these skills..

1. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency, the foster parent(s) cannot take the First Aid class in a classroom with the first aid trainer, the First Aid training may be completed online. The foster parent(s) must then complete the classroom training with the first aid trainer as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

2. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency, the foster parent(s) cannot take the CPR class in a classroom with the CPR trainer, and the foster parent(s) has successfully completed a CPR class within the last five (5) years, the foster parent(s) may take the CPR class online. The foster parent(s) must then complete the classroom training with a CPR instructor as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

c. The county department of human/social services shall train foster parents how to determine whether to approve the child’s/youth’s participation in an extracurricular, enrichment, cultural, or social activity consistent with the reasonable and prudent parent standard, based upon criteria in Section 7.701.200 (12 CCR 2509-8).

2. Ongoing Training a. Each applicant shall have twenty (20) hours of ongoing training every year, except specialized providers outlined in Section 7.708.65.E (12 CCR 2509-8).

The training shall be relevant to fostering the children and/or youth being served in the foster care home or kinship foster care home.

b. If there are children and/or youth in the home and training is not completed, no additional children and/or youth shall be placed until training is complete.

Children and/or youth who are currently in placement shall not be disrupted due to this requirement.

B. Exceptions to the Training and CBI, FBI, and Five-Year Child Abuse and Neglect Records Check Requirements An exception to the rules may be made for emergency child specific placements identified in

Section 7.304.21.E.2.f, and for non-emergency child specific placements in Section 7.500.312.D.

These are defined as placements where the child/youth has a prior relationship to the applicant.

1. The applicant may have ninety (90) calendar days from the date of application to complete training.

2. In the event of an emergency child specific placement in a previously uncertified home, prior to or at the time of the placement the county department shall receive the completed Original Application to Care for Children and Youth. In addition, the county staff and the applicant shall review and sign the CWS 7A, “Individual Provider Contract for Purchase of Foster Care Services in a Foster Care Home”.

C. If a provisional certificate will be issued because a child specific emergency placement is required in a previously non-certified home, prior to or at the time of the placement the county department of human/social services shall receive the completed Original Application to Care for Children and Youth, and the county staff and the applicant shall review and sign the CWS 7A, “Individual Provider Contract for Purchase of Foster Care Services in a Foster Care Home”, and submit fingerprints and current processing fee to the Colorado Bureau of Investigation. When a child/youth that was in foster care is to be placed with a foster parent that is no longer certified, a provisional certificate may be issued if it is in the child’s/youth’s best interest to return to the foster care home.

The following shall be completed by the county department prior to an emergency child specific placement of a child/youth. The county shall complete a background check for each adult (eighteen (18) years and older) living in the home for the following:

1. Review the court case management system at the State Judicial Department and include a copy in the provider record;

2. The CBI sex offender registry, the NSOPW operated by the United States Department of Justice, and include a copy in the provider record using:

a. Known names, nicknames, AKAs, and addresses of each adult residing in the foster care home; and, b. Address only of the provider’s home with a map from the respective databases to confirm that the address of the home has been checked;

3. CCWIS (Trails) screen prints, including prior names, nicknames, and AKAS, and complete the following requirements in the time frames identified below:

4. Child abuse/neglect records checks in every state where any adult residing in the home has lived in the five (5) years immediately preceding the date of application shall be initiated no later than seven (7) business days following placement; and, 5. Fingerprint-based criminal history record information checks from the CBI and the FBI shall be initiated no later than five (5) calendar days after the child(ren)/youth are placed in the home or no later than fifteen (15) calendar days after the child(ren)/youth are placed in the home when documented urgent circumstances exist, consistent with

Section 7.304.21.E.2.f (12 CCR 2509-4).

D. If a provisional certificate will be issued because a non-emergency child specific placement is required in a previously non-certified home:

1. The county department of human/social services shall submit fingerprints to CBI and FBI and complete all other background checks prior to placement of the child/youth, consistent with Section 7.500.2.A.5, except that child abuse and neglect records in other states where an adult has resided in the five (5) years preceding the application shall be initiated no later than seven (7) working days following placement; and, 2. The county department of human/social services shall review the completed “Original Application to Care for Children and Youth” and the CWS-7A “Individual Provider Contract for Purchase of Foster Care Services in a Foster Care Home” with the provider, and collect the signed documents. 7.500.312 Issuance/Denial of Certificate Every application used in the state of Colorado for employment with a child care provider or facility, or for the certification of a foster home, shall include the following notice to the applicant:

“Any applicant who knowingly or willfully makes a false statement of any material fact or thing in the application is guilty of perjury in the second degree as defined in Section 18-8-503, C.R.S., and, upon conviction thereof, shall be punished accordingly.”

Each applicant must provide verification of a social security number (SSN) or an individual taxpayer identification number (ITIN) issued by the federal government.

After the completion of the SAFE™ assessment, the county department shall take one of the following certification actions:

A. A one (1) year time-limited certificate shall be issued when it is determined that the applicant has completed the necessary training, and is in compliance with the Rules Regulating Foster Care Homes, Section 7.708. The certificate issue date is the date that the assessment is completed and the foster care home is in compliance.

1. The number and age of children/youth for whom the foster care home is certified shall be determined by the size of the home and the Rules Regulating Foster Care Homes, the applicant’s previous experience, parenting skills, and input from the foster parent.

2. Before a certificate is issued, the county department shall review the foster care contract and agreement with the foster parents. The contract and agreement must be signed by each applicant prior to certification. If a child/youth is placed and care paid by the county department, rules found in the provider rules in Section 7.417.1 (12 CCR 2509-5) shall be utilized.

B. A provisional certificate shall be issued for child specific homes if the home is temporarily unable to conform to all appropriate regulations upon proof by the applicant that attempts are being made to comply with the appropriate regulations.

1. A provisional certificate may be issued to allow the applicant to complete required training or in the event that an emergency placement into a previously uncertified home is required. If the applicant does not complete training within six months after application, no additional children/youth can be placed in the home until this requirement is met. The reasons for the issuance of a provisional certificate shall be displayed on the certificate.

The Department will not reimburse for children/youth placed in a provisionally certified foster care home more than ninety (90) calendar days from the date of application.

2. The provisional certificate shall be issued for no more than six months from the date it is determined that time will be needed to comply with the regulations or that care is to begin. Only one original provisional certificate may be issued to a foster home at one location address.

C. The application shall be closed when the applicant no longer chooses to pursue certification.

D. The application shall be denied for one or more of the following reasons::

1. Pursuant to Section 26-6-905(10), C.R.S., when the individual or person who resides with the applicant has been determined to be insane or mentally incompetent by a court of competent jurisdiction and, if the court enters, pursuant to Part 3 or Part 4 of Article 14 of Title 15, C.R.S., or Section 27-65-109(4) or 27-65-127, C.R.S., an order specifically finding that the mental incompetency or insanity is of such degree that the applicant is incapable of operating a Residential or day treatment child care facility, foster care home, or child placement agency, the record of such determination and entry of such order being conclusive evidence thereof.

2. If the person applying for the certificate or a person who resides at the home has been convicted of any of the crimes defined in a-e, below. “Convicted” means a conviction by a jury or a court and also includes a deferred judgment and sentence agreement, a deferred prosecution agreement, a deferred adjudication agreement, an adjudication, and a plea of guilty or nolo contendere. This does not apply to a diversion, deferral or plea for a juvenile who participated in diversion (defined in Section 19-2.5-102, C.R.S.), and does not apply to an adult who successfully completed the child abuse and/or neglect diversion program (defined in Section 19-3-310, C.R.S.).

a. Child abuse, as specified in Section 18-6-401, C.R.S.

b. A crime of violence, as defined in Section 18-1.3-406, C.R.S.

c. An offense involving unlawful sexual behavior, as defined in Section 16- 22- 102(9), C.R.S.

d. A felony, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as defined in Section 18-6- 800.3, C.R.S.

e. A felony involving physical assault, battery or a drug-related offense within the five years immediately preceding the date of application for a certificate.

3. No certificate to operate a foster care home shall be issued by a county department of human/social services if the person applying for such certificate or a person who resides with the applicant at the foster care home has shown a pattern of misdemeanor convictions within the ten (10) years immediately preceding submission of the application.

“Pattern of misdemeanor” shall be defined as:

a. Three (3) or more convictions of 3rd degree assault as described in Section 18-3- 204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6-800.3, C.R.S.; or, b. Five (5) misdemeanor convictions of any type, with at least two (2) convictions of 3rd degree assault as described in Section 18-3-204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6- 800.3, C.R.S.; or, c. Seven (7) misdemeanor convictions of any type.

4. Any offense in any other state, the elements of which are substantially similar to the elements listed in 1-3.

E. The application may be denied or the foster care certification suspended, revoked or made probationary pursuant to Section 26-6-914, C.R.S., for one or more of the following reasons, if the person applying for the certificate or any individual living with the applicant or employed by the applicant:

1. Is convicted in Colorado or in any other state of any felony, or has entered into a deferred judgment agreement or a deferred prosecution agreement in Colorado or in any other state to any felony, other than those offenses specified in Section 26-6-905(8), C.R.S., or child abuse, as specified in Section 18-6-401, C.R.S., the record of conviction being conclusive evidence thereof, notwithstanding Section 24-5-101, C.R.S.; or, 2. Is convicted of third degree assault, as described in Section 18-3-204, C.R.S., any misdemeanor, the underlying factual basis of which has been found by the court on any record to include an act of domestic violence, as defined in Section 18-6-800.3, C.R.S., any misdemeanor violation of a restraining order, as described in Section 18-6-803.5, C.R.S., any misdemeanor offense of child abuse as defined in Section 18-6-401, C.R.S., or any misdemeanor offense in any other state, the elements of which are substantially similar to the elements of any one of the offenses described in this paragraph; or, 3. Uses any controlled substance, as defined in Section 8 of the Colorado Revised Statutes including retail marijuana, or consumes any alcoholic beverage during the operating hours of the facility or is under the influence of a controlled substance or alcoholic beverage during the operating hours of the facility; or, 4. Is convicted of unlawful use of a controlled substance as specified in Section 18-18-404, C.R.S., unlawful distribution, manufacturing, dispensing, sale, or possession of a controlled substance as specified in Section 18-18-403.5 or 18-18-405, C.R.S., or unlawful offenses relating to marijuana or marijuana concentrate as specified in Section 18-18-406, C.R.S.; or, 5. Consistently fails to maintain standards prescribed and published by the Colorado Department of Human Services; or, 6. Furnishes or makes any misleading or any false statement or report to the Colorado Department of Human Services; or, 7. Refuses to submit to the Colorado Department of Human Services any reports or refuses to make available to the Department any records required by it in making an investigation of the facility for licensing purposes; or, 8. Fails or refuses to submit to an investigation or inspection by the Colorado Department of Human Services or to admit authorized representatives of the Department at any reasonable time for the purpose of investigation or inspection; or, 9. Fails to provide, maintain, equip, and keep in safe and sanitary condition premises established or used for child care pursuant to standards prescribed by the Colorado Department of Public Health and Environment and the Colorado Department of Human Services or by ordinances of regulations applicable to the location of the foster care home; or, 10. Willfully or deliberately violates any of the provisions of Part 9 of Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing Act; or, 11. Fails to maintain financial resources adequate for the satisfactory care of children served in regard to upkeep of premises and provision for personal care, medical services, clothing, and other essentials in the proper care of children; or, 12. Is charged with the commission of an act of child abuse or an unlawful sexual offense, as specified in Section 18-3-411(1), C.R.S., if:

a. The individual has admitted committing the act or offense and the admission is documented or uncontroverted; or, b. The Administrative Law Judge finds that such charge is supported by substantial evidence; or, 13. Admits to an act of child abuse or if substantial evidence is found that the licensee, person employed by the licensee, or person who resides with the licensee in the foster home has committed an act of child abuse, as defined at 19-1-103(1), C.R.S.; or, 14. Is the subject of a negative licensing action.

15. Misuses funds: the individual(s) making the expenditure decision had deliberate, willful, and intentional disregard for the fiduciary responsibility for how public funds are to be used for children placed in foster care or adoptive homes.

F. A kinship foster care certificate shall be issued when it is determined the applicant has met requirements outlined in Section 7.500.31.

G. Denial of an original or renewal application.

1. When an original or renewal application is denied, the county department of human/social services must notify the applicant in writing of the denial and mail it to the address listed on the application. The denial letter should be sent by certified mail to verify the date the applicant received the denial letter. In addition to sending the letter by certified mail, the county department may also use another method to communicate the information to the applicant. If the applicant chooses to appeal the decision, a request by the applicant for a hearing must be made in writing to the county department within thirty (30) calendar days after the applicant received the notice of denial. 7.500.313 Supervision and Support A. Supervision and support of the identified needs of the foster home shall occur according to the following:

A face-to-face contact shall be made in the foster care home with at least one (1) foster parent present at least once a month while children/youth are placed in the foster care home.

Documentation of such contact shall be entered in the CCWIS in the contacts for the provider and/or the children/youth placed in the foster care home. The purpose of the contact is to provide support and answer questions that the foster parent has about the program, to indicate to the foster parent any concerns the county department of human/social services has about the operation of the foster care home, and to observe child care/interaction when possible 1. If the face-to-face contact is not possible, the reasons must be documented in the provider record and an alternate contact must be made. The maximum number of allowable days between face-to-face contacts shall not exceed forty-five (45) calendar days.

2. For a two (2) foster parent foster care home, efforts should be made to meet with both foster parents. If a foster parent is unable to be present in the foster care home, the reason a face-to-face contact is not feasible shall be documented in the CCWIS. All foster parents must have face-to-face contact in the foster care home quarterly during the year and documented in the CCWIS. For exceptional circumstances, a waiver may be submitted.

3. If a child/youth is not present during the support visit, and it is documented, the observation of child care/interaction is not needed. At a minimum annually, the support caseworker must observe the interaction between the foster parent, the child/youth in foster care, and any other child/youth living in the foster care home.

B. Prior to recertification, an annual on-site visit must be made to the foster care home to prepare for recertification. Written documentation of the visit must be given to the foster parent to document any necessary action needed to complete recertification. The documentation must be maintained in the provider file, including the CCWIS.

C. If a county department of human/social services no longer chooses to place children/youth in the foster care home, the county department shall follow one or more of the following procedures:

1. The county department must send a written statement to the foster parent explaining that the county department will no longer place children/youth in the foster care home and that the foster parent must not accept any children/youth for care from other sources; or, 2. The county department must meet with the foster parents and ask them to sign a statement that they are withdrawing from the foster care program or, the county department must send a letter to the foster parents requesting the foster parents to sign and return a statement that they are withdrawing from the foster care program.

3. The county department shall close the certification and provide the foster parent with written notice of the right to appeal. 7.500.314 Renewal Notice The county department of human/social services shall send a renewal notice to the foster parents at least ninety (90) calendar days prior to the expiration of a certificate.

A. If the foster parents wish to continue to provide care, the renewal notice shall be completed and returned to the county department prior to the expiration of the certificate.

B. If the renewal notice is received by the county department prior to the expiration of the certificate, the renewal notice is timely and the certificate continues to be valid until action is taken by the county department.

C. If the renewal notice is received after the expiration of the certificate, the renewal notice is untimely. If the county department plans to pursue recertification the renewal notice may be acted upon as an original application or the county may follow the appropriate procedure(s) referenced in Section 7.500.315.B.1-3. 7.500.315 Recertification Action A. Timely renewal means a renewal application notice was received by the county department prior to or on the date of the expiration of the certificate. If all requirements have not been completed the foster care home service shall be entered into the CCWIS and the approval status is entered as pending for no more than ninety (90) calendar days from the date received. The county department must complete the following actions to determine if continued certification is appropriate:

1. Review the health assessment.

If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the medical exams for the foster parent(s), other children, and other adults residing in the home cannot be completed for the child/youth in the required time frame, the medical exam(s) must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

2. Complete searches on the CBI sex offender registry and the NSOPW operated by the United States Department of Justice and include a copy in the provider record using the following criteria, at a minimum:

a. Known names, nicknames, AKAs, and addresses of each adult residing in the foster care home; and, b. Address only, of the foster care home, including a map from the respective database to confirm that the address of the foster care home has been checked.

3. Review the following information, for the applicant(s) and all adults residing in the foster care home. as applicable, provide a copy in the provider record of:

a. Any child abuse and/or neglect referrals or assessments in the previous year;

b. Any arrest or conviction records in the previous year;

c. Any other involvement with the foster family with the county department; and, d. The Colorado court case management system.

4. If the foster parent or any adult living in the foster care home left the state for three (3) consecutive months or longer, a new FBI fingerprint-based criminal history record information check shall be conducted.

5. Evaluate the foster parent’s current and past compliance with the Rules Regulating Foster care Homes.

6. Conduct an annual onsite visit in accordance with Section 7.500.313.A.2-4;

7. Complete a SAFE™ update to document the status of the foster family, including changes that have occurred and signature and date from Section A of the update form.

8. Complete a CWS-7A, “Individual Provider Contract for Purchase of Foster Care Services in a Foster Care Home”; and, 9. If all requirements are met, a one year time-limited certificate shall be issued. The certificate issue date is the date that the foster care home is in compliance with the “Rules Regulating Foster Care Homes”; or, 10. If the renewal application for the certificate is denied, the process for denial of a renewal application is the same as the process for denial of an original application.

11. The certificate information shall be entered into the CCWIS.

B. A renewal application notice is untimely if it is received after the date the foster care home certificate expired. Section 7.406.1.C (12 CCR 2509-5) authorizes state reimbursement when the child is with a provider in possession of a valid certificate or license, when one is required. No additional children/youth may be placed in the home until it is fully certified. Children/youth who are currently in placement are not disrupted if the county department wishes to continue certification. The options are:

1. The foster care home service may be entered into the CCWIS with the approval in pending status. All certification requirements must be completed within 15 working days; or, 2. If completion of all requirements will take longer than fifteen (15) working days an emergency appeal may be filed by the certifying county department. If the emergency appeal is denied, the home is not certified and is considered closed.

3. A provisional certificate may be issued only if none was previously issued for the same address. The foster care home must be certified within ninety (90) calendar days or the foster care home shall be closed.

4. In any subsequent certification year if an untimely renewal application notice is received after the expiration of the certificate, the foster parent must complete an original application and meet all certification requirements.

a. A provisional certificate may be issued only if none was previously issued for the same address. Follow 7.500.315.B.3; or, b. If the county plans to certify the home, Section 7.406.1.C applies.

C. A foster care home certificate is no longer valid whenever one of the following situations exists:

1. A foster family moves to a new address.

2. A foster parent decides to withdraw from the foster care program and confirms it in writing.

3. A certificate has been revoked or the renewal application has been denied.

4. A certificate has expired and no action is taken pursuant to 7.500.315.B.1-3. 7.500.316 Inter-county Transfer or Move of A Foster CARE Home A. When a foster family moves to a new location within the county of residence or within a new county, the family must make a timely notification at least thirty (30) calendar days prior to the move to the current certifying county by submission of an original application.

B. When a foster family moves to a new residence in the same county, the county department of human/social services shall inspect the new residence to assure compliance with the Rules Regulating Foster Care Homes, Section 7.708 (12 CCR 2509-8).

Certification action which results in issuance of a certificate shall be completed in the following way:

1. A certificate shall commence the date that the county department determines that there is compliance with the Rules Regulating Foster Care Homes, Section 7.708.

2. The county department may issue a child specific provisional certificate if the foster care home is temporarily unable to conform to all appropriate rules of the Rules Regulating Foster Care Homes, Section 7.708, upon proof by the foster parents that attempts are being made to comply with the appropriate regulations. The reasons for the issuance of the provisional certificate will be displayed on the certificate. The provisional certificate may not exceed ninety (90) calendar days from the date it is determined that time will be needed to meet the rules. Only one original provisional certificate may be issued to a foster care home at one location address. The department will not reimburse for children/youth placed in a provisionally certified foster care home more than ninety (90) calendar days from the date of the application.

C. When a foster family with children/youth in foster care placement moves to another county, the county of original residence may forward the record on the foster care home and children/youth in placement to the county where the foster family moves and ask that county to certify and supervise the home in the new location.

D. When a foster family with children/youth in foster care placement moves to an adjoining county, the county of original residence shall immediately or within two (2) business days, notify the adjoining county and may ask permission to continue to certify and supervise the foster care home. Upon notification from the second county of its approval, certification assessment of the foster care home shall be completed by the original county, and a provisional certificate issued.

E. If a foster care home transfers to a county department from another agency or tribal foster care program, a SAFE™ assessment update may be completed if the previous entity provides the original SAFE™ assessment and all subsequent updates. 7.500.317 Response to a Notification of an Allegation of Abuse and/or Neglect or Another Type of Concern in a County Foster Care Home A. When notification of a referral alleging abuse or neglect in a county foster care home is received and it has not been accepted for assessment, the certifying county foster care support worker shall take the following actions:

1. Review the referral to determine if there are certification concerns identified.

a. If no certification concerns are identified, document receipt of the referral in resource notes in the Comprehensive Child Welfare Information System (CCWIS).

b. If concerns are identified, the foster care support worker will complete a thorough review of the circumstances and the incident. This includes the following:

1) Meet with the foster parent;

2) Identify any corrections or modifications that need to be incorporated and provide any training, or technical assistance to mitigate concerns; and, 3) Document any actions taken.

B. When notification of a referral alleging abuse and/or neglect in a county foster care home has been accepted for assessment, the certifying county’s foster care support worker and/or designated staff shall take the following actions:

1. A determination shall be made as soon as possible, in conjunction with recommendations from the assessment caseworker, whether children/youth should remain in placement in the foster care home; and, 2. Whether other children/youth should be placed in the home while the assessment is in progress.

3. The results of the assessment shall be summarized and included in the foster care home record maintained by the county department. this may be in the form of the final written report completed by the county responsible for the assessment.

4. Upon receipt of the written report from the county responsible for the assessment of child abuse and/or neglect, the certifying county shall make a determination within three (3) working days regarding continued use of the home. The foster care home shall be notified in writing of the decision and the notification recorded in the foster care home record maintained by the certifying county. If the foster care certificate is closed, suspended, or revoked, the county department shall document this in the CCWIS.

5. The final decision regarding future use of the foster care home shall be confirmed in writing to the foster parent and recorded in the foster care home record within ten (10) working days of the receipt by the certifying agency of the final written report of a child abuse and/or neglect assessment.

a. If the county department continues certification of a foster care home where there has been a confirmed report of medium or severe child abuse and/or neglect, written justification and additional follow-up must be identified. The county director or designee must sign the statement that includes the justification and follow-up.

b. The county department must notify the Child Welfare Director and Foster Care Program Administrator at the Division of Child Welfare in writing within three (3) business days and submit the justification and follow-up for maintaining the foster care home certification.

c. The statement must be documented in notes in the referral for the provider.

6. Administrative proceedings to modify, limit, or revoke the certificate will be initiated by the certifying agency within 30 calendar days of notification of any adverse decision regarding continued use of the foster care home.

7. After the State Institutional Abuse Review Team (IART) evaluates the finding and assessment by the county responsible for the assessment, the State Institutional Abuse Review Team may recommend a follow-up review. A follow-up is a review of the original assessment completed by the certifying county to determine if the agency has culpability based on practices, policies, and procedures, If any certification requirements were violated in the foster care home, or by the foster care providers. The county shall enter a report in the CCWIS within thirty (30) calendar days of the receipt of the State Institutional Abuse Review Team's request. Follow-up must be documented in the provider record.

C. Other types of complaints or identified concerns shall be reviewed and addressed by the certifying county. The county’s review of the concern shall be documented and, if applicable, what corrections or modifications the foster care home must make. The results shall be confirmed in writing within ten (10) working days to the foster parent and documented in the provider record in the CCWIS. 7.500.324 Dual Licenses and Certificates A. A home may be licensed to provide child care and certified for foster care simultaneously. This is known as a dual care provider. Dual care providers utilized by county departments of human/social services are certified by the county for foster care and licensed by the State for child care.

1. If a foster care home wishes to accept children for child care on a regular basis, the provider shall apply for a license for child care from the Colorado Department of Early Childhood and pay the prescribed fee.

2. If the foster care home wishes to provide child care, the certifying agency must approve.

a. The county department shall complete a justification statement describing how the needs of all children/youth will be met and protected in this home if certified for foster care and licensed for child care, which shall be filed in the case record.

b. The county department shall document in the case record the specific number of children for combined use of the home, specific number of children as a child care home, and a specific number of children/youth in foster care.

3. A home that is licensed for child care may only be certified for foster care for one (1) child/youth or for a group of siblings.

4. A county department that has a foster care home that is licensed for child care must notify the Colorado Department of Early Childhood when any of the following situations occur in the foster care home:

a. A complaint is received; or, b. A child abuse and/or neglect assessment occurs; or, c. A follow-up review occurs; or, d. A child/youth in foster care is removed from the home because of abuse and/or neglect allegations; or, e. The foster care home certificate is revoked or closed.

5. A county department that has a foster care home that is also licensed for child care must submit the following reports to the Colorado Department of Early Childhood.

a. All complaint reports; and, b. All child abuse/Neglect assessment reports; and, c. All follow-up review reports. 7.500.33 SAFE™ Assessment Practitioner Qualifications (Home Study)

The following are the requirements for practitioners and their supervision when completing home study assessments.

A. County departments of human/social services staff or contract vendors must meet the following educational qualifications:

1. A SAFE™ assessment practitioner must have a bachelor’s, master’s, or doctorate degree from a college, university, or higher education institution in a human service or mental/behavioral health related field, such as psychology, sociology, human development, family studies, social work, criminal justice, and/or counseling; and be supervised by an individual who meets both these educational requirements and workrelated requirements of three (3) years experience in child placement, child protection, foster care, or adoption.

B. All SAFE™ assessment practitioners completing a SAFE™ home study must receive supervision for each SAFE™ assessment by a supervisor trained in SAFE™ protocol, SAFE™ supervision, and who meets the educational and work-related requirements in 7.500.33.A.1. Approved practitioners completing a SAFE™ home study must utilize the SAFE™ supervisory process as outlined by the Consortium for Children. If the SAFE™ supervision protocol is not followed, the home study will not be considered a valid SAFE™ home study. There is no exception.

C. All individuals functioning as a SAFE™ supervisor must have completed the SAFE™ two-day certification training, SAFE™ supervisor training, and completed SAFE™ refresher trainings timely.

D. SAFE™ assessment practitioners who are supervisors must also receive supervision from a separate qualified SAFE™ supervisor for each SAFE™ assessment completed. The supervisor verifies that this home study was conducted with due professional diligence and in accordance with Colorado law and the rules adopted by the Colorado Department of Human Services.

E. The Colorado Department of Human Services is required to maintain an approved contract vendor list of home study report providers.

1. All SAFE™ assessment practitioners that are on the contract vendor list must provide verification of a college, university, or higher education transcript, resume, attestation of individual responsibilities, SAFE™ assessment training, SAFE™ supervisor training (if applicable), and current individual liability insurance.

a. Individual contract vendors must submit professional liability insurance in an amount reasonable as related to their exposure to risk.

2. An individual contract vendor must provide a current risk assessment to the Colorado Department of Human Services if requested.

7.500.34 (NONE) 7.500.35 Adoption Resources 7.500.351 Applications and Adoption Services A. When a SAFE™ assessment or SAFE™ update is intended for adoption, the assessment must be completed ninety (90) working days from receiving the completed background checks.

County departments of human/social services and child placement agencies shall be required to report to the court the results of a fingerprint-based criminal history records check when it reveals that the prospective adoptive parent was convicted of a felony or misdemeanor of: 1 Child abuse or neglect;

2. Any crime against a child, including child pornography;

3. Any crime, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as specified in Section 18-6-800.3, C.R.S.;

4. Violation of a protective order, as described in Section 18-6-803.5, C.R.S;

5. Any crime involving violence, rape, sexual assault, or homicide; and, 6. Any felony drug-related conviction within, at a minimum, the past five years. Felony drugrelated convictions at least ten years prior to the application do not need to be reported.

7. No person convicted of a felony offense shall be allowed to adopt a child/youth, except a person may be allowed to adopt a child/youth if:

a. The applicant has had no further arrests or convictions subsequent to the original conviction;

b. The applicant has not been convicted of a pattern of misdemeanor, as defined by

rule of the State Board of Human Services at Section 7.500.312.D.3.a-c; and, c. The court enters a finding consistent with Section 19-5-210(2)(d), C.R.S., that the adoption is in the best interests of the child.

B. Recruiting and Inquiries 1. The county department of human/social services recruits adoptive homes that reflect the racial, ethnic, cultural, and linguistic backgrounds for all waiting children/youth. The county department shall make reasonable efforts to recruit families of the same ethnic, cultural, and racial background as the children/youth awaiting adoption pursuant to the Multiethnic Placement Act (42 U.S.C. 5115a)

2. The county department provides information about adoption services within the county department and services available through other adoption agencies and organizations.

Requests for SAFE™ assessments for children/youth from private sources shall be referred to private agencies.

3. Prospective adoptive parent(s) approved for intercountry adoption and waiting for adoptive placement can be simultaneously approved for adoption with public and a licensed private adoption agency as long as both agencies are aware and in agreement with the arrangement.

a. The prospective adoptive parent(s) shall inform the public agency of its current relationship with the licensed private child placement agency that approved it for intercountry adoption.

b. The prospective adoptive parent(s) shall sign a release of information from the private child placement agency to be provided to the county department of their choice. The released information shall include, but not be limited to, the following:

1) Current SAFE™ assessment by the private agency;

2) Documentation of training completed by the prospective adoptive parent(s).

c. The county department shall complete a SAFE™ update and clarify the characteristics of children/youth for whom the prospective adoptive parent(s) would be approved using the county department’s approval process.

d. The county department must obtain the following new information from the prospective adoptive parent(s):

1) References;

2) Health assessments;

3) Background check for each adult age eighteen (18) and older living in the home, for the following:

a) Fingerprint-based criminal history checks from the CBI and FBI as required in Section 7.701.33 in all circumstances.

b) Child abuse/neglect records in every state where the adult has resided in the five (5) years preceding the date of application.

c) The CBI Sex Offender and NSOPW operated by the United States Department of Justice by:

i. Known names, nicknames, AKAs, and addresses of each adult residing in the home; and, ii. Address only of the home, including a map from the respective databases to confirm it has been checked.

d) A comparison search on the Colorado Court Case Management system at the State Judicial Department, using the name and date of birth with available criminal history information for each adult eighteen (18) years and older living in the home. The

purpose is to determine any crime(s) for which an applicant or other adult residing in the home was arrested or convicted and the disposition. This search shall be completed regardless of whether the CBI and FBI fingerprint history and record confirms or does not confirm a criminal history.

e) Within ninety (90) days prior to finalization of an adoption, complete all background checks including: CCWIS, Colorado court case management system, CBI and FBI fingerprint based criminal history record information check, CBI sex offender check and NSOPW.

4) All background checks shall be documented in the CCWIS.

a) The county department of human/social services shall continue to follow its policies and procedures in considering the prospective adoptive parent(s) for potential placements.

b) The prospective adoptive parent(s) shall sign an agreement with both the public and private agency stating that the prospective adoptive parent(s) will inform either agency when there is a potential placement. The agreement shall state the following:

i. All parties understand and agree the home of the prospective adoptive parent(s) is not available for any new placements for a minimum of six (6) months following the date that the child/youth is placed in the home;

ii. At the end of the six (6) month period that the home is not available for new placements, all parties including the prospective adoptive parent(s) and both the public and licensed private adoption agency shall determine and document whether the non availability period should continue;

iii. The placing agency shall complete a SAFE™ update regarding the progress and appropriateness of the new placement and make recommendations for any further adoptive placements;

iv. The non-placing agency shall complete a SAFE™ update addressing the placement of a child/youth into the prospective adoptive home.

c) The county department shall advise the prospective adoptive parent(s) that the SAFE™ assessment completed for county departments is not suitable to determine the appropriateness for intercountry adoption.

The county department shall advise the prospective adoptive parent(s) that a private licensed adoption agency must complete the SAFE™ assessment as referenced in 7.351.4.

d) The county department shall assure that the required information is included in either the private agency’s SAFE™ assessment or in the SAFE™ update completed by the county department.

5) Applications a) The county department of human/social services shall only accept applications for the adoption of children/youth from persons who meet the requirements of Colorado statute, who have expressed an interest in the placement of a child/youth through the county department.

b) The applicants shall be informed that submitting an application does not guarantee that a SAFE™ assessment will be completed or a child/youth placed with them.

c) The county department shall notify the prospective adoptive parent(s) of the disposition of the application within six (6) months.

d) Lawful presence in the United States is not required to approve an application for a child/youth's adoption. The county department of human/social services shall not verify a prospective adoptive parent’s lawful presence to approve an application for a child/youth's adoption.

e) Requirements for Adoption i. A SAFE™ assessment as outlined in Section 7.500.2 must be completed prior to the child/youth being placed with the intent of adoption.

ii. The assessment must include a visit to the home and separate interview of the potential adoptive parent(s) and all other adults living in the home shall be interviewed.

a. As part of the assessment, the SAFE™ practitioner must conduct a minimum of one (1) joint interview with all applicants, one (1) individual interview with each adult member of the household, and an age/developmentally appropriate interview with each child/youth residing in the home. For a single applicant, a minimum of two (2) interviews is required; and, b. The SAFE™ practitioner must ensure the second interview, and any subsequent interviews, of the adults, shall not be performed until at least three (3) calendar days after the previous interview.

6) Approval a) An applicant(s) shall be made aware of their standing with the agency. If there are serious concerns during the SAFE™ assessment process which cannot be resolved, the SAFE™ assessment practitioner shall discuss these concerns and the decision to proceed with the applicant(s). The applicant(s) shall be encouraged to withdraw if this is advisable. If the applicant(s) does not withdraw, then the county department shall send a denial letter with information about the right to appeal.

b) When a SAFE™ adoption assessment has been approved, the county department shall:

i. Inform the applicant in writing of the final decision regarding their application within fifteen (15) working days from the date the decision is made.

ii. Send written notification to the applicant, which includes the following:

a. The application to adopt is approved.

b. The age, gender, and any special characteristics of the child(ren)/youth which will be considered.

c. Any other conditions of the approval that pertain.

d. The SAFE™ adoption assessment is available only for the adoption of a child(ren)/youth placed by a Colorado county department of human/social services or child(ren)/youth placed in cooperation with an agency licensed to place children/youth for adoption.

e. The applicant’s right to a review of the decision by the county director or the director's designee of the characteristics of the child/youth for which the prospective parent(s) is approved.

f. The applicant’s responsibility to inform the county department of significant changes of circumstances which could impact an adoption.

7) Denial of applicant based on assessment The decision to deny approval of the applicant’s SAFE™ adoption assessment shall be a joint decision involving at least the caseworker and the supervisor. The county department of human/social services shall complete the following:

a) Send the applicant(s) written notice of the denial within fifteen (15) working days of the decision.

b) The county department shall have a face-to-face meeting to discuss the reasons for the denial at the applicant’s request.

c) Notify the applicant of the right to a review by the county director or the director's designee if the applicant(s) is dissatisfied with the decision.

8) Reevaluation of assessment If a child/youth has not been placed in the prospective adoptive home within one (1) year from the date of the approval of the SAFE™ adoption assessment, the assessment shall be reevaluated to determine if the home is to remain active for consideration of a child/youth, and annually thereafter until a placement is made or the case is closed. Reevaluation shall consist of at least the following:

a) A current health assessment is required for each family member.

The assessment is valid for a maximum of two (2) years. Health assessments may be completed by a licensed doctor of medicine or osteopathy, physician assistant, or nurse practitioner.

If the county department has concerns about the health of any family members prior to the expiration date of the previous health assessment the county department may require an updated health assessment.

b) Documentation of any changes in the home and family, including but not limited to finances, employment, housing, illnesses, pregnancy, and current information, where applicable, on growth, development, and activities of children/youth in the home. c). Changes, if any, in the preferences in the characteristics of the child/youth to be adopted, the reason for the change, and the applicant’s capacity to provide for the long term needs of the child/youth currently identified.

d) Determination whether to continue approval of the home.

9) Second or additional update to assessments If a prospective adoptive parent chooses to be considered for another adoption with the same licensed child placement agency, the following applies:

a) If the last SAFE™ assessment is within three (3) years of the approval date of the original SAFE™ assessment, a subsequent SAFE™ update shall be completed. The update shall include at least one (1) joint interview with the prospective adoptive applicants or an interview with the prospective adoptive applicant, and one (1) interview with each adult member of the household, and an age/developmentally appropriate interview with each child/youth. at least one (1) interview with the family must be conducted in the home. The individual interviews with the adoptive applicants must be completed on the same date. All interviews shall be documented.

b) If the period of time since the approval of the original SAFE™ assessment is longer than three (3) years, a full SAFE™ assessment shall be completed with emphasis on adoption.

10) Update to assessments when the applicant chooses to be considered for an adoption through a different licensed child placement agency:

a) When the full SAFE™ assessment is received directly from the originating agency with an update with an approval date of less than one (1) year, the new agency may either complete:

i. A SAFE™ update of the original SAFE™ assessment or, a full SAFE™ assessment.

ii. If the SAFE™ assessment or update approval date is more than one (1) year old, a full SAFE™ assessment must be completed as prescribed in Section 7.500.2.

11) Foster Parent Assessments a) The SAFE™ assessment along with a SAFE™ update focusing on the ability of the parent to meet the specific needs and to parent the child(ren)/youth placed for adoption will be accepted for adoption. the caseworker will check the adoption box on the state prescribed application.

b) The caseworker shall discuss the Adoption Assistance Program with the foster parent, focusing on the needs of the child/youth and the foster parent’s ability to meet those needs as addressed in Section 7.306.4 (12 CCR 2509-4). .12) Intercountry Adoption a) Non-public intercountry adoptions shall only be completed according to the Children's Code and Section 7.710 (12 CCR 2509-8). 7.500.352 Fees A. The county department of human/social services shall inform individuals applying to adopt the fees that may be involved in adopting through the county. Fees are based on the ability to pay for the adoptive services rendered by the county department which provides the SAFE™ assessment. Fees may be waived. A fee may be charged to a family at the discretion of the county department.

B. A non-discriminatory fee structure shall be established by the county department. The fee is established on ability to pay or cost of service, whichever is less.

C. Fees will be charged to out-of-state prospective adoptive parents seeking to adopt a child/youth from Colorado or prospective Colorado parents seeking to adopt a child/youth from another state, in accordance with the adoption services provided. If the child/youth being placed is in the custody of a public agency and receiving services through the Interstate Compact on the Placement of Children (ICPC), the prospective adoptive parents shall not be charged a fee.

D. No fee is charged to individuals or families whose income is below the poverty level, as established by the United States Department of Agriculture (USDA), or who are recipients of Supplemental Security Income (SSI), Colorado public assistance programs, or state/countyfunded assistance payments.

E. Fees may be waived in whole or in part by the county department which provides the SAFE™ assessment and other related adoption services when such fees pose a barrier to the adoption of children/youth for whom a county department is financially responsible. If the fee is waived, the waiver should be documented in the county record. If a prospective adoptive parent, for whom the fee has been waived, decides not to adopt a child/youth then the prospective adoptive parent may be required to pay the appropriate fee.

F. When an assessment is court ordered, the prospective adoptive parents may be charged a fee for a home assessment, supervision, or a report to the court in accordance with the above fees. 7.500.353 Case Records A. The Adoptive Family Record will contain all documentation required for approval for adoption, including but not limited to the application, SAFE™ assessment, SAFE™ updates, required background checks, and medical information.

B. The county department maintains a record for each adoptive family approved for the placement of a child/youth. Upon completion of the legal adoption of a child(ren)/youth, the record shall be closed and maintained in a secure location at the county department in order to preserve confidentiality as required by § 19-5-305, C.R.S.

C. Any material contained in the record regarding a child/youth placed with and adopted by the family shall be maintained at the county department with the adoption record. After the decree of adoption has been issued, the county department shall not retain information in an open record which will link the adoptive family with the child's/youth’s original identity except information necessary to maintain the adoption assistance record.

D. Access to Adoption Information and Records 1. Prior to filing a petition to adopt:

a. The records of prospective adoptive parents are confidential, as provided in § 26- 1-114(1), C.R.S.

b. The county department shall not provide records of prospective adoptive parent(s) to an individual or agency, other than another Colorado county department involved in the adoptive process, without the written permission of each prospective adoptive parent if both are involved in the adoption process.

c. The county department shall provide a copy of the SAFE™ assessment to the prospective adoptive parent for the purpose of reviewing the accuracy of the assessment.

2. After filing a petition to adopt:

a. The county department of human/social services will provide court reports on adoptions to the prospective adoptive parents as outlined in Colorado statute § 19-5-209(1), C.R.S.

b. Records and information received by the county department during relinquishment and/or termination of parental rights in adoption proceedings shall be confidential pursuant to Colorado statute § 26-1-114(1), C.R.S. 7.500.354 Correspondence with Out of State Agencies All correspondence with an out-of-state child placement agency regarding adoption shall be forwarded to the selected Colorado Child Placement agency for routing to the out-of-state child placement agency. 7.500.355 Purchase of Adoption Services from Licensed Child Placement Agency Providers The county department of human/social services may elect to purchase any of the following from licensed child placement agency providers: pre-placement services, SAFE™ assessment services, placement services, post-placement services, and post-finalization/permanency services.

The county department must have a written and signed contract with the licensed child placement agency that details the services to be provided, the fees to be paid for the services, and the appropriate time frames for the services to be concluded.

A. Eligible Cases 1. Children/youth for whom adoption services may be purchased by a county department shall be children/youth who are available for adoption, and for whom an adoptive home is not available, and who are listed with the Colorado Adoption Resource Registry (CARR).

2. All children/YOUTH in need of adoptive placement must be listed with the CARR or a request for exclusion must be submitted to the CARR (See Section 7.306.13 in 12 CCR 2509-04).

3. In the case of a child/youth who is available for adoption and has complex needs and the county department wishes to purchase or contract for pre-placement assessment, the county may do so prior to the child/youth’s information being submitted to the CARR.

4. Services for children/youth with complex needs who are not yet available for adoption may be purchased by a county department when in the judgment of that department it is anticipated and likely that the child/youth will become available for adoption. Adoption services purchased for these children/youth shall be limited to pre-placement, recruitment, and home assessment services.

B. Case Referral 1. Eligible cases shall be referred to the licensed child placement agency provider for purchase of part or all of the adoption services.

2. In its agreement, the county department shall require that the licensed child placement agency provider write a case plan for providing adoptive services to the referred child/youth reflecting the joint planning. This plan shall include objectives, specific desired outcomes, and target dates. Regular progress reports shall be submitted to the county department by the agency provider, and shall address all of the requirements of the case plan.

C. Service Hour Rate Payment for purchased adoption services shall be on an actual cost basis, up to a specified maximum for each adoption component. The rate shall be based on the base service hour cost of the agency provider, which is the allowable program costs divided by case service hours in the program (i.e., hours spent by professional staff in performing adoption services on a case).

D. Provider Billing and Fees 1. Billing for adoption services provided shall be case-specific and component-specific. That is, the county department shall accept bills from the agency provider only on those cases on which it has entered into an agreement with the county department and only for the component(s) of the adoption process which the county department has agreed to purchase.

2. In its agreement with the agency provider for a specific child/youth the county department shall require that payment be the only payment under the contract. The county department must require that payment for child/youth specific adoption services be paid under single payment contracts.

E. Payment to Provider 1. Payment shall be made to the agency provider for those components provided and billed.

2. Payment to the provider shall be for satisfactory completion of the duties required by the agreement.

3. In the case of disrupted placements, the licensed child placement agency provider shall be paid for actual time spent on the case, not to exceed the maximum allowed for the component(s) utilized to that point in the placement. This payment shall be at the rate of the approved service hour cost as reflected in the component computation.

F. Reimbursement to the County Department of Human/Social Services The Colorado Department of Human Services shall reimburse the county department for purchase of adoption service expenditures under approved agreements pursuant to Section 7.406.1.NN (12 CCR 2509-5).

G. Provider Agreement and Requirements 1. The county department and the licensed child placement agency provider shall enter into a provider agreement for adoption services to be purchased.

2. The county department shall monitor the provision of services under the purchase of adoption services agreement.

3. The licensed child placement agency provider shall be responsible to the county department for the quality of services provided under the agreement. For pre-placement, home assessment/evaluation, placement, and post-placement service components, the agency provider shall meet the standards for service quality as per the licensing regulations for adoption agencies.

4. County departments shall purchase adoption services only from licensed child placement agency providers who give assurance in their agreement that the purchased services shall be delivered only by staff who meet the following minimum qualifications for nondirect service components, for example, recruitment and legal services:

a. Some background showing awareness of and sensitivity to adoption issues; and, b. At least one (1) year of experience and/or a degree appropriate to the service being purchased and (for legal services) a license to practice in their specialty field. 7.500.356 [Repealed eff. 11/01/2015] _________________________________________________________________________ Editor’s Notes

History Rules 7.500.2.B-C.3, 7.500.311 emer. rules eff. 08/03/2007.

Rules 7.500.2-C.3, 7.500.315 eff. 09/01/2007 Rules 7.500.2, 7.500.311 eff. 10/30/2007.

Rules 7.500.2, 7.500.351 emer. rules eff. 12/7/2007.

Rules 7.500.2, 7.500.351 eff. 1/30/2008.

Rules 7.500.3, 7.500.317 eff. 4/1/2008.

Rules 7.500.2, 7.500.31, 7.500.32 eff. 11/1/2008.

Rule 7.500.351 (A-B) eff. 02/01/2010.

Rules 7.500.3, 7.500.351.A.1, 7.351.B.1, 7.351.C.1 eff. 03/02/2011.

Rules 7.500.11, 7.500.2.A-.C, 7.500.2.E-.H, 7.500.3, 7.500.31.E-.J, 7.500.311.B-.D, 7.500.313.A, 7.500.314, 7.500.315, 7.500.316.A-.B, 7.500.317.A.6, 7.500.321.B-.C eff. 04/01/2012.

Rules 7.500.31, 7.500.31.K eff. 12/01/2012.

Rule 7.500.311 eff. 11/01/2015. Rule 7.500.356 repealed eff. 11/01/2015.

Rules 7.500.2, 7.500.3, 7.500.31, 7.500.311, 7.500.312, 7.500.313, 7.500.315, 7.500.316, 7.500.32, 7.500.323, 7.500.324 eff. 01/01/2016.

Rules 7.500.2, 7.500.315, 7.500.316, 7.500.321, 7.500.351 eff. 10/01/2017.

Rules 7.500.2 A.3-4, 7.500.2 A.6.a, 7.500.2 A.6.c.vi, 7.500.2 A.6.d.i, 7.500.2 A.6.d.v, 7.500.311 A, 7.500.311 B.a.5, 7.500.311 B.b.1-2, 7.500.315 A.1 emer. rules eff. 06/12/2020.

Rules 7.500.2 A.3-4, 7.500.2 A.6.a, 7.500.2 A.6.c.vi, 7.500.2 A.6.d.i, 7.500.2 A.6.d.v, 7.500.311 A, 7.500.311 B.a.5, 7.500.311 B.b.1-2, 7.500.315 A.1 eff. 09/01/2020.

Entire rule eff. 06/30/2023.

##### **12 CCR 2509-7** County Responsibilities, Staff Training and Qualifications, Client Rights, Confidentiality {#sec-12-ccr-2509-7 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-7}

DEPARTMENT OF HUMAN SERVICES

COUNTY RESPONSIBILITIES, STAFF TRAINING AND QUALIFICATIONS, CLIENT RIGHTS,

CONFIDENTIALITY

12 CCR 2509-7 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 7.600 COUNTY RESPONSIBILITIES, STAFF TRAINING AND QUALIFICATIONS, CLIENT RIGHTS, CONFIDENTIALITY [Eff. 1/1/15] 7.601 COUNTY RESPONSIBILITIES [Eff. 1/1/15]

There are basic information, legal mandates, and policies generic to the administration and/or provision of services that cut across all program and service areas. These include general administrative responsibilities, protection of clients' rights, responsibilities of clients, case processing and documentation, and reporting requirements. The county departments shall provide services to persons who are eligible and belong to the particular Program Area target groups within the following rules of the State Department. 7.601.1 COUNTY RESPONSIBILITIES TO THE STATE DEPARTMENT [Eff. 1/1/15]

A. County departments shall administer child welfare services programs in compliance with State Department fiscal and program regulations.

B. County departments shall report to the State Department at such times and in such manner and form as the State Department requires, including through the state automated case management system. 7.601.11 County Responsibilities to Complete Background Checks for Foster Care Homes and Kinship Foster Care Homes, and Sanctions for Non-Compliance [Rev. eff. 1/1/16]

County departments of human services shall complete a background check for foster care homes and kinship foster care homes pursuant to Section 26-6-106.3(5) and (6), C.R.S., and the results shall be documented in the resource section of state automated case management system. Failure to comply shall result in a corrective action process described in Section 1.110 (9 CCR 2501-1), and may result in sanctions described in Section 1.152.

7.601.2 COUNTY RESPONSIBILITIES FOR COOPERATIVE AGREEMENTS WITH LAW

ENFORCEMENT, CHILDREN’S ADVOCACY CENTERS, AND OTHER AGENCIES [Eff. 1/1/15]

A. County departments shall develop written, time limited cooperative agreements with incorporated and unincorporated municipality, city, county, and state law enforcement agencies that include:

1. Protocols for cooperation and notification between parties on abuse and/or neglect referrals and child deaths resulting from abuse and/or neglect;

2. Protocols for distributing the Notice of Rights and Remedies when required by Section 19-3-212, C.R.S., and Section 7.601.31, of these rules, including, but not limited to assessments of abuse and/or neglect in out-of-home care settings.

3. Joint law enforcement investigation and human or social service assessment procedures;

4. Procedures for independent law enforcement investigation and child welfare service assessment by either party;

5. Procedures for law enforcement investigation of abuse and/or neglect in out-of-homecare settings provided that a law enforcement investigation regarding the criminal aspects of an institutional abuse and/or neglect case shall not relieve the county department of its responsibility to assess the safety of the children in out-of-home care settings; and, 6. Procedures to ensure review and updates to the agreement every four years.

7. County departments shall sign the State Department’s cooperative agreement with the Colorado State Patrol, or submit a copy of the county department’s signed cooperative agreement with the Colorado State Patrol within thirty (30) days of signature.

8. County departments shall provide the State Department with a copy of all signed cooperative agreements with law enforcement within thirty (30) days of signature.

B. The county department may develop a Memorandum of Understanding with Child Advocacy Centers as defined in Section 19-1-103(19.5), C.R.S., that is to include:

1. Protocols with advocacy center authorizing the use of their video tape or audio tape equipment;

2. Interviewers are to be qualified;

3. Interviews should meet the National Children's Alliance performance forensic standards for persons conducting these forensic interviews, as found in the National Children's Alliance Standards for accredited member programs; no later amendments or editions are incorporated. Copies of these standards are available from the Colorado Department of Human Services, Division of Child Welfare, 1575 Sherman Street, Denver, Colorado 80203, or at any state publications depository library;

4. The county department is not responsible for the training of the forensic interviewer employed by the advocacy center;

5. Procedures for conducting forensic interviews in a manner that is of a neutral fact-finding nature and coordinated to avoid duplicate interviews; and, 6. The child advocacy center shall provide technical assistance for forensic interviews, forensic medical examinations, or evidence collection or preservation.

C. Requests for services, from agencies, including other county departments or states, shall be responded to with the same level of attention and to the same extent as requests received from within the county, and as specified in each of the program areas.

7.601.3 COUNTY RESPONSIBILITIES TO ADVISE CLIENTS – COOPERATION AND

RESIDENCE – AVAILABLE SERVICES [Eff. 1/1/15]

A. County departments shall ensure that clients are advised of their responsibility to work with the county department throughout service assessment, planning and delivery in court involved and voluntary cases, in order to establish and achieve common goals of safety, well-being and permanency. Failure of clients to participate or cooperate may result in modification or termination of services.

B. County departments shall ensure that clients are advised in writing and orally of the client's responsibility to report within thirty (30) calendar days, changes of circumstances affecting their eligibility.

C. When a client leaves the original county of residence that county department shall close its case file with exceptions found in individual Program Areas (e.g., Program Areas 3 and 5). Clients are to be advised of the county department’s action on the state prescribed notice of social service action form, if applicable.

D. County departments shall make reasonable efforts to advise county residents of services available through the state and county department by means of such methods as press releases, presentations, pamphlets, websites, social media and other mass media. 7.601.31 Required Notice of Rights and Remedies [Eff. 1/1/15]

A. All county departments shall utilize the state prescribed “Notice of Rights and Remedies for Families” in cases subject to Article 3 of the Colorado Children's Code, “Dependency and Neglect”.

B. County departments shall add county-specific information to the state prescribed form and supply copies of the notice to all law-enforcement agencies within the county or district.

C. The notice shall be delivered at the time of a child's removal to the parent(s) and family from whom the child is removed by court order or by law enforcement personnel. The notice shall specify the cause of the removal of the child or children.

1. If the removal is an emergency pursuant to Section 19-3-401, C.R.S., a copy of the court order directing the removal of the child or children from the home shall be delivered to the family promptly upon its availability.

2. If the removal of the child or children is not an emergency, a copy of the court order directing the removal shall also be provided to the parents and family at the time of removal. 7.601.4 COUNTY RESPONSIBILITIES TO RESPOND TO REFERRALS [Eff. 1/1/15]

A. County departments shall have staff continuously available twenty-four (24) hours a day to receive referrals of alleged abuse and/or neglect, conduct initial reviews of such referrals and assess those referrals that are appropriate for child welfare services.

B. County departments shall establish written response protocols outlining the county plan for weekends, holidays, and after-hour coverage, to include:

1. How the county department will ensure that those individuals reporting abuse and/or neglect after hours are directed to the designated number or agency for response;

2. Requirements for thorough documentation to support the disposition or actions of the county department; and, 3. Requirements that referrals are entered into the state automated case management system as outlined in described in 7.103.9, A.

C. County departments shall ensure that personal, telephone, or written contact is made within five (5) working days of receiving a request for services that does not involve allegations of abuse and/or neglect or as otherwise specified for target groups within Program Areas. 7.601.5 MANDATORY REPORTING OF CHILD ABUSE AND/OR NEGLECT [Eff. 1/1/15]

All county department staff who have reasonable cause to know or suspect child abuse or neglect as set forth in Section 19-3-304, C.R.S., are mandated to report such information to the appropriate county department staff or local law enforcement. 7.601.6 COUNTY RESPONSIBILITIES FOR CASE DOCUMENTATION [Eff. 1/1/15]

A. There shall be case documentation in all active cases as required by the individual Program Area.

1. Frequency of case documentation of case activity will be at a minimum every six (6) months and more often as needed, according to the case plan or Family Service Plan.

2. Summary documentation updating a case record shall be done at least every six (6) months or whenever a case is transferred from county to county, between workers in a county, or when a case is closed.

3. For cases in Program Areas 4, 5, and 6, when there is a change in caseworker or a transfer of a service case to another county, the new caseworker shall have telephone or in-person contact with the child and/or provider within thirty (30) calendar days after the change or transfer.

B. A written narrative summary of case activity shall include, but is not limited to, the following (a court report containing the same information will suffice):

1. Ongoing assessment of individual and/or family functioning;

2. Assessment of progress toward objectives and goals;

3. Chronology of significant events including dates of occurrence;

4. Method of intervention/treatment and impressions of effectiveness;

5. Changes and/or refinements of case plan;

6. Type and extent of court involvement; and 7. Other significant individuals or agencies involved.

For cases in Program Areas 4, 5, and 6 in which an Administrative Review is substituting for a court review, the county shall assure that a written summary containing the above information is complete and present in the case file. The county shall submit this written summary with the Administrative Review findings to the court.

C. A case plan/agreement for each service period shall be developed which contains all of the required information.

D. Documentation of all pertinent contact sheets shall be prepared and prior to the periodic summary of such activities.

E. Evaluation and reassessments pertaining to each service period shall be conducted which reflect case movement toward the long-term goal.

F. A written summary shall be completed within thirty (30) calendar days of closure which shall include:

1. Summary of contacts;

2. Reason for closure;

3. Summary of services provided; and 4. Assessment of effectiveness of services in terms of client's stated goals including, where possible, the client's assessment of the experience.

7.601.7 COUNTY RESPONSIBILITIES TO DETERMINE AND DOCUMENT FUNDING SOURCE

FOR THE PURPOSE OF REPORTING SERVICES AND TO GAIN MAXIMUM FEDERAL

REIMBURSEMENT [Eff. 1/1/15]

If a child is determined eligible for services, the county department shall document the child's funding source eligibility on the Department's automated reporting system. This activity shall occur for each child opened on the department's automated reporting system. Eligibility shall be documented for each funding source for which the child is eligible.

Eligibility criteria and required time frames for determination are found in subsections 7.601.71 through 7.601.74. 7.601.71 Title IV-E Foster Care [Eff. 1/1/15]

Title IV-E of the Social Security Act provides federal matching funds to help pay for the cost of foster care for eligible children. It also pays for training and administrative costs associated with the delivery of services to Title IV-E eligible children/youth.

A. Eligibility Verification and Documentation 1. Verification of the child's citizenship or non-citizen status is required. Other information received by the county department to support a Title IV-E eligibility determination does not require verification unless it conflicts with other information in the possession of the department. If such a conflict occurs, the county department shall use verification procedures provided in the rules for the Colorado Works Program to resolve the conflict (Section 3.140, et seq.; 9 CCR 2503-1).

2. The county department shall document each of the eligibility factors on the state prescribed form. The county must ensure that a copy of the signed voluntary placement agreement or court order and any required verification are present in the case file.

3. The county department shall use the following eligibility effective dates in the state automated case management system:

a. The eligibility effective date of the child for Title IV-E shall be the first day of the month in which all eligibility criteria for the child are met, but can be no earlier than the first day of placement.

b. The date of eligibility of the placement for reimbursements through Title IV-E is the first day of the month in which all the Title IV-E provider eligibility criteria are met.

c. With respect to the court order/petition, the date that is used is the date of the court order or the date a petition is filed for custody/authority for care and placement of the child/youth which eventually leads to a court ordered removal of the child from the home.

B. Title IV-E Eligibility Criteria for a Child/Youth - Initial Determination 1. The child was removed from his/her parent(s) or other specified relative either by:

a. A voluntary placement agreement entered into by the child's parent or legal guardian; or b. A voluntary services agreement entered into by a youth who is participating in the foster youth in transition program as described in 12 CCR 2509-3; 7.203.4 et seq.

c. Order of the court.

2. The first court ruling sanctioning the removal of the child from the home must contain findings to the effect that:

a. Continuation in the home would be contrary to the welfare of the child; or, b. Out-of-home placement is in the best interests of the child.

If this “best interests” determination is not recorded in the first written court order, signed by a judge or magistrate, pertaining to the removal of the child from the home, a transcript of the findings and orders from the court proceeding is the only other documentation that can be accepted to verify that the required judicial determination was made. Neither affidavits nor subsequent “nunc pro tunc” orders are acceptable verification for meeting the “best interests” requirement.

3. There must be an order of the court within sixty (60) calendar days after the date the child is placed in out-of-home care with a finding to the effect that:

a. Reasonable efforts were made to prevent the removal of the child from the home; or b. An emergency situation exists such that the lack of preventative services was reasonable; or, c. Reasonable efforts to prevent the removal of the child from the home were not required. (See Section 7.304.53, B, 3, for circumstances in which the court may determine, that reasonable efforts to prevent removal are not required).

If a “reasonable efforts to prevent the removal” determination was made by the court as required, but was not recorded in the original written court order signed by the judge or magistrate pertaining to that judicial determination, a transcript of the findings and orders from the court proceeding is the only other documentation that can be accepted to verify that the required determination was made. Neither affidavits nor subsequent “nunc pro tunc” orders are acceptable verification for meeting this “reasonable efforts” requirement.

4. The county is granted legal custody/authority for placement and care of the child/youth or the child/youth is in out-of-home care under a voluntary placement agreement/voluntary services agreement.

5. The child must have lived with a parent or other specified relative from whom the child is removed through a voluntary placement agreement or court-ordered custody with the county department in the month, or within the six (6) months preceding the month, in which the voluntary placement agreement was signed or court proceedings were initiated to remove the child or the child has entered into a voluntary services agreement pursuant to section 19-7-306, C.R.S.

6. A child removed through a “constructive removal” shall be determined Title IV-E eligible if all other applicable criteria for Title IV-E eligibility are met.

A constructive removal occurs when all of the following apply:

a. The child resides with a non-parent caretaker who is not the legal custodian or guardian of the child;

b. The child is court ordered into the custody of the county department or placed through a voluntary placement agreement; and c. The child remains in the home of the caretaker who serves as the out-of-home care provider to the child after the county is awarded custody or obtains the agreement for voluntary placement.

7. To be eligible for Title IV-E, the child must be determined eligible for Aid to Families with Dependent Children (AFDC) in accordance with the July 16, 1996, regulations (and exceptions as allowed).

C. Title IV-E Eligibility Criteria of a Provider For the placement costs of a Title IV-E eligible child/youth to be claimable through Title IV-E funding the provider must be a Title IV-E eligible provider. An out-of-home provider must be fully licensed or fully certified to be a Title IV-E eligible provider.

Placement costs of Title IV-E eligible children/youth placed with provisionally licensed or provisionally certified out-of-home care providers will not be claimable through Title IV-E foster care as they are not fully licensed or fully certified providers.

Administrative costs for an otherwise Title IV-E eligible child who is placed in less than fully licensed or fully certified out-of-home care placements are not claimable through Title IV-E funding, except when the child/YOUTH is placed with a relative and the relative is pursuing full foster care certification. Administrative costs can be claimed for up to six months while the child/youth remains in placement with a provisionally certified relative provider.

Administrative costs are not claimable through Title IV-E funding for children/YOUTH who are placed in facilities that are not Title IV-E eligible facilities, such as a detention placement, except for the calendar month in which a child moves from a facility that is not eligible for Title IV-E funding to a Title IV-E claimable out-of-home care facility.

Placement costs of Title IV-E eligible youth who are residing in a supervised independent living placement as described in 12 CCR 2509-04; 7.305.2(D) and have reached the age of 18 are claimable.

D. AFDC Eligibility Tests Title IV-E requires that eligibility for Aid to Families with Dependent Children (AFDC) must be determined in accordance with the regulations as in effect on July 16, 1996, and exceptions as allowed. See 42 U.S.C. SECTION 672(a)(3). The AFDC eligibility month is the month court proceedings leading to the removal were initiated or the month in which a voluntary placement agreement was signed.

1. Living with a Relative - The child/youth must have lived with a parent or other specified relative:

a. During the month in which court proceedings to remove the child/youth were initiated or a voluntary placement agreement/voluntary services agreement was signed; or b. Sometime within the six (6) months preceding the month in which court proceedings to remove the child/youth were initiated or a voluntary placement agreement/voluntary services agreement was signed.

2. Deprivation of Parental Support - The child/youth must be deprived of parental support or care of one or both parents by reason of:

a. Death; b Incapacity - physical or mental;

c. Continued absence from the home; or d. Unemployment - deprivation due to unemployment exists when:

1) Both of the child's natural or adoptive parents resided in the removal home in the month the voluntary placement agreement was signed or court proceedings were initiated to remove the child from the home; and 2) The household income, after AFDC income tests are applied, is less than the need standard for the household.

e. Deprivation of parental support findings are not required when the youth is participating in the foster youth in transition program.

3. Determination of Need The income and resources of the household members of the removal home must be within the allowable standards for an AFDC assistance unit. Refer to the AFDC rules from July 16, 1996, to determine which members of the household are considered in the determination of income and resources.

a. Resources - The family must have less than $10,000 in countable resources.

b. Income Test - The household income after AFDC income tests are applied must be less than the need standard for the household.

4. Additional AFDC Eligibility Factors a. Age - The child must be under eighteen (18) years, or if over eighteen (18) but not yet nineteen (19) years of age, must be a fulltime student in a secondary school or in the equivalent level of vocational or technical training and expected to complete the program before age 19. Such children are eligible for Title IV-E though the month of completion of the educational program.

(i) The youth is participating in the foster youth in transition program and meets eligibility criteria described in 12 CCR 2509-03 7.203.4.

b. Citizenship - The child must be a United States citizen, naturalized citizen, or qualified non-citizen to be eligible for Title IV-E. Refer to Section 3.140 of the Income Maintenance rules (9 CCR 2503-1).

c. Residency - The child must be a resident of Colorado. If the child's residency is from another state, that state is responsible for determining Title IV-E eligibility of the child.

E. Eligibility Factor - Voluntary Placement Agreement 1. A voluntary placement agreement must be completed and signed by the parent(s) or legal guardian and the county department.

2. Eligibility for Title IV-E foster care can begin no earlier than the signature date of the voluntary placement agreement.

3. Voluntary placement agreements are limited to ninety (90) calendar days. If placement of the child is to continue beyond ninety (90) calendar days, the county department must obtain a petition to review the need for placement that leads to a court order granting the county department legal custody.

4. There must be an order by the court within one hundred eighty (180) calendar days of the child's placement in foster care that “continued placement is in the best interests of the child”, or words to that effect. If such an order is not made by the court within the allowable one hundred eighty (180) calendar days, the child is not eligible for Title IV-E foster care reimbursement for the remainder of the child's placement in out-of-home care.

F. Eligibility Factor – Voluntary Services Agreement 1. A voluntary services agreement must be completed and signed by the youth and the county department.

2. Eligibility for Title IV-E foster care can begin no earlier than the signature date of the voluntary services agreement.

3. If the placement of the youth is to continue beyond ninety (90) calendar days, the county department must file a petition for a foster youth in transition case to ensure judicial oversight.

4. There must be an order by the court within one hundred eighty (180) calendar days of the youth's placement in foster care that “continued placement is in the best interests of the youth”, or words to that effect. if such an order is not made by the court within the allowable one hundred eighty (180) calendar days, the youth is not eligible for Title IV-E foster care reimbursement for the remainder of the youth's placement in out-of-home care.

G. Eligibility Factor - Relinquishment If a child is relinquished to the county department, the county shall petition the court to judicially remove the child even though the parent relinquished the child to the agency. Children relinquished to the county department can be Title IV-E eligible when:

1. The child had last been living with the parent within six (6) months of the date court proceedings were initiated.

2. The court order contains the findings shown at Section 7.601.71, B, 2.

3. The child meets other eligibility factors.

H. Minor Parent and Child in Mutual Care A child residing in mutual out-of-home care with his/her adult parent is not considered removed from the parent because the child continues to reside with the parent in the same residence; therefore, the child is not IV-E eligible.

When the parent is a minor and the minor parent has been determined eligible for Title IV-E foster care, the child's placement costs are reimbursable through Title IV-E foster funding as an extension of the minor parent's cost of care.

I. Required Time Frames 1. The county department is responsible for determining the eligibility of every child entering out-of-home foster care within forty-five (45) calendar days of the placement date unless good faith efforts have been made and recorded in the child's record.

2. Counties shall redetermine eligibility using the state prescribed form every twelve (12) months from the date the child enters foster care.

J Redetermination of Title IV-E Eligibility Requirements 1. A court order must remain in effect which grants legal custody of the child to the county department or a petition to review the need for placement was filed and the court has ordered legal authority for continued placement within one hundred eighty (180) calendar days of the date a child entered out-of-home care by voluntary placement agreement.

2. Effective March 27, 2001, there must be an order of the court finding that the county department has made reasonable efforts to finalize a permanency plan. This finding must be made within twelve (12) months of the date the child enters foster care, and every twelve (12) months thereafter while the child remains in out-of-home care. If twelve (12) months elapse without this judicial determination, eligibility for Title IV-E foster care temporarily ends. Title IV-E eligibility can resume the 1st day of the month in which the finding is made. 3. Redeterminations of AFDC requirements are not required for youth participating in the foster youth in transition program.

K. Redetermination of Provider Eligibility An out-of-home care provider must be licensed or certified to be a Title IV-E eligible placement.

Placement costs for a Title IV-E eligible child are only Title IV-E claimable when a child is placed with a Title IV-E eligible provider. Effective September 1, 2000, provisionally licensed or provisionally certified out-of-home care providers will not be claimable placements through Title IV-E foster care as they are not fully licensed or fully certified.

L. Reasonable Candidates Reasonable candidates for foster care, for the purposes of Title IV-E program, are children determined to be at risk of imminent placement out of the home as defined in Section 19-1- 103(64), C.R.S. Administrative costs may be claimed for children who are determined to be at imminent risk of removal from the home through a voluntary placement agreement or court ordered custody with the county department. A determination must be made as to whether the child is at imminent risk of removal from the home no less frequently than every six (6) months.

Reasonable efforts shall be made to prevent the removal of the child from the home until such time that pursuing removal of the child from the home becomes necessary. 7.601.712 Referral to Child Support Services IV-E and Non IV-E Case(s)

The county department may refer any child/youth placed in out of home care to the county department's Child Support Services Unit if the county department finds that a referral is appropriate. A referral may only be appropriate when:

1. The referral will not impede successful achievement of the child/youth's permanency plan or compromise the parent's ability to meet the current or future financial needs of the child/youth;

2. The referral will not compromise the parent's ability to meet the needs of the other children in the household who may be at risk of removal;

3. The child/youth is in continuous placement for more than forty-five (45) days; and 4. The youth is not participating in the foster youth in transition program.

If a referral is made, the county department must review the case every 6 months to reassess the appropriateness of the referral. The county department may consult with the Child Support Services Unit during the reassessment. 7.601.72 Supplemental Security Income (SSI) [Eff. 1/1/15]

Supplemental Security Income is a federal monthly award granted to a child 0–21 years of age who has a verified disability.

A. Recipients of Social Security Administration (SSA) death benefits or Supplemental Security Disability Income for Dependents (SSDI) shall not be coded in this fund source.

B. The county department shall make application to the Social Security Administration for any child who is believed to meet Supplemental Security Income eligibility criteria. Application for Supplemental Security Income is required for all children enrolled in the Children's Habilitation Residential Program (CHRP) waiver.

C. Concurrent eligibility for Title IV-E foster care and Supplemental Security Income (SSI) is allowed.

D. Required Time Frames - Application for benefits shall begin within forty-five (45) calendar days of the child's out-of-home placement in appropriate cases. 7.601.73 Title IV-A Emergency Assistance [Eff. 1/1/15]

The county department shall determine eligibility for the Title IV-A Emergency Assistance Program anytime services are provided or purchased for families with children at risk of placement or when the worker transfers an intake case for on-going services.

A. Eligibility Factors The eligibility determination shall be documented on the state prescribed form and shall include:

1. Whether an emergency exists, defined as the removal of a child from his or her home into publicly funded care or state or county supervision, or risk of such removal as determined by the responsible state or county agency officials.

2. Whether the child has lived with a relative anytime within the six (6) months preceding the Title IV-A Emergency Assistance application. See the Income Maintenance manual for requirements of relative (9 CCR 2503-1).

3. Whether the family's total gross annual income is under $75,000.

B. Maintenance of Effort (MOE)

Expenditures of services to or on behalf of eligible members of an Emergency Assistance eligible family can be attributed to the State's TANF Maintenance of Effort requirement if a child is living in the household with the parent or other adult relative. The Maintenance of Effort entitlement shall be recorded in the state automated case management system if a case is opened for the child.

C. Required Time Frames The county shall complete the eligibility determination within thirty (30) business days of case opening. The eligibility effective date can be no earlier than the date when the application is initiated. 7.601.74 Without Regard to Income [Eff. 1/1/15]

The Without Regard to Income entitlement shall be the default funding stream when a case is opened in the state automated case management system.

7.601.8 COUNTY RESPONSIBILITIES TO REPORT FRAUD – RECOVER MONIES OWED

AND REPORT FALSIFICATION [Eff. 1/1/15]

A. County departments shall refer, within ten (10) working days, to the appropriate investigatory agency and the district attorney any alleged discrepancy which may be a fraudulent act or suspected fraudulent act by a staff member, client, former client, or provider of services.

B. County departments shall seek recovery for the total amount of services costs if the county department finds that the individual was not eligible for the service or if fraud is established.

C. County departments shall take whatever action is necessary to recover payments when staff members, current or former clients and/or providers owe money to the state and/or county department because of overpayments, ineligibility and/or failure to comply with applicable state laws, rules or procedures.

7.601.81 PROTOCOL AND NOTIFICATION REQUIREMENTS FOR FALSIFICATION OF CHILD

WELFARE RECORDS

A. The Colorado Department of Human Services shall maintain and utilize a written protocol regarding the quality assurance process when the Division of Child Welfare is notified by a county department of a confirmed incident of falsification of child welfare records. The Colorado Department of Human Services shall notify the county departments each time the written protocol is updated.

A confirmed incident of falsification of child welfare records is an incident where, after an investigation by the county department, the county department establishes by a preponderance of the evidence that a person knowingly or intentionally made a false entry or falsely altered information in the comprehensive child welfare information system known as Trails.

B. County departments shall maintain and utilize a written protocol regarding quality assurance and investigatory processes to monitor for falsification of child welfare records in the comprehensive child welfare information system known as Trails. The county department shall submit its written protocol to the Colorado Department of Human Services’ Division of Child Welfare for review, and submit it again each time the written protocol is updated.

The county department’s written protocol shall include at minimum the following:

1. If a county department places an employee on administrative leave or temporary suspension for the purpose of investigating a suspected incident of falsification of child welfare records, then the county department shall request that the state department suspend the employee’s access to the comprehensive child welfare information system known as Trails within one (1) working day from the date the employee is placed on leave.

2. The county department shall make reasonable efforts to promptly preserve evidence that a child welfare record has been falsified and supervise or restrict the employee's access to child welfare records including but not limited to the comprehensive child welfare information system known as Trails, hard copy case files, and other child welfare case related documents.

3. The investigation shall be completed by the county department even when the employee subject of the investigation resigns, is terminated, or is no longer employed by the county department at the time the suspected falsification of child welfare records becomes known to the county department.

4. The county department shall use a state department approved letter of notice when there is a confirmed incident of falsified child welfare records.

C. Each county department shall post their written protocol regarding falsification of child welfare records on the county department public-facing website, or shall otherwise provide the written protocol to individuals involved in the county child welfare system.

D. The county department shall notify the Division of Child Welfare of a confirmed incident of falsification of child welfare records within three (3) working days of the confirmation.

E. The county department shall refer confirmed incidents of falsification of child welfare records to the appropriate law enforcement agency or the district attorney within ten (10) working days of the confirmation. The referral to the appropriate law enforcement agency or the district attorney shall be documented by the county department in the employee’s personnel record.

F. The county department shall correct the comprehensive child welfare information system known as Trails when an incident of falsification of child welfare records is confirmed and shall make notice of the correction as follows:

1. If the falsified record relates to an assessment, referral or case for which there is no corresponding dependency and neglect or juvenile delinquency case, the county department shall notify the parents and guardians of the child/youth who was alleged or found to be the victim of abuse or neglect or a youth in conflict, the person found or alleged to be responsible for the abuse or neglect, and the child/youth if age ten (10) years old or older, that a child welfare record has been corrected if that individual would be entitled to access the corrected record pursuant to C.R.S. § 19-1-307 and any other applicable state or federal privacy requirements. Notice to the individuals shall be made through any preferred contact method for the individuals documented in the comprehensive child welfare information system known as Trails. Additionally, the county department shall make notice to all individuals with the state approved notification letter which shall be mailed by first class U.S. mail to the last known address of each individual within ten (10) working days.

2. If the falsified child welfare record relates to an open dependency and neglect or juvenile delinquency case, the county department shall notify the court, parties to the case, their legal counsel, and Guardian ad Litem that a record in the comprehensive child welfare information system known as Trails has been corrected within ten (10) working days of making the correction. The county department shall notify the parents and guardians of the child/youth who was alleged or found to be the victim of abuse or neglect or a youth in conflict, the person found or alleged to be responsible for the abuse or neglect, and the child/youth if age ten (10) years old or older, that a child welfare record has been corrected if that individual would be entitled to access the corrected record pursuant to C.R.S. § 19-1-307 and any other applicable state or federal privacy requirements. Notice to the individuals shall be made through any preferred contact method documented in the comprehensive child welfare information system known as Trails. Additionally, the county department shall make notice to all individuals with the state approved notification letter which shall be mailed by first class U.S. mail to the last known address of each individual within ten (10) working days.

3. To the extent permitted by C.R.S. § 19-1-307 and any other applicable state or federal privacy requirements, the county department shall include a description of the corrections made to a child welfare record in its notification letters to those individuals entitled to notice.

Any notice of a corrected child welfare record issued pursuant to this rule shall be documented in the comprehensive child welfare information system known as Trails. 7.602 COUNTY RESPONSIBILITIES - STAFF AND VOLUNTEERS [Rev. eff. 11/1/15] 7.602.1 STAFF [Rev. eff. 11/1/15]

A. The county shall ensure supervision of casework and case management staff through:

1. Review of individual and family assessments;

2. Family Service Plans;

3. Records maintenance and documentation, including updated information in the Department's automated reporting system; and, 4. Plans for termination of services.

These review findings shall be documented in writing by supervisory personnel and provided to the social service staff and state staff upon request.

B. All current and prospective employees of the county department, who in their position have direct contact with any child in the process of being placed or who has been placed in out of home care, shall submit a complete set of fingerprints to the Colorado Bureau of Investigation (CBI) that were taken by a qualified law enforcement agency to obtain any criminal record held by the CBI.

1. The person's employment is conditional upon a satisfactory criminal background check; and subject to the same grounds for denial or dismissal as outlined in Section 26-6- 104(7), C.R.S., including:

a. Checking records and reports; and, b. Individuals who have not resided in the state within the preceding five (5) years shall be required to have a Federal Bureau of Investigation (FBI) fingerprintbased criminal history.

2. Payment of the fee for the criminal record check is the responsibility of the individual being checked.

3. Prospective employees who are transferring from one county department to another are not required to be re-fingerprinted if they complete the following process:

a. New employees must obtain their CBI clearance letter or a photocopy of their processed fingerprint card from their former employer. They must attach it to a new fingerprint card, with the top portion completed.

b. The new fingerprint card must include the new employer's address. “Transfer- County Department” must be inserted in the “Reason Fingerprinted” block.

c. The CBI clearance letter (or photocopy of the old fingerprint card) and the new fingerprint card must be sent with money order payable to the CBI.

d. County departments that have accounts with CBI are not required to send the money order, and they shall enter their CBI account number in the OCA block of the new fingerprint card. 7.602.2 VOLUNTEERS [Rev. eff. 11/1/15]

County departments may use volunteers to the extent feasible and practical in the administration and delivery of services. County Departments shall employ a process to screen volunteers if such persons’ responsibilities include direct contact with children.

A. The county department shall have a policy that contains:

1. The county department’s commitment to and use of volunteers within the department.

2. Job descriptions for volunteers that describe the duties, location(s), and supervision of the volunteer roles;

3. Information on volunteer evaluation and recognition for his/her contribution to the agency;

4. Agency and volunteer liability.

B. Volunteers shall be trained about topics needed for the volunteer's specific role.

C. The volunteer shall sign a statement that he/she has been trained in the agency standards of confidentiality, understands the principles of confidentiality, and will not share information about the client outside the agency.

7.603 CHILD WELFARE STAFF QUALIFICATIONS AND TRAINING 7.603.1 Child Welfare Qualification and Certification Requirements [Eff. 9/1/22]

The county department and/or the Hotline County Connection Center shall ensure that all staff who perform the following duties meet the required minimum qualifications and fulfill all certification and recertification requirements prior to assuming, or continuing to perform, the duties described in this section on an independent basis as prescribed by the state department (Section 26.5.109, C.R.S.):

A. Hotline Worker Certification 1. Job duties that require hotline worker certification a. Engages callers in the phone interview process;

b. Responds to inquiries; and/or, c. Executes all components of the information gathering process as outlined in the 2. Minimum Educational Requirements a. A high school diploma or general equivalency diploma (GED)

3. Initial Certification Requirements a. To be certified as a hotline worker and perform the duties as outlined in 7.603.1, A, 1, a-c, the staff person shall:

1. Complete the pre-service hotline training for workers;

2. Complete all required Transfer of Learning exercises with the assistance 3. Demonstrate competence through pre-and post-tests, trainer 4. Re-certification Requirements a. To be re-certified as a hotline worker, the staff person must participate in ten (10) hours of in-service training each state fiscal year. Qualifying in-service training exercises include:

1. Quality assurance exercises by the supervisor;

2. Observation and/or participation in RED Teams; and/or, 3. Training focused in the area of the hotline worker’s primary job responsibilities.

B. Hotline Staff Supervisor Certification 1. Job duties that require hotline staff supervisor certification a. Oversees the work of hotline workers, ensuring that all calls received by the county, or hotline county connection center, have information gathered and documented in the state automated case management system, and may participate in the RED team process;

b. Determines jurisdiction of referrals and child welfare inquiries, coordinates their transfer to the appropriate county departments, ensures delivery of referrals to law enforcement and/or judicial partners as needed;

c. Monitors the workload of hotline workers and data associated with the operations of the county departments, or county connection centers, hotline staff, determines resource needs to achieve the goals of the hotline staff, and makes recommendations to higher level management;

d. Meets with hotline workers individually and in groups to counsel staff regarding rules, policies, procedures, data trends, and laws; reviews specific calls, actions taken and problems encountered;

e. Establishes individual training needs of hotline workers and ensures that an effective training plan is in place; and, f. Establishes individual performance plans, reviews the performance of hotline workers on a periodic basis, including review and evaluation of hotline workers’ call recordings, and completes an annual performance evaluation.

2. Minimum Educational Requirements a. A high school diploma or GED; and, b. Three (3) years of professional child welfare experience in a public or private human services agency.

3. Initial Certification Requirements a. To be certified as a hotline staff supervisor and perform the duties as outlined in 7.603.1, B, 1, a-f, the staff person shall:

1. Complete the pre-service hotline training for supervisors;

2. Complete all required Transfer of Learning exercises with the assistance 3. Demonstrate competence through pre- and post-tests, trainer 4. Re-certification Requirements a. To be re-certified as a hotline staff supervisor, the staff person must participate in ten (10) hours of in-service training each year. Qualifying in-service training exercises include:

1. Quality assurance exercises by the supervisor;

2. Observation and/or participation in RED teams; and/or, 3. Training focused in the area of the hotline staff supervisor’s primary job responsibilities.

C. Social Caseworker Trainee Certification The social caseworker trainee is a professional training level position with intensive supervision and/or coaching by the county department in which assignments are limited to fifty percent (50%) of the county’s average workload or ten (10) assessments and/or cases at any given time, whichever is less, and are planned and devised to develop and teach professional social casework techniques, basic foundations, and concepts appropriate to the assigned areas.

1. Job duties that require Social Caseworker Trainee certification a. Provides prevention, assessment, and/or ongoing casework services for Program Areas 4, 5, and/or 6;

b. Provides intensive family services as an alternative to out-of-home placement;

c. Recruits and/or supervises certified foster family care homes, certified and noncertified kinship family care homes, and adoptive family homes;

d. Conducts home studies, grants certifications, and monitors the quality of care provided in foster family care homes, certified and non-certified kinship care homes, and adoptive family homes;

e. Provides individual and/or family counseling on an ongoing or crisis basis to children and/or youth and their parents, families and/or caregivers;

f. Provides training to local community partners regarding the referral, assessment, and service provision process.

2. Minimum Educational Requirements a. A bachelor’s degree from a higher education institution with course work related to the job responsibilities of child welfare social caseworker. Course work examples can include and are not limited to, the development of human measures, or therapeutic techniques.

3. Initial Certification Requirements a. To be certified as a social caseworker trainee and perform the duties as outlined in 7.603.1, C, 1, a-f, the staff person shall:

1. Complete the pre-service training for new social caseworkers; and, 2. Demonstrate an emerging level of competence through pre- and posttests, trainer observation, and verification by the county department as outlined in the request for trainee certification.

4. Re-certification Requirements a. The social caseworker trainee certification is valid for up to one (1) year from initial certification date. Prior to the end of the certification year, the county department must request social caseworker certification to allow the staff person to continue to perform the duties described in 7.603.1, C, 1, a-f, or 7.603.1, D, 1, a- f.

D. Social Caseworker Certification 1. Job duties that require social caseworker certification a. Provides prevention, assessment, and/or ongoing casework services for Program Areas 4, 5, and/or 6;

b. Provides intensive family services as an alternative to out-of-home placement;

c. Recruits and/or supervises certified foster family care homes, certified and noncertified kinship family care homes, and adoptive family homes;

d. Conducts home studies, grants certifications, and monitors the quality of care provided in foster family care homes, certified and non-certified kinship care homes, and adoptive family homes;

e. Provides individual and/or family counseling on an ongoing or crisis basis to children and/or youth and their parents, families and/or caregivers;

f. Provides training to local community partners regarding the referral, assessment, and service provision process.

2. Minimum Educational Requirements a. A bachelor’s degree from a higher education institution with course work related to the job responsibilities of child welfare social caseworker. Course work examples can include and are not limited to, the development of human measures, or therapeutic techniques; and, b. Professional, internship, or volunteer work experience in a human services related agency.

3. Initial Certification Requirements a. To be certified as a social caseworker and perform the duties as outlined in 7.603.1, D, 1, a-f, the staff person shall:

1. Complete the pre-service training for new social caseworkers;

2. Complete all required transfer of learning exercises with the assistance 3. Demonstrate competence through pre- and post-tests, trainer b. Upon initial certification as a social caseworker, the staff person receives dual certification as a hotline worker.

c. If a newly hired social caseworker has been certified as a social caseworker in the state of Colorado within the previous four (4) years, pre-service training for new social caseworkers is not required.

4. Re-certification Requirements a. To be re-certified as a social caseworker, the staff person must participate in forty (40) hours of in-service training each state fiscal year, with a minimum of sixteen (16) of those hours focused in the area of the social caseworker’s primary job responsibilities. Qualifying in-service training includes, but is not limited to:

1. Safety;

2. Risk;

3. Permanency;

4. Well-being;

5. Assessment;

6. Interviewing;

7. Family engagement;

8. Legal issues;

9. Indian Child Welfare Act;

10. Foster care, kinship care and adoption;

11. Effects of child abuse/neglect on development;

12. Principles of strengths-based, family-focused, child-centered and culturally responsive case planning and case management;

13. Sexual abuse issues;

14. Behavioral health issues;

15. Domestic violence issues;

16. Cultural disparity; and/or 17. Other innovative, emerging, promising, and/or best practices.

E. Social Casework Supervisor certification 1. Job duties that require social casework supervisor certification a. Provides direct supervision to social casework staff and para-professionals;

b. Oversees the work of the unit, may make screening decisions regarding referrals, and assigns caseloads to workers based on the knowledge and skills of the social caseworkers in that unit;

c. Monitors the workload of the unit, determines resource needs to achieve the goal of the unit, and makes recommendations to higher level management;

d. Meets with social caseworkers individually and in groups, and counsels regarding rules, policies, procedures, data and laws; reviews specific cases, actions taken, and problems encountered; and creates an environment that allows for professional growth;

e. Establishes individual training needs of social caseworkers, and ensures that an effective training plan is in place;

f. Establishes individual performance plans, reviews the performance of social caseworkers on a periodic basis, and completes an annual performance evaluation.

2. Minimum Educational Requirements a. A bachelor’s degree from a higher education institution with course work related to the job responsibilities of child welfare social casework supervisor. Course work examples can include and are not limited to, the development of human measures, or therapeutic techniques; and, b. Three (3) years of professional, internship, or volunteer work experience in a human services related agency; or, c. A master’s degree or higher in a social work or human behavioral sciences field;

d. Two (2) years of professional, internship, or volunteer work experience in a human services related agency.

3. Initial Certification Requirements a. To be certified as a social casework supervisor, and perform the duties outlined in 7.603.1, D, 1, a-f, the staff person shall:

1. Complete the pre-service training for new social caseworkers if not previously certified within the previous four (4) years in the State of Colorado;

2. Complete the pre-service training for new social caseworker supervisors;

3. Complete all required transfer of learning exercises with the assistance 4. Demonstrate competence through pre- and post-tests, trainer b. Upon certification as a social casework supervisor, the staff person receives dual certification as a hotline staff supervisor.

4. Re-certification requirements a. To be re-certified as a social casework supervisor, the staff person must participate in forty (40) hours of in-service training each state fiscal year, with a minimum of sixteen (16) of those hours focused in the area of the social casework supervisor’s primary job responsibilities. Qualifying in-service training includes, but is not limited to:

1. Leadership and management;

2. Data informed practice;

3. Worker safety;

4. Assessment;

5. Interviewing;

6. Family engagement;

7. Legal issues;

8. Indian Child Welfare Act;

9. Foster care, kinship care, and adoption;

10. Effects of child abuse/neglect on development;

11. Principles of strengths-based, family-focused, child-centered, and culturally responsive case planning and case management;

12. Sexual abuse issues;

13. Behavioral health issues;

14. Domestic violence issues;

15. Cultural disparity; and/or 16. Other innovative, emerging, promising, and/or best practices.

F. Case Aide/Life Skills worker 1. Minimum educational requirements a. This position has obtained a high school diploma or a General Equivalency Diploma (GED); and, b. Has six (6) months of full-time public contact in human services or a related field.

2. Substitution for public contact shall include successful completion of a certificate program and/or college course equivalent to public contact in Human services or a related field.

G. Temporary Educational Waiver Process If proven recruitment difficulty exists, county departments may request a temporary waiver of the educational requirements by submitting a request to the Colorado Department of Human Services, Division of Child Welfare, which includes the following information:

1. For Initial Hiring:

a. Documentation of the recruiting efforts and the identified difficulties;

b. Description of the specific services to be provided by the position, the title of the position, and the name of the candidate;

c. Justification as to how the candidate meets all other qualifications for the position; and, d. A plan on how and when the candidate will meet the requirements contained in these rules.

A temporary educational waiver may be granted for up to two (2) years, with an option for the county department to request one (1) additional year. The progress on the plan outlined by the temporary waiver will be assessed every six (6) months by the Colorado Department of Human Services, Division of Child Welfare, and can be revoked or withdrawn at any time if the requirements are unable to be fulfilled within the identified timeframe.

2. For County Directors:

County directors who also provide direct supervision of child welfare services and who do not meet the minimum qualifications for the casework supervisor position must apply, and qualify, for a temporary educational waiver to provide these services.

H. Training Substitutions If a newly hired person has previous experience and has successfully completed comparable child welfare training to the pre-service training for hotline workers, hotline worker supervisors, social caseworkers, or social casework supervisors, the county department may request a training substitution from the Colorado Department of Human Services, Division of Child Welfare Training unit. The following information must be submitted:

1. Documentation of previous child welfare training including a description of the training and documentation of training completion;

2. Documentation of previous child welfare experience;

3. Completion of state automated case management system navigation training if applicable 4. Completion of the Colorado Family Safety and Risk Assessment training, if applicable;

5. Completion of county-specific Transfer of Learning exercises designed to prepare the worker to perform required job functions Certification will be awarded after requirements of Section 7.603.1, H, 1-5, have been satisfied. 7.603.2 Child Welfare Reporting to Inquiries Regarding Child Welfare Certification Status A. The Colorado Department of Human Services will respond to county department inquiries regarding an individual’s Colorado Child Welfare Training Academy certification status within five (5) working days of receiving the inquiry. The Division of Child Welfare will provide the individual’s current certification status and applicable dates in their response.

B. The Colorado Department of Human Services will respond to any other inquiries regarding an individual’s Colorado Child Welfare Training Academy certification status within ten (10) working days of receiving the inquiry. The Division of Child Welfare will provide the individual’s current certification status and applicable dates in their response. 7.603.3 Decertification Review Process The decertification review process applies to any of the following Child Welfare Training Academy certification types: hotline worker; hotline staff supervisor; social caseworker trainee; social caseworker; and social casework supervisor.

A. Upon notice from a county department of a confirmed incident of falsification, within one (1) working day the Colorado Department of Human Services shall suspend the individual’s access to Colorado’s Comprehensive Child Welfare Information System known as Trails.

B. Upon completion of notification of a confirmed incident of falsification in accordance with section 7.601.81.D, the county department shall provide its original investigatory file to the Division of Child Welfare within ten (10) working days. The county department’s investigatory file shall include, at minimum, the following information:

1. Copies of the specific documentation falsified in the child welfare record.

2. Notes from interviews and written communications with any witnesses contacted as part of the county department’s investigation.

3. The names and contact information for all county department staff involved in the investigation.

4. Documentation of the steps completed to confirm falsification.

5. Any other documents or affidavits relevant to the suspected incident of falsification.

C. The county department will complete its investigation and submit a revised investigatory file with any additional findings, as applicable, to the Division of Child Welfare within sixty (60) calendar days from the date of the initial notice to the Division of Child Welfare of a confirmed incident of falsification. The county department shall still adhere to notification timelines outlined in section 7.601.81. The revised investigatory file shall include, at minimum, all elements outlined in section 7.603.3.B.1-5.

D. The county department shall redact personal identifying information for the county clients and reporting parties contained in the investigatory file to comply with applicable state and federal law regarding the confidentiality of child welfare records or other protected information. Redactions shall include but are not limited to: reporting party names and addresses, social security numbers, and information pertaining to other parties that the individual under review does not have a right to access.

E. The county department shall provide its original investigatory file to the individual under review within ten (10) working days from the date the county department completed notification to the Division of Child Welfare of a confirmed incident of falsification, in accordance with section 7.601.81.D. The county department shall mail a copy of the investigatory file by certified U.S. Mail to the last known address of the individual under review. If requested by the individual under review, the investigatory file may be transmitted through electronic means.

F. When the county department sends a revised investigatory file with any additional findings, the county department shall provide a copy of the county’s revised investigatory file to the individual under review within five (5) working days from the date it is submitted by the county department.

The revised investigatory file shall include, at minimum, all elements outlined in section 7.603.3.B.1-5. The county department shall mail a copy of the revised investigatory file by certified U.S. mail to the last known address of the individual under review. If requested by the individual under review, the investigatory file may be transmitted through electronic means.

G. Within five (5) working days of receipt of the county department’s complete investigatory file, the Division of Child Welfare’s Director (or their designee) shall determine if the individual under review’s state-issued Child Welfare Training Academy certification will be temporarily suspended.

The Division of Child Welfare’s Director (or their designee) shall consider the nature and scope of the falsification of child welfare records, any harm resulting from the falsification, and the necessity to protect the public’s health, safety, or welfare. If the Division of Child Welfare’s Director (or their designee) determines that a temporary suspension of the individual’s Child Welfare Training Academy certification is not necessary, the individual’s Trails access eligibility will be reinstated.

H. Decertification Review Requirements 1. Following the determination to temporarily suspend the individual under review’s Child Welfare Training Academy certification, the Division of Child Welfare shall immediately issue an initial written notice of the temporary suspension to the individual. The written notice will notify the individual that a review process to determine if the individual will be decertified will be initiated. The initial written notice to the individual shall be personally served on the individual unless service is waived.

2. The initial written notice from the Division of Child Welfare to the individual shall include, at minimum, the following information:

a. The individual’s current Child Welfare Training Academy certification type.

b. The effective date and expiration date of the current Child Welfare Training Academy certification type.

c. The name of the county department that notified the Division of Child Welfare of the confirmed incident of falsification, in accordance with section 7.601.81.D., and the date the notification was received.

d. A description of the falsification of child welfare records which was confirmed by the county department, subject to redaction of any personally identifiable information of county child welfare clients.

e. Notice that a temporary suspension of the individual’s current Child Welfare Training Academy certification is in effect until a review panel decertification determination is reached.

f. The process by which the confirmed incident of falsification will be reviewed to determine if the individual will be decertified from Child Welfare Training Academy certification.

g. The date the decertification review panel is scheduled to occur, and how the individual can attend in person or virtually.

h. How to request reasonable accommodations in accordance with the Americans with Disabilities Act, should such accommodations be necessary for the individual to attend the decertification review in person or virtually.

i. Notice that the individual is permitted, but not required, to present documentation or witnesses for the review panel’s consideration. The individual shall provide any such documentation to the Division of Child Welfare no later than twenty-one (21) calendar days after the initial written notice date of receipt.

j. Notice that the individual is permitted, but not required, to be represented by legal counsel throughout the state level decertification review, hearings, and appeal.

k. Notice that the individual is permitted to request an extension of up to thirty (30) calendar days regarding the scheduled decertification review panel date to prepare for the review.

l. Notice that the individual is permitted to request the scheduled decertification review be held in abeyance when a criminal prosecution is pending arising out of the same report.

m. That a copy of this written notice will be provided to the county department that notified the Division of Child Welfare of the confirmed incident of falsification in accordance with section 7.601.81.D.

3. The Division of Child Welfare will provide the county department that notified the Division of Child Welfare of the confirmed incident of falsification with a copy of the initial written notice sent to the individual. The Division of Child Welfare shall redact the individual’s contact information from the copy of the initial written notice sent to the individual that is provided to the county department.

I. When reasonable accommodations are requested by the individual under review to attend the decertification review, such accommodations shall be provided by the Colorado Department of Human Services in accordance with the Americans with Disabilities Act of 1990. No later editions or amendments are included. Copies may be obtained or examined during regular business hours by contacting the Division of Child Welfare’s Director, at the Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado 80203; or any state of Colorado publications depository library.

J. The individual shall have the right to appeal even if a criminal prosecution arising from the same confirmed incident of falsification is pending. The Colorado Department of Human Services shall hold in abeyance the administrative process pending the outcome of the criminal action if requested by the individual. 7.603.4 Review Panel Decertification Determination A. The Colorado Department of Human Services shall convene a five (5) person review panel comprised of the Division Of Child Welfare’s Director (or their designee); a representative of the Division of Aging and Adult Protective Services; a representative of the Administrative Review Division; a county department representative; and a person with lived experience from either the Colorado Department of Human Services’ Family Voice Council or the Division of Child Welfare’s Family Advisory Council.

1. All review panel members will be required to sign an acknowledgement of confidentiality and a conflict of interest disclosure.

2. When a conflict of interest exists for one of the review panel members, an alternative representative shall be designated by the assigned program area or agency they are representing as listed in 7.603.4.A.

3. County department representatives shall not be from a county the individual under review was previously employed by. When a county department has a conflict of interest, a representative from a different county department shall be designated.

4. When a person with lived experience from either the Colorado Department of Human Services’ Family Voice Council or the Division of Child Welfare’s Family Advisory Council is not available to participate in the review panel, then the Division of Child Welfare will make reasonable efforts to include a person with lived experience from a county department or partner agency’s child welfare lived expert groups.

5. Persons with lived experience participating as panelists may be reimbursed for their reasonable expenses incurred in participating in the review panel.

6. Proceedings before the review panel shall be recorded or transcribed.

B. The Division of Child Welfare will provide a copy of the complete investigatory file to the review panel members by the deadline set by the panel.

C. The five (5) person review panel shall review the circumstances surrounding the county department’s confirmation of the incident of falsification of child welfare records, and issue an initial agency decision determining whether to decertify the individual from their Child Welfare Training Academy certification.

D. After consideration of the county department’s complete investigatory file and any additional evidence submitted by the individual under review or the county which confirmed the falsification , the review panel may decertify the individual from their Child Welfare Training Academy certification if the review panel finds the county department’s finding of a confirmed incident of falsification to be supported by a preponderance of the evidence. In determining whether decertification is appropriate , the review panel may consider the following factors:

1. The nature of the records that were falsified;

2. The quantity of confirmed falsified entries in child welfare records created by the individual;

3. The extent to which the falsification incident impacted the county department’s client(s);

4. The risk the falsification incident posed to the safety of a child/youth, a parent, or community member;

5. Whether the falsification incident caused or contributed to a final custody determination in a court involved case;

6. The risk of harm to the public trust caused by the falsification incident;

7. The need to further protect the public’s health, safety, or welfare;

8. Whether the individual had previously been confirmed to have falsified child welfare records; and 9. Any other relevant factors presented to the review panel for consideration.

E. No later than thirty-six (36) calendar days after the initial written notice is personally served on the individual, the review panel shall issue an initial agency decision , in writing regarding whether it is decertifying the individual’s Child Welfare Training Academy certification.

F. The initial agency decision shall be sent to the individual under review by certified U.S. mail to the last known address of the individual. A copy of the review panel determination will also be sent to the county department.

G. The initial agency decision shall include, at minimum, the following information:

1. The individual’s current Child Welfare Training Academy certification type.

2. The name of the county department that notified the Division of Child Welfare of the confirmed incident of falsification in accordance with section 7.601.81.D.

3. A description of the confirmed incident of falsification which was submitted by the county department, along with the definition of a confirmed incident of falsification as stated in

section 7.601.81.A.

4. A description of the evidence presented to the review panel and the review panel’s findings of fact.

5. The outcome of the review process and effective date of the review panel determination.

6. When the review panel decides to decertify the individual, the initial agency decision must also include:

a. A description of the review panel’s application of the factors stated in section 7.603.4.D to the evidence and the review panel’s findings of fact.

b. A description of the process by which the individual can file exceptions to the review panel’s decision to decertify the individual from Child Welfare Training Academy certification.

c. An advisement that the failure to file exceptions to provisions of the initial agency decision will waive the right to seek judicial review of a final agency decision affirming those provisions, d. Notice that the individual under review’s access to Colorado’s Comprehensive Child Welfare Information System known as Trails will remain suspended due to lack of proper credentialing.

e. Notice that the individual is permitted, but not required, to be represented by legal counsel when filing exceptions .

H. If the review panel determines that decertification of the individual’s Child Welfare Training Academy certification is not necessary, the individual’s Trails access eligibility will be reinstated . 7.603.5 Child Welfare Decertification State Department Office Of Appeals Functions A. A party seeking a final agency decision that reverses, modifies or remands the initial agency decision of the review panel must file exceptions to the decision within fifteen (15) days (plus three (3) days for mailing) from the date the initial agency decision is mailed to the parties, or within such greater time as the Office of Appeals may allow upon written request. Exceptions must state specific grounds for reversal, modification, or remand.

If the party asserts that the review panel’s findings of fact are not supported by the weight of the evidence, the party shall simultaneously with, or prior to the filing of exceptions, request the review panel to cause a transcript of all or a portion of the hearing to be filed with the Office of Appeals. Within five (5) days of the request for the transcript, the party requesting it shall advance the cost therefore to the transcriber designated by the review panel unless prior payment is waived by the transcriber.

A party who is unable to pay the cost of a transcript due to indigency may file a written request with the Office of Appeals for permission to submit a copy of the hearing recording instead a of a transcript. If submission of the recording is permitted, the review panel shall promptly deliver a copy of the recording to the Office of Appeals.

If the exceptions do not challenge the findings of fact, but instead assert only that the review panel improperly interpreted or applied state rules or relevant statutes, no transcript or audio recording review is required.

B. The Office of Appeals shall serve a copy of the exceptions on each party by first class mail. Each party shall be limited to ten (10) calendar days from the date exceptions are mailed to the parties to file a written response to such exceptions. The Office of Appeals shall not permit oral argument and shall not consider evidence which was not part of the record before the review panel.

However, the case may be remanded to the review panel if a party establishes in its exceptions that material evidence has been discovered which the party could not with reasonable diligence have produced at the hearing.

C. The Division of Child Welfare may file exceptions to the initial agency decision, or respond to exceptions filed by a party. The division’s exceptions must be filed in compliance with the requirements of section 7.603.5.A, above. Exceptions filed by the division shall be treated as requesting review of the initial agency decision upon the state department’s own motion.

D. Review shall be conducted by a state adjudicator in the Office of Appeals not directly involved in any prior review of the county report being appealed. Review by the Office of Appeals shall determine whether the decision properly interprets and applies the rules of the state department, or relevant statutes, and whether the findings of fact and conclusions of law support the decision.

In the absence of exceptions filed by any party or by the Division of Child Welfare, the office of appeals shall review the initial agency decision, and may review the hearing file and/or the recordings of proceedings before entering a final agency decision.

E. The Office of Appeals shall mail copies of the final agency decision to all parties by first class mail. The final agency decision shall advise the appellant of their right to seek judicial review in the State District Court, City and County of Denver, if the appellant had timely filed exceptions to the initial agency decision.

F. If the appellant seeks judicial review of the final agency decision, the state department shall be responsible for defending the final agency decision on judicial review.

G. In any action in any court challenging a county department’s confirmed incident of falsification, the Division of Child Welfare will defend the statutes, rules, and state-mandated procedures leading up to the finding, and will defend all county department actions that are consistent with statutes, rules, and state-mandated procedures. The Division of Child Welfare shall not be responsible for defending the county department for actions that are alleged to be in violation of, or inconsistent with, state statutes, state rules or state-mandated procedures.

H. If the final agency decision reverses a review panel determination to decertify, the individual’s suspension of access to Colorado’s Comprehensive Child Welfare Information System known as Trails shall be lifted. 7.603.6 Confidentiality of Appeal Records A. All records submitted by the parties as part of the state level appeal process and all notices, orders, agency notes created by or made part of the state department’s agency record shall be confidential and shall not be released or disclosed unless otherwise permitted by law.

B. Initial and final agency decisions where information identifying the appellant, reporting parties, county clients, or other minors have been blocked out may be released to the public. 7.604 ANTI-DISCRIMINATION [Eff. 1/1/15]

Child welfare services programs shall be administered in compliance with Title II of the Americans with Disabilities Act of 1990, Title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, and the requirements of section 504 of the Rehabilitation Act of 1973. No later editions or amendments are included. Copies may be obtained or examined during regular business hours by contacting the Director, Division of Child Welfare Services, at the Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado 80203; or any state publications depository library.

A. County department staff shall not deny a person aid, services, or other benefits or opportunity to participate therein, solely because of age, race, color, religion, creed, sex, national origin, political beliefs, method of payment, sexual orientation, veterans status, or disability.

B. County departments shall make services available to all eligible children and their families, including disabled individuals, through hiring qualified staff or through purchase of necessary services.

C. County departments must be accessible to all [CLIENTS] and recipients who wish to receive services, or the services must be made accessible at an alternate location, as set forth in the county written plan.

D. County departments shall have an affirmative action plan and a disability services plan.

E. County departments shall take reasonable and prudent steps to ensure that persons with limited English proficiency have meaningful and equal access to programs, services and information free of charge.

F. County departments shall take extra care to ensure that the choice of interpreter by a person with limited English proficiency is voluntary and made with the knowledge that a competent interpreter could be provided by the county department at no cost to the person with limited English proficiency upon request.

G. County departments shall post signs in reception areas, intake areas or other entry points in the department notifying persons with a physical or mental disability that auxiliary aids and services, including sign language, are available upon request. 7.605 CONFIDENTIALITY [Eff. 1/1/15]

Unless authorized in these rules the use or disclosure of information by the county department concerning current or former clients is prohibited. 7.605.1 CONFIDENTIAL INFORMATION PROTECTED [Eff. 1/1/15]

A. County departments shall treat all information as confidential according to applicable statutes, including, but not limited to, the following:

1. Names and addresses of current or former clients and services provided;

2. Information related to the social and economic conditions or circumstances concerning any individual including wage or income information or correspondence obtained from any source including state or federal agencies;

3. Agency evaluation of information about any individual;

4. Medical, psychological, or social evaluations including diagnosis or past history of disease, or disability of any kind; and, 5. The name, address, and any other identifying information of the reporting party in an abuse and/or neglect referral.

B. All confidential information shall be sorted and processed so that there are safeguards to ensure no unauthorized personnel can acquire or retrieve the information.

C. When the use of any and all records obtained, created, or used are no longer needed, they shall be destroyed or returned. Destruction shall be in a secure manner, such as shredding. 7.605.2 PROCEDURES FOR RELEASE OF CONFIDENTIAL INFORMATION [Eff. 1/1/15]

A. County departments shall obtain written permission from the individual or family for the release of information, unless such release is otherwise authorized in these rules or by law or unless the referring agency has already secured written permission.

B. The release or use of information concerning current or former clients shall be restricted to persons or agency representatives who are subject to standards of confidentiality that are comparable to those of the state and county departments.

C. County departments shall apply these rules to requests for information from such groups or individuals as legislators, governmental authority, the courts, or law enforcement officials, as from any other source. Whenever there is a question about the legality of releasing information to persons seeking information from the county department, the requestor shall be advised to request the court to require the county department to produce the desired records or information within the custody or control of the county department. 7.605.21 County Responsible for Processing Inquiries Concerning Abuse and/or Neglect Referrals [Eff. 1/1/15]

The county department that entered the founded report of abuse and/or neglect shall process all inquiries submitted by the following types of entities or individuals:

A. Departments of human or social services, Court-Appointed Special Advocate Program (CASA), the courts or individuals authorized to review records and reports of abuse and/or neglect;

B. Individuals or child placement agencies approved to conduct home studies for out of home placement providers;

C. Governing bodies for the purposes of carrying out their duties; and, D. Inquiries from individuals who have been involved with the county department requesting a copy of the information pertinent to himself or herself or as having the legal responsibility or authorization to care for, treat, or supervise a child who is the subject of a report or record. The exception to this is employment and volunteer related background check inquiries (see sections 7.605.22, C and 7.701.32). 7.605.22 Sharing of Confidential Information Between Governmental Agencies – Administrative Reviews [Eff. 1/1/15]

A. County departments shall share appropriate information with other human or social services agencies and community professionals who care for, treat, or supervise a child to ensure coordination of services and protection of the child. Agencies or individuals receiving the information must have a need to know the information for the purposes of investigations and case management in the provision of services or the administration of their respective programs.

County departments shall require that these agencies and persons have confidentiality standards.

Release of information shall be obtained, when required.

B. Individuals participating in a kinship, foster care, or alternative service review of a child at the invitation of the county department shall be considered as part of the administration of the child welfare services program for purposes of handling confidential information. The role of such persons is to contribute information essential to the delivery of services to the child and the child's family. Information concerning the child and the child's family shall be considered confidential by all parties to the review system. Releases of information shall be obtained, when required.

C. Provisions for employment and volunteer related background check inquiries will be followed as outlined in section 7.701.32 “Use of Reports and Records of Child Abuse or Neglect for Background and Employment Inquiries”. 7.605.23 Release of Confidential Information in Court Proceedings – Reporting Party [Eff. 1/1/15]

A. In a criminal or civil proceeding in which the county case record is subpoenaed or any county representative is ordered to testify concerning a current or former client, the court shall be advised through proper channels of the statutory provisions, policies, or rules and regulations concerning disclosure of information. Confidential information shall not be released in a judicial proceeding unless so ordered by the court.

B. Confidential information, such as the identity of the reporting party, shall not be released in a judicial proceeding unless so ordered by the court. 7.605.24 Release of Confidential Information to Clients [Eff. 1/1/15]

County departments shall define in writing and submit to the State department a process by which clients and former clients may obtain access to their case records. The following elements shall be included in the process:

A. Designated source (individual and position) within the county department who will handle client requests for records access;

B. Directions for maintaining a record of the requests;

C. Time frames for responding to requests;

D. Directions for individuals requesting access to records;

E. How editing is to occur and by whom (removal or reporting party information; removal of other confidential information which is protected by law);

F. Charges involved for the requestor; and, G. Warning regarding the sharing of confidential information by the requestor. 7.605.25 Release of Confidential Information for Conflict Resolution Purposes [Eff. 1/1/15]

For purposes of carrying out the conflict resolution duties as set forth in section 19-3-211, C.R.S., county governing bodies shall be given access to child abuse and/or neglect records or reports related to specific grievances under their purview. County departments shall ensure that members understand the confidential nature of such information. 7.605.3 USE OF CONFIDENTIAL INFORMATION – RELEASE NOT REQUIRED [Eff. 1/1/15] 7.605.31 Internal Inquiries [Eff. 1/1/15]

County departments shall perform inquiries into the state automated case management system for information pertaining to their own internal county department operations, including, but not limited to:

A. Investigations and assessments of allegation of abuse and/or neglect;

B. Certifying individuals as county kinship providers, county foster and/or adoptive homes; and, C. Screening of county department employees and volunteers if such persons’ responsibilities include direct contact with children. 7.605.32 Assessments of Known or Suspected Incidents of Child Abuse and/or Neglect [Eff. 1/1/15]

County departments shall provide child abuse and/or neglect records and reports to the law enforcement agency, district attorney, coroner, or county department investigating or assessing a report of a known or suspected incident of child abuse and/or neglect or treating a child or family which is the subject of the report. 7.605.4 PERMITTED USES OF CONFIDENTIAL INFORMATION [Eff. 1/1/15]

To the extent county departments may access and use confidential information as described above, such access and use is permitted only for purposes directly connected with the administration of child welfare programs and related State Department activities which include:

A. Administration of county child welfare programs:

1. Establishing of eligibility;

2. Determining amount and type of services to be provided; and, 3. Providing services.

B. Any investigation, prosecution, or criminal or civil proceeding in connection with the administration of the program.

C. Any records or reports that are unconfirmed may only be used to assist in future risk or safety assessments. 7.605.5 PENALTY FOR UNAUTHORIZED RELEASE [Eff. 1/1/15]

Any person who willfully permits or who encourages the release of data or information related to abuse and/or neglect contained in the state automated case management system to persons not permitted access to such information, commits a Class 1 misdemeanor and shall be punished as provided in

Section 18-1.3-501, C.R.S. 7.606 CHILD WELFARE GRIEVANCE RESOLUTION PROCESS [Eff. 1/1/15]

The governing body of each county, and city and county, shall establish a grievance process. A grievance filed by a complainant concerning the conduct of a county department employee can be submitted to the county department, the Colorado Department of Human Services Client Services unit, or the Office of The Child Protection Ombudsman.

The following requirements apply to the grievance process:

A. Definitions “Grievance” means a complaint filed by a complainant regarding the conduct of an employee of a county department of social services in performing his/her duties under Article 3 of the Children's Code. “Grievance” does not include complaints regarding conduct by the courts, attorneys, law enforcement officials, employees of the State, foster parents or other providers of services to children, or other family members.

“Complainant” means any person who was the subject of an investigation of a report of child abuse or neglect or any parent, guardian, or legal custodian of a child who is the subject of a report of child abuse or neglect and brings a grievance against a county department in accordance with the provisions of Section 19-3-211, C.R.S.

“Conduct” means the manner in which a county department employee behaves when performing his/her duties under Article 3 of the Children’s Code. If an employee makes a decision that is appealable under Colorado statutes and the rules governing child welfare services, an individual may pursue those remedies. The grievance resolution process does not modify the time frames for pursuing the other forms of relief available under Colorado statutes and the rules governing child welfare services.

“Governing body” means the board of county commissioners of a county, or a city council of a city and county, in accordance with Section 19-1-103(54), C.R.S.

“Recommendation” means a proposed course of action that may be implemented by a county director to resolve a grievance. These proposed actions may include reassigning a case to a different employee, requiring an employee to receive training, or administering disciplinary action to an employee, subject to applicable safeguards afforded to the employee through the personnel system under which the employee is employed.

B. Time Frames for Resolving Grievances Any grievance shall be forwarded to the county child welfare director for internal resolution within ten (10) working days after it has been received by the county department.

The county child welfare director shall act on the grievance within twenty (20) calendar days after they receive it. If the county department has resolved the grievance to the complainant's satisfaction, it will issue a written final decision within thirty-five (35) days of receipt of the grievance. If the county department is unable to resolve the grievance to the complainant's satisfaction and upon the request of the complainant, the county department shall refer the grievance to the Office of The Child Protection Ombudsman.

C. Grievance Process Information Each county department shall post information about the grievance process on the county department’s public-facing website or otherwise provide information concerning the grievance process to individuals involved in the county child welfare system.

D. Annual Reports On or before July 31 of each year, every county or city and county shall submit to the State Department an annual report regarding the resolution of grievances pursuant to this section. At a minimum, this report shall include:

1. The number of grievances received by the county child welfare director, the number of grievances referred to the governing board, and the actual time frames for resolving grievances at each level.

2. A brief description of the disposition of the grievances, including the number that were concluded without any action taken, the number which were substantiated, the number resolved by case reassignment, the number resolved by requiring additional training, the number resolved by imposing disciplinary action against a county employee, and the number resolved in other ways; and, 3. A copy of its county grievance policy.

E. Counties shall publicize:

1. The availability of the process for all dependency and neglect cases through the “Notice of Rights and Remedies” and by informing child welfare clients, guardians, and legal custodians of the process during the initial contacts with parties and periodically throughout the provision of services related to dependency and neglect cases.

2. The rights and remedies for families as specified in Section 7.601.31.

3. Any other information about the process as deemed relevant by the governing body.

7.607 COUNTY RESPONSIBILITIES FOR PURCHASE OF SERVICE, CONTRACTING AND

ADMINISTRATIVE SERVICE [Eff. 1/1/15] 7.607.1 DEFINITIONS [Eff. 1/1/15]

A. “Administrative services” are personal services delivered by an individual or organization in lieu of the services being delivered directly by county department employees within the Merit System or county personnel system.

B. “Program services” are direct program costs.

1. Non-contractual program case services are a type of program service obtained by purchase for a specific client or client groups without the use of a contract. These involve a direct payment to a client or one-time or irregular vendor payment for services provided to a specific client where a contract would be difficult or impossible to obtain.

2. Contractual program services are obtained by purchase for a specific client or client groups and a contract is required. 7.607.2 CONTRACTING REQUIREMENTS [Eff. 1/1/15]

A. The county department shall enter into a contract before the initiation of administrative or program services, except for non-contractual program case services identified in this section.

B. The county department shall initiate a written corrective action plan or terminate the contract when it determines that services do not comply with the terms of the contract.

C. The county department has direct responsibility for, and shall not purchase activities of:

1. Service eligibility determination or redetermination;

2. Development of the Services Agreement or Family Services Plan;

3. Authorization of purchased services;

4. Service fee determination; and, 5. Monitoring of purchased services.

D. County department employees shall not act as a provider of purchased program services.

E. The county shall purchase services only when the rates of payment for services do not exceed the amounts reasonable and necessary to assure the quality of service. Reasonable means the cost does not exceed the community prevailing rate. Necessary means the service is directly related to the client's need.

F. When contractors are required by statute to be licensed, registered, or certified in order to perform the purchased service, county departments of social services shall assure that such requirements are met, before the execution of the contract. In addition to or in the absence of such statutory requirements, the contractor shall meet standards or criteria as established by the State Department. All personnel engaged in the administration or direct delivery of services purchased by the county department shall meet qualifications as provided under Merit System rules and regulations or an approved county personnel system.

G. The county department shall purchase services only from contractors independent of the county.

State reimbursement shall be available only for purchase of service contracts where the relationship between the county department of social services and the contractor is a relationship of employer-independent contractor, not that of employer-employee.

H. In cases where the contractor status is not clear, status resolution shall be in favor of the employee status classification.

I. For program or administrative contracts in the amount $10,000 or less, the county department may use its own selection criteria for awarding purchase of service contracts.

J. The county department shall establish a separate file for each contract in excess of $10,000 and include the following documentation:

1. Supporting the basis for award cost or price; and, 2. Identifying the procurement method used (formal advertising or negotiation).

a. If formal advertising was used, the county shall include descriptive material used to solicit bids and copies of published bid solicitation notices.

b. If negotiation was used, include justification for using this procurement method.

Justification shall include one or more of the five acceptable reasons for negotiation listed below.

K. The county department shall use the most formal procurement method that is possible and practical.

1. Formal advertising is the procurement method that involves open and free competition (i.e., public notice of bid solicitations, a clear and adequate description of the technical requirements for the service to be procured, sealed bids, and the public opening of bids).

2. Procurements may be negotiated if it is not practicable or feasible to use formal advertising. Generally, such procurements may be negotiated if one or more of the following conditions prevail:

a. The public exigency will not permit the delay incident to advertising.

b. The material or service to be procured is available from only one person or firm.

c. The contract is for personal or professional services, or for any service to be rendered by a university, college, or other educational institution. (Personal services here refer to a contract with an individual for the services of that individual. Professional services refer to services rendered by a person or organization licensed or certified by the state.)

d. No acceptable bids have been received after formal advertising.

e. Formal advertising is otherwise not practicable or feasible, and negotiation is authorized by applicable law, rules, or regulations.

L. Excluded from requirements of this section, “ Purchase of Services,” are services purchased under the Employment First Program.

M. Any county department and child placement agency entering into a contract for the provision of foster care services shall include a provision in the contract that recognizes a right of the State Department or county department to recover any funds misused by the Child Placement Agency and to withhold subsequent payments. The provision in the contract shall provide for an appeal of the decision to recover or withhold the funds.

7.607.3 PURCHASE OF PROGRAM SERVICES

A. The purchase of program services:

1. May or may not require a contract depending upon the specific service purchased.

2. Does not require State Department prior approval as long as the service is authorized by state rule.

B. Authorized Non-Contractual Program Case Services 1. Transportation for children in out-of-home care, limited to the following purposes:

a. For return of runaways, who are in county department custody, to their Colorado home county.

b. For a child in out-of-home care to receive services specified in the Family Services Plan that are directly related to family time and reunification.

c. To facilitate a permanent plan through the Interstate Compact.

d. To access one-time physical, dental, and psychological examinations for children in out-of-home care who are not Medicaid eligible and have no other insurance.

2. A one-time physical, dental, and psychological examination for children in out-of-home care who are not Medicaid eligible and have no other insurance. 3 Case services authorized in the Adoption Services and Relative Guardianship Assistance Program sections that are specified in a current signed Adoption or Relative Guardianship Assistance Agreement.

4. Other case services provided to children in out-of-home placement when such services are not a part of either room and board or Medicaid treatment or case management services.

C. Contractual Program Services 1. Services may be obtained by purchase for specific clients using the standardized form contracts, identified by number in the paragraph below. Standardized form contracts comply with federal and state statutes and/or regulations for the purchase of service.

a. Child Welfare Child Care: Use contract form SS-19 as appropriate.

b. Child Foster Care Service: Use state authorized contract forms as appropriate.

c. Psychological Evaluations, when purchased once and not through an agency contract: Use contract form SS-21B. Psychological evaluations shall not be purchased for children or adults who are eligible for Title XIX (Medicaid). Third party payment for psychological evaluations shall be used as first payer where possible.

1) Limited purposes for children:

a) For assessment of the need for protection - includes psychological evaluations for parents or substitute caretakers.

Substitute caretakers are persons providing care as an alternative to the parent, i.e., includes guardians or legal custodians and excludes foster parents.

b) For foster care placement.

c) For adoptive home placement.

2) Limited purposes for adults:

For biological parents, on behalf of children in foster care.

d. Physical evaluations, when purchased once and not through an agency contract shall use the state authorized contract form. Physical evaluations shall not be purchased with program service funds for children or adults who are eligible for Title XIX (Medicaid). Third party payment for physical evaluations shall be used as first payer where possible.

Limited purposes for children:

1) Needing assessment of need for protection.

2) In Child Welfare Child Care.

3) In out-of-home care.

e. Evaluation shall include the cost of the examination as well as any written and/or verbal interpretation of the results of the psychological or physical evaluation.

Core Services Program Services: County departments with state approved Core Services plans may use Form FPP-1 or develop and use their own contract for the purchase of Core Services. County developed contracts shall meet the contract content requirements provided in Section 7.607.4, D.

D. Billing and Payment County department billings for the purchase of program service shall follow state procedures. 7.607.4 ADMINISTRATIVE SERVICES [Eff. 1/1/15]

A. The purchase of administrative services requires:

1. A contract; and, 2. State Department approval.

B. The content of all administrative contracts shall comply with the requirements as established by the State Department.

C. The county department shall monitor the provision of services at least every six (6) months under an administrative service contract for compliance with the contract and maintain written documentation of such monitoring including dates of monitoring and results/conclusions.

D. Contract Content 1. If a county department determines that certain administrative services are to be purchased, the county department shall negotiate terms and write a contract for the purchase.

2. When the county department writes an administrative service contract, the contract shall contain:

a. All terms of the contract in one instrument, be dated, and be executed by authorized representatives of all parties to the contract prior to the date of the implementation;

b. A definite beginning and ending date for provision of services up to a maximum of one (1) year duration;

c. A detailed description of the services to be provided and of the methods, including subcontracting, to be used by the contractor in carrying out its obligations under the contract;

d. A stated number of units of service at a specific dollar rate, and/or for a specific dollar amount;

e. The method and source of payment to the contractor;

f. The source of funds and provision that “Payment pursuant to this contract, if in federal and/or state funds, whether in whole or in part, is subject to and contingent upon the continuing availability of federal and/or state funds for the purposes hereof”;

g. Provision that no fees shall be imposed by the contractor related to services provided under this contract;

h. Provision that the contractor meets applicable state licensing requirements, and/or federal standards and/or qualifications as provided under Merit System rules and regulations or county personnel system;

i. Provision that contractor strictly adheres to all applicable federal, state, and local laws that have been or may hereafter be established;

j. The address(es) of facilities to be used in providing services;

k. Provision that the contractor shall comply with the requirements of the Civil Rights Act of 1964, the requirements of Section 504 of the Rehabilitation Act of 1973, Americans with Disabilities Act, and for safeguarding information according to rules of the State Department;

l. Provision that any subcontracts permitted by the contract shall be subject to the requirements of the contract as listed here, and that the contractor is responsible for the performance of any subcontractor;

m. A statement specifying requirements for fiscal and program responsibility, billing, records, controls, reports, and monitoring procedures;

n. Provision for access to financial, program, and other records pertaining to services provided under this contract by county, state, and federal officials, and others as authorized in writing by the county;

o. Provisions for contractor to keep financial, program, or other records pertinent to this contract for a period of 5 years from the contract termination date;

p. Provision that the parties of the contract intend that the relationship between them contemplated by the contract is that of employer-independent contractor;

q. Provisions for termination by either party including the manner by which termination will be effected and the basis for settlement. In addition, such contracts shall set forth the conditions under which the contract may be terminated for default as well as conditions where the contract may be terminated because of circumstances beyond the control of the contractor; and, r. For contracts over $10,000 certain provisions that will allow for administrative, contractual, or legal remedies in instances in which contractors violate or breach contract terms, and provide for such sanctions and penalties as may be appropriate; and for contracts in excess of $100,000, the contract must contain provisions for compliance with the Clean Air Act and the federal Water Pollution Control Act.

E. Additional County Option Contract Components The county department may add optional provisions to the above required standard contract items.

F. Billings and Payment 1. County department billings for administrative service contractual purchase of services shall follow state procedures.

2. State Department reimbursement for a properly approved county administrative service contract is subject to the availability of funds within the county's allocation. 7.608 HUMAN IMMUNODEFICIENCY VIRUS (HIV) POLICY [Eff. 1/1/15] 7.608.1 DEFINITIONS [Eff. 1/1/15]

Acquired Immunodeficiency Syndrome (AIDS): The late stage of the illness triggered by infection with Human Immunodeficiency Virus (HIV). A person receives an AIDS diagnosis when he or she has a CD4 (helper 1-cell) count of less than 200 and/or certain opportunistic infections common with advanced immune deficiency.

HIV: The detection by laboratory antibody tests of the presence of the Human Immunodeficiency Virus (HIV) in an individual.

Universal Precautions: Measures used to keep a barrier between a person and blood and/or other infectious bodily fluids. The precautions are published by the Centers for Disease Control as accepted methods of preventing the spread of infectious disease and, when used routinely and properly, are sufficient to control the spread of infectious blood borne diseases, including HIV. Following are the universal precautions:

A. Universal precautions apply to blood and to other body fluids containing visible blood. Blood is the single most important source of HIV in a care giving setting.

B. Universal precautions also apply to semen and vaginal secretions. Although both of these fluids have been implicated in the sexual transmission of HIV, they have not been implicated in transmission from client to care providers.

C. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, saliva and vomitus unless they contain visible blood. The risk of transmission of HIV from these fluids, while theoretically possible, is extremely low or nonexistent.

D. In any contact with visible blood, use a barrier such as latex gloves. When these are not immediately available, such as immediate response to a nosebleed or wound, use a barrier such as a towel. If hands are exposed to blood, they must be washed with soap and water immediately after contact. 7.608.2 Testing and Confidentiality [Eff. 1/1/15]

A. For children and youth in the legal custody of the county department of human or social services, the county department shall recommend to the medical care provider that the child or youth be tested for HIV based on determination of risk including the following considerations:

1. Specific medical reasons for testing related to the well-being of the child or youth.

2. Authority to test based on legal mandates or the informed consent of the client or those authorized to make medical decisions for the client.

3. Mandatory pre and post test counseling shall include age appropriate information regarding the illness, assistance in dealing with psycho social issues, information about safer sex and a risk reduction plan.

4. A plan shall be developed for re-testing based upon risk behaviors.

5. In the event a child or youth refuses to consent to testing for HIV, the medical care provider shall be requested to provide counseling to the child.

B. Confidentiality

Section 25-4-1405(6), C.R.S., allows for minors to be examined and treated for HIV infection without the consent of the parent or guardian. Further, if the minor is age sixteen (16) or older, the results of the examination or treatment need not be divulged to the minor's parent or guardian, or to any person, unless necessary under reporting requirements of Title 25 or Title 19, C.R.S.

In the event that the county becomes aware of positive HIV test results, the county shall develop a plan for confidential management of test results and HIV status. The county's policy may limit access to the test results based on the need to know and must comply with provisions of Title 25,

Article 4, Part 14, C.R.S. The need to know shall include, but not be limited to:

1. The care provider, with consideration of his or her capacity to provide appropriate physical and emotional care to a child or youth who is HIV-infected and his or her capacity to appropriately manage confidentiality issues. In the case of residential child care facility, residential treatment center, or child placement agency placement, HIV information shall be provided to the person designated by the facility to coordinate medical care.

2. The caseworker and supervisor for the child or youth, who must manage the case including medical care.

3. Child's biological parents based on the determination of risk to the child. The county department shall include the child's parents in decisions for medical procedures and treatment based on risk to the child, except where parental rights have been terminated. 7.608.3 SERVICE PROVISIONS [Eff. 1/1/15] 7.608.31 Non-Discrimination [Eff. 1/1/15]

The status of being at risk for HIV exposure or being diagnosed with HIV/AIDS shall not be a cause for denial of services. 7.608.32 General Services [Eff. 1/1/15]

The county department shall identify and may refer for medical evaluation children or youth in county custody who are at risk of HIV infection, considering the following factors:

A. Infants born to known HIV infected mothers or mothers with high risk behavior.

B. Children who have been involuntary sexual partners because of sexual assault, rape, incest and/or sexual abuse.

C. Children with hemophilia who were exposed to blood or blood products before 1985 or children or youth who have received blood transfusions before March 1985.

D. Children engaged in injection drug use past or present, including other injection behaviors such as needle sharing.

E. Children engaged in unprotected, oral, vaginal, or anal intercourse. 7.609 FEES – RECORDS AND REPORTS [Eff. 1/1/15]

A. The county department may assess a fee for the reproduction of county documents. Such fees may be waived in accordance with county policy.

B. The State Department shall assess a uniform fee for the purpose of conducting employment, volunteer, placement and adoption background screening to determine if the individual has been confirmed in the state automated case management system as a person responsible in a child abuse and/or neglect incident. The fee shall be established by the State Department not to exceed the direct and indirect costs of administering Section 19-1-307(2)(i), (k) to (o), and (t), C.R.S., and Section 19-3-313.5(3) and (4), C.R.S.

C. The State Department shall review the fee at least annually to determine whether the fee is consistent with funding the direct and indirect costs indicated above.

D. The State Department is authorized to set the fee not to exceed $35, taking into consideration the appropriation level set by the General Assembly and the fund balance of, and the funds collected and paid into, the Records and Reports Cash Fund.

E. The State Department shall not set the fee above $35, unless specifically approved by the State Board of Human Services. The State Department shall notify the State Board of Human Services of changes to the fee at least annually upon the assessment of the fee.

F. When the State Department anticipates changing the fee under the parameters set forth above, the State Department shall notify interested persons, at least thirty (30) calendar days in advance, if practicable, to obtain public comment to consider prior to the change.

G. The State Department shall notify interested persons by way of the Department's Background Investigations Unit website and through information provided by the Background Investigations Unit when responding to background screen requests. 7.610 LOCAL DISPUTE RESOLUTION PROCESS [Eff. 1/1/15]

A. County department staff shall advise clients orally and in writing at the time of application of their right to appeal a county department decision either to the State Department for a fair hearing and/or to the county department for a local level dispute resolution conference.

B. Clients or recipients shall be advised in writing and provided an opportunity for a county level dispute resolution conference within ten (10) calendar days of the mailing date of notice of a decision by the county department of the denial, decrease, discontinuation, or modification of human or social services, and/or Medicaid for children in foster care. Refer to the Income Maintenance rules, Section 3.840 (9 CCR 2503-8), for the proper policy and procedures for noticing and conduct of the local conference. 7.611 STATE APPEAL [Eff. 1/1/15]

County departments shall advise clients in writing of their right to appeal from adverse decisions of county departments. When issuing a written adverse decision, county departments shall include complete information on appeal rights, including any right to a local conference with the county department.

The rules governing the appeals process, including timeframes and notice, are set forth in rule section 3.850 (9 CCR 2503-8). Appeals of confirmed abuse and/or neglect shall proceed in accordance with Sections 7.202.604 through 7.202.609 (12 CCR 2509-3). _________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 03/01/2000.

Entire rule eff. 01/01/2015.

Rules 7.602, 7.602.1-7.602.2, 7.603, 7.603.1, 7.603.1 J, 7.603.1 O eff. 11/01/2015.

Rules 7.601.11, 7.603.1 eff. 01/01/2016.

Rule 7.603 eff. 07/01/2017.

Rules 7.601.6-7.601.8 eff. 12/01/2017.

Rule 7.601.71 eff. 04/30/2022.

Rules 7.603.1 C, 7.603.1 C.2.a, 7.603.1 D.2, 7.603.1 E.2 eff. 09/01/2022.

Rules 7.601.71 J-L, 7.601.712 eff. 06/01/2023.

Rule 7.607.3 B.1.b eff. 06/01/2024.

Rules 7.605.21 C, 7.605.25, 7.606 eff. 07/01/2024.

Rules 7.601.8-7.601.81 eff. 09/01/2024.

Rule 7.603 eff. 10/30/2025.

##### **12 CCR 2509-8** Child Care Facility Licensing {#sec-12-ccr-2509-8 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-8}

DEPARTMENT OF HUMAN SERVICES

CHILD CARE FACILITY LICENSING

12 CCR 2509-8 [Editor’s Notes follow the text of the rules at the end of this CCR Document.]

7.700 CHILD CARE FACILITY LICENSING

7.701 GENERAL RULES FOR CHILD CARE FACILITIES

7.701.1 INTRODUCTION

All rules in Section 7.701 through 7.701.500, shall be known and hereinafter referred to as the General Rules for Child Care Facilities and will apply to all child care applicants and licensees subject to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act, Sections 26-6- 901 to 26-6-923, C.R.S. 7.701.11 Licensing Exemptions A. A license must be obtained before care begins unless such care is exempt as set forth below.

B. Pursuant to Section 26-6-904, C.R.S., a license is not required for:

1. A child care facility that is approved, certified, or licensed by another state agency or by a federal government department or agency that has standards for operation of the facility and inspects or monitors the facility;

2. Occasional care of children that has no apparent pattern and occurs with or without compensation;

3. Juvenile courts; or 4. Nursing homes that have children as residents. 7.701.12 Civil Penalties and Injunctions A. Violation of any provision of the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act or intentionally false statements or reports made to the Department or to any agency lawfully delegated by the Department to make an investigation or inspection may result in fines assessed of not more than $250 a day for the first day, $500 a day for the second day, and $1,000 a day for the third and subsequent days, to a maximum of $10,000, pursuant to Section 26-6-921, C.R.S.:

1. A civil penalty will be assessed by the Department only in conformity with the provisions and procedures specified in Article 4 of Title 24, C.R.S. No civil penalty will be assessed without a hearing conducted pursuant to

Section 26-6-901 through 26-6-923, C.R.S. of the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act and Article 4 of Title 24, C.R.S., before an Administrative Law Judge acting on behalf of the Department.

2. Upon receipt of a cease and desist order from the Department and after making an investigation or inspection under the provision of the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act, any unlicensed child care facility or agency may be fined up to $250 a day for the first day, $500 a day for the second day, and $1,000 a day for the third and subsequent days, to a maximum of $10,000 for providing the type of care without a license for which a license is required.

3. Assessment of any civil penalty under this Section will not preclude the Department from initiating injunctive proceedings pursuant to Section 26- 6- 918, C.R.S.

4. A licensed child care facility or agency may be fined up to $250 a day for the first day, $500 a day for the second day, and $1,000 a day for the third and subsequent days, to a maximum of $10,000 for each violation of the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act or for any statutory grounds as listed at Section 26-6-914(2), C.R.S.

5. Assessment of any civil penalty does not preclude the Department from also taking action to deny, suspend, revoke, make probationary, or refuse to renew that license.

6. Any person intentionally making a false statement or report to the Department or to any agency delegated by the Department to make an investigation or inspection under the provisions of the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act may be fined up to $250 a day for the first day, $500 a day for the second day, and $1,000 a day for the third and subsequent days, to a maximum of $10,000.

7. Civil penalties assessed by the Department must be made payable to the Colorado Department of Human Services.

B. In addition to civil penalties that may be assessed under Section 7.701.12.A, when an individual operates a facility or agency after a license has been denied, suspended, revoked, or not renewed, or before an original license has been issued, injunctive proceedings may be initiated to stop the individual from operating a facility or agency without a license.

C. Pursuant to Section 26-6-915, C.R.S., within ten (10) days after receipt of a written notice with regard to a negative licensing action or the imposition of a fine, pursuant to Section 26-6-914(2) and (8), C.R.S., the facility or agency must provide the Department with the name(s) and mailing address(es) of the parent(s) or legal guardian(s) of each child/youth cared for at the facility or agency. Within twenty (20) days after receiving the names and addresses of parents and legal guardians, the Department shall send a written notice to notify the parent(s) or legal guardian(s) of the negative licensing action taken or the fine imposed and provide a description of the basis for the action as it relates to the impact on the health, safety, and welfare of the children/youth in the care of the facility or agency. Written notice must include the current mailing address and telephone number of the Division within the Department responsible for licensing.

The facility/agency will be responsible for paying a fine to the Department that is equal to the direct and indirect costs associated with the mailing of the notice. 7.701.13 Appeals and Waivers The Department is authorized to hear and decide two (2) kinds of appeal or waiver requests by applicants or licensees: hardship appeals in this rule set, also referred to as hardship waivers and stringency appeals according to the following procedures. For purposes of this Section 7.701.13, a county department of human/social services that certifies foster homes under Section 26-6-910, C.R.S., is a “licensee.”

A. Hardship Waivers 1. Any applicant or licensee who has applied for or been issued a license to operate a child care facility or agency has a right to appeal, pursuant to

Section 26-6-909(4), C.R.S., any rule or standard which, in their opinion, poses an undue hardship on the person, facility, or community.

a. “Undue hardship” is defined as a situation where compliance with the rule creates a substantial, unnecessary burden on the applicant or licensee’s business operation or the families or community it serves, which reasonable means cannot remedy. An undue hardship does not include the normal cost of operating the business.

b. Emergency hardship waivers are requests by applicants or licensees to excuse noncompliance with a specific child care licensing rule due to urgent, significant, and unexpected situations outside the applicant’s or licensee’s control. Specific situations that may be considered “emergencies” under this paragraph include, but are not limited to:

1) Natural disasters;

2) Infectious disease outbreaks;

3) Mold outbreaks;

4) Acts of nature or an accident resulting in structural damage to the child care facility; or, 5) For foster care homes and residential child care facilities, an immediate, child(ren)/youth-specific emergency placement, a situation which may disrupt placement, or a situation posing a safety risk to child(ren)/youth in out-of-home placement.

2. Such a waiver must be submitted to the Department in writing within sixty (60) calendar days from the date on which the rule, standard, or emergency situation allegedly created the hardship. The applicant or licensee or their designated representative must send an appeal on the state-prescribed form to the Department. Each rule appealed requires an individual appeal and applicable fee. If the appeal is an emergency hardship waiver appeal, the applicant or licensee must mark it as such on the state-prescribed form.

3. When submitting a waiver, the applicant/licensee/designated representative must consider the impact on the health, safety, and wellbeing of any children/youth in care and include a proposed alternate compliance plan.

4. The Department must consider the impact of a waiver on the health, safety, and wellbeing of the children/youth in care, which must take priority over any undue hardship alleged, when determining whether an appeal should be granted.

5. If the Department grants a waiver for undue hardship, it will issue the applicant or licensee an official decision notification letter temporarily excusing the applicant or licensee from compliance with the appealed rule or standard and accepting the alternate compliance plan.

B. Stringency Appeals 1. Any applicant or licensee who has applied for or been issued a license to operate a child care facility or agency has a right to appeal, pursuant to

Section 26-6-909(4), C.R.S., any violation of a child care licensing rule cited in a report of inspection, on the basis that the rule has been too stringently applied by a representative of the Department.

a. “Stringency,” as used in this Section 7.701.13, means the Department representative applied rules too strictly, improperly, or unfairly.

b. Disputes over the factual accuracy of a cited violation are not reviewable under this provision and must be resolved with the licensing representative’s supervisor.

2. Such an appeal must be submitted to the Department in writing within sixty (60) calendar days from the date of the report of inspection at issue.

The applicant or licensee or their designated representative must send an appeal on the state-prescribed form to the Department. Each rule citation requires an individual appeal and applicable fee.

3. When submitting an appeal, the applicant/licensee/designated representative must provide all evidence that it believes shows the rule was applied too stringently.

4. The Department must consider the impact of an appeal on the health, safety, and well-being of the children/youth in care.

5. If the Department finds a licensing rule was too stringently applied in the appealed citation, it will issue the applicant or licensee a new report of inspection with that citation removed, which shall, for all purposes, supersede the original report of inspection. If the Department grants an appeal for stringency, it will issue the applicant or licensee an official decision notification letter.

C. The requirements of applicants and licensees that are not appealable are outlined in the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act in Section 26-6-901, C.R.S. through Section 26-6-923, C.R.S.

D. Administrative Review and Appeal Panel Procedures 1. The applicant or licensee must comply with all child care licensing rules and standards, including the rule(s) subject to an appeal or waiver until the applicant or licensee has received a written decision granting the appeal or waiver.

2. The Department will receive, review, and schedule all appeals and waiver requests for review by the appeals review panel constituted under Section 26-6-909(4), C.R.S a. For hardship appeals/waivers, the Department may propose that the appeal panel grant one (1) or more appeals as part of a consent agenda, which the appeal panel may approve with a single vote; except if any panel member objects to the consent agenda, the appeals on such agenda must be decided individually. The appeal panel may not deny appeals by consent agenda.

b. For emergency hardship appeals, the Department may administratively grant the appeal if it meets the definition of an emergency and the proposed alternate compliance plan adequately protects the health, safety, and wellbeing of children/youth in care.

If the Department does not administratively grant the emergency hardship appeal, it must schedule the appeal for review by the appeal panel.

3. The appeal panel will adopt a written decision recommending that the Department grant, deny, or grant with modifications an appeal request.

The Department must send an official decision letter, including the written decision of the appeal panel, to the applicant or licensee, within ten (10) calendar days from the date of the appeal panel meeting.

a. For hardship appeal requests, the official decision letter must be posted next to the child care license until its expiration date. If there is no expiration date, the letter expires one (1) year from the date it was issued. If the official decision letter is child-specific, it must be kept in the agency/facility file and provided to the Department upon b. If the Department approves a hardship appeal request and the applicant or licensee wishes to make changes to the alternate compliance plan or safety policy submitted with the original appeal or request, the applicant or licensee must submit a new hardship appeal request.

c. If, after the Department approves a hardship appeal request, and the applicant or licensee violates the terms and conditions described in the approved alternate compliance plan, approved safety policy, or official decision letter, the Department’s approval will immediately be rescinded and considered null and void. For purposes of this provision, any injuries, accidents, or founded complaints or investigations related to the appealed or waived licensing rule constitute a violation.

4. Hearing Requests a. For hardship or stringency appeals, if an applicant or licensee is aggrieved by the decision of the Department, the applicant or licensee may request an administrative hearing pursuant to Section 24-4-105, C.R.S. Written requests for an administrative hearing must be received in writing within thirty (30) calendar days from the date the applicant or licensee received the Department’s decision.

In all such administrative hearings, the applicant or licensee will bear the burden of proof by a preponderance of the evidence. 7.701.14 Civil Rights and Other Incorporations by Reference All facilities licensed under the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are subject to the following federal laws and regulations: the non-discrimination provisions of Title VI of the Civil Rights Act of 1964, 42 U.S.C. Section 2000D through Section 2000D- 7(2024), and its implementing regulation, 45 C.F.R. Part 80 (2024); Title VII of the Civil Rights Act of 1964, 42 U.S.C. Section 2000E through Section 2000E-17 (2024) and its implementing regulation, 29 C.F.R. Part 1606 (2024); the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101-6107 (2024) and its implementing regulation, 45 C.F.R.

Part 91 (2024); Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Sections 791 and 794 (2024), and its implementing regulation, 45 C.F.R. Part 84 (2024), all of which are hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman St. Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available at no cost at http://uscode.house.gov and http://www.ecfr.gov.

All facilities licensed under the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are also subject to Titles I through V of the Americans with Disabilities Act, 42 U.S.C. Section 12101 through Section 12213 (2024), and its implementing regulation, 29 C.F.R. Part 1630 (2024), which are hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman St. Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available at no cost at http://uscode.house.gov and http://www.ecfr.gov.

Decisions related to the enrollment, placement, or dismissal of a child/youth with a disability or chronic condition must be in compliance with the Americans with Disabilities Act. The facility must provide reasonable accommodations for the child/youth with a disability who has special needs.

A lack of independent ambulation or the need for assistance in feeding, toileting, or dressing or in other areas of self-care cannot be used as sole criteria for enrollment or placement or denial of enrollment or denial of placement. Efforts must be made to accommodate the child's/youth’s needs and to integrate the child/youth with their peers who do not have disabilities.

Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are also subject to 42 C.F.R. Parts 160, 162, and 164 of the Health Insurance Portability and Accountability Act (HIPAA) (2024); which are hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services Sherman St., Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available for public inspection at no cost at the U.S. Department of Health and Human Services website https://www.hhs.gov/HPIAA.

Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are also subject to all applicable rules and regulations in the International Fire Code, ICC IFC-2024, which is hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public Street, Denver, Colorado 80203, during regular business hours. These regulations are also available for public inspection at no cost through the International Codes website at https://codes.iccsafe.org.

Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are also subject to all applicable rules and regulations of the Family First Prevention Services Act (FFPSA) 42 U.S.C. Section 672 (K)(4) (2024), which is hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman Street, Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available for public inspection at no cost through the Family First Prevention Services federal website at https://www.congress.gov/115/bills/hr253/BILLS-115hr253ih.pdf.

Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act are also subject to all applicable rules and regulations of the Individuals with Disabilities Education Act (IDEA) at 20 U.S.C. Sections 1400 through 1482 (2024), if applicable, which is hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman Street, Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available for public inspection at no cost through the IDEA website on the U.S.

Department of Education’s webpage at http://sites.ed.gov/idea/statute-chapter-33.

Subject to 20 U.S.C. 1232G and 34 C.F.R. Part 90 of the Family Educational Rights and Privacy Act (FERPA) (2024) which is hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman St., Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available for public inspection at no cost at the U.S.

Department of Education website at https://studentprivacy.ed.gov/ferpa.

7.701.2 DEFINITIONS

“Affiliate of a licensee,” means (A) a person or entity that owns more than five (5) percent of the ownership interest in the business operated by the licensee or the applicant for a license; or (B) a person who is directly responsible for the care and welfare of children served; or (C) an executive, officer, member of the governing board, or employee of a licensee; or (D) a relative of a licensee, which relative provides care to children at the licensee’s facility or agency or is otherwise involved in the management or operations of the licensee’s facility or agency.

“Aftercare” means a continuum of treatment and family-based support that is developed in collaboration with the family and permanency team throughout treatment and prior to the child’s/youth’s discharge, is designed to support the child/youth and family during the child’s/youth’s transition out of the program and to safely maintain the child/youth in a lower level of care, and is provided for at least six (6) months after discharge.

“Annually” means the time frame from the initial date of hire, training, licensing, or certification, and the following twelve (12) months.

“Application” means a declaration of intent to obtain or continue a license or certificate for a residential or day treatment child care facility or child placement agency.

“Behavioral Health Administration” (BHA) is the state administration established in the Department of Human Services and charged with creating a coordinated, cohesive, and effective behavioral health system pursuant to Section 27-50-102, C.R.S. The BHA is responsible for ensuring that behavioral health programs delivered by state agencies and commercial payers are comprehensive, evidence-based, affordable, high quality, equity-focused, and easily accessible for all Coloradans pursuant to Section 27-50-103, “Calendar year” means the time frame from January 1 to December 31.

“Case plan” means a plan that is developed in a day treatment center, specialized group facility, runaway and homeless youth services program or shelter services program, child placement agency, or host family home that includes goals regarding personal and group living skills, anticipated behavioral changes of the child/youth, projected length of participation in the program, and any other components as required in 12 CCR 2509-8 Sections 7.706, 7.709, 7.710, and 7.721.

“Certificate” means a legal document granting permission to operate a foster care home or a kinship foster care home.

“Certification” means the process by which a county department of human or social services, a child placement agency, or a federally recognized tribe pursuant to applicable federal law approves the operation of a foster care home or a kinship foster “Chemical restraint” as defined in Section 26-20-102(2), C.R.S., means giving an individual medication involuntarily for the purpose of restraining that individual; except that “chemical restraint” does not include the involuntary administration of medication pursuant to Section 27-65-111(5), C.R.S., or administration of medication for voluntary or life-saving medical procedures.

“Child” pursuant to Section 19-1-103(21), C.R.S. means a person under eighteen (18) years of age.

“Child abuse,” and “child neglect” mean the same as in the definition of “child abuse or neglect” set forth in Section 19-1-103(1), C.R.S., unless otherwise indicated.

“Child Care Centers,” as defined in Section 26-6-903(5), C.R.S., means a facility, by whatever name known, that is maintained for twenty-four (24)-hour care for five (5) or more children, unless otherwise specified in Section 26-6-903(5), who are not related to the owner, operator, or manager of the facility, whether the facility is operated with or without compensation for such care and with or without stated educational purposes.

The term includes, but is not limited to, facilities commonly known as residential child care facilities, day treatment facilities, specialized group facilities, secure residential treatment centers, and respite child care centers.

“Child Placement Agency” is defined at Section 26-6-903(6), C.R.S. Child placement agencies are further detailed at 12 CCR 2509-8 Section 7.710, “Rules and Regulations for Child Placement Agencies”.

“Children's Habilitation Residential Program (CHRP) Waiver” is described at Section 25.5-6-903, C.R.S. Information regarding level of care evaluations and determinations are further detailed in 10 CCR 2505-10 Sections 8.400 (2024), 8.500 (2024), 8.600 (2024), and 8.700 (2024) which is hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available for public Street, Denver, Colorado 80203 during regular business hours. These regulations are also available for public inspection at no cost through the state’s website page at https://www.sos.state.co.us/ccr.

“Citizen/legal resident” means a citizen, current legal resident, or a person lawfully present in the United States.

“Client representative” means a person designated by the facility to process grievances.

“Colorado Criminal Justice Records Act” or “CCJRA” means the maintenance, access, and dissemination, completeness, accuracy, and sealing of criminal justice records according to Section 24-72-309, C.R.S.

“Consumer Product Safety Commission”, means the National Commission that establishes standards for the safety of children’s equipment and furnishings and for playground safety as outlined under federal laws and regulations.

“Contraband” means dangerous instruments or materials that are prohibited for children/youth to have in their possession or for visitors to introduce into their facility/agency and materials that can harm the child/youth in the facility, other children/youth, or staff. Dangerous instruments include any device, material, or substance which is capable of causing or inducing fear or death or bodily injury.

Contraband can include items such as lock picks, cutting tools, combustible materials, unauthorized drugs, drug paraphernalia, ropes or ladders, obscene material, sharpened instruments, firearms, knives, or any article that may pose a threat to safety and security.

“Conversion therapy” means any practice or treatment by a licensee, registrant, or certificate holder that attempts or purports to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attraction or feelings toward individuals of the same sex, as defined in Section 12-245-202(3.5)(a), C.R.S.

“Convicted” means a conviction by a jury or by a court and also includes a deferred judgment and sentence agreement, a deferred prosecution agreement, a deferred adjudication agreement, an adjudication, and a plea of guilty or nolo contendere as defined in Section 26-6-914(6)(a)(II), C.R.S.

“Court-appointed special advocate” or “CASA volunteer” means a volunteer appointed by a court pursuant to Part 2 of Article 1 of Title 19 to assist in advocacy for children, as defined in Section 19-1-103(46), C.R.S.

“Criminal child abuse” means the same as in the definition set forth in Section 18-6-401, C.R.S. identified in Section 26-6-905(8)(a)(I)(A), C.R.S., unless otherwise indicated.

“Critical incident” is a serious incident or concern or potential incident or concern that poses a danger to a child/youth at the facility, a staff member at the facility, or a foster parent.

“Cultural Responsiveness” means that an organization designs and implements services and practices that consider the unique culture of the individuals, families, and communities served.

“Custodian”, as defined in Section 19-1-103(50), C.R.S. means a person who has been providing shelter, food, clothing, and other care for a child in the same fashion as a parent would, whether or not by order of court.

“De-escalation” means the use of therapeutic interventions with a child/youth during the escalation phase of a crisis. The interventions are designed to support children/youth through co-regulation or allow them to regulate their own behavior so that acute physical behavior does not develop that would lead to the need to use physical restraint.

“Department” or “State Department” means the state Department of Human Services.

“Department representative” means any staff member from the Colorado Department of Human Services, Provider Services Unit to include, but need not be limited to, licensing specialists, monitoring specialists, performance management outcomes specialists or PMO specialists, licensing supervisors, monitoring supervisors, provider performance manager, provider development manager, the ICPC deputy compact administrator or ICPC compact administrator, and/or the provider services unit manager.

“Day Treatment Center,” is defined at Section 26-6-903(8), C.R.S. Day treatment centers are further detailed at 12 CCR 2509-8 Section 7.706, “Rules Regulating Day Treatment Centers”.

“Electroni signature” as defined in Section 24-71-101(1), C.R.S. and Section 24-71- 101(2), C.R.S., means an electronic sound, symbol, or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign the record. In any written communication in which a signature is required or used, any party to the communication may affix a signature by use of an electronic signature that complies with the requirements of Article 71.3 of this Title 24, Colorado Revised Statutes, for electronic signatures.

“Emergency” means a serious, probable, imminent threat of bodily harm to self or others where there is present ability to effect such bodily harm as defined in Section 26-20- 102(3), C.R.S.

“Employee” or “applicant for employment,” for the purpose of background checks required in Section 7.701.32, Section 7.701.321, and Section 7.701.33, is defined as: an individual (other than an individual who is related to all children/youth for whom child care services are provided):

Who is employed or associated with a licensed child care provider, including individuals who have access to protected information or other individuals associated with the license who engage with the children/youth in any capacity;

Whose activities involve the care or supervision of children for a licensed child care provider or unsupervised access to children who are cared for or supervised by a licensed child care provider; or Any individual residing in a licensed child care facility or foster home who is age eighteen (18) and older.

Employee does not include those individuals that will not have contact with children/youth while at the licensed facility or agency, such as hired tradespeople, contractors, or other maintenance service professionals where a plan for ensuring their whereabouts and activities of the individual while at the facility is documented and implemented.

“Escalation” is an increase in intensity or seriousness of a child’s/youth’s behavior.

“Facility” or “child care facility” is any business or operation established for the purpose of providing child care services that are required to be licensed pursuant to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act, Section 26-6-901, C.R.S. through Section 26-6-923, “Family and permanency team” consists of all the appropriate biological and/or legal family members, relatives, and psychological kin of the child/youth, as well as professionals who are a resource to the child/youth, such as teachers, medical and mental health providers, or clergy, etc., who review the child’s/youth’s permanency needs. In the case of a child/youth who has reached age fourteen (14), the family and permanency team shall include the members of the permanency planning team for the child/youth that are selected by the child/youth.

“Family engagement” means joining with the family/kin of the child/youth to establish common goals of safety, well-being, and permanency, and is inclusive of other systems, as defined in 12 CCR 2509-4 Section 7.300.1.

The “family services plan” (FSP) means a case services plan completed by a county caseworker jointly with a child/youth, parent(s) and/or legal guardian(s), and providers within sixty (60) calendar days of the referral date in the automated case management system for each child/youth receiving services from a county department of human or social services pursuant to 12 CCR 2509-4 Section 7.301.21.

“Final Agency Action” means the determination made by the Department, after the opportunity for hearing to deny, suspend, revoke, or demote to probationary status a license issued pursuant to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act or an agreement between the Department and the licensee concerning the demotion of such a license to a probationary license.

“Foster Care Home,” is defined at Section 26-6-903(10), C.R.S. Types of foster care homes are further detailed at 12 CCR 2509-8 Section 7.708, “Rules Regulating Family Foster Care Homes”.

“Foster Youth in Transition Program” as defined in Section 19-7-302(14), C.R.S. means the program established pursuant to Section 19-7-303, C.R.S., in which an eligible youth may voluntarily opt to continue or resume receiving child welfare services that may include but are not limited to foster care maintenance payments.

“Gender identity” as defined in Section 19-1-130(1)(B), C.R.S. means a person’s innate sense of the person’s own gender, which may or may not correspond with the person’s sex assigned at birth.

“Governing Body” means the individual, partnership, corporation, or association in which the ultimate authority and legal responsibility is vested for the administration and operation of a residential or day treatment child care facility or a child placement “Guardian” means a person who is entrusted by law with the care of a child under eighteen (18) years of age.

“Health Department” is the Colorado Department of Public Health and Environment (CDPHE) or the local county department of health.

“Health First Colorado” is Colorado’s Medicaid program and public health insurance for Coloradans who qualify. Medicaid is funded jointly by the federal government and Colorado state government, and is administered by the Colorado Department of Health Care Policy and Financing.

“Homeless youth shelter” means a facility that, in addition to other services it may provide, provides services and mass temporary shelter for a period of three (3) days or more to youths who are at least eleven (11) years of age or older and who otherwise are homeless youth as that term is defined in Section 26-5.7-102(2), C.R.S. Youth may reside at a homeless youth shelter for a period not to exceed twenty-one (21) days as outlined and in accordance with Section 26-5.7-105, C.R.S.

“Human trafficking for involuntary servitude” means a person who knowingly sells, recruits, harbors, transports, transfers, isolates, entices, provides, receives, or obtains by any means another person for the purpose of coercing the other person to perform labor or services commits human trafficking for involuntary servitude, as outlined in

Section 18-3-503(1), C.R.S.

“Human trafficking for sexual servitude” is defined as outlined in Section 18-3-504, “Independent assessment” (IA) means a process to assess the strengths and needs of the child using an age-appropriate, evidence-based, validated, functional assessment tool. The assessment determines whether treatment in a qualified residential treatment program (QRTP) provides the most effective and appropriate level of care for the child in the least restrictive environment in accordance with Department of Human Services The “Individual child’s/youth’s plan” is based upon an assessment of the child/youth following placement at the facility or therapeutic foster home. It is developed by the facility or child placement agency for each child/youth, designed to meet or address the individualized needs of each child/youth, and must be consistent with the family service plan (FSP) for the child/youth.

“Interdisciplinary team” means staff in a psychiatric residential treatment facility (PRTF) comprised of a physician, and a licensed mental health professional, registered nurse or occupational therapist responsible for the treatment of the client, as defined in 10 CCR 2505-10 Section 8.765.1 (2024) which is hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available for public Street, Denver, Colorado 80203 during regular business hours. These regulations are also available for public inspection at no cost through the state’s website page at https://www.sos.state.co.us/ccr.

“Interstate compact on the placement of children” (ICPC) is a statutory agreement that establishes procedures and responsibilities for those involved in placing a child/youth out of state, and is further described at Section 24-60-1801, C.R.S. through Section 24- 60-1804, C.R.S.

“Kinship foster care homes” as defined at Section 26-6-903(16), C.R.S., means a kinship foster care home that has been certified pursuant to Section 26-6-910, C.R.S. to care for a relative or kin only. A kinship foster care home provides twenty-four (24)-hour foster care for a child or youth who is a relative or kin, who is less than twenty-one (21) years of age, and who is eligible for the same foster care reimbursement, assistance, and other supports as foster care homes pursuant to Section 26-6-904.5, C.R.S.

“Kinship foster care home” does not include non-certified kinship care as that term is defined in Subsection (21.5) of this Section (26-16-21.5, C.R.S.).

“License” means a legal document issued pursuant to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act granting permission to operate a residential or day treatment child care facility or child placement agency. A license may be in the form of a provisional, probationary, permanent, or time-limited license.

“Licensed health care provider” means a physician, doctor of osteopathic medicine, physician assistant, nurse practitioner, registered nurse, or other licensed or registered health care provider.

“Licensee” means the entity or individual to which a license is issued and that has the legal capacity to enter into an agreement or contract, assume obligations, incur and pay debts, sue and be sued in its own right, and be held responsible for its actions. A licensee may be a governing body.

“Licensing” means, except as otherwise provided in Section 26-6-903(10), the process by which the Department approves a facility or agency for the purpose of conducting business as a residential or day treatment child care facility or child placement agency, as defined in Section 26-6-903(19), C.R.S.

“Licensing Specialist” is the authorized representative of the Department who inspects and audits child care facilities to ensure compliance with licensing requirements. The Licensing Specialist inspects and audits the operations of licensed agencies and facilities to ensure their compliance with related state laws and regulations. The Licensing Specialist inspects and audits the operations of licensed agencies and facilities to ensure their compliance with related state laws and regulations.

“Mechanical restraint” means a physical device used to involuntarily restrict the movement of an individual or the movement or normal function of a portion of their body pursuant to Section 26-20-102(4), C.R.S.

“Mental health professional” means a person licensed to practice medicine or psychology in this state or any person on the staff of a facility designated by the executive director of the Department of Human Services for seventy-two-hour treatment and evaluation who is authorized by the facility to do mental or behavioral health hospital placement prescreenings, as defined in Section 19-2.5-102, and who is under the supervision of a person licensed to practice medicine or psychology in this state.

“Monitoring specialist” is the authorized representative of the Department who is responsible for investigations to determine agency/facility culpability and compliance with Social Services Rules (Volume 7: Child Welfare, Child Care Facilities) and related statutes.

“Multi-disciplinary team” (MDT) means staff in a residential child care facility (RCCF) providing mental health services comprised of at least one (1) licensed mental health professional and other staff responsible for the treatment of the client and may include a staff member from the federal agency, or a group of personnel, acting within their professional role(s) and respective scope(s) of practice, who are members of different professions, working together to provide services to individuals.

“Nationally recognized criteria” means standardized practices that are acknowledged as acceptable and appropriate for use with at-risk populations, that are incorporated into the model of physical restraint utilized by the facility. The nationally recognized criteria must include, at a minimum the following:

A. Annual staff training and/or certification, to include training upon hire, and ongoing (at least every six (6) months) refresher training or practice exercises for each staff member trained or certified in restraint, to review and refresh skills involved in positive behavior intervention, prevention, de-escalation, and physical restraint, in accordance with the model.

B. A restraint prevention and de-escalation component, to include identifying antecedents that may cause an individual to escalate, and/or development of behavior management plans that are in alignment with individual child’s/youth’s plans if necessary.

C. A physical restraint process that prohibits or provides alternatives to a prone position, and includes identifying primary control techniques that emphasize utilizing only the minimum amount of force necessary to gain control and keep the individual safe.

D. A debriefing process which includes a review of physical restraint, to determine the appropriateness and effectiveness of preventive/de-escalation strategies or interventions used, the appropriateness of physical restraint, and how, or if, physical restraints are preventable.

“Negative licensing action”, as defined at Section 26-6-903(21)(A), C.R.S., means a final agency action resulting in the denial of an application, the imposition of fines, or the suspension or revocation of a license issued pursuant to this Part 9 of Article 6 of Title 26 or the demotion of such a license to a probationary license.

“Neutral reviewer” means a staff member who observes a physical restraint and is able to monitor the child/youth during the restraint and provide an objective review of the restraint during the debriefing process.

“Nonpublic home-based educational program”, as defined at Section 22-33-104.5(2)(a), C.R.S., means the sequential program of instruction for the education of a child which takes place in a home, which is provided by the child’s parent or by an adult relative of the child designated by the parent, and which is not under the supervision and control of a school district. This educational program is not intended to be and does not qualify as a private and nonprofit school.

“Performance management outcomes specialist” is the authorized representative of the Department who evaluates and analyzes the quality of programming, practices, and policies with licensed agencies and facilities, specifically through the content contained within trauma-informed care plans, file reviews, assessments, interviews, observations, and review of agency/facility data, policies, and procedures.

“Physical restraint” means the use of bodily, physical force to involuntarily limit an individual’s freedom of movement for more than one (1) minute, except that “physical restraint” does not include the holding of a child by one adult for the purposes of calming or comforting the child.

“Prone position” means a face-down position.

“Prone restraint” means a restraint in which the individual who is being restrained is secured in a prone position pursuant to Section 26-20-102(5.5), C.R.S.

“Psychiatric residential treatment facility” (PRTF), pursuant to Section 25.5-4-103(19.5), C.R.S., means a facility that is licensed as a residential child care facility, as defined in

Section 26-6-903, C.R.S., that is not a hospital, and that provides inpatient psychiatric services for individuals who are less than twenty-one (21) years of age under the direction of a physician licensed pursuant to Article 240 of Title 12, and that meets any other requirement established in rule by the State Board.

“Qualified manager” means a person who is the owner or operator of the facility or a supervisor designated by the owner or operator of the facility for the purpose of implementing Section 25-1.5-303, C.R.S.; and has completed training in the administration of medications pursuant to Section 25-1.5-303, C.R.S, or is a licensed nurse pursuant to Part 1 of Article 255 of Title 12, a licensed physician pursuant to

Article 240 of Title 12, or licensed pharmacist pursuant to Article 280 of Title 12. Every unlicensed person who is a “qualified manager” within the meaning of Section 25-1.5- 301(4) shall successfully complete a competency evaluation pertaining to the administration of medications.

“Qualified residential treatment program” (QRTP), as defined in Section 26-6-903(26), means a licensed and accredited program that has a trauma-informed treatment model that is designed to address the child’s or youth’s needs, including clinical needs, as appropriate, of children and youth with serious emotional or behavioral disorders or disturbances in accordance with federal “Family First Prevention Services Act”, 42 U.S.C.A. 672(K)(4), and is able to implement the treatment identified for the child or youth by the assessment of the child or youth as required in Section 19-1-115(4)(E)(I), “Reasonable” as used in the rules means appropriate and suitable, not excessive or extreme.

“Referral agency or placing authority/legal custodian” means the Division of Youth Services, a county department of social/human services who has custody of the child/youth, an organization or entity placing a child/youth through the Child and Youth Mental Health Treatment Act (CYMHTA), a Regional Accountable Entity (RAE), a parent or legal guardian of the child/youth, or other entity given authority by a court of jurisdiction that refers the child for the purpose of placement.

“Registered dietitian” means someone who holds a certificate or registered dietician through the Commission on Dietetic Registration.

“Relative” as defined at Section 26-6-903(28), C.R.S. means any of the following relationships by blood, marriage, or adoption: parent, grandparent, son, daughter, grandson, granddaughter, brother, sister, stepparent, stepbrother, stepsister, stepson, stepdaughter, uncle, aunt, niece, nephew, or cousin.

“Religion” when used in these regulations includes beliefs, spiritual beliefs, and other practiced ideologies.

“Residential or day treatment child care facility” or “facility” means a residential child care facility, including a qualified residential treatment program, psychiatric residential treatment program, shelter care program, and homeless youth program; specialized group facility, including a group home and group center; day treatment center; secure residential treatment center; respite child care center; or homeless youth shelter, including a host family home, as defined at Section 26-6-903(30), C.R.S.

“Residential Child Care Facility” (RCCF) as defined at Section 26-6-903(29), C.R.S. means a facility licensed by the State Department pursuant to Part 9 of Article 6 of Title 26 to provide twenty-four (24)-hour group care and treatment for five (5) or more children operated under private, public, or nonprofit sponsorship. “Residential child care facility” includes community-based residential child care facilities; qualified residential treatment programs, as defined in Section 26-5.4-102(2), C.R.S.; shelter facilities; and psychiatric residential treatment facilities as defined in Section 25.5-4-103(19.5), C.R.S.

A residential child care facility may be eligible for designation by the executive director of the state Department pursuant to Article 65 of Title 27. A child who is admitted to a residential child care facility must be:

A. Five (5) years of age or older but less than eighteen (18) years of age; or B. Less than twenty-one (21) years of age and placed by court order or voluntary C. Accompanied by a parent if less than five (5) years of age.

“Residential Child Care Provider Training Academy”, as defined in Section 26-6-923, C.R.S., also known as “Colorado Provider Training Academy”, is created in the State Department to facilitate a pipeline of high-quality staff for residential child care providers and ensure that individuals hired to work at residential child care facilities receive the necessary training to perform an individual’s job functions responsibility and effectively.

The Residential Child Care Provider Training Academy is associated and a subpart of the Colorado Provider Training Academy.

The training academy is designed to facilitate, build, coach, and support providers in the promoting high-quality staff to ensure individuals hired to work in child care facilities receive the necessary training to perform their job functions competently, responsibly, and effectively, utilizing trauma-informed practices. This involves all staff who are direct care workers, supervisors, case management staff, clinical staff, managers, administrators, and directors.

“Residing in the home” means all individuals whose home base for a period of time is in the certified foster or kinship home for:

A. Fourteen (14) consecutive calendar days; or B. For more than forty (40) calendar days per year.

“Respite child care center” means a facility for the purpose of providing temporary twenty-four (24)-hour group care for three (3) or more children or youth who are placed in certified foster care homes or approved noncertified kinship care homes, and children or youth with open cases through a Regional Accountable Entity. A respite child care center is not a treatment facility, but rather its primary purpose is providing recreational activities, peer engagement, and skill development to the children and youth in its care.

A respite child care center serves children and youth from five (5) years of age to twenty-one (21) years of age. A respite child care center may offer care for only part of a day. “Respite child care” means an alternate form of care to enable caregivers to be temporarily relieved of caregiving responsibilities, as defined at Section 26-6-903(31), “Restraint” means, in accordance with Section 26-20-102(6), C.R.S., any method or device used to involuntarily limit freedom of movement, including bodily physical force, mechanical devices, or chemicals. Restraint must not be used as a form of discipline or to gain compliance from a child/youth. If property damage might be involved, restraint may only be used when the destruction of property could possibly result in bodily harm to the individual or another person. “Restraint” includes chemical restraint, mechanical restraint, and physical restraint. “Restraint” does not include:

A. The use of any form of restraint in a licensed or certified hospital when such use:

1. Is in the context of providing medical or dental services that are provided with the consent of the individual or the individual’s guardian; and 2. Is in compliance with industry standards adopted by a nationally recognized accrediting body or the Conditions of Participation for federal Medicare and Medicaid programs;

B. The use of protective devices or adaptive devices for providing physical support, prevention of injury, or voluntary or life-saving medical procedures;

C. The holding of an individual for less than one (1) minute by a staff person for the protection of the individual or other persons; except that nothing in Section 26- 20-102(6)(C) may be interpreted to permit the holding of a public school student in a prone position, except as described in Section 26-20-111(2), (3), or (4), C.R.S.; or D. Placement of an inpatient or resident in their sleeping room for the night.

“Seclusion” means the placement of an individual alone in a room or area from which egress is involuntarily prevented, except during normal sleeping hours, pursuant to

Section 26-20-102(7), C.R.S.

“Secure Residential Treatment Center,” means a facility operated under private ownership that is licensed by the Department pursuant to Part 9 of Article 6 of Title 26 to provide twenty-four (24)-hour group care and treatment in a secure setting for five (5) or more children or persons up to the age of twenty-one (21) years over whom the juvenile court retains jurisdiction pursuant to Section 19-2.5-103(6), C.R.S. who are committed by a court, pursuant to an adjudication of delinquency or pursuant to a determination of guilt of a delinquent act or having been convicted as an adult and sentenced for an act that would be a crime if committed in Colorado, or in the committing jurisdiction, to be placed in a secure facility as defined at Section 26-6-903(32), C.R.S. Secure residential treatment centers are further detailed at 12 CCR 2509-8 Section 7.713, “Minimum Rules and Regulations for Secure Residential Treatment Centers”.

“Serious emotional disturbance” means a diagnosable mental, behavioral, or emotional disorder that is of sufficient duration and has resulted in a functional impairment that substantially interferes with or limits a child’s/youth’s role or functioning in family, school, or community activities. Serious emotional disturbances do not include developmental disorders, substance-related disorders, or conditions or problems that may be a focus or clinical attention unless they occur with another diagnosable serious emotional disturbance.

“Serious illness” means a health condition that carries a high risk of mortality and/or either negatively impacts a person’s daily function or quality of life, or excessively strains their caregivers.

“Serious injury” means an injury that results in either severe laceration, a broken or distorted extremity, crush injuries, suspected skull, chest, or abdominal injury other than bruises or minor lacerations, significant burns, unconsciousness, or paralysis.

“Shelter care services” means basic short-term services for children/youth placed by a county department of human/social services, including, but not limited to, shelter, food, education, clothing, recreation, basic medical care, supervision, and guidance.

“Sibling” means one (1) or more individuals having one (1) or both parents in common.

“Social and behavioral sciences” includes sociology, psychology, social work, criminal justice, human services, human development, and counseling.

“Specialized Group Facility,” as defined at Section 26-6-903(34), C.R.S. means a facility sponsored and supervised by a county department or a licensed child placement agency for the purpose of providing twenty-four (24)-hour care for three (3) or more children, but fewer than twelve (12) children, whose special needs can best be met through the medium of a small group. A child who is admitted into a specialized group facility must be:

A. At least seven (7) years of age or older but less than eighteen (18) years of age;

B. Less than twenty-one (21) years of age and placed by court order or voluntary C. Accompanied by a parent or legal guardian if less than seven (7) years of age.

“Specialized group facility” includes specialized group homes and specialized group centers.

A “Specialized Group Home” is located in a house owned or otherwise controlled by the group home parents who are primarily responsible for the care of the children/youth and reside at the home.

A “Specialized Group Center” is located in a facility owned or controlled by a governing body that hires the group center parents or personnel who are primarily responsible for the care of the children/youth.

“Staff member” of a facility as used in these rules includes individuals working as a specialized group home parent or in a specialized group center, or residential child care facility. For Section 7.714.53 through Section 7.714.536, a “staff member” of the facility also includes an individual certified as a foster parent in a foster home or working in a day treatment facility or secure residential treatment facility.

“Thereapeutic foster care”, as defined in Section 26-6-903(35) C.R.S., means a program of foster care that incorporates treatment for the special physical, psychological, or emotional needs of a child placed with specially trained foster parents, but does not include medical foster care. Therapeutic foster care is further detailed at 12 CCR 2509-8 Section 7.703, Rules Regulating Therapeutic Foster Care.

“Therapeutic wilderness program” means a residential child care program in which the program is based outside of a building or physical space and the children/youth move from one site to another throughout the course of the program. The wilderness program may originate in Colorado or move into and/or through Colorado from another state. The program operates for three (3) or more consecutive twenty-four (24)-hour days during one (1) or more seasons of the year for the care of children/youth who are at least twelve (12) years to eighteen (18) years of age and for those persons twenty-one (21) years of age who are placed by court order prior to their eighteenth (18) birthday, are a voluntary placement, or are participating in the foster youth in transition program as defined in 12 CCR 2509-3 Section 7.203.4 through Section 7.203.43. The program must have as its purpose an individualized child and family plan through group learning experience offering behavioral, mental health, substance abuse education, and recreational activities utilizing an outdoor wilderness environment.

“Trails” means the statewide comprehensive child welfare case management system.

“Transitional measure” means physical guidance, prompting techniques of short duration or an initial, temporary, approved physical positioning of an individual at the onset or in response to a re-escalation during a physical management, for the purpose of quickly and effectively gaining physical control of that individual in order to prevent harm to self or others. Momentary utilization of a short term (as quickly as possible, but not to exceed five (5) minutes) prone position is only permissible during a transitional measure.

“Treatment foster care”, as defined at Section 26-6-903(36), C.R.S., means a clinically effective alternative to a residential treatment facility that combines the treatment technologies typically associated with more restrictive settings with a nurturing and individualized family environment. Treatment foster care is further detailed at 12 CCR 250-8 Section 7.704, Rules Regulating Treatment Foster Care.

“Trauma-Informed” refers to the services to be provided to or on behalf of a child or youth under an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma and in accordance with recognized principles of a trauma-informed approach and traumaspecific interventions to address trauma’s consequences and facilitate healing.

“Unaccompanied refugee minor (URM)” means a minor who has been displaced from their home country and is unable to return due to concerns for their safety, who has been determined eligible by the federal government for resettlement in the U.S., and whose parent(s) and other relatives and caregivers are unable to be located or are deceased.

“Unaccompanied refugee minor program (URM)” means a program authorized by the U.S. Office of Refugee Resettlement (ORR) to provide specialized culturally and linguistically appropriate foster care and independent living services that facilitate social, cultural, and economic integration for children and youth who have been determined eligible to resettle in the United States through foster care with an additional goal to reunify program youth with family or kinship when appropriate.

“Voluntary placement” means a child/youth who, meets the admission criteria of the RCCF, can benefit from the services provided, and is voluntarily placed in a facility/agency via a county department of human/social services’ voluntary placement agreement with the parent(s) or guardian(s) of the child/youth in accordance with

Section 19-1-127, C.R.S., or through independent entities choosing to voluntarily place at a facility/agency or program.

“Vulnerable youth” means a youth who is emancipating from foster care, a runaway or homeless youth, a youth involved in the juvenile justice system, an immigrant youth and youth with limited English proficiency, a youth with physical and/or mental disabilities, a youth with mental disorders, or a youth receiving special education services. Vulnerable youth encompass children and youth who do not have the capacities to achieve a typical level of functioning in one or more life domains or to some extent have special needs in regard to support or helping aids to achieve a typical level of functioning and thriving.

“Youth” pursuant to Section 19-1-103(145), C.R.S. means an individual who is less than twenty-one years of age.

7.701.3 APPLICATION PROCESS 7.701.31 Original Application A. A completed, original application accompanied by the appropriate fee must be submitted to the Department a minimum of sixty (60) days prior to the proposed opening date for the facility. The application submitted must include the attachments with specific requirements completed, in accordance with the addendum associated with the license type.

B. A licensing audit will occur only after the Department has received the completed application and appropriate fee.

C. If a county or agency establishes and plans to sponsor a Specialized Group Facility, the governing body for the Specialized Group Facility is the licensee. A written plan for the supervision and responsibilities in accordance with 12 CCR 2509-8 Sections 7.710.46 and 7.710.47 of the Specialized Group Facility must accompany the application. 7.701.32 BIU (Background Investigation Unit) - Use of Records and Reports of Child Abuse or Neglect for Background and Employment Inquiries A. The Trails child abuse and neglect records request must be accompanied by the applicant’s prior written or electronic authorization to obtain such information from the state automated system. The Trails child abuse and neglect records request must be accompanied by the required fee, according to Section 7.701.4, paid by check, credit card, money order, electronic payment, or other means specified by B. An operator of a licensed facility must submit a request to determine if an operator, applicant for employment or foster care, current employee, or any individual who has direct contact with children/youth or is associated with the license, has been found responsible for a confirmed, as defined by Section 19-1- 103(33), C.R.S., report of child abuse or neglect in the Department's automated system. All requests must be submitted on or up to thirty (30) days prior to the first day of employment or service.

1. For all individuals whose activities involve the care or supervision of children/youth for any length of time or who have unsupervised access to children/youth, requests must be submitted and successfully completed prior to caring for children/youth or having unsupervised contact with C. Pursuant to Section 26-6-912(1)(a)(I)(B), C.R.S., and Section 26-6- 912(1)(a)(I)(D)(II)(B), C.R.S., the agency must require any applicant for foster care to complete a request to determine if they have been found responsible for a confirmed, as defined by Section 19-1-103(33), C.R.S., report of child abuse or neglect in the Department's automated system. Results must be received and reviewed prior to the certification of the foster home.

1. The agency must require any person eighteen (18) years of age or older who resides in the foster care home to complete a request to determine if they have been found responsible for a confirmed report of child abuse or neglect in the State Department's automated system. Residing in the home applies to all individuals whose home base for a period of time is in the foster home for fourteen (14) consecutive calendar days or for more than forty (40) calendar days per year.

2. For each adult eighteen (18) years of age or older who begins residing in the foster or specialized group home after care begins, requests must be submitted within five (5) calendar days of when the individual begins residing in the home, and these adults must not be allowed unsupervised access to children/youth in care until all background checks have been successfully completed.

D. The Department will inform the requesting party in writing of whether the individual has been confirmed, as defined by Section 19-1-103(33), C.R.S., to be a person responsible for an incident of child abuse or neglect.

1. If the result of the inquiry is that the individual has been confirmed, as defined by Section 19-1-103(33), C.R.S., as responsible for an incident of child abuse or neglect, the Department must provide the requesting party with information regarding the date of the reported incident, the type of abuse or neglect with the severity level, and the county department that confirmed the report.

2. If the result of the inquiry is that the individual has not been confirmed, as defined by Section 19-1-103(33), C.R.S., to be responsible for an incident of child abuse or neglect, the Department must notify the requesting party of this fact.

E. The information provided by the Department must serve only as the basis for further investigation. The director or operator may inform an applicant or employee that the report from the Department’s automated system was a factor in the director or operator's decision with regard to the applicant or employee's F. When a facility or agency receives a result that an individual has been confirmed, as defined by Section 19-1-103(33), C.R.S., as responsible for an incident of child abuse and/or neglect, the agency or facility must notify their licensing specialist within five (5) business days. The notification must address whether the individual will continue involvement with the facility or agency and in what capacity or if they will no longer be working with that licensed facility.

G. Any person who willfully permits or who encourages the release of data or information related to child abuse or neglect contained in the Department’s automated system to persons not permitted access to such information commits a Class 1 misdemeanor and must be punished as provided in Section 18-1.3- 501, C.R.S.

H. Every five (5) years, all child abuse and neglect inquiry background checks must be renewed by resubmitting an inquiry form and current fee to the Department for processing. An updated clearance letter or verification of the submission of the inquiry form must be obtained before five (5) years from the date reflected on the current clearance letter.

I. The results of the abuse and neglect inquiry must be maintained at the facility or agency and must be available for review upon request by a Department representative.

J. Any person who has lived in another state in the five (5) years previous to application for employment or foster care, any person who is engages with children/youth at a facility or agency, or any person eighteen (18) years of age or older who resides in the foster care home must provide a copy of the state child abuse and neglect registry check from each state in which they have resided K. A child placement agency (“CPA”) must also complete a review utilizing the CPA supervisor profile in the state automated system of all existing county department case records. This includes a review of the state automated child welfare system for each applicant and persons over the age of eighteen years (18) years of age residing in a family foster care home.

L. The Trails child abuse and neglect records checks are not required for temporarily placed children/youth who are eighteen (18) years of age or older who are not legal, permanent residents of the certified kinship or foster home, agency, or facility. 7.701.321 Required Review of Records for History of Sex Offender An operator of a licensed facility must conduct sex offender searches in the Colorado Bureau of Investigation (CBI) sex offender registry and the national sex offender public website operated by the United States Department of Justice for each operator, applicant for employment or foster care, current employee, or any individual who has direct contact with children/youth or is associated with the license prior to the first day of employment or service at the agency/facility and annually thereafter. Sex offender searches are not required for temporarily placed youth who are eighteen (18) years of age or older who are not legal, permanent residents of the certified kinship or foster home, agency, or facility. Records of the checks must be maintained in the employee file and include the following criteria at minimum:

A. Known current names, prior names, and addresses of each individual, and B. Addresses only of the foster care home, kinship care home, or specialized group 7.701.33 Criminal Record Check A. Criminal records checks are required under the following circumstances:

1. In order to obtain any Colorado Bureau of Investigation (CBI) and/or Federal Bureau of Investigation (FBI) fingerprint criminal history records, each applicant listed below must have their fingerprints taken and processed. All requests must be submitted on or up to thirty (30) days prior to the first day of employment or service. Fingerprints must be taken at a vendor approved by CBI. Approved vendors may be located using the CBI website at Colorado.gov/cbi. Payment of the fee for the criminal record check is the responsibility of the individual being checked, identified as follows:

a. Each applicant for an original license for a facility or agency, applicant for a certificate at a family foster home, and any adult eighteen (18) years of age or older who resides in the licensed facility or agency.

b. Applicants for an original certificate for a foster care home, and any adult eighteen (18) years of age or older who resides in the foster 1. For each adult eighteen (18) years of age or older, who begins residing in the foster or specialized group home after care begins, fingerprints must be submitted within five (5) calendar days of when they begin residing in the home, and these adults must not be allowed unsupervised access to children/youth in care until all background checks have been successfully completed.

c. Any person working in an agency or facility including any individuals who have direct contact with children/youth or have access to protected information, volunteers as stated in Section 7.701.33.C.2-3, self-employed individuals, or other individuals associated with the license.

B. The results of the criminal records check, including at least the individual CBI and FBI response letters, must be maintained at the facility or agency and must be available for review by a department representative. Except for records of official actions, which must be available for inspection, all other criminal justice records may be open for inspection subject to the discretion of the official custodian. The Colorado Criminal Justice Records Act (CCJRA) defines an official action as an arrest; indictment; charging by information; disposition; pre trial or post trial release from custody; judicial determination of mental or physical condition; decision to grant, order, or terminate probation, parole, or participation in correctional rehabilitation programs; and any decision to formally discipline, reclassify, or relocate any person under criminal sentence according to Section 24-72-302(7), C.R.S.

1. Letters and information received by a facility or agency that include information protected in the Criminal Justice Information System (CJIS) must immediately pass the letter or information to the subject of the fingerprint check without opening and viewing the information. Such correspondence will be mailed to the facility or agency mailing address and will be marked “to applicant” in the address field.

2. The facility or agency must not require any applicant to divulge background information that is protected in the Criminal Justice Information System (CJIS) as a requirement for employment or 3. For all individuals whose activities involve the care or supervision of children or youth or who have unsupervised access to children/youth, all background checks must be submitted prior to caring for children or youth and completed prior to allowing unsupervised access to children/youth.

C. Each owner, employee of a facility or agency, and licensee shall complete the fingerprint process at an approved vendor. Payment of the fee for the criminal record check is the responsibility of the individual being checked or the facility or agency. The results of the criminal record check and the CBI and FBI response letters, must be maintained at the facility or agency and must be available for review upon request by a Department Representative.

1. When an individual leaves employment, the facility/agency must submit to the Department within thirty (30) days a completed notification of name removal form to request the removal of the individual’s name from their facility/agency license number in the Department background flag database. School district employees who currently work at a licensed child welfare child care facility must have their criminal history report linked to the license number of the child care facility.

2. Any adult volunteer working as a staff member to meet the required staffchild ratio or staff qualifications, who works fourteen (14) days (112 hours) or more in a calendar year must complete the fingerprint process at an approved vendor. The results of the criminal record check must be maintained at the facility or agency and must be available for inspection by a Department Representative. An individual operating as a volunteer to meet required staff-child ratio or staff qualifications that does not have a completed background check on file must be supervised at all times by a qualified staff member who has successfully completed all background checks.

3. Criminal background check requests for volunteers, whose activities involve the care and supervision of children/youth or who have unsupervised access to children/youth, must be submitted and successfully completed prior to caring for children/youth or allowing the individual unsupervised access to children/youth in a child care facility.

4. Every five (5) years, requests for FBI criminal record checks must be renewed by completing the fingerprint process at an approved vendor. An updated clearance letter or verification of the submission of the request must be obtained prior to five (5) years from the date reflected on the current clearance letter.

5. Facilities and agencies that hire individuals who have been convicted of any felony, except those listed in Subsection 6.A-F below, unlawful sexual behavior, or any misdemeanor, the underlying factual basis of which has been found by the court on record to include an act of domestic violence must inform the Department of that hiring within fifteen (15) calendar days of receiving knowledge of the conviction.

6. A child care facility shall not employ, or a child placement agency shall not employ or certify, an individual who has been convicted of:

a. Child abuse, as specified in Section 18-6-401, C.R.S.

b. A crime of violence, as defined in Section 18-1.3-406, C.R.S.

c. An offense involving unlawful sexual behavior, as defined in

Section 16-22-102(9), C.R.S.

d. A felony, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as defined in Section 18-6-800.3, C.R.S.

e. A felony involving physical assault, battery, or a drug-related offense within the five (5) years preceding the date of application for a license or certificate.

f. A pattern of misdemeanor convictions within the ten (10) years immediately preceding submission of the application. “Pattern of misdemeanor” shall include consideration of Section 26-6-914(2), C.R.S., regarding suspension, revocation and denial of a license, and shall be defined as:

1. Three (3) or more convictions of third (3rd) degree assault as described in Section 18-3-204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6-800.3, C.R.S.;

2. Five (5) misdemeanor convictions of any type, with at least two (2) convictions of third (3rd) degree assault as described in Section 18-3- 204, C.R.S., and/or any misdemeanor, the underlying factual basis of which has been found by any court on the record to include an act of domestic violence as defined in Section 18-6-800.3, C.R.S. or, 3. Seven (7) misdemeanor convictions of any type.

g. Any offense in any other state, the elements of which are substantially similar to the elements listed in this Subsection a-f.

D. Payment of the fee for the FBI check is the responsibility of the individual who is obtaining the check or the facility or agency.

E. In multi-service agencies, only individuals who are the applicant for, a person employed by the applicant, or a person who resides at the facility or home may be submitted for a fingerprint based criminal background check under the

authority of Section 26-6-910(5), C.R.S.

F. According to Section 26-6-914(2), C.R.S., the Department may deny an application or suspend, revoke, or make probationary the license, of any facility or agency regulated and licensed pursuant to Part 9 of Article 6 of Title 26 or assess a fine against the licensee pursuant to Section 26-6-921, C.R.S. If the licensee, an affiliate of the licensee, a person employed by the licensee, or a person who resides with the licensee at the facility or agency:

1. Is convicted of a felony, other than those offenses specified in Section 26- 6- 905(8), C.R.S., or child abuse, as specified in Section 18-6-401, C.R.S., the record of conviction being conclusive evidence thereof, notwithstanding Section 24-5-101, C.R.S., or have entered into a deferred judgment agreement or a deferred prosecution agreement to a felony, other than those offenses specified in Section 26-6-905(8), C.R.S., or child abuse, as specified in Section 18-6-401, C.R.S., or if the Department has a certified court order from another state indicating that the applicant, licensee, person employed by the licensee, or any person residing with the license has been convicted of a felony, other than those offenses specified in Section 26-6-905(8), C.R.S., under a law of another state or of the United States or has entered into a deferred judgment agreement or a deferred prosecution agreement in another state as to a felony, other than those offenses specified in Section 26-6-905(8), C.R.S.; or 2. Is convicted of third (3rd) degree assault, as described in Section 18-3- 204, C.R.S.; any misdemeanor, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as defined in Section 18-6-800.3, C.R.S.; the violation of a protection order, as described in Section 18-6-803.5, C.R.S.; any misdemeanor offense of child abuse, as defined in Section 18-6-401, C.R.S.; or any misdemeanor offense in any other state, the elements of which are substantially similar to the elements of any one of the offenses described in this paragraph; or 3. Is determined to be insane or mentally incompetent by a court of competent jurisdiction, and a court has entered, pursuant to Part 3 or Part 4 of Article 14 of Title 15, or Section 27-65-110(4), C.R.S. or Section 27- 65-127, C.R.S, an order specifically finding that the mental incompetency or insanity is of such a degree that the licensee is incapable of operating a facility or agency, the record of such determination and entry of such order being conclusive of evidence thereof; or 4. Uses any controlled substance, as defined in Section 18-18-102(5), C.R.S., including retail marijuana, or consumes any alcoholic beverage during the operating hours of the facility or agency or is under the influence of a controlled substance or alcoholic beverage during the operating hours of the facility or agency; or 5. Is convicted of unlawful use of a controlled substance as specified in

Section 18-18- 404, C.R.S.; unlawful distribution, manufacturing, dispensing, sale, or possession of a controlled substance as specified in

Section 18-18-403.5 or 18-18-405, C.R.S.; or unlawful offenses relating to marijuana or marijuana concentrate as specified in Section 18-18-406, C.R.S.; or 6. Consistently fails to maintain standards prescribed and published by the Department; or 7. Furnishes or makes any misleading or any false statement or report to the Department; or 8. Refuses to submit to the Department any reports or refuses to make available to the Department any records required by it in making investigation of the facility or agency for licensing purposes; or 9. Fails or refuses to submit to an investigation or inspection by the Department or to admit authorized representatives of the Department at any reasonable time for the purpose of investigation or inspection; or 10. Fails to provide, maintain, equip, and keep in safe and sanitary condition premises established or used for child care pursuant to standards prescribed by the Department of Public Health and Environment and the Department of Human Services or by ordinances of regulations applicable to the location of such facility; or 11. Willfully or deliberately violates any of the provisions of Part 9 of Article 6 of Title 26 or any of the standards prescribed and published in Department

rule pursuant to Part 9 of Article 6 of Title 26; or 12. Fails to maintain financial resources adequate for the satisfactory care of children served in regard to upkeep of premises and provision for personal care, medical services, clothing, and other essentials in the proper care of children; or 13. Is charged with the commission of an act of child abuse or an unlawful sexual offense, as specified in Section 18-3-411(1), C.R.S., if:

a. The individual has admitted committing the act or offense and the admission is documented or uncontroverted; or b. The Administrative Law Judge finds that such charge is supported by substantial evidence; or 14. Admits to an act of child abuse or if substantial evidence is found that the licensee, person employed by the licensee, or person who resides with the licensee in the licensed facility or agency has committed an act of child abuse, as defined at Section 19-1-103(1), C.R.S.; or 15. Is the subject of a negative licensing action; or 16. Misuses any public funds that are provided to a foster care home, or child placement agency that places or arranges for placement of a child in foster care, for the purposes of providing foster care services, child placement services related to the provision of foster care, or any administrative costs related to the provision of foster care services or foster-care-related child placement services.

G. The Department may deny an application for a child care facility license or a child placement agency license if the applicant is a relative or affiliate of a licensee, as defined in Section 26-6-903(28), C.R.S. and Section 26-6-903(1), C.R.S., of a child care facility or child placement agency, which is the subject of a previous negative licensing action or is the subject of a pending investigation by the Department that may result in a negative licensing action.

H. For all CBI fingerprint-based criminal history record information checks required in this Section 7.701.33, including those confirming a criminal history as well as those confirming no criminal history, the Department will conduct a comparison search on the State Judicial Department's court case management system and the sex offender registry of the Colorado Department of Public Safety. The court case management search must be based on name, date of birth, and address, in addition to any other available criminal history data that the Department deems appropriate, is used to determine the type of crime(s) for which a person was arrested or convicted and the disposition thereof. The sex offender registry search is used to determine whether the address of a licensee or prospective licensee is listed as belonging to a registered sex offender, except that:

1. County departments of human/social services must conduct sex offender searches in the CBI sex offender registry and the national sex offender public website operated by the United States Department of Justice prior to certification and annually; include a copy in the provider record using the following criteria at a minimum:

a. Known names and addresses of each adult residing in the foster care home or kinship foster care home; and, b. Address only, of the foster care home or the kinship foster care 2. Child placement agencies must conduct sex offender searches in the CBI sex offender registry and the national sex offender public website operated by the United States Department of Justice prior to certification and annually, include a copy in the provider record using the following criteria at a minimum:

a. Known names and addresses of each adult residing in the foster care home or kinship foster care home; and, b. Address only of each adult residing in the foster care home or the kinship foster care home.

I. Portability of Background Checks 1. Where two (2) or more individually licensed facilities are wholly owned, operated, and controlled by a common ownership group or school district, a fingerprint-based criminal history records check and a check of the records and reports of child abuse or neglect maintained by the Department, completed for one (1) of the licensed facilities of the common ownership group or school district pursuant to this Section for whom a criminal records check is required under Section 26-6-912, C.R.S., may satisfy the records check requirement for any other licensed facility under the same common ownership group or school district. A new fingerprintbased criminal history records check or new check of the records and reports of child abuse or neglect maintained by the Department is not required of such an individual if the common ownership group or school district maintains a central records management system for employees of all its licensed facilities; takes action as required pursuant to Section 26-6- 905, C.R.S., when informed of the results of a fingerprint-based criminal

history records check or check of the of records and reports of child abuse or neglect maintained by the Department that requires action pursuant to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act; and informs the Department whenever an additional licensed facility comes under or is no longer under its ownership or control.

2. When a licensee is inspected pursuant to the Foster Care, Kinship Foster Care, Residential, Day Treatment, and Child Placement Agency Licensing and Certification Act and records regarding CBI and FBI fingerprint-based criminal background checks, as well as records and reports of child abuse and neglect maintained by the Department, and the comparison search on the State Judicial Department’s court case management system are held at a central records management system, the licensee must be afforded fourteen (14) calendar days to provide to the Department documentation necessary to verify that employees at the licensed facility have the required records related to fingerprint-based criminal background checks.

3. When an organization completes all fingerprint checks under a singular provider number and the license for that provider number is either surrendered, revoked, or closed, the organization must submit new fingerprint-based criminal history record checks under at least one (1) of its current active provider licenses for every employee working in the facility or agencies that continue to hold a child care license.

J. State-based background checks 1. The following background check requests must be submitted and successfully completed for each state an individual has resided in, in the past five (5) years, prior to an individual caring for children or allowing the individual unsupervised access to children in child care facilities:

a. State criminal history check.

b. State sex offender registry check.

c. State abuse and neglect registry check K. Any person who has lived in another state in the five (5) years previous to application for employment or involvement with the agency/facility must inform the agency/facility to obtain a copy of the state criminal history check from each state in which they had resided. This is a fingerprint or name-based criminal

history check through an approved state agency of previous residence to determine if prospective employees who have lived in other states prior to living in Colorado within five (5) years of applications have been convicted of any criminal offenses that are identified in the foster care, residential, day treatment and child placement agencies licensing and certification act. This check is not required for states participating in the National Fingerprint File (NFF) program.

L. Criminal record checks are not required for temporarily placed youth who are eighteen (18) years of age or older that are not legal, permanent, and habitual residents of the certified kinship or foster home, agency, or facility. 7.701.331 Volunteers and Interns A. If volunteers and/or interns are used by a facility, the facility’s administration must define specifically the services to be given or provided by that individual.

B. Facilities and agencies must ensure, prior to working in the facility, volunteers and interns:

1. Have a completed information form including name, address, phone number, date of birth, and person to contact in case of emergency including name, address, and phone number.

2. Have a signed acknowledgement form including the volunteer or intern’s specific roles and responsibilities, and a signed mandatory abuse/neglect reporting form.

3. A volunteer or intern must have an orientation that includes, at minimum:

a. A facility overview;

b. Information about the facility and description of the population served;

c. The mission statement and philosophy of the facility;

d. Safety procedures of the facility;

e. The confidential nature of the work; and f. Their specific job assignment, prior to the assignment.

C. Volunteers or interns who work on behalf of the facility but do not come to the facility for the fulfillment of their duties, are excluded from background check requirements in this Section.

D. Volunteers and interns who work directly with children/youth must be under the direct supervision of a paid staff member at all times, in addition to the requirements in Section 7.701.331.B must:

1. Be subject to reference checks as performed for employment applicants.

2. Be subject to a check of the Background Investigation Unit, Trails abuse and neglect system to determine if the person was found to be responsible in a confirmed, as defined by Section 19-1-103(33), C.R.S., report of child abuse or neglect reported to the Department’s automated system.

Parental consent must be obtained to conduct a background check on a minor under the age of eighteen (18). Background check results must be maintained at the licensed facility or agency and made available to the 3. Individuals must not be permitted to volunteer or intern if the individual suspects they might be infected with a contagious disease.

E. Volunteers and interns whose activities involve the care and supervision of children/youth or who have unsupervised access to children/youth must be under the professional supervision of a paid staff member and may work alone with the child/youth in individual sessions or mentoring. In addition to requirements in

Section 7.701.331.B and C, they must:

1. Be subject to CBI and FBI fingerprint based background checks required for all staff members. Parental consent must be obtained to conduct a background check on a minor under the age of eighteen (18);

2. Be subject to a check of the Background Investigation Unit, Trails abuse and neglect system to determine if the person was found to be responsible in a confirmed report of child abuse or neglect reported to the Department’s automated system. Parental consent must be obtained to conduct a background check on a minor under the age of eighteen (18);

3. Be subject to training as required in Section 7.714.92.B;

4. Be currently licensed in the state of Colorado if providing professional services to children/youth;

5. Be subject to face-to-face supervision with a paid staff member providing supervision and guidance of the volunteer or intern on at least a weekly

basis; and 6. Have a performance review, by a paid staff member on at least a semiannual basis.

F. Volunteers and interns are not substitutes for paid staff members, and the facility must be fully staffed according to the requirements herein. 7.701.34 Fire and Health Inspections, Zoning Codes A. Prior to the original license being issued, following the renovation of the facility that would affect the licensing of the facility and at least every two (2) years thereafter, all child care facilities except family foster homes must be inspected and obtain an approving inspection report from the local department of health or the Colorado Department of Public Health and Environment and from the local fire department. These reports must be maintained at the facility and be available for review upon request by a Department Representative. The fire authority will inspect each facility at annual intervals for compliance.

B. Prior to the original license being issued, all child care facilities except for foster homes must submit to the Department written approval from the local zoning department approving operation of the facility. The approval must include the address of the child care facility and the ages and number of children/youth to be served. The facility must also submit written zoning department approval to the Department any time there is a change to the license, including moving the facility to another location, increasing the capacity, or adding different ages of C. All child care facilities must operate in compliance with local planning and zoning requirements of the municipality, city, and county where the facility is located.

D. According to Section 26-6-909(2)(e)(ii), C.R.S., a facility that provides child care exclusively to school-age children and operates on the property of a school district, district charter school, or institute charter school may satisfy any fire or radon inspection requirement required by law by providing a copy of the satisfactory fire or radon inspection report of the property of a school district, district charter school, or institute charter school where the child care is provided if the fire or radon inspection report was completed within the preceding twelve (12) months. The Department shall not require a duplicate fire or radon inspection if a satisfactory fire or radon inspection report of the property was completed within the preceding twelve (12) months. 7.701.35 Changes Requiring a New Application Pursuant to Section 26-6-907(2), C.R.S., a license is deemed surrendered, and a new application is required in any of the following circumstances:

A. Change of licensee, owner, or governing body;

B. Change in classification of facility or service offered; or C. Change in location of the facility. 7.701.36 Types of Licenses 7.701.361 Permanent License A. A permanent license is granted when the Department is satisfied that the facility or agency is in compliance with the appropriate Department rules and Section 26-6-901 through Section 26-6-923, C.R.S. The permanent license remains in effect until surrendered, suspended, or revoked.

B. Once a permanent license has been issued, the licensee must annually submit to the Department a declaration of compliance with the applicable licensing rules and notice of continuing operation on the form prescribed by the Department, along with the appropriate annual fee as set forth at Section 7.701.4.

C. Failure to submit the annual Continuation Notice and fee will constitute a consistent failure to maintain Department standards and may result in fines or the revocation of the license. 7.701.362 Time-Limited License A. A time-limited license is granted for specific types of child care facilities or agencies when the Department is satisfied that the facility or agency is in compliance with the appropriate Department rules and Sections 26-6-901 through 26-6-923, C.R.S. The time-limited license will expire on a set date.

B. Once a time-limited license has been issued, the licensee must submit a renewal application and appropriate fee prior to the expiration of the time-limited license.

This will keep the license in effect until a new time-limited license can be issued.

C. Failure to submit the renewal application prior to the expiration of the time-limited license will result in the expiration of the license and closure of the facility. 7.701.363 Provisional License A. Pursuant to Section 26-6-906(3), C.R.S. a provisional license or certificate may be issued only for the initial six (6) month licensing period in the event of a zoning or other delay or dispute between a facility and the municipality, city and county, or county where the facility is situated.

B. This license permits the facility to operate while it is temporarily unable to conform to all rules upon proof by the applicant that attempts are being made to comply with the rules.

C. If an applicant holds a valid provisional license at the time of re-application for a permanent license, the provisional license will remain in effect until the new application is acted on by the Department. 7.701.364 Probationary License A. The Department may make the license of any facility probationary as provided in

Section 26-6-914(2), C.R.S. Making a license probationary is a negative licensing action as defined in Section 26-6-903(21), C.R.S.

B. If the applicant holds a valid probationary license and submits the renewal application and appropriate fee for a permanent license, the current license will remain in effect until the renewal application is acted on by the Department. 7.701.365 Multiple Licenses A. If a licensee wishes to assume child care responsibility in more than one (1) classification of care, separate applications, fees, and licensing evaluations are required for each classification. A family child care home and a specialized group home may only be licensed as one type of classification at any one location address.

B. If a licensee wishes to operate more than one (1) facility of the same classification but at different locations, a separate application, fee, and evaluation are required for each location.

C. Operating multiple licenses of the same classification at a single location by the same licensee or governing body is prohibited.

7.701.4 FEES

A. The appropriate application fee outlined in Section 7.701.4.E, must be submitted to the Department with the application for a child care facility or agency license at least ninety (90) calendar days prior to the anticipated opening date of the facility or the expiration date of the one (1) year time-limited, provisional, or probationary B. The appropriate annual continuation fee outlined in Section 7.701.4.E, must be submitted to the Department annually, at least sixty (60) calendar days prior to the anniversary date of the license, along with a completed continuation declaration.

C. When a facility moves to a new physical address, an original application and an original fee is required. If a child placement agency moves office locations, a change fee is required along with a letter of notification.

D. If the licensee already holds a base license of the required type and the licensee wants to add an additional service type to the existing license, the licensee must submit the original application and pay only the fee to add a new initial service to the base license.

E. Following is a schedule of original and annual continuation/renewal fees for all types of child care facilities and agencies:

Day Treatment Center Original Application $911.00 Continuation 0-12 Students $552.00 Continuation 13-25 Students $901.00 Continuation 26-50 Students $1,252.00 Continuation 51 or more Students $1,627.00 Specialized Group Facility Original Application $365.00 Continuation $275.00 Change of Certifying Agency $100.00 Child Placement Agency- Foster Care Original Application $1,428.00 Therapeutic Foster Care (Plus CPA Fee Above) $300.00 Treatment Foster Care (Plus CPA Fee Above) $300.00 Renewal 0-5 Homes $726.00 Renewal 6-15 Homes $926.00 Renewal 16-30 Homes $1,141.00 Renewal 31-50 Homes $1,352.00 Renewal 51 or More Homes $1,578.00 Child Placement Agency- Foster Care (***With renewal of therapeutic foster care add $150.00 to listed license fees)

(***With renewal of treatment foster care add $150.00 to listed license fees)

Child Placement Agency- Adoption Original Application $1,091.00 Continuation 0-5 Finalized $528.00 Continuation 6-11 Finalized $615.00 Continuation 12-17 Finalized $651.00 Continuation 18-23 Finalized $726.00 Continuation 24 or More Finalized Adoptions $752.00 F. A child placement agency licensed for both foster care and adoptions will pay only one fee, either the foster care fee or the adoption fee, whichever is greater.

The annual report required by Section 7.710.72.B, must be attached.

Homeless Youth Shelter Original Application $911.00 Continuation $751.00 Residential Child Care Facility 2025 and beyond* ** *** Original Application $1,803.00 Original Application for QRTP (Plus RCCF Fee Listed Above) $500.00 Original Application for PRTF (Plus RCCF Fee Listed Above) $500.00 Runaway and Homeless Youth and Shelter Care (Plus RCCF Fee Listed Above) $250.00 Renewal 0- 12 Children/Youth $551.00 Renewal 13-25 Children/Youth $901.00 Renewal 26-50 Children/Youth $1,252.00 Renewal 51-100 $1,627.00 Residential Child Care Facility Renewal 101 or More $1,854.00 (***With Renewal of Qualified Residential Treatment Programs (QRTP) Add $200.00 to Listed License Fees)

(***With Renewal of Psychiatric Residential Treatment Facilities (PRTF) add $200.00 to Listed License Fees)

(**With Renewal of Runaway and Homeless Youth and Shelter Care add $100.00 to Listed License Fees)

Secure Residential Treatment Center 2025 and beyond Original Application $1,854.00 Continuation 0- 12 $1,854.00 Respite Child Care Center Original Application $365.00 Continuation $275.00 (*One Year From Licensed Anniversary Date)

Changes Made to All License Types Increases to Licensed Capacity $100.00 Changes to Physical Premises at Current Address $100.00 Duplicate Licenses $44.00 G. International adoption agencies with out-of-state offices will be required to reimburse the Department for actual and necessary charges involved with travel to out-of-state offices.

H. The appropriate fee must be submitted for each appeal request submitted within each licensing year. There will be no charge for initial hardship and stringency requests or emergency appeals. Section 26-6-907(1)(B)(V), C.R.S. allows for the collection of fees associated with the filing of appeals.

Provider Appeal and Waiver Fees County Appeals Free Hardship Waivers* Free Emergency Appeals Free Stringency Appeals* Free (*If more than five (5) hardship waivers or stringency appeals are submitted by a facility or agency per month, the sixth (6th) and subsequent appeals will each be charged a fee.) $25.00 7.701.5 ADMINISTRATION 7.701.51 Governing Body A. The governing body must be identified by its legal name on the original application and annual continuation notice or renewal application. The names and addresses of individuals who hold primary financial control and officers of the governing body must be fully disclosed to the Department.

B. The governing body must demonstrate to the Department, upon request, that there is sufficient financial support to operate and maintain the facility in accordance with all rules in Section 7.701, the rules regulating the specific type of facility, and the goals and objectives of the facility. 7.701.52 Reports A. As defined under Section 7.701.2, a critical incident must be reported for licensed agencies, facilities, and day treatment centers and the licensee, facility, or agency must follow all confidentiality laws and regulations that apply to critical incident reporting.

In no case must a critical incident be reported later than twenty-four (24) hours after receiving information, excluding weekends and state-observed holidays, of the occurrence of a critical incident at the facility or within twenty-four (24) hours of a child's/youth’s return to the facility. A report may include more than one (1) child, youth, and/or staff and is required per incident and category type. Incidents must be reported under the most serious category listed below.

1. Death a. Report any child/youth death in the facility or foster home while a child/youth has an open placement, to include while a child/youth is on or off grounds;

b. Report death of a child/youth while a child/youth is on the premises of a day treatment center;

c. Report death of staff while on duty;

d. Report death of foster parent with child(ren)/youth in placement;

e. Report death of volunteer or visitor while on premises.

2. Abuse and neglect (Critical incident reporting must be completed in addition to reporting pursuant to Section 19-3-304, C.R.S.)

a. Report any allegation, suspicion, reasonable cause to know, observation, or condition of physical, sexual, verbal, emotional, psychological, human trafficking, or financial abuse to a child/youth when they are in placement or on the premises;

b. Report any allegation, suspicion, reasonable cause to know, observation, or condition of physical, deprivation of needs, medical, supervisory, emotional, psychological, or financial neglect to a child/youth while they are in placement or on the premises; and c. Report notification of an open investigation conducted by the county department when the allegation originated outside of the agency or facility or for which the agency or facility did not report to the hotline system as set forth in Section 26-5-111, C.R.S.

3. Injury a. Report any serious injury to a child/youth that requires emergency medical attention by a healthcare professional at a medical facility or by an emergency medical technician (EMT) or other first responder at a foster home;

b. Report any serious injury in which there is no known cause or due to alleged lack of supervision;

c. Report any injury, bruise, or abrasion on the child/youth or complaint of physical injury made by the child/youth that occurs as a result of a physical restraint;

d. Report any serious injury to a foster parent, staff, volunteer, or visitor as a result of an adverse physical interaction with a child/youth;

e. Report any serious injury of a child/youth requiring admission to a hospital; and f. Report any self-injurious behavior by a child/youth that requires emergency medical attention by a healthcare professional outside of the facility or foster home.

4. Illness a. Report any serious illness that requires emergency medical attention by a healthcare professional outside of the facility or foster home;

b. Report when the wrong medication or dosage is given, or when the prescribed medication is not given to the child/youth, which results in an adverse side effect (physiological or psychological) which requires treatment from a medical professional outside of the facility or foster home to address the adverse effects and ensure the safety of the child/youth to sustain life;

c. A communicable reportable disease, as required by the Colorado Department of Public Health and Environment, of a child/youth, or staff member;

d. Report any suicidal attempt by a child/youth that requires emergency medical attention by a health care professional outside of the facility;

e. Report if a child/youth is placed on any involuntary hold;

f. Report if a child, foster parent, or staff on duty receives medical or emergency attention outside of the facility as a result of a drug or alcohol-related incident; and g. Report any serious illness of a child/youth requiring admission to a hospital.

5. Emergency response a. Report if a fire department responds to a fire;

b. Report a hazardous situation that occurs that could have possibly threatened the lives of other people around a facility or foster home;

c. Report incidents that result in law enforcement taking control of a situation or taking control of a facility or foster home;

d. Report any major or/credible threat to the security and/or safety of a facility, foster home, or child/youth in out-of-home care;

e. Report if a law enforcement agency files charges; issues a summons or citation to a child/youth, and/or a child/youth is arrested while the child/youth has an open placement at the facility or foster home, to include when child/youth is on or off grounds;

f. If a child/youth under the age of eighteen (18) is absent from the facility or foster home without consent, the facility or agency must make a report to the Department no later than twenty-four (24) hours after receiving information of when the child/youth left the facility or foster home; and g. Report if a Division of Youth Services child/youth escapes the facility or foster home.

B. A critical incident report must be submitted by the licensed provider directly through the Colorado Department of Human Services, Division of Child Welfare, Trails automated system.

C. The residential child care facility must notify the Department in writing within five (5) business days when a determination is made by the administration to continue employing a staff member on whom the facility has received notice, either verbally or in writing, of a confirmed, as defined by Section 19-1-103(33), C.R.S., report of the staff member being found culpable for an act of abuse or neglect. The written notice must include a supervision plan as well as the justification of continuing to employ the staff member.

D. Required Notification 1. A facility must immediately notify the child’s/youth’s legal custodian(s) and/or the responsible placing agency of any serious illness or serious injury resulting in medical treatment away from the facility, hospitalization, or death involving a child/youth in care.

2. The facility must notify the legal custodian(s) and/or placing authority as soon as possible or at least within twenty-four (24) hours excluding weekends and holidays upon discovery that a child/youth has run away.

3. Critical incidents must be reported as outlined in Section 7.701.52.A.

E. Reports Made to the Department within Ten (10) Business Days 1 Any legal action against a facility, agency, owner, operator, or governing body that relates to or may impact the care or placement of children/youth;

2. Change of director of facility or agency;

3. Closure of the facility or agency; 4 Change of placement supervisor for a child placement agency;

5. Change in Trails child placement agency (CPA) supervisor or Trails public provider profile.

F. Changes to a License Requiring Written Notification to the Department and Prior Department Approval 1. Proposed change in the number, gender identity, or age of children/youth for whom the facility is licensed that differs from that authorized by the 2. Changes in the physical facility or use of rooms for child care at a facility.

3. Change of name of the facility or agency.

4. Change of residents in the facility, not to include those residents placed in the facility by a county department or a child placement agency. 7.701.53 Reporting of Child Abuse/Neglect A. All agencies and facilities must require each foster parent or staff member of the foster home or facility to read and sign a statement clearly defining child abuse and neglect pursuant to state law and outlining the staff member's or foster parent’s personal responsibility to report all incidents of child abuse or neglect according to state law.

B. Pursuant to Section 19-3-304, C.R.S., any worker in any facility or agency that is licensed or certified pursuant to Part 9 of Article 6 of Title 26 who has reasonable cause to know or suspect that a child/youth has been subjected to abuse or neglect or who has observed the child/youth being subjected to circumstances or conditions that would reasonably result in abuse or neglect must immediately upon receiving such information report or cause a report to be made of such fact to the county department, the local law enforcement agency, or through the child abuse reporting hotline system as set forth in Section 26-5-111, C.R.S.

C. Any caregiver or staff member in a child care facility who has reasonable cause to know or suspect that a youth ages eighteen (18) to twenty-one (21) years old, who is considered a vulnerable youth in placement, has been subjected to abuse or neglect or who have observed the child/youth being subjected to circumstances or conditions that would reasonably result in abuse or neglect, must immediately upon receiving such information, report or cause a report to be made of such fact to the state hotline, county intake department of human/social services, or local law enforcement agency.

D. At the time of admission the facility must give the child’s/youth’s parent or guardian information that explains how and where to report suspected child abuse or child neglect.

E. The facility must ensure there is no retaliation or punishment for any staff member who files a complaint or otherwise reports any concerns or issues with the facility, the administration, other staff members, or activities within the program to the Department, county department of human services, or local law enforcement. 7.701.54 Investigation of Child Abuse/Neglect A. Staff members of the county department of human/social services or a law enforcement agency that investigates an allegation of child abuse must be given the right to interview staff and children/youth in care, and to obtain names, addresses, and telephone numbers of parents or legal guardians of children/youth enrolled at the child care facility. 1 An agency or facility must not interfere or refuse to cooperate with a child protection investigation. Cooperation includes, but is not limited to, a request for documentation, videos, contact information, and interviews with staff and child(ren)/youth.

2. An agency or facility must not interview staff or children/youth regarding the specific allegation(s) of child abuse or child neglect until the county department of human/social services and/or local law enforcement agency has had the opportunity to interview all appropriate individuals and completed their investigation.

B. Any report made to the law enforcement authorities or a county department of human/social services of an allegation of abuse of any child/youth at the child care facility will result in the temporary suspension of duties of the alleged perpetrator to remove the risk of harm to the child(ren)/youth if there is reasonable cause to believe that the life or physical/mental health of the victim or other child(ren)/youth at the facility is in imminent danger due to continued contact between the alleged perpetrator and the child(ren)/youth at the facility.

Such suspension or reassignment of duties will remain in effect pending the outcome of the investigation by the appropriate authorities. 7.701.55 Reporting of Licensing Complaints Agencies and facilities must provide written information to parents, legal guardians, or foster parents at the time of admission and staff members at the time of employment on how to file a complaint concerning observed or suspected licensing violations. The information must include the complete name, mailing address, and telephone number of the Colorado Department of Human Services, Division of Child Welfare. 7.701.56 Posting Licensing Information A. At all times during the operating hours of the facility, except for foster care homes, the facility/agency must post the current child care license in a prominent and conspicuous location easily observable by those entering the child care facility or agency. For foster care homes, the certificate must be available for review/upon request of the public.

B. At all times during the operating hours of the facility, except for foster care homes, the facility/agency must post all approved appeals and waivers in a prominent and conspicuous location easily observable by those entering the child care facility or agency. If the official decision letter is child-specific, it must be kept in the agency/facility file and provided for the department upon request.

C. Agencies and facilities providing out-of-home care and Day Treatment centers must post in a prominent and conspicuous location information regarding the procedures for filing a complaint with the Colorado Department of Human Services, Division of Child Welfare, including the telephone number and mailing address. For foster care homes and child placement agencies, information for filing a complaint must be made available upon request. 7.701.57 Fiscal Management A. Facilities and Agencies with Less Than $750,000 Total Annual Revenue 1. Each facility or agency must declare to the department the annual fiscal year used for the operation of the facility or agency.

2. A facility or agency with less than $750,000 total annual expenditure must submit a cost report annually on the state-prescribed form within sixty (60) days of the agency’s or facility’s identified end of the fiscal year. Any charitable organization required by statute to conduct an audited financial statement prepared by an independent certified public accountant (CPA) must submit the audited financial statement to the Department.

3. The cost report submitted must contain an affidavit signed by the facility or agency’s executive director and an officer of its board attesting to the grounds for suspension of the license.

B. Facilities and Agencies with More Than $750,000 Total Annual Revenue 1. Each facility or agency must declare to the Department the annual fiscal year used for the operation of the facility or agency.

2. A facility or agency with more than $750,000 total annual expenditure must submit a cost report annually on the state-prescribed form within sixty (60) days of the agency’s or facility’s identified end of the fiscal year.

3. The cost report submitted must contain an affidavit signed by the facility or agency’s executive director and an officer of its board attesting to the grounds for suspension of the license.

4. Each facility or agency whose total annual expenditures are $750,000 or more must provide an annual financial review by an independent certified public accountant in accordance with appropriate generally accepted auditing standards.

5. Annually, every facility or agency whose annual expenditures are $750,000 or more must submit a copy of its financial review to the Department. The financial review must be submitted to the department within six (6) months of the facility’s or agency’s fiscal year end.

6. The financial review submitted must contain an affidavit signed by the facility’s or agency’s executive director and an officer of its board attesting to the authenticity of the information. Submission of falsified information shall be grounds for suspension of the facility or agency license.

7.701.6 CONFIDENTIALITY PRACTICES AND NECESSARY RECORDS AND

THEIR RETENTION 7.701.61 Confidentiality Practices A. The records concerning the licensing of facilities and agencies are open to the public except as provided below.

B. Anyone wishing to review a record of a child/youth in the legal custody of the state of Colorado must make a written request to the Department.

C. The following documents are confidential and not available for review:

1. Information identifying children/youth or their families;

2. Scholastic records, health reports, social reports, or documentation covered under therapeutic privilege, such as psychotherapy notes, drug or alcohol treatment records, and mental health records containing protected health information. These are available only to the person to whom the records pertain or others as provided by law;

3. Personal references requested by the Department; and 4. Reports and records received from other agencies, including police and child protection investigation reports.

D. The facility/agency must have a policy as to the maintenance, storage, and confidentiality of records. Records stored in an electronic format must have safeguards and controls for appropriate access to the records; have a secure back-up system to ensure records are not lost; and must be accessible for review by a representative of the Department at all times.

E. Records are the property of the facility/agency and must be protected against loss, tampering, or unauthorized use. Records must be maintained for a minimum of three calendar (3) years plus the current year’s records and accessed in accordance with all state and federal confidentiality laws, including HIPAA, as incorporated above. Access must be given to the Department upon request pursuant to Section 26-6-912(3), C.R.S. for purposes of investigations and auditing as identified within 42 C.F.R. Parts 160 through 164, as incorporated above and 42 C.F.R. Parts 1 and 2, which is hereby incorporated by reference. No later amendments or editions are incorporated. These regulations are available at www.ecfr.gov and also available for public inspection and copying at the Colorado Department of Human Services, Division of Child Welfare, 1575 Sherman Street, Denver, Colorado 80202, during regular business F. Images of children/youth must be kept confidential in accordance with all applicable state and federal confidentiality laws. Except for surveillance cameras installed in common areas of the facility/agency, staff must not take pictures/images or recordings of children/youth. If the facility/agency utilizes surveillance cameras, it must take steps to prevent the unauthorized disclosure of any recordings and appropriately protect the identity of child/youth if the recording is released, with the exception of auditing and/or investigative purposes by the state and county departments or by court order. Data storage for surveillance camera footage specific to any critical incident reports or police investigations must be kept and stored for a minimum of three (3) prior calendar years plus the current calendar year. The only exceptions to the confidentiality for images of youth are:

1. For promotional materials, including social media, where parental and guardian(s) consent and consent of children/youth aged ten (10) and older has been given;

2. When the facility/agency is required to have a photo of the child/youth on file for purposes of notification to law enforcement or other local emergency service agencies; and 3. When the facility/agency uses a child’s/youth’s photo for internal purposes only.

G. Facts learned about children/youth and their families must be kept confidential, with the following exceptions:

1. In medical emergencies, and then only the minimum amount of information necessary for medical professionals to provide assistance and/or expertise; or 2. To the child/youth; the child/youth’s parent(s) or guardian(s) and their respective legal counsel(s); a court having jurisdiction over the child/youth; or licensing specialist in performance of their mandated duties; or 3. If the parent(s) or guardian(s) have given voluntary, written consent; or 4. For purposes of mandatory reports of abuse and/or neglect to the state child protection hotline; or 5. When otherwise required to provide those facts pursuant to law.

H. School records must be transmitted according to Section 22-32-138(3)(A), C.R.S. through Section 22-32-138(3)(D), C.R.S.; The Rehabilitation Act of 1973 at 29 U.S.C. Sections 701 through 796L; and the Individuals with Disabilities Education Act (IDEA) at Sections 20 U.S.C. 1400 through 1482, as incorporated above, if applicable.

I. Medical records must be kept in a secure location at the facility and only be released in accordance with the Health Insurance Portability and Accountability Act (HIPAA), as incorporated above.

J. Any information concerning observed behavior which reasonably appears to constitute a criminal offense committed on the premises of a facility or any criminal offense committed against any person while performing or receiving services is not considered privileged or confidential.

K. Research using identifying information of children/youth is permitted only under the following circumstances:

1. The parent/guardian of the child/youth has given written permission to conduct research on a child/youth.

2. Any research being conducted on a child/youth must have previously been approved by an Institutional Review Board (IRB). An Institutional Review Board is an administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities conducted under the auspices of the institution with which the IRB is affiliated.

3. All researchers conducting clinical research on a child/youth must sign an oath of confidentiality.

4. All information identifying children/youth by name, address, telephone number, and/or social security number collected for research purposes must not be further disclosed by the researcher without parent/guardian consent or consent of the child/youth if they are of age to hold the privilege.

L. When names are redacted and other identifying information is disguised or redacted, material from case records may be used by the facility/agency for teaching purposes; development of the facility/agency’s governing bodies’ understanding; knowledge of the facilities’ services; or similar educational M. Information regarding treatment for alcohol or drug abuse disorders may be released only in compliance with the federal regulations on Confidentiality of Substance Use Disorder Treatment Records, 42 C.F.R. Part 2 (2024), which is incorporated above.

N. A facility or agency may make available information in the case record to the child/youth, their parent(s), or guardian(s) and their respective legal counsel including the child’s/youth’s guardian ad litem (GAL) and/or counsel for youth (CFY) if the information being released does not contain material which violates the right of privacy of another individual and/or that must be withheld from release according to other laws or by order of a court. If in the professional judgment of the administration of the facility, it is determined that information contained in the record would be damaging to a child/youth, that information may be withheld except under court order. In order to withhold this information, the facility must document the reasons for withholding in the child’s/youth’s file. 7.701.62 Maintenance and Confidentiality of Child/Youth Records A. Each licensed child care facility or agency shall maintain records as required by the Department pertaining to the admission, progress, health, and discharge of children/youth in care at the facility.

1. These records shall be made available to the Department upon request.

2. These records shall be maintained and stored in a confidential format.

3. All information regarding children/youth and their families shall be kept confidential. 7.701.63 Necessary Records A. The facility must maintain an organized, legible, chronological, current written or electronic record for each child/youth in care as required for the licensing of the facility in accordance with the rules regulating the facility. The record must be separated into discrete sections addressing medical, educational, clinical, milieu, and therapy.

B A record of admission/case file must be completed for each child/youth in care prior to or at the time of placement. The admission record must be accessible for review at the facility where the child/youth resides and must contain:

1. Child’s/youth’s legal name; date, and place of birth (verified by a birth certificate when possible); gender identity; race; religious preferences of parent(s) or child/youth; date and reason for placement in the current level of care.

2. Child’s/youth’s address and telephone number, and parent(s) or guardian(s) address and telephone number if different from the 3. Name; address; day and after-hours telephone number of the individual or agency placing the child/youth; the name of the individual arranging the 4. The legal custody status of the child/youth and any documents pertaining to the child’s/youth’s custody status such as court orders, including the appointment of a guardian ad litem, counsel for youth, legal guardianship, custody agreements, or the termination of parental rights.

5. A copy of the placement agreement pursuant to Section 7.714.21.B.9.

6. Health records including a health history; chronic medical problems of the child/youth; allergies; illnesses; special diets the child/youth has had during the last six (6) months; and a complete list of all medications the child/youth is taking.

7. Current medical reports; accident, injury, or illness reports; and a record of medication administered and necessary medical care provided to the child/youth while in placement. Psychiatric and psychological reports must be obtained and placed in the child/youth’s file, when available.

8. Copies of educational records, including any individualized education plan (IEP) and/or 504 plan where applicable. Reports of school work, including scholastic performance; accumulation of high school credits, if applicable; certificates of achievement or award; and extracurricular interests.

9. The individual child’s/youth’s plan (ICP) and family services plan (FSP) when developed, or individualized treatment plan (ITP) for committed youth. A summary of the periodic evaluations of the child’s/youth’s progress and resultant changes in the ICP, FSP, or ITP.

10. Written summaries of significant contacts with parent(s), guardian(s), and other involved agencies while in care.

11. Persons authorized to have contact with the child/youth while in care at the facility and persons not authorized via formal court order to have contact with the child/youth while in care at the facility.

12. Copies of all assessments used to determine admission to the facility; documentation of the need for continued care in the facility and how to determine the appropriateness of discharge from the facility, including documentation of all attempts to gain copies of relevant assessments. The assessments may include, but are not limited to, the state-approved assessment , as completed by the independent assessor and subsequent assessment revisions completed by the facility; the assessments as completed while the child/youth is receiving treatment and care within the facility; any psychological or psychiatric assessments, or assessments completed at the request of the child’s/youth’s treatment team or as ordered by the court. 7.701.64 Retention of Records A. Facility records for children/youth must be retained for at least three (3) years at the licensed location. Facility records can include, but are not limited to: intake documentation, demographic information, education information, and/or signed policies and procedures. Facilities must maintain a child/youth mental health record for seven (7) years at the licensed location. Mental health records can include but are not limited to: treatment plans or individual child/youth plans, diagnosis, medication prescriptions, therapy sessions, clinical tests, symptoms, prognosis, and/or substance use evaluations. Retention of records for a longer period may be desirable when they reflect an accident, injury, or other unusual circumstance or as determined by agency/facility policy.

B. The following records must be on file at the facility or administrative office:

1. Governing structure, including the charter, articles of incorporation, bylaws, or other legal basis for existence;

2. Insurance coverage; and 3. Annual financial audit or financial statements.

C. The following records must be on file at the licensed location:

1. Current health department inspection report specific to the child care license number;

2. Current fire department inspection report specific to the child care license number; and 3. A list of current staff members, substitute staff members, and staffing patterns, which must include actual schedules worked, for at least six (6) months prior. 7.701.65 Personnel Records for Direct Care Staff A. Personnel records for any employee having direct contact with children/youth 1. Name, address, birth date;

2. Date of hire and date and reason for separation;

3. Official documents verifying education (e.g. transcripts, ged certificate, high school diploma);

4. Training and work experience;

5. At least two (2) employment references;

6. Current health evaluation or physical stating fitness for work prior to the start date;

7. A written indication of awareness of agency policies; and 8. All required background checks.

B. Records for personnel must be obtained prior to the start date for the employee and retained for at least three (3) years after separation. Records must be immediately accessible to the Department upon request.

7.701.7 PARENTAL ACCESSIBILITY

A. During hours of operation, a facility must allow access to parents and guardians and custodians having legal custody of a child/youth in care to those areas of the facility that are licensed for child care. Parents, legal guardians, and custodians may be given access to the facility when in the best interest of the child/youth and approved by the multidisciplinary team (MDT) when a court is not involved. If a court is involved and there is a valid court order regarding child/youth contact with their parents, legal guardians, or custodians, that court order will control facility access. Parent, legal guardian, and custodian access to the facility decisions must be done in collaboration with the MDT and on a scheduled basis.

B. During the hours of operation, the facility’s most recent licensing, fire department, and health department inspection reports must be accessible to parents and legal guardians of children/youth in care or their designee and to parents and legal guardians considering placing their children/youth in care at the facility.

C. A facility does not violate this section when it restricts access by a parent, guardian, or their designee to a child/youth during an emergency as instructed by local authorities.

7.701.8 PERJURY STATEMENT - APPLICATION FORMS FOR EMPLOYMENT

WITH A CHILD CARE PROVIDER

Every application used in the State of Colorado for employment with a child care provider, agency, or facility, or for the certification of a foster home, must include the following notice to the applicant:

“Any applicant who knowingly or willfully makes a false statement of any material fact or thing in the application is guilty of perjury in the second degree as defined in Section 18- 8- 503, C.R.S., and, upon conviction thereof, shall be punished accordingly.”

7.701.9 GENERAL HEALTH RULES 7.701.91 Smoking and Tobacco Products A. Tobacco and nicotine products are prohibited by law from use in and around licensed child care facilities, as identified in Section 25-14-103.5, C.R.S.

B. Smoking and tobacco product use is prohibited at all times while transporting C. Smoking and tobacco product use is prohibited inside the foster homes when children/youth are in placement. 1 Foster parents are exempt from this rule when no children/youth are in D. A person shall not give, sell, distribute, dispense, or offer for sale a cigarette, tobacco product, or nicotine product to any person who is under twenty-one (21) years of age, as identified in Section 18-13-121(1)(a), C.R.S. 7.701.92 The Use of Restrictive Devices A. The use of restrictive devices, including, but not limited to, the use of handcuffs, shackles, straight jackets, posey vests, ankle and wrist restraints, craig beds, vail beds, or any other restrictive beds, hospital cribs, and chest restraints is prohibited.

B. Children/youth may only be restrained when authorized by applicable federal and state law. In order to be approved to utilize a restrictive device of any kind, the facility/agency must submit an appeal in accordance with Section 7.701.13 or receive prior approval from the Behavioral Health Administration (BHA). BHA approval applies solely to those entities supervised or licensed by the BHA. 7.701.200 The Reasonable and Prudent Parent Standard Requirements for Facilities Providing Twenty-Four (24) Hour Out-Of-Home Care to Approve Activities for a Child or Youth in Foster Care “Reasonable and prudent parent standard” as defined in 12 CCR 2509-1 Section 7.000.2, means careful and sensible parental decisions that maintain the health, safety, and best interests of the child or youth while encouraging the emotional and developmental growth of the child or youth that a provider shall use when determining whether to allow a child or youth in foster care to participate in extracurricular, enrichment, cultural, and social activities based up on the criteria in Section 7.701.200.

Children and youth in foster care are entitled to participate in age or developmentally appropriate extracurricular, enrichment, cultural, and social activities that are determined on an individual basis and include the child’s/youth’s input. Such activities provide opportunities for brain development, normalcy, inclusion, social interaction, social capital, permanency options, and permanent connections. Providers must use a “reasonable and prudent parent standard” when determining whether to allow a child or youth in foster care to participate in such activities following the criteria below:

A. When applying the reasonable and prudent parent standard and prior to approval of the activity, the provider must take reasonable steps to obtain or determine:

1. Adequate information about the child or youth, including the child’s/youth’s particular religious, spiritual, cultural, social, or behavioral practices and preferences;

2. Any current safety concerns for the child/youth as related to the activity;

3. The age and developmental maturity of the child/youth to engage in the activity; and 4. An assessment of the child’s/youth’s abilities in reference to the potential risks of the activity.

B. Providers and counties must consider and work to approve privileges and activities appropriate and in alignment with the child’s/youth’s age, developmental level, and overall assessed readiness for increased independence and autonomy. Providers and counties must make every attempt to ensure children/youth in their care are afforded the same opportunities for independence and autonomy as their peers within the confines of personal and community safety.

C. When appropriate and not otherwise impacted by legal requirements including, but not limited to, probation, the level of supervision for individualized activities and privileges that is required shall be based on the child’s/youth’s individually assessed level of need as informed by the child’s/youth’s age, developmental level, and overall demonstration of safety and stability.

D. Out of home placement alone is not a reason for a child/youth to be denied participation in activities.

E. The county department of human/social services or licensed child placement agency staff that are responsible for direct oversight of foster homes or placement of children/youth must complete the same state training in applying the reasonable and prudent parent standard at least every five (5) years.

F. At least one (1) staff member or administrator in each specialized group facility or Residential Child Care Facility (RCCF) must have completed the reasonable and prudent parent standard training. The staff with the reasonable and prudent parent standard training shall be designated as authorized to apply the reasonable and prudent parent standard to decisions involving the participation of a child or youth in extracurricular, enrichment, cultural, or social activities.

G. The rationale used to authorize an activity for a child or youth must be clearly documented in the facility records and provided in a timely manner to the placing entity.

1. The facility must obtain and comply with a current copy of the policy from the responsible placing entity regarding activities that are considered appropriate for the facility to approve. If there is a conflict between placing entity policies, then the facility shall consult with the placing entities.

a. Appropriate activities considered for children/youth to participate in may include, but are not limited to, school activities, communityprovided activities, and social activities including sports, recreation, field trips, birthday parties, sleepovers, and overnight activities lasting one (1) or more days.

b. The responsible county department of human/social services or DYS may restrict certain activities based upon the documented exceptional needs and circumstances of a child or youth in foster care, which impacts their identified safety needs.

2. The wishes of the parents/legal custodian must be considered, including cultural and religious implications that are not in conflict with identified safety needs.

3. Caregivers are encouraged to approve activities requested by the child/youth, as outlined in Sections 7.701.200.A and 7.701.200.B, unless there is a likelihood of moderate to severe harm. If a caregiver can define how a requested activity would put the child/youth at risk for moderate to severe harm, the caregiver must request a meeting with the multidisciplinary team to review the request.

4. The facility may consult with the responsible agency for guidance about individual cases.

H. Providers must not incur liability to the Department or to the county department of human/social services because of an extracurricular, enrichment, cultural, or social activity approved by the provider if the provider demonstrates compliance with the reasonable and prudent parent standard and has made an informed judgment demonstrated through documentation. In a child welfare investigation arising out of such an activity approved by the provider, the facility must not be founded for institutional neglect if the provider demonstrates compliance with the reasonable and prudent parent standard. 7.701.300 Cultural Responsiveness For Residential Child Care Facilities, Specialized Group Facilities, Homeless Youth Shelters, Child Placement Agencies, Day Treatment Centers, Foster Care Homes, and Secure Residential Treatment Centers.

A. All policies and procedures must reflect culturally responsive operations, and a specific policy must be developed to ensure that the provider will implement and practice culturally responsive programming that acknowledges, respects, and integrates the child’s/youth’s family’s cultural values, beliefs, and practices.

B. All staff members, interns, and foster parents must complete four (4) hours of initial training in cultural responsiveness and two (2) hours annually thereafter.

Volunteers that work directly with youth two (2) or more times in a twelve (12) month period must complete four (4) hours of initial training in cultural responsiveness and two (2) hours annually thereafter. Members of the governing body must complete two (2) hours of annual training in cultural responsiveness.

Members of the board of directors must be given training in the agency’s or facility’s cultural responsiveness policies and procedures at the time they are appointed to the board of directors.

C. Assessments of children/youth and families must identify cultural factors, and services must be in alignment with cultural values assessed and presented by the child/youth and/or family of origin. 7.701.350 Cultural Competence Plan for Agencies and Facilities Facilities and agencies must:

A. Develop and implement policies that promote equitable access to treatment and resources for children/youth of all backgrounds, ensuring non-discrimination based on race, ethnicity, sex, sex assigned at birth, gender identity, sexual orientation, religion, ability level, or any other protected characteristic.

B. Implement a zero-tolerance policy for any form of discrimination or harassment within a licensed program with clear reporting mechanisms and follow-up.

C. Regularly assess clinical interventions and practices to identify and resolve any disparities related to cultural competence.

D. Provide two (2) hours of initial training on cultural competence principles and how these principles apply to the licensed provider's practices. 7.701.400 Trauma-Informed Care For Residential Child Care Facilities, Specialized Group Facilities, Homeless Youth Shelters, Child Placement Agencies, Day Treatment Centers, Foster Care Homes, and Secure Residential Treatment Centers.

A. All policies and procedures must be trauma-informed, and a specific policy must be developed to ensure that the provider will implement and practice traumainformed care and services to include, at a minimum, the following:

1. A safe and supportive environment;

2. Collaboration, mutuality, and transparency between provider, interested parties, and family;

3. Family and child/youth empowerment, input, and choice in the treatment process; and 4. Individualized family service plans, clinical interventions, crisis intervention protocols, and transition and aftercare planning.

B. All staff members, interns, and foster parents must complete four (4) hours of initial training in trauma-informed care and two (2) hours annually thereafter.

Volunteers that work directly with youth two (2) or more times in a twelve (12) month period must complete four (4) hours of initial training in trauma-informed care and two (2) hours annually thereafter. Members of the governing body must complete two (2) hours of annual training in trauma-informed care. Members of the board of directors must be given training in the agency’s or facility’s traumainformed care policies and procedures at the time they are appointed to the board of directors.

C. Assessments of children/youth and families must screen for a history of traumatic experiences and associated needs, and services must be responsive to the needs of children/youth and families, as identified in the assessments.

D. All licensed agencies and facilities must have a trauma-informed treatment model in alignment with the standards set forth by the Department.

1. The trauma-informed treatment model must be implemented as approved by the Department.

2. Any substantive changes to the trauma-informed treatment model must be submitted and approved by the Department prior to implementation and at the time of renewal at least one hundred twenty (120) days and no later than sixty (60) days prior to the date of the expiration of the license.

3. The agency/facility must implement and adhere to their trauma-informed treatment model.

4. The agency/facility must develop policies and procedures and train all staff within one hundred twenty (120) days of hire and annually for the population served and the agency’s/facility’s trauma-informed model. 7.701.450 Quality Improvement Practices for Agencies and Facilities A. Providers must develop quality improvement policies and procedures and establish a quality improvement committee that meets at least quarterly.

B. Providers must implement quality improvement practices that assess those operations, activities, interventions, and practices to identify and resolve problems and barriers that impact positive treatment outcomes.

C. Providers must document the quality improvement process, indicators, measures, outcomes, and revisions to improve programming. This documentation must be made available to the Department upon request. 7.701.500 Trails Data Entry For Residential Child Care Facilities, Homeless Youth Shelters, Child Placement Agencies, Day Treatment Centers, and Secure Residential Treatment Centers A. Each facility or agency must apply to the Department for permission to access the Trails system, to complete all functions assigned to their facility type.

1. Each facility or agency must have at least two (2) employees assigned to access the Trails system to enter critical incident reports as listed at

Section 7.701.52.

2. Child placement agencies must have at least two (2) employees assigned to access the Trails system to enter original and renewal foster care certificates.

3. Child placement agencies must have one (1) employee assigned to access the Trails system to review any child abuse and neglect history for foster care applicants, adoptive applicants, and other adults residing in the B. The child placement employee who accesses the Trails system to review any child abuse and neglect history cannot also access the Trails system for critical incident reporting or entering foster care certificates.

C. Each facility or agency must submit to the Department the prescribed form to delete access for persons who are no longer employed within ten (10) working days of their departure from the agency or facility or immediately for employees whose access to Trails has been restricted by their employer or by the D. All persons accessing the trails system must adhere to all guidelines identified on the application and ensure that all information added into Trails is true and accurate, in accordance with Sections 18-8-114(1)(a), C.R.S. and 26-6-914(2)(g), 7.702 RULES REGULATING CHILD CARE CENTERS THAT PROVIDE LESS THAN 24-HOUR CARE [Repealed eff. 03/02/2026]

7.703 RULES REGULATING THERAPEUTIC FOSTER CARE

Child placement agencies’ or county department of human/social services’ therapeutic foster care programs shall comply with all rules in this section, the General Rules for Child Care Facilities in section 7.701, Rules and Regulations for Child Placement Agencies in section 7.710, and the Rules Regulating Foster Care Homes in section 7.708, 7714.532.

7.703.1 DEFINITIONS

A. “Therapeutic Foster Care” means a program of foster care that incorporates treatment for the special physical, psychological, or emotional needs of a child placed with specially trained foster parents, but does not include medical foster care. § 26-6-102(39), C.R.S. (2020).

B. “Therapeutic Foster Care Program” means a specialized program of foster care that complies with section 7.703 and that is approved to operate by the Colorado Department of Human Services (herein referenced as the Department).

C. “Therapeutic Foster Care Agency” means a county department of human/social services or a licensed child placement agency (CPA) that is approved by the Department to operate a therapeutic foster care program.

D. “Therapeutic Foster Care Home” means a certified foster care home that provides therapeutic foster care to children or youth in care.

7.703.2 THERAPEUTIC FOSTER CARE AGENCY RESPONSIBILITY

A. Policies The therapeutic foster care agency shall develop a written statement of purpose and policies for the operation and management of the therapeutic foster care program (herein referenced as program). The therapeutic foster care agency must provide the Department with the statement of purpose and policies for the Department’s approval upon adoption or revision.

1. The statement of purpose and policies must describe or provide for:

a. The population of children or youth to be served, to include age, level of development, types of behavior, mental health presentation, and other needs;

b. Strategies for supporting emotional regulation, including deescalation techniques, targeted to address the needs of the children/youth served;

c. Supports to maintain placement stability including respite;

d. Assessment, reporting, and transition services for discharge;

e. Cultural responsiveness, as described in 7.701.300; and f. Trauma-informed care, as described in 7.701.400.

7.703.3 PERSONNEL REQUIREMENTS

All personnel requirements in sections 7.710.22 through 7.710.25 apply to child placement agencies. County departments of human/social services’ personnel requirements apply to county departments of human/social services personnel.

A. The therapeutic foster care agency’s staff shall include, at a minimum, one home supervisor.

1. Home supervisors shall meet the following minimum qualifications:

a. Child placement agency home supervisors shall meet the requirements of a placement supervisor per section 7.710.22.A.6 (12-CCR 2509-7).

If additional home supervisors are necessary to fulfill the placement responsibilities of the agency, additional home supervisors shall meet the minimum requirements per section 7.710.22.A.7 (12-CCR 2509-7).

b. County department of human/social services home supervisors shall meet the requirements of a social caseworker per section 7.603.1.D.2 (12-CCR 2509-7).

2. The responsibilities of the home supervisor include:

A. Coordinate, obtain, or provide services to ensure the needs of the child/youth are met, including but not limited to:

1. Psychiatric, psychological, or developmental evaluations;

2. Assessment of child’s/youth’s history, current functioning, and service needs;

3. Development and maintenance of the individual child’s plan, per 7.714.4.D; and 4. Group, individual, or family therapy, as indicated in the individual child’s plan.

b. Consult as needed with therapeutic foster parents to provide emotional support, share information, and address problems or concerns;

c. Ensure that the therapeutic foster parents communicate the current progress and needs of the child/youth with the parent(s), legal custodian, or identified permanent family at the frequency determined in the individual child’s plan;

d. Conduct face to face contact with therapeutic foster parent(s) in the therapeutic foster home at the frequency indicated in the individual child’s plan, but not less than twice monthly;

e. Assess, at a minimum of twice monthly, the needs of the foster parents, including respite, and coordinate, obtain, or provide services to ensure needs are met;

f. Conduct face to face contact with the child/youth in the therapeutic foster home at the frequency indicated in the individual child’s plan, but not less than monthly;

g. Conduct a monthly review of the individual child’s plan for each child/youth and document progress and changes to goals; and h. Document all assessments, services, and face to face contacts monthly.

3. Home Supervisor Training Prior to assuming the responsibilities of a therapeutic foster care caseload, and annually thereafter, a home supervisor shall have a minimum of twenty hours (20) of training in the following areas:

a. The Rules Regulating Therapeutic Foster Care;

b. Strategies to maintain placement stability in therapeutic care foster homes; and c. Competencies related to the needs of the children/youth in the therapeutic foster care program.

7.703.3 REQUIREMENTS FOR THERAPEUTIC FOSTER CARE HOMES

A. Training for a Therapeutic Foster Parent 1. In addition to the certification requirements per section 7.708.65, before accepting placements and annually thereafter, therapeutic foster parents shall have 12 hours of competency-based training in the following areas:

a. Specific content related to diagnoses, behaviors, interventions, and other identified needs of the population(s) served; and b. The Rules Regulating Therapeutic Foster Care.

B. The roles and responsibilities of a therapeutic foster parent include:

1. Communicate the current progress and needs of the child/youth with the parent(s), legal custodian, or identified permanent family at the frequency determined in the individual child’s plan; and 2. Consult and collaborate with the home supervisor, and other therapeutic team members as needed, to address the needs of the child/youth;

C. Qualifications The therapeutic foster care(s) parent must have experience, as demonstrated through verified documentation, with the population(s) served.

7.703.4 PLACEMENT IN THERAPEUTIC FOSTER CARE HOMES

A. Capacity No foster child/youth shall be placed in a therapeutic foster care home if that placement will result in more than six total children/youth, including biological, adoptive, and other children/youth, in that home.

B. Placement Indicators for therapeutic foster care placement include, but are not limited to: discharge from a residential child care facility or treatment foster care home, a determination that the needs of the child/youth cannot be met in a traditional foster care home, and/or a disrupted foster care home placement.

C. Transition Within no more than sixty days (60) days of the placement of a child/youth into the therapeutic foster care home, the therapeutic foster care agency shall collaborate with the family engagement and permanency team to develop and implement a transition plan to address services and supports needed for the child/youth to be in a lower level of care.

D. Reporting 1. The therapeutic foster care agency shall document progress on goals, new or unmet needs, and challenges and report these to the county department of human/social services or other referring entity on a monthly 2. At a minimum of every six months, the therapeutic foster care agency shall review and consider and document outcomes for each therapeutic foster care home, to include placement stability, length of stay, achievement of treatment goals, achievement of permanency, and safety of the children/youth in the home during the review period.

7.704 RULES REGULATING TREATMENT FOSTER CARE

Child placement agencies’ or county department of human/social services’ treatment foster care programs shall comply with all rules in this section, the general rules for child care facilities in section 7.701, and the rules regulating foster care homes in section 7.708.

7.704.1. DEFINITIONS

A. “Applicant” means a county department of human/social services or a licensed child placement agency (CPA) that applies to the department to operate a treatment foster care program.

B. “Care Coordination” means the integration of services and activities provided by the treatment team into a comprehensive plan. The purpose is to manage the delivery of appropriate services for and with the child/youth, treatment foster parent(s), and identified permanent family.

The qualifications, responsibilities, training, and caseload requirements for the care coordinator are identified in 7.704.3.E.

C. “Juvenile Justice Staff” means juvenile assessment center staff, Senate Bill 94 (SB94) staff, pre-trial staff, probation officers, client managers or juvenile parole officers.

D. “Juvenile Justice Placement” means a detention or commitment facility, operated by the division of youth services.

E. “Treatment Foster Care” means a clinically effective alternative to residential treatment facilities that combines the treatment technologies typically associated with more restrictive settings with a nurturing and individualized family environment (§ 26-6-102 (40), C.R.S.).

F. “Treatment Foster Care Program” means a specialized program of foster care that complies with Section 7.704 and that is approved to operate by the Colorado Department of Human Services (herein referenced as the Department).

G “Treatment Foster Care Agency” means a county department of human/social services or a licensed child placement agency (CPA) that is approved by the Department to operate a treatment foster care program.

H. “Treatment Foster Care Home” means a certified foster care home that provides treatment foster care to children or youth in care. 7.704.11 Treatment Team The treatment team members may include, and are not limited to: biological or adoptive parents, treatment foster parent(s), legal custodian(s), Guardian ad Litem (GAL) AND/OR COUNSEL FOR YOUTH Court Appointed Special Advocate (CASA), county department of human/social services caseworker or designee, child placement agency staff, current or previous treatment providers, juvenile justice staff, school district personnel, and the child/youth If the child/youth is unable to or it is inappropriate to participate, the child/youth voice shall be represented in decision making.

7.704.2 TREATMENT FOSTER CARE AGENCY RESPONSIBILITY

A. Policies The treatment foster care agency shall develop a written statement of purpose and policies for the operation and management of the treatment foster care program (herein referenced as program the treatment foster care agency must timely provide the department with the statement of purpose and policies upon adoption or revision.

1. The statement of purpose must describe or provide for:

a. The ages of children or youth to be served;

b. The use of trauma informed practices and de-escalation techniques in treatment foster care homes;

c. Supports to maintain placement stability including respite;

d. Supports for treatment foster parents to remain active participants in the treatment program for the child/youth when the child/youth is clinically placed for the short-term in an RCCF or hospital (up to 30 calendar day);

e. Procedures for supporting the treatment foster care home to remain open for the child/youth’s return; and, f. Assessment, reporting, and transition services for discharge.

2. The treatment foster care agency will adopt a personnel policy including, but not limited to job descriptions, qualifications for positions; required documentation for position; and documentation of a background check, as required in section 7.701.

7.704.3 PERSONNEL REQUIREMENTS FOR THE TREATMENT FOSTER

CARE AGENCY

All personnel requirements in sections 7.710.22 through 7.710.25 apply to CPAs.

County departments of human/social services’ personnel requirements apply to county departments of human/social services personnel.

A. The county director of a county department of human/social services with a treatment foster care program or her/his designee serves in the same capacity as the CPA executive director.

B. The treatment foster care agency shall inform the department in writing, about a change in the executive director or care coordinator of a CPA or the county director/designee or care coordinator in writing within 30 calendar days.

C. The treatment foster care agency’s direct staff shall include, at a minimum one or more care coordinators.

1. Care coordinators shall meet the following minimum qualifications:

a. County departments of human/social services care coordinators shall meet education requirements of a social caseworker as set out in Section 7.603.1.D.2 (12 CCR 2509-7).

b. Staff CPA care coordinators shall meet educational requirements of a placement supervisor set out in section 7.710.22.A.6.

If additional care coordinators are necessary to fulfill the placement responsibilities of the agency, additional care coordinators shall meet the minimum educational requirements set out in Section 7.710.22.A.7.

2. The responsibilities of the care coordinator are:

a. Daily leadership of the treatment team: the care coordinator:

1) Organizes and manages all team meetings, and manages team decision-making regarding the care and treatment of the child/youth;

2) Provides support and consultation to treatment foster parents, to the families of children and youth in care, and to other treatment team members;

3) Advocates, coordinates, and links activities to assure children, youth, and families receive needed services; and, 4) Prepares individuals and/or providers to work with the treatment foster parents and the child/youth’s family in a supportive manner of the treatment foster parents and the safety, permanency, and social and emotional well-being of b. Provision of family preservation strategies, including:

1) On-call support to the treatment parent, child/youth, and family twenty-four hours/seven days a week (24/7). If the agency uses a contracted service for on-call support, the agency must provide information about the circumstances of the child/youth, treatment foster parents, and family sufficient to provide meaningful support, and must ensure the contractor shall meets the minimal educational, personnel, and training standards of a care coordinator, and, 2) Support and consultations with treatment foster parents, such as problem-solving, emotional support, information sharing, and assessment of child/youth safety and wellbeing.

c. Coordination of the state-approved assessment, preparation and approval of treatment foster care plan(s), revisions, and quarterly updates.

d. Minimum contact as judged necessary and appropriate by the treatment team and described in the treatment foster care plan unless decreased under Paragraph 3) below. “Minimum contact” must consist of at least:

1) Weekly face to face contact with treatment foster parent(s);

a) One (1) visit per month face to face with both treatment foster parents if it is a two (2) parent treatment foster care home; and, b) At least one (1) visit shall occur in the treatment foster 2) Three (3) monthly face-to-face contacts with the child/youth in the treatment foster care home.

3) At the discretion of the treatment team the weekly meetings may be decreased, depending upon the acuity level of the 3. Caseload The preferred maximum number of children/youth in treatment foster care assigned to a care coordinator is eight (8). Some circumstances may allow for a larger maximum caseload size, but the maximum caseload size shall not exceed twelve (12).

4. Staff training Prior to assuming responsibilities of a treatment foster care caseload, and annually thereafter, a care coordinator shall have forty (40) hours of competency-based training in the following areas:

a. The program’s treatment philosophy and the specific treatment methodologies the program uses;

b. Trauma-informed care, including the impact of trauma, grief, and loss;

c. Strategies to maintain placement stability in foster care;

d. Rights of children/youth in treatment foster care in the education system and Special Education programs;

e. Treatment foster care rules; and, f. Program policies and procedures.

7.704.4 REQUIREMENTS FOR TREATMENT FOSTER CARE HOMES

A. Training for a Treatment Foster Parent 1. In addition to initial certification requirements (Section 7.708.2-7.708.52), before accepting placements, treatment foster parents shall have thirtytwo (32) hours of competency-based training in the following areas:

a) Trauma-informed care, including the impact of trauma, grief, and loss;

b) Trauma-informed behavior management;

c) Child/youth-specific content related to diagnoses, behaviors, and/or other identified needs;

d) Intensive mental and behavioral health training;

e) Confidentiality and cultural responsiveness; and, f) Annual requirements for foster parents (Section 7.708.65.C.1-9).

B. The Roles and Responsibilities of a Treatment Foster Parent are:

1. Cooperatively and directly working with the parent(s), legal custodian, or identified permanent family in the treatment foster care home, unless there is a documented safety issue. If there is a safety issue, the care coordinator shall work with the treatment team, including the family to address the concerns.

2. Application of treatment foster care agency programming, policies and procedures, including but not limited to protection of privacy.

3. Seeking consultation as needed from the care coordinator or other treatment team members, including requesting a family engagement meeting to maintain placement stability; should a short-term (up to thirty (30) calendar days) clinical placement be required, actively participate in the treatment program so that the treatment foster care home remains open for the return of the child/youth.

4. Completing thirty-two (32) hours of training described in a written training development plan established between the treatment foster care agency and each treatment foster care parent. The training development plan must provide for:

a. Training that emphasizes skill development, knowledge, acquisition, and preparation related to meeting the needs of the child/youth placed in the treatment foster care home;

b. Training in program policies and procedures, ethics, and cultural competency;

c. No less than twenty two (22) hours of required training shall take place in a classroom setting or in an interactive setting that allows the program to gauge the treatment foster care parent(s)’ strengths and needed supports and facilitates the development of positive relationships between program staff and treatment foster parents, as well as between peer treatment foster parents; and, d. First aid and CPR training hours do not count toward the required thirty-two (32) annual training hours.

7.704.5 PLACEMENT OF CHILDREN AND YOUTH IN TREATMENT FOSTER

CARE HOMES

A. Capacity in a Treatment Foster Care Home A treatment foster home shall not exceed two (2) children or youth placed in the home for treatment., except a sibling(s) of a child/youth who is placed for treatment in the foster home may be placed in the same foster home when it is in the best interest of all of the siblings, in order to maintain their relationship.

B. Referral Indicators for treatment foster care placement include, but are not limited to prior placement in a RCCF, a hospital setting, a community crisis center, an acute care unit, a juvenile justice placement, a disrupted or dissolved adoption, and a disrupted foster home care placement; and, Current behaviors that demonstrate high levels of aggression, suicidality, emotional distress, delinquent behaviors, and/or other emotional or psychological issues.

Referral steps to be completed 1. The custodial or responsible county department of human/social services or other referring agency (i.e., Division of Youth Services or mental health agency) shall make the referral to the treatment foster care agency;

2. The treatment foster care agency shall review treatment foster care homes to determine compatibility and appropriateness of placement;

3. Prior to placement and when the treatment foster care home is identified, the referring and/or treatment foster care agency shall administer the state approved assessment instrument.

4. The custodial or responsible county shall schedule a meeting for treatment team members (Section 7.704.11).

5. If the child/youth does not have an established clinical relationship with a behavioral health provider, the treatment foster care agency shall determine the appropriate behavioral health provider and follow the authorization process for treatment services in order to determine the individual needs of the child/youth and his/her family.

a. The child/youth may be placed during the process, and any treatment services shall begin as soon as possible.

b. The clinician associated with the treatment foster care agency shall work with the child/youth, treatment foster parent(s), the parent(s), legal custodian(s), or identified permanent family, and all other relevant parties to facilitate a seamless intervention and address the clinical needs holistically.

C. Transition Upon acceptance into the treatment foster care program, the referring agency and the treatment foster care agency shall develop and implement a transition plan of services to promote reunification with the parent(s), legal custodian(s), or identified permanent family.

D. Ongoing Treatment Team Staffing 1. The county caseworker or designee shall participate in monthly treatment team meetings to review treatment progress, service delivery, and the behavioral needs of the child/youth (Section 7.704.11).

E. Reporting 1. The treatment foster care agency shall document time spent with the child/youth, progress on goals, new or unmet needs, and challenges and report these to the county department of human/social services or other referring on a monthly basis.

2. The county department of human/social services or other referring agency shall review the appropriateness of services and placement based on the treatment foster care agency’s reports.

3. The treatment foster care agency shall collect child/youth’s outcomes quarterly, regarding placement stability, length of stay, achievement of permanency, and current state approved assessment ratings.

7.705 RULES REGULATING RESIDENTIAL CHILD CARE FACILITIES

All Residential Child Care Facilities must comply with the “General Rules for Child Care Facilities” found in Sections 7.701 through 7.701.500, and the Quality Standards for Twenty-Four (24)-Hour Care for Children and Youth found at Sections 7.714 through 7.714.92, the Rules Regulating Special Activities found at Sections 7.719 through 7.719.8, and the Rules and Regulations Governing the Health and Sanitation of Child Care Facilities in the State of Colorado found at 6 CCR 1010-7 (2025), which is hereby incorporated by reference. No later editions or amendments are incorporated. The rules can be found at https://www.sos.state.co.us/ccr/numericaldeptlist.do. Copies are also available for public inspection and copying by contacting the Department of Human Services, 1575 Sherman St., Denver, Colorado 80203, during regular business hours, or any other state publications library during regular business hours.

In accordance with Section 26-6-903, C.R.S., a “residential child care facility (RCCF)” means a facility licensed by the state Department pursuant to Part 9 of Article 6 of Title 26 to provide twenty-four (24) hour group care and treatment for five (5) or more children operated under private, public, or nonprofit sponsorship. “Residential child care facility” includes community-based residential child care facilities; qualified residential treatment programs, as defined in Section 26-5.4-102(2), C.R.S.; shelter facilities; and psychiatric residential treatment facilities as defined in Section 25.5-5.4-103(19.5), C.R.S. a residential child care facility may be eligible for designation by the executive director of the state department pursuant to Article 65 of Title 27. A child who is admitted to a residential child care facility must be:

A. Five (5) years of age or older but less than eighteen (18) years of age; or B. Less than twenty-one (21) years of age and placed by court order or voluntary C. Accompanied by a parent if less than five (5) years of age. 7.705.11 Governing Body A. The governing body is the individual, partnership, corporation, or association in whom the ultimate authority and legal responsibility is vested for the conduct of the residential child care facility (RCCF).

B. When the governing body does not include a board of directors, there must be an advisory committee of at least two (2) other individuals who act in an advisory capacity to the governing body. The names of the board of directors or advisory committee members must be disclosed to the Department. The board of directors or advisory committee must meet at regularly stated intervals and must provide a written performance evaluation of the administrator on an annual basis. The performance evaluation must be available to the Department upon request.

C. The meeting minutes of the advisory committee or the board of directors must be maintained in accordance with a record retention policy. At minimum, the minutes for the preceding three (3) years must be available to the Department upon D. The functions of the governing body must include:

1. The appointment of an administrator who is responsible, according to established performance criteria, to the governing body and delegation to the administrator of executive authority and responsibility for the administration of the residential child care facility according to its defined

purpose.

2. The formulation and - at a minimum - regularly-planned review of policies and procedures to be followed by the facility every two (2) years, or as needed.

3. The provision of necessary facilities, adequate financing, qualified children/youth in accordance with these rules.

4. Ensuring the agency’s administrator, chief financial officer, executive director, and other officers or employees with direct responsibility for financial transactions or financial responsibility are bonded.

5. Ensuring the facility/agency maintains an average sufficient cash reserve or liquid assets to meet its operating expenses for two (2) months, taking into account the agency’s projected volume of placements and its size, scope, and financial commitments.

6. If the facility/agency does not have sufficient funds to meet operating expenses including less than two (2) months of cash reserves or liquid assets or determines there to be a significant financial hardship with potential to impact its programs, the facility/agency must notify their Department Representative in writing of the financial hardship and any potential negative impacts due to the hardship as soon as it is identified. 7.705.12 Fiscal Management A. Each RCCF must develop an annual budget reflecting anticipated income by source and expenses by purpose, plus an accompanying balance sheet, which demonstrates that the RCCF has assured resources to carry out its defined

purpose. The budget must be approved by the governing body or advisory committee. The first year's budget must be submitted with the original license application.

B. An RCCF must demonstrate that it is financially sound and manages its financial affairs prudently. All funds disbursed by the facility must be expended in accordance with the program objectives as specified by the governing body or advisory committee.

C. An RCCF must have a double entry accounting system, and all financial transactions must be posted to this system. Financial statements, prepared from information provided by this system, must be presented in conformity with the U.S. Generally Accepted Accounting Principles (GAAP). Books and records of the RCCF must be subject, at any time the RCCF business office is open, to inspection, audit, or copying by designated Federal, State, or county personnel, or such independent auditors or accountants as may be designated by these 7.705.13 Insurance A. Every facility must carry public liability insurance. The applicant or licensee must submit the amount of the insurance and the name and the address of the insurance agency providing the insurance for the facility. Information about the insurance must be maintained at the facility and must be made available to the B. Facilities operating their own transportation vehicles must carry insurance in compliance with the minimum limits required by the Colorado Revised Statutes, Title 10, Article 4. Information about the insurance must be maintained at the facility and must be made available to the Department upon request.

C. The facility must carry workers’ compensation and unemployment insurance as required by law. Information about the insurance must be maintained at the facility and must be made available to the Department upon request.

7.705.2 CHILD CARE SERVICES 7.705.21 Case Management Services Provided by the Residential Child Care Facility A. A staff member qualified as stated at Section 7.705.44.A must be assigned the responsibility for case management for each child/youth.

B. Each individual assigned the responsibility of providing case management services for a child/youth must:

1. Participate actively in the admission procedure, treatment planning, discharge, and after care planning.

2. Assure that appropriate information concerning the child/youth and their treatment needs or interventions is shared with other staff members who supervise or care for the child/youth regularly and maintain and document communication with parents, guardians, referring agency, or the agency responsible for discharge planning and follow-up care of the child/youth.

3. Assure that an individual child’s/youth's plan is developed with the child/youth and required plan review and necessary modifications are made in accordance with Section 7.714.4.B.

4. Assure that requested progress reports for court and placing agencies are completed and submitted in a timely fashion.

5. Attend administrative reviews in person, virtually, or by conference call, if applicable.

6. Assure that the individual child’s/youth's plan developed for each child/youth is implemented, including treatment by specialists, and documented in the child’s/youth’s file.

C. RCCF providers who are serving children or youth enrolled in the Children's Habilitation Residential Program (CHRP) waiver must be in compliance with rules contained in the Department of Health Care Policy and Financing's Medical Assistance Rules and Regulations at Section 8.508 (10 ccr 2505-10; 8.500)

(2024), which is hereby incorporated by reference. No later amendments are incorporated. These regulations are available at https://www.sos.state.co.us/ccr/generaterulepdf.do?ruleversionid=11637&filenam e=10%20ccr%202505-10%208.500. Copies are also available for public inspection and copying by contacting the Colorado Department of Human Services, director of the Child Welfare Division, 1575 Sherman Street, Denver, Colorado, 80203, or at any state publications library during regular business hours.). 7.705.22 Recreation and Leisure Activities A. A residential child care facility (RCCF) must have a written plan for ensuring that a range of indoor and outdoor recreational and leisure opportunities are provided for children/youth in care. Adaptive recreation and/or adaptive recreation opportunities must be provided to those children/youth with required accommodations and to comply with the Americans with Disabilities Act (ADA), 42 U.S.C. Section 12101 through Section 12213, and its implementing

regulation, 29 C.F.R. Part 1630 (2025), as incorporated by reference in Section 7.701.14, if applicable, and documented within the child’s/youth’s individualized plan. Such opportunities must be based on the individual interests of the children/youth, with personal and treatment needs being considered. The reasonable and prudent parent standard requirement for staff to approve activities for a child or youth in care includes the following actions:

1. At least one (1) staff or administrator in a Residential Child Care Facility (RCCF), who is trained in determining how to use and apply the Reasonable and Prudent Parent Standard, must be designated to apply the Reasonable and Prudent Parent Standard to decisions involving the participation of a child/youth in age or developmentally appropriate 2. The staff must receive training in how to determine whether approving a child’s/youth’s participation in an extracurricular activity, enrichment, cultural, or social activity is consistent with the Reasonable and Prudent Parent Standard based upon the criteria in Section 7.701.200.

B. Responsibility must be assigned for supervision and coordination of the total recreation program, including training and supervision of staff and volunteers, to assure maximum safety for each participant. For programs without a total recreation program, a designated responsible adult must be assigned for supervision and coordination of any recreational activity to ensure child/youth C. Outdoor and indoor recreational areas and equipment must be provided in sufficient variety and quantity to meet the needs of children/youth and to offer some choice of activities. Adaptive recreation equipment and/or adaptive recreation opportunities must be provided to those children/youth with required accommodations and to comply with the Americans with Disabilities Act (ADA), 42 U.S.C. Section 12101 through Section 12213, and its implementing

regulation, 29 C.F.R. Part 1630 (2025), as incorporated by reference in Section 7.701.14, if applicable, and documented within the child’s/youth’s individualized plan. Games, toys, equipment, and arts and crafts material must be selected according to developmental appropriateness, number of children/youth, and with consideration of the needs of children/youth to engage in both active and quiet play. All equipment and materials must be of a sufficient quality to assure safety, and must be of a type which allows for imaginative play and creativity.

D. If the facility takes residents on out-of-state trips, the facility must develop a written plan for each trip, which includes goals for participants for the trip, selection criteria of participants, necessary skills for staff members, necessary equipment to meet participants' needs on the trip, supervision plan, and a letter of information to parents and/or guardians.

1. The facility must obtain the written permission of the parent and/or guardian for each out-of-state trip or must obtain an overall written permission of the guardian for any out-of-state trip in which the child/youth will participate.

E. Some facilities may participate in special activities which are either comprehensively integrated and salient to the total treatment program or which supplement and enhance the treatment process. When the facility participates in any special activities, such as swimming, boating, horseback riding, use of the trampoline, white water rafting, backpacking, camping, or winter sports, the facility must comply with the Rules Regulating Special Activities found at Section 7.719. The child’s/youth’s participation in a special activity must be included in the individual child’s/youth’s plan.

1. When the residents of the facility participate in a special activity, each facility must have a plan of action in case of natural disasters relevant to the terrain and activity, lost participants, injuries, and illnesses. The plan must include available means of communication during special activities.

These plans must be in writing and must accompany the participants and staff, and also be on file at the facility office. The staff must have received training regarding the implementation of these plans prior to the departure of the participants.

2. First Aid supplies must be made available in vehicles, recreation areas, and in a central location in the building. First Aid supplies must be in compliance with CDPHE regulations. There must be a person holding at least a current American Red Cross First Aid/CPR/AED certificate for schools and communities or equivalent at the site of the activity when the activity is in progress.

7.705.3 PERSONAL CARE OF THE CHILD/YOUTH 7.705.31 Food and Nutrition A. Menus must be planned at least one (1) week at a time and must be dated, posted, and filed for at least one (1) year. Menus must be made available to the 1. If menus are used on a rotating basis, they must not repeat for three (3) weeks, or if cycle menus are used, they must be at least three (3) weeks long.

2. Residential child care facilities must make available or make provisions for each child/youth to have three (3) nutritious meals per day scheduled at regular intervals. If more than four (4) hours elapse between meals or fourteen (14) hours elapses between evening meal and breakfast, a nutritious snack must be served.

3. Milk must be made available with all meals, and accommodations must be made for those children/youth with lactose intolerance or who are dairy free.

4. A facility must take into account any cultural and/or religious considerations and any special dietary restrictions of the children/youth in placement when planning menus, such as, but not limited to, children/youth who are vegan, vegetarian, pescetarian, gluten free, dairy free, or who have any other specific food allergies, preferences, or dietary restrictions.

5. Any accommodations made to menus specific to allergies, preferences, or other dietary restrictions must be approved by a registered dietitian and documented for review by the Department upon request.

B. If menus are not prepared by a registered dietitian, there must be a review and approval by a registered dietitian at least annually or when the menu is changed more than three (3) days per month.

C. Facilities participating in the United States Department of Agriculture (USDA) food program must have the menus for non-reimbursable meals and snacks reviewed and approved by a registered dietitian.

7.705.4 HUMAN RESOURCES 7.705.41 Administrative Staff A. Administrator The administrator of a residential child care facility (RCCF) must be qualified as follows:

1. The administrator must have received a bachelor's degree from a regionally accredited college or university and have a minimum of three (3) years of verified experience in the human services field, one (1) of which was in a supervisory or administrative position; or, 2. The administrator must have received a master's degree from a regionally accredited college or university and have a minimum of two (2) years of verified experience in the human services field, one (1) of which was in a supervisory or administrative position.

3. The administrator must assume or oversee the following duties: human resources management; policy and procedures development and implementation; quality assurance; regulatory compliance and accountability; overall professionalism of the agency; responsibility for the daily operation of the agency; overall direction and responsibility for the children/youth, program, facility, and fiscal management; oversight of trauma-informed care plans that are approved by the Department; overall direction and responsibility for supervision of adequate staffing as defined in rule; the selection and training of a staff member who can assume responsibility for managing the facility in the administrator's absence; and the establishment of resources within the community.

B. Assistant or Acting Administrator 1. In each residential child care facility (RCCF), there must be a specifically designated staff member, age twenty-one (21) or over, capable of acting as a substitute for the administrator during their absence. The duties and responsibilities of the substitute administrator must be aligned with the duties and responsibilities of the administrator.

2. If the administrator is regularly absent from the facility for more than fifty percent (50%) of their working hours, an assistant administrator must meet the same qualifications as the administrator found at Section 7.705.41.A. A licensed professional may act as the acting administrator.

C. Administrative Coverage 1. When there is a change in administrator, or when the administrator has left the facility permanently without a replacement, the Department must be notified in writing within twenty-four (24) hours. When a possible change in administrator is anticipated, the facility must notify the Department in writing prior to the change.

2. The administrator or the staff member to whom the administrator has delegated responsibility must be available at all times either at the facility or via a virtual or telephonic option. 7.705.42 Medical, Health, and Clinical staff The following apply to facilities who are only residential child care facilities (RCCF). For qualified residential treatment program requirements for medical and health staff, see

Section 7.705.204 through Section 7.705.206.

A. A residential child care facility (RCCF) must have access to medical consultative services and a health care provider licensed pursuant to Article 240 of Title 12, C.R.S., in order to provide effective healthcare to meet the needs of the children/youth in the facility. A residential child care facility may employ a licensed health care provider(s) who would be responsible for the health care of the children/youth in the facility. Such contracts or terms of employment must outline the number of hours to be provided for on-site consultation and/or intervention.

B. If the licensed medical health care provider is not an employee of the facility, there must be a description of the contracted consultative services or other medical duties to be performed, and there must be a written contract outlining the duties to be performed and their required availability to the facility. 7.705.43 Child Care Staff A. Residential Child Care Facilities (RCCFs) and Shelter Care Facilities 1. Each child care staff working within an RCCF must be at least twenty-one (21) years of age and have a high school diploma or equivalent. An emphasis may be placed on skills-based hiring for staff as well as valuing lived experience in the child welfare system.

2. Child care staff aides must be at least eighteen (18) years old and must have a high school diploma or equivalent. Child care staff aides must work directly under the supervision of a child care staff member in activities specified by the child care staff member or with the approval of the director.

3. Relief staff must have the same qualifications as regularly assigned child 4. Supervisors are required to have a college degree as well as a minimum of two (2) years of experience working in a child care setting. An associate degree may be substituted for the college degree requirement. Staff members promoted into supervisory positions or people hired into supervisory positions without supervision experience must complete six (6) hours of training within ninety (90) days of hire/promotion, as provided by the provider training academy or the facility/agency.

B. Qualified Residential Treatment Programs (QRTPs) and Psychiatric Residential Treatment Facilities (PRTFs)

1. Each child care worker must be at least twenty-one (21) years of age and have completed two (2) years of college education. An associate degree may be substituted for the college requirement. A high school diploma or equivalent and a minimum of two (2) years’ experience in the human services field may be substituted for the college requirement. A child care worker may substitute each year of work experience with thirty (30) semester hours of credit earned from a regionally accredited college or university. a high school diploma or equivalent and thirty (30) semester hours and a minimum of one (1) year of experience may be substituted for the required college. An emphasis may be placed on skills-based hiring for staff as well as valuing lived experience in the child welfare system.

2. Child care staff aides must be at least eighteen (18) years old and must have a high school diploma or equivalent. Child care staff aides must work directly under the supervision of a child care staff member in activities specified by the child care staff member or with the approval of the director.

3. Relief staff must have the same qualifications as regularly assigned child 4. Each child care worker and any staff member who provides direct care for children/youth must be provided with ongoing supervision. Each child care worker and staff member who provides direct care for children/youth must be provided individual supervision at least every thirty (30) days and documented and maintained in the employee file. More frequent supervision must be provided as necessary for support or to address performance and must be documented in the individual staff file.

5. Supervisors are required to have a college degree in the human services field or related field as well as a minimum of two (2) years of experience working in a child care setting. Staff members promoted into supervisory positions or people hired into supervisory positions without supervision experience must complete six (6) hours of training within ninety (90) days of hire/promotion, as provided by the provider training academy or the facility/agency.

6. Supervision of staff should address, at a minimum, the clinical needs of the children/youth in the care or service of the staff, trauma-informed practices, performance, emotional regulation, and vicarious trauma.

7. Documentation of the discussions during supervision should be signed or acknowledged by both parties and must be maintained by the facility and made available upon request by the Department. 7.705.44 Case Management Staff and Other Professional Staff A. Case management must be provided by:

1. A qualified professional having a master’s degree in social work, psychology, or child development from a regionally accredited college or university and have a minimum of two (2) years of treatment-oriented or case management experience, or 2. A designated member of the staff who must have a bachelor’s degree from a regionally accredited college or university with a major in social and behavioral sciences, and a minimum of three (3) years of experience working with children/youth. The designated case management staff must have an arrangement for consultation from a qualified professional as described above. Effective consultation must include, at a minimum, professional and documented supervision of each case management staff at least once every thirty (30) days to review pending and new admissions to the facility, initial assessments and initial individual child’s/youth’s plans, current discharge plans, individual child’s/youth’s individual plan reviews and modifications, communication strategies with partners and families, progress reports, and planning of care following discharge.

B. The case management staff must ensure the individual child’s/youth’s plan, as described in Section 7.714.4.B, aligns with the reason for residential child care facility level of care and outlines anticipated length of stay, specific care, treatment, and aftercare planning guidelines for successful discharge, as approved and signed off on by the licensed clinician.

C. The qualified professional, as specified in Section 7.705.44.A.1 may be a fulltime or part-time employee of the facility or an individual with which the facility has a contract to provide the necessary services and/or consultation.

D. The ratio of case management staff to children/youth must be dependent on the type of facility and the needs of the children/youth therein, but there must be at least one (1) full-time case management staff member for every twenty (20) children/youth or a part-time staff member assigned for a fraction thereof.

E. The case management staff must be responsible for providing case management services as stated at Section 7.705.21.

F. Psychiatrists used by the child care facility must be qualified and licensed to practice and must provide, as needed, diagnosis, treatment, and consultation G. Only licensed and trained clinicians, as outlined in Section 7.705.205.A may provide testing and diagnostic services for assessment purposes and must be qualified and licensed to practice as designated by Colorado law.

H. Other professionals providing specific therapy must be licensed professionals as designated by Colorado state law. 7.705.45 Food Services and Maintenance Staff Members A. All food services and maintenance staff members must comply with the general requirements for all personnel as specified in Section 7.714.92.

B. There must be one (1) food service staff member who has basic knowledge and understanding of nutrition, food purchasing, and menu planning. If the staff member is not qualified as a registered dietitian, there must be available written consultation from a registered dietitian.

C. Maintenance staff must be in sufficient numbers to maintain an adequate physical space as determined by the policies and procedures of the facility. 7.705.46 Child Care Staff-to-Child/Youth Ratios A. There must be a minimum of one (1) child care worker on duty and one (1) staff person on call who can be physically present at the facility within sixty (60) minutes, at all times when there is one (1) child/youth or more at the facility. In the event of an emergency, local emergency services must be called immediately.

B. At night there must be at least one (1) awake staff person within each physically separate building and within hearing distance of children/youth and a second person who can be physically present at the facility within sixty (60) minutes. In the event of an emergency, local emergency services must be called immediately.

C. The ratio of child care staff to children/youth in care must be dependent on the needs of the children/youth, and the ratio of such staff must not be less than the following schedule:

Age of Child/Youth Waking Hours Sleeping Hours 5 - 6 years 1 staff member: 6 1 staff member: 12 7 -12 years 1 staff member: 8 1 staff member: 16 13 years and over 1 staff member: 10 1 staff member: 20 D. Specialized group homes or group centers who are serving children/youth enrolled in the Children’s Habilitation Residential Program (CHRP) waiver must be in compliance with rules contained within the Department of Health Care Policy and Financing (HCPF) Medical Assistance Manual at 10 CCR 2505-10

Section 8.508 (2024), which is hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available at https://www.sos.state.co.us/ccr/generaterulepdf.do?ruleversionid=11637&filenam e=10%20ccr%202505-10%208.500. Copies are also available for public inspection and copying by contacting the Colorado Department of Human Services, Director of the Division of Child Welfare, 1575 Sherman Street, Denver, Colorado, 80203 or at any state publications library during regular business Specialized Group Facility Maximum Capacity CHRP Non-CHRP Total Children/Youth 0 11 11 1 7 8 2 6 8 3 5 4 4 8 5 3 8 6 2 8 E. For children/youth with intellectual and developmental disabilities, impairment to intellectual and adaptive functioning, or physical disabilities, the administrator shall ensure that there is sufficient trained staff on duty to meet the current or potential needs of all residents at all times, considering individual needs such as the risk of accidents, hazards, or other challenging events.

1. The administrator shall ensure that the facility does not depend upon residents to perform staff functions.

2. The ratio of staff to children/youth must be at least:

a. If a child/youth has near appropriate functioning with limited intellectual functioning, the ratio must be one (1) staff member to every five (5) children/youth during waking hours and one (1) staff member to every ten (10) children/youth during sleeping hours.

b. If a child/youth has limited adaptive behavior and will always need a defined level of supervision, the ratio must be one (1) staff member to every four (4) children/youth during waking hours and one (1) staff member for every eight (8) children/youth during sleeping c. If a child/youth has minimal independence and communication, the ratio must be one (1) staff member to every three (3) children/youth during waking hours and one (1) staff member to every six (6) children/youth during sleeping hours.

d. If a child/youth is completely unable to manage self, the ratio must be one (1) staff member to every two (2) children/youth during waking hours and one (1) staff member for every four (4) children/youth during sleeping hours. 7.705.47 Supervision of Children/Youth A. The residential child care facility (RCCF) must have a written policy for the standard supervision of children/youth in the program based on the identified population described in the admission policies. The facility must adhere to the policy, and it must include supervision of children/youth while at the facility, during transportation, and while off the premises. The policy must be approved by the Department on an annual basis. When a child’s/youth’s individual needs require deviation from the supervision policy, it must be documented in the individual child’s/youth’s plan.

B. When a child/youth is in their bedroom or is not involved in regular programming, staff must conduct visual checks of each child/youth at irregular intervals, not to exceed fifteen (15) minutes between visual checks.

C. During sleeping hours, visual checks may not exceed fifteen (15) minutes. Staff must ascertain that children/youth are present in their assigned bed.

D. Visual checks may need to be conducted at more frequent intervals as determined by the clinician or direct care supervisor on shift when a child/youth presents with a history of or current high-risk behaviors, as identified in the individual child’s/youth’s plan, that may endanger self or others. high-risk behaviors may include, but are not limited to, aggression, elopement, suicidal ideations, self-harming behaviors, and sexualized behaviors.

E. The facility/agency must provide supervision and care as stated in the facility’s written policies and as stated in the individual child’s/youth’s plan. The facility/agency must also provide any specific, time-limited safety plans, as required by the child/youth’s behavior and/or needs.

F. The use of cameras or recording devices is prohibited in children’s/youth’s sleeping areas and restrooms.

7.705.5 BUILDING AND FACILITIES 7.705.51 Building Plans Prior to construction, architectural plans for new buildings or for extensive remodeling of existing buildings must be submitted for review and approval by the local fire department and local building department. If required by the Colorado Department of Public Health and Environment (CDPHE) or local public health agency, plans must be submitted for review and approval. Plans must be submitted and reviewed by the Department as to appropriateness, general adequacy, and suitability for child care as well as for compliance with all applicable federal and state laws. 7.705.52 Living Spaces and Equipment Necessary in Residential Child Care Facilities A. All children’s/youth’s sleeping arrangements must be made in consideration of their self-identified gender. Sleeping arrangements for all children/youth must be made according to their safety, clinical, and supervision needs, as documented in each child’s/youth’s individual child’s/youth’s plan. In sleeping rooms that accommodate two (2) to four (4) children/youth, sixty (60) square feet of floor space per child/youth must be provided. There must be no more than four (4) children/youth in any bedroom. Each bedroom for single occupancy must have a minimum of eighty (80) square feet of floor space. Children/youth must not be required to sleep in a common area of the residential child care facility, outside the sleeping rooms, unless the procedures for a restriction of a child’s/youth’s rights found in Section 7.714.31.C-E or 7.714.33.B if the youth is in foster care or participating in the foster youth in transition program, are followed. 1 A closet or designated container(s) with a minimum of four (4) square feet per child/youth must be provided for storage of personal items inside the sleeping room. Provisions for storage may include open shelving units. A separate container for the storage of soiled laundry must be provided for each child/youth.

2. Children/youth who are non-ambulatory or have documented limited mobility must be sleeping in rooms that are at ground level for exiting access. The facility must comply with all accommodations required in the Americans with Disabilities Act (ADA), if applicable.

B. Each child/youth must be provided suitable sleeping facilities consisting of individual beds or bunks complete with a mattress. Single beds must be spaced not closer than thirty-six (36) inches laterally or end-to-end. Triple-deck bunks are prohibited. Beds being used by children/youth must have an impervious, easily cleanable mattress cover or pad, clean sheets, pillows, pillowcases, and blankets. All sleeping equipment must be maintained in a clean and sanitary condition as required in 6 CCR Section 1010-7 (2025), which are incorporated by reference. No later editions or amendments are incorporated. The regulations can be found at https://www.sos.state.co.us/ccr/generaterulepdf.do?ruleversionid=6576&filename =6%20ccr%201010-7 . Copies are also available for public inspection and copying by contacting the Colorado Department of Human Services, 1575 Sherman St., Denver, Colorado 80203, during regular business hours or at any state publications library during regular business hours.

C. Each room of occupancy must be adequately ventilated by exterior windows or by an approved air-conditioning system. If a mechanical ventilation system is provided, it must meet requirements of local building codes and fire regulations.

D. When child care staff live in or sleep at the facility, there must be at least one (1) room adequately furnished and a private bath facility reserved for child care staff.

Arrangements where child care staff share sleeping rooms with children/youth who have special needs must be approved by the Department.

E. Work areas for staff who are supervising youth during sleeping hours must be located on the same floor or in the general area of children/youth's sleeping rooms so that the child care worker can supervise children/youth and be accessible when needed. If physical work areas are not located on the same floor or in the general area of children’s/youth’s sleeping rooms, provisions must be made for line-of-sight supervision at all times between sleeping rooms.

F. There must be a minimum of twenty-five (25) square feet of space for each child/youth for informal individual or group activities. The area must be adequately and appropriately furnished to accommodate social and recreational activities associated with such living areas.

G. There must be a designated space distinct from children’s/youth’s living areas to serve as an office for administrative duties.

H. There must be a designated room(s) to allow private discussions and counseling sessions. 7.705.53 Outdoor Space and Equipment A. The grounds of the residential child care facility must be maintained in a manner that is free from any hazard to health or safety.

1. Fences must be in good repair. There must be at least one (1) fence gate that remains unlocked for immediate emergency egress. The designated exit gate may have time-delay panic hardware provided that such timedelay panic hardware is approved by the fire department having jurisdiction over the facility.

The approved exit gate must release and open automatically after no more than a thirty (30) second delay without constant pressure being applied to the gate latch and must remain open for at least fifteen (15) seconds. The approved exit gate can neither automatically reset itself nor be reset from a central control panel for a period of at least fifteen (15) seconds after release. Magnetic locks in conjunction with time-delay panic hardware that meets these criteria are allowed. 2 Areas determined to be unsafe, including steep grades, cliffs, open pits, swimming pools, high voltage boosters, or high-speed roads, must be fenced off or have natural barriers to protect children/youth.

3. Playground equipment must be located, installed, and maintained in compliance with the Consumer Products Safety Commission standards for public playgrounds.

B. A residential child care facility must have access to outdoor recreational space and suitable recreational equipment to include adaptive recreation spaces and equipment, as needed, for the children/youth in care. 7.705.54 Dining, Kitchen, Laundry, Bathroom Facilities A. The dining area, whether located in the living unit or in a separate central dining facility, must meet the following requirements and comply with all accommodations required in the Americans with Disabilities Act (ADA), 42 U.S.C.

Section 12101 through Section 12213 (2024), and its implementing regulation, 29 C.F.R. Part 1630 (2024), as incorporated by reference in Section 7.701.14, if applicable:

1. The dining area and kitchen shall be kept in a clean and sanitary condition, as required by the Colorado Department of Public Health and Environment (CDPHE) in 6 CCR 1010-7 (2025), as incorporated in

Section 7.705 above.

2. It must be large enough to accommodate the children/youth and staff.

3. Floors must be constructed and maintained with a non-slipping surface.

4. Tables and chairs must be of sturdy construction, scaled, or adjusted to the proper height and size so that children/youth can be comfortably served. 5 Table service and settings must be of the type, size, and design appropriate to the ages and developmental abilities of children/youth served.

6. Dining and recreation areas may be combined if regulations for dining areas are consistently met.

B. The kitchen must be designed and equipped to meet the requirements of efficiency, fire safety, and comfortable working conditions for the staff. Each kitchen must contain a CO2 or dry powder fire extinguisher designed to extinguish fires involving organic solids, flammable liquids, and flammable gasses.

C. Noncommercial types of laundry facilities with ample space for sorting, drying, and ironing must be made available to children/youth old enough and capable of handling their personal laundry. Laundry facilities must be supervised as defined in the agency’s written policies and procedures and based on the developmental level and needs of the children/youth in care. When an agency has a central laundry facility, it must be located in an area separate from areas occupied by D. There must be a ratio of at least one (1) accessible toilet, sink, bathtub and shower for every six (6) children/youth. Toilet and bath facilities for males and females and staff must be separate. Toilets and bath facilities must have doors or partitions. Residential child care facilities (RCCF) licensed after July 1, 2024 must also have available at least one (1) single occupancy, gender-neutral toilet, sink, and bath facility. Where possible, all facilities licensed prior to July 1, 2024 must attempt to provide a single occupancy, gender-neutral toilet, sink, and bath facility. Children/youth must be allowed to use the bathroom facilities of their identified gender or use the gender-neutral bathroom if they prefer. Urinals may be substituted for up to one-third of the required number of toilets in areas of the facility in which males sleep. Toilet and bath/shower areas with multiple toilets or showers in one (1) open area must have partitions between each toilet or bath/shower fixture. Toilet and bath facilities, if not located within the sleeping rooms, must be accessible from a common hallway and be on the same floor with sleeping rooms. 7.705.55 Building Safety A. Building Site 1. The facility must be located in an area that is accessible to health resources, public and private utilities, adequate and safe water supplies, sewage disposal, and fire and police protection. If health resources or fire and police protection are limited or not available within a reasonable distance to the facility, a plan must be submitted to the Department for approval through the waiver process, in accordance with Section 7.701.13. If health resources are limited or not available within a reasonable distance to the facility, a plan must be submitted to the Department for medical and mental health emergencies and to meet the needs of routine care.

2. The facility site must be located in accordance with local zoning department requirements.

3. The entire premises of the facility is subject to inspection for licensing purposes, including, but not limited to, the residence where care is to be provided, the grounds surrounding the facility, the basement, the attic (if accessible), any storage buildings, and a garage or carport, if applicable.

4. All stairways containing more than four (4) steps must be equipped with a handrail.

5. The facility must have an active, working telephone. Each separate living unit within a facility must have twenty-four (24)-hour telephone service or an intercom system connected with an outside telephone service. Each facility must have a back-up form of communication that is described in the facility’s disaster plan and maintained in working condition at all times.

Emergency numbers must be posted near the telephone, including those related to medical care, local fire, local law enforcement, ambulance, the statewide child abuse and neglect hotline, the National Suicide Hotline, the Colorado Crisis Line, Safe2Tell Hotline, and poison control where available. Numbers for the agency or person having legal custody of each child/youth must also be available.

6. If the facility is located in the same building as, or immediately adjacent to, other facilities, an adult treatment center, or nursing home, it must be so arranged that the care and activities of the children/youth residing in the facility are completely separate and independent from the other facility.

The facility may not be operated on the premises of a business that might be hazardous to the health, safety, morals, or welfare of children/youth and the operation of the facility.

7. The facility, including indoor and outdoor space, must be maintained in safe condition free from hazards to health and safety.

8. There must be outdoor space available to provide a recreation area for children/youth. This area must be fenced if children/youth younger than five (5) years old are in care or older children/youth with disabilities require either containment or protection from outside elements such as animals.

9. If in-ground swimming pools, permanent wading pools, or above ground pools, hot tubs, or spas are located on the property, each must have a barrier on all sides and have a method of access through the barrier equipped with a safety device, such as a bolt lock.

B. Maintenance 1. Buildings shall be kept in good repair and maintained in a safe condition.

Good housekeeping shall be observed in all areas at all times. Needed repairs must be identified regularly and corrected immediately.

2. All areas of the facility available for children's/youth’s activities, including equipment, materials, and furnishings must be maintained in safe condition and free from hazards such as sharp points or corners, splinters, protruding nails, and broken play and recreational equipment. This also includes the elimination of debris and hazardous items of all kinds and removal of broken play and recreational equipment and any other devices which are in poor repair.

3. Closets, attics, basements, cellars, furnace rooms;, and exit routes must be kept free from the accumulation of significant amounts of extraneous materials such as discarded furniture, Furnishings, newspapers, or magazines that could pose a fire or health hazard. Combustibles such as cleaning rags, mops, and cleaning compounds must be stored in wellventilated areas. Solutions, cleaning compounds, and other hazardous substances must be properly labeled and stored in areas inaccessible to 4. All hazardous chemicals, tools, and other equipment, including, but not limited to, matches, paints, gasoline, sharp kitchen utensils, insecticides, cleaning materials, computer duster spray, and personal hygiene or other products containing more than five (5) percent alcohol content, must be inventoried and stored in a secured, locked area. All other household chemicals, tools, or other equipment must be secured out of reach of children/youth as dictated by the lowest level of functioning within the facility.

5. When a facility’s program description and admission criteria define their population and program as preparing for independent living within the next two (2) years, and the youth in the program are at least seventeen (17) years of age, the facility may provide limited amounts of household cleaners and laundry products accessible to youth to promote independent use of these products.

6. Storage of gasoline, kerosene, fuel oil, and other flammable material must meet requirements of safety and fire codes. Indoor storage of such materials is not permitted unless fire code standards are met.

7. Storage must not be permitted around water heaters and furnaces.

C. Exits 1. Every building or structure must be provided with exits sufficient to permit the prompt escape of occupants from the building and away from the premises in case of fire or other emergency. Additional safeguards must be provided for life safety in case any single safeguard is ineffective due to some human or mechanical failure. The facility must comply with all accommodations required in the Americans with Disabilities Act (ADA). 42 U.S.C. Section 12101 through Section 12213 (2024), and its implementing

regulation, 29 C.F.R. Part 1630 (2025), as incorporated by reference in

Section 7.701.14, if applicable.

2. Each residential child care facility (RCCF) must have at least two (2) approved, alternate, remotely-located means of egress from each floor of the building to safe and open space at ground level.

3. Egress from each dwelling unit, sleeping room, and dormitory must be directly available without passage through another dwelling or rooming unit to the outside or to a common hallway leading to the outside. If a facility utilizes a vestibule or common hallway to move from one area to another, any doors blocking that vestibule must remain open and unlocked to allow for egress.

4. In residential child care facilities (RCCF), time-delay, panic hardware utilizing no more than thirty (30)-second delays before release may be installed on the one (1) approved exit door on each floor of the facility, provided that such time-delay, panic hardware is approved by the fire department having jurisdiction over the facility.

The one (1) approved exit doors on each floor must release and open automatically after no more than a thirty (30)-second delay without constant pressure being applied to the doors and must remain open for at least fifteen (15) seconds. The one (1) approved exit door on each floor can neither automatically reset themselves nor be reset from a central control panel for a period of at least fifteen (15) seconds after release.

Magnetic locks in conjunction with time-delay panic hardware that meets these criteria are allowed. Delayed egress is only permitted in buildings set up with sprinkler systems, and the locks must release upon activation of the fire system.

5. In every building or structure, exits must be so arranged and maintained as to provide free and unobstructed egress from all parts of the building or structure at all times when it is occupied. No lock or fastening device to prevent free escape from the inside of any building can be installed unless specifically authorized pursuant to Section 7.714.53. All exit doors must be equipped with single-action hardware only.

6. Every exit must be clearly visible, or the route to reach it must be conspicuously indicated in such a manner that every occupant of every building or structure who is physically and mentally capable will know the direction of escape from any point. Each path of escape must be so arranged or marked that the way to a place of safety outside is unmistakable.

7. In every building or structure, adequate and reliable illumination must be provided for all exit facilities. Lighting must be tested monthly and maintained. 8 Every building or structure must be so constructed, arranged, equipped, maintained, and operated as to avoid undue danger to the lives and safety of its occupants from fire, smoke, fumes, or resulting panic during the period of time reasonably necessary for escape from the building or structure in case of fire or other emergency.

9. Compliance with this rule must not be construed as eliminating or reducing the necessity for other provisions for safety of persons using a structure under normal occupancy conditions, nor shall any provision of this rule be construed as requiring or permitting any condition that may be hazardous under normal occupancy conditions.

10. The local fire department must determine the adequacy of exits and other International Building Codes and the National Fire Protection Association Codes. In cases of practical difficulty or unnecessary hardship, the local fire department may grant exceptions from the International Building Codes or the National Fire Protection Association Codes, but only when it is clearly evident that reasonable safety is thereby secured.

D. Electrical Equipment 1. Electrical wiring systems in all buildings must conform to the requirements of the state electrical board. Electrical appliances must be examined frequently for worn or otherwise defective wiring.

2. No more than one (1) extension cord or power strip may be connected between an electrical appliance and the wall outlet.

E. General Safety Practices 1. A residential child care facility (RCCF) must immediately notify the responsible emergency agency or department of a fire or other disaster which might endanger children/youth or require their removal for reasons of health and safety. The Department of Human Services must be immediately notified of a fire or other disaster in accordance with reporting requirements outlined in Section 7.701.52.

2. Security guards patrolling the grounds and structures of a residential child care facility, whether employed by the facility or by a security service under contract to the facility, must not be permitted to be in possession of any firearm, taser, knives, or chemical weapons on the grounds or within the structures of the facility.

3. Porches, elevated walkways, and elevated play areas within a residential child care facility must have barriers to prevent falls.

4. Power-driven equipment used by a residential child care facility must be kept in safe and good repair. Such equipment must be used by children/youth only under the direct supervision of a staff member and according to state law. The ignition keys for power-driven equipment and vehicles must be inventoried daily and stored in an area inaccessible to 5. Staff and children/youth must be trained to report fires and other emergencies appropriately. Children/youth and staff must be trained in fire prevention, including proper utilization of fire extinguishers and proper storage of combustibles in proximity to ignition sources.

6. In every building or structure, fire alarm facilities must be provided to warn occupants of the existence of fire so that they may escape or to facilitate the orderly conduct of fire exit drills. Fire alarms must be maintained in accordance with International Fire Code and manufacturer standards.

7. Responsibility for the planning, conducting, evaluating, and documenting of fire drills must be assigned to an individual staff member.

8. A residential child care facility (RCCF) must maintain an active safety program, including investigation of all accidents and recommendations for prevention.

9. Smoking, including vaping, is prohibited in all areas of the licensed facility, including all buildings, vehicles, grounds, or areas otherwise owned or controlled by the facility as further outlined in Section 25-14-103.5, C.R.S.

a. Smoking, including vaping, is prohibited by children/youth, staff members, visitors, or other individuals at the facility, on the grounds of the facility, or in an offsite location in which the children/youth are transported or attending. Staff shall not use tobacco products with children/youth at the facility or off grounds.

b. No tobacco or nicotine products will be stored by the facility for off grounds use by the children/youth.

c. Nicotine products used to aid in the process of quitting smoking may be stored at the facility if approved by the child’s/youth’s multidisciplinary team, parent(s) and/or guardian(s), and the facility 10. A facility must not maintain any weapons, such as firearms, air rifles, air soft or bb guns, hunting bows, hunting knives, or hunting slingshots on the grounds or within the structure of the facility. A facility must not permit any staff member or child/youth to be in possession of any firearm on the grounds or within the structures of the facility. Chemical weapons, even when carried by staff members to and from work for protection, must be in a secure, locked location when present at the facility. Weapons must not be transported in any vehicle in which children/youth are riding. Law enforcement professionals are exempt from the requirements of this

section if conditions of their employment require them to carry weapons.

F. Fire Safety 1. Fire hazards, such as defective electrical appliances and electric cords, dangerous or defective heating equipment, or flammable material stored in such a manner as to create a risk of fire must be corrected or eliminated.

2. The facility must contain at least one (1) U.L.-approved fire extinguisher on each floor of the facility and in the kitchen that is highly visible, easily accessible, and in working condition, weighing not less than five (5) pounds, that has a rating of 2A, 10bC. Extinguishers are required to be maintained annually.

3. A smoke detector, in working condition, must be installed on each level of the facility where child care occurs and near sleeping areas, and at least one (1) carbon monoxide detector must be installed per floor, per manufacturer directions, in the facility.

4. All heating units, gas or electric, must be installed and maintained with safety devices to prevent fire, explosions, or other hazards. No gas or electric space heaters, open-flame gas or oil stoves, hot plates, or unvented heaters may be used in the facility for heating purposes.

5. Flammables, aerosol paints, insecticides, chemicals, and other dangerous materials must be locked or stored so that they are inaccessible to children/youth and must be stored in areas separated from sleeping or living areas with a fire resistance barrier of at least one (1) hour. No more than ten (10) gallons of flammable or combustible liquids may be stored outside a flammable cabinet with the exception of materials stored in an approved safety can. A “safety can” means an approved container, of not more than five (5) gallon capacity, having a spring-closing lid and spout cover and so designed that it will safely relieve internal pressure when subjected to fire exposure.

6. Heating devices such as radiators, registers, fireplaces, and steam and hot water pipes that pose a fire or burn hazard to children/youth must be screened or otherwise protected.

7. Flammable material must not be stored near a furnace, hot water heater, or other heating device.

8. There must be no candles or other highly flammable objects permitted in sleeping areas.

9. Exit doors must be obvious, clearly identified as an exit, and marked by an approved sign that is clearly visible from any direction of exit access. No lock or fastening to prevent free escape from the inside of any room used by the children/youth may be permitted except for a Department-approved seclusion room as outlined in Sections 7.714.54 through 7.714.549.

10. Exit routes must be kept free of any barriers to free escape including, but not limited to, discarded furniture, furnishings, laundry, and stacks of newspapers or magazines that could interfere with the prompt evacuation of the facility.

11. All fencing around the perimeter of the property must have at least one (1) exit gate, and the gate(s) must remain unlocked at all times to allow unobstructed egress from the facility and grounds in case of an emergency. The gate must be clearly marked and easily accessible.

G. Disaster Drills 1. There must be written procedures for staff and children/youth to follow in case of emergency or disaster specific to occupancy type. These procedures must be developed by the facility with the assistance of qualified fire and safety personnel and must include provisions for staff roles and responsibilities during an emergency, evaluation of the facility, and the assignment of a central meeting place where each individual may be accounted for.

2. Fire exit drills, to include wildland fire drills where appropriate, must be held on each shift on a rotating basis with no less than one (1) drill per shift at least every six (6) months so that all occupants are familiar with the drill procedure and their conduct during a drill is a matter of established routine.

3. Drills must be held at unexpected times and under varying conditions to simulate the conditions of an actual fire.

4. Drills must emphasize orderly evacuation under proper discipline rather than speed. Running or horseplay must not be permitted.

5. Drills must include suitable procedures for ensuring that all persons in the facility actually participate.

6. A record of fire drills held over the past twelve (12) months must be maintained by the facility on the drill log, including the date and time of the drill, the amount of time taken to evacuate the facility, number of children/youth and staff participating in the drill, and any incidents or conditions of the drill that need follow-up for safety purposes.

7. Fire alarm systems must be regularly used in the conduct of drills.

Accidental activation of the system will not count as a drill.

8. The facility must make special provisions for the evacuation of any physically handicapped children/youth in the facility.

9. The facility must take special care to help children/youth with intellectual and developmental disabilities understand the nature of such drills.

10. If appropriate to the location of the facility, tornado drills and/or drills for those facilities in wildland urban interfaces (WUIs) must be held often enough so that all occupants are familiar with the drill procedure and conduct during a drill is a matter of established routine. A record of tornado drills and/or wildland urban interface (WUI) drills held over the past twelve (12) months must be maintained by the facility.

11. Lockdown drills must be completed at least once every six (6) months so that all occupants are familiar with the procedure if there were to be a possible threat within the building. Staff are instructed to bring children/youth inside a room and lock the door. Children/youth are instructed to go to a safe space in the room and remain quiet until first responders give an “all clear”.

12. A record of lockdown drills held over the past twelve (12) months must be maintained by the facility on a drill log, including the date and time of the drill, the amount of time taken to evacuate the facility, number of children/youth and staff participating in the drill, and any incidents or conditions of the drill that need follow-up for safety purposes. 7.705.56 Transportation A. A facility must ensure that each child/youth is provided with the transportation necessary for implementing the child’s/youth’s individual plan.

B. A facility must have means of transporting children/youth in cases of emergency.

C. Any vehicle used by the facility in transporting children/youth in care, whether such vehicle is operated by a staff member or any other person acting on behalf of the facility, must be properly licensed, including current registration and insurance on file at the agency/facility, and the vehicle must be maintained in accordance with Colorado law.

D. Any staff member or other person acting on behalf of the facility operating a vehicle for the purpose of transporting children/youth must be properly licensed to operate the class of vehicle in accordance with Colorado law.

E. All passengers in the vehicle must be properly fastened into a restraint system that conforms to all applicable federal motor vehicle safety standards pursuant to F. A facility must not allow the number of persons in any vehicle used to transport children/youth to exceed the number of available seats with fully functioning seatbelts in the vehicle.

1. All seats in vehicles used to transport children/youth must be forwardfacing and must be securely fastened to the vehicle body.

2. A seat belt or booster seat for children/youth under forty (40) pounds must be provided for each seat.

3. Only the number of passengers that can be comfortably seated on passenger seats shall be permitted in the vehicle.

4. Each occupant must be sitting when the vehicle is moving.

5. Passengers must not sit on the floor.

G. The vehicle must be enclosed and provided with door locks and contain a First Aid kit and fire extinguisher.

H. A facility must ascertain the nature of any need or problem of a child/youth which might cause difficulty during transportation, such as seizures, a tendency toward motion sickness, or identified behaviors that would place the driver or other children/youth in the vehicle at risk. The facility must communicate this information to the driver of any vehicle transporting the children/youth in care.

I. The facility must have naloxone available onsite and in facility vehicles at all times. All staff must be trained on how to use naloxone. Certificates of training must be kept in each staff file.

7.705.6 POLICIES AND PROCEDURES

All policies and procedures must be in written form and available to the department for review upon request. Staff must be trained to and adhere to all written policies and procedures implemented by the facility.

All policies and procedures must be consistent with the child/youth rights outlined in

Section 7.714.31. Additionally, policies and procedures must be consistent with requirements outlined in Sections 7.714.33 through 7.714.34 and Section 19-7-101(2), C.R.S. if the youth is in foster care or participating in the foster youth in transition 7.705.61 Child’s/Youth’s Rights A. Children’s/youth’s rights are listed in Sections 7.714.31 through 7.714.34.

B. All policies and procedures must be consistent with the rights outlined in Section 7.714.31. Additionally, policies and procedures must be consistent with rights outlined in Section 7.714.33 and Section 19-7-101(2), C.R.S. if the child/youth is in foster care or participating in the foster youth in transition program.

C. For rights listed in Section 7.714.31, the facility must have written policies for any restrictions or limitations to a child’s/youth’s right, and any restrictions or limitations must only limit a child’s/youth’s rights to ensure the safety of the child/youth. If a facility enforces any restrictions upon the child’s/youth’s rights, the facility must follow guidelines as outlined in Sections 7.714.31.C through 7.714.31.E. Written policies must be made available to the Department upon D. For rights listed in Section 7.714.33 and Section 19-7-101, C.R.S., all rights limitations or denials must go through the judicial system. A juvenile court shall not limit or deny a child’s/youth’s rights unless the court finds by clear and convincing evidence that there are extraordinary circumstances and the limitations or denial is necessary for the safety of the child/youth in foster care.

E. The facility must have written policies regarding monies earned and spent.

All policies and procedures must be consistent with the child/youth rights outlined in Section 7.714.31. Additionally, policies and procedures must be consistent with requirements outlined in Sections 7.714.33 through 7.714.34 and Section 19-7-101(2), C.R.S. if the youth is in foster care or participating in the foster 7.705.62 Individual Child’s/Youth’s Plan A. The facility must have written policies concerning the individual child’s/youth’s plan.

All policies must be consistent with applicable federal and state laws, including Sections 19-7-101(2)(b)(x) and 19-7-101(2)(h)(V), C.R.S. if the youth is in foster care or participating in the foster youth in transition program.

All written policies must include the following:

1. Staff responsibility for planning and implementation of the treatment procedures and techniques;

2. The range of procedures and techniques to be used and the anticipated range or types of behavior or conditions for which such procedures and techniques are to be used, including philosophy of treatment, modes of therapy, treatment modalities, positive behavior intervention, problem management, discipline, physical restraint, and seclusion, where allowed and approved by law;

3. The facility’s responsibility for monitoring the safety of the children/youth during treatment;

4. Review procedures for ensuring the appropriateness of the ongoing treatment and placement for each child/youth;

5. Policies and procedures requiring termination of the treatment procedures in the event of achievement of goals identified for successful completion of treatment or when the procedures are proving to be ineffective or detrimental for a particular child/youth;

6. Policies and procedures for ensuring the child/youth, their family of origin, and/or other support persons are involved in the development of and revisions made to the individual child’s/youth’s plan and consent to its content, consistent with state and federal law;

7. Policies and procedures for ensuring the child/youth, their family of origin, and/or other support persons are involved in the development of and revisions made to the individual child’s/youth’s plan and consent to its content;

8. Policies and procedures on how the facility/agency monitors the ongoing physical and emotional safety and the privacy of a child/youth during treatment or therapy, including face-to-face or virtual telehealth interactions(s) with the child/youth;

9. Requirements, where appropriate, for medical examination of a child/youth prior to implementation of a treatment strategy on a regular basis;

10. Policies and procedures on how the facility will monitor and analyze the facility’s treatment program and strategies, including how the facility will assess the overall effectiveness of the treatment program; and 11. Each facility must adopt and implement a written policy for continuity of resident care which includes, at a minimum, the following:

a. Ease of resident movement from one element of service to another one within the facility; and b. Plans for discharge, aftercare, medication management, and referrals to community resources as a component of the individual child’s/youth’s plan as outlined in Section 7.714.4.B and elements of a discharge summary as found in Section 7.714.85.I. Any recommendations must involve the family of origin or other supportive individuals as defined in Section 7.714.4.B.2 if actively participating in treatment. 7.705.63 Policies for Admission, Discharge, and Confidentiality of Child/Youth Files A. Each facility must develop and adhere to written admission policies. Such policies must be provided to the referring agencies and parent(s) and/or guardian(s) of the child/youth referred for placement.

All policies must be consistent with applicable federal and state laws, including the child’s/youth’s rights and requirements outlined in Section 19-7-101, C.R.S. if the youth is in foster care or participating in the foster youth in transition program.

All policies, at a minimum, must include:

1. Policies related to intake, including how the facility assesses and provides for the child’s/youth’s immediate basic needs of clothing, food, and medical care, and identification of all documents that need to be completed upon admission. Documents must include, where applicable, but are not limited to:

a. When consistent with state and federal laws, consent to treatment according to Section 27-65-104, C.R.S.;

b. Consent to release confidential information;

c. Disclosure statements for therapists;

d. Consent for healthcare;

e. Placement agreement;

f. Appropriate authorizations;

g. Use of restraint/seclusion;

h. Grievance procedure; and i. Specific to QRTPs, consent for the BHA to release the stateapproved assessment.

2. The age range, sex assigned at birth, and identified gender of the children/youth accepted for care;

3. Any special programming offered by the facility;

4. Any pre-placement requirements for the child/youth, the parent(s) or guardian(s), and/or the placing entity;

5. The criteria, situations, and specific behaviors that would result in a request to remove a child/youth from placement prior to the planned discharge;

6. Specific to QRTPs and PRTFs, the facility’s policy concerning the provision of mental health services to children/youth, if appropriate, and the application of Section 27-65-104, C.R.S. - Voluntary Applications for Mental Health Services - when a child/youth is receiving mental health treatment;

7. A statement regarding the religious orientation or affiliation of the facility and of the religious activities of the facility;

8. Opportunities for children’s/youth’s participation in recreational activities, religious activities, and community life;

9. A statement regarding the potential use of images of the children/youth;

10. A process for the completion of the requirements of the interstate compact on the placement of children (ICPC) in accordance with Section 24-60- 1802, C.R.S. for any child/youth in which the placing entity is outside of Colorado; and 11. A policy regarding usage of cell phones or other electronic communication devices by children/youth.

B. As identified in Section 7.714.2.A, a facility that accepts youth who are eighteen (18) years of age and older but under twenty-one (21) years of age must have a written policy to address how the facility will ensure the youth’s adult rights and duties will be accommodated, including, but not limited to, registering to vote and registering for selective service, in addition to rights identified in Sections 19-7- 101(2), C.R.S. and Section 7.714.33 if the child/youth is in foster care or participating in the foster youth in transition program.

C. Provisions must be made for the storage and protection of children’s/youth’s property when admitted into the facility. Provisions must be consistent with

Section 19-1-701(2)(d)(II) and 19-7-101(2)(f)(III), C.R.S. If the child/youth is in foster care or participating in the foster youth in transition program the facility is responsible for creating a written policy or acknowledgement that identifies the length of time a children’s/youth’s property will be stored at the facility.

D. The facility must allow a child/youth in care to bring their personal belongings to the program, as outlined in facility policy. If the child/youth is in foster care or participating in the foster youth in transition program, the facility must allow a child/youth to bring their personal belongings to the program consistent with

Section 19-7-101(2)(f)(III), C.R.S.

E. For children/youth in foster care or participating in the foster youth in transition program, the facility is responsible for creating a written policy or acknowledgment consistent with Section 19-7-101(2)(f)(III), C.R.S. that identifies the procedures for having the child’s/youth’s belongings transported in appropriate luggage with the child/youth during or shortly after a change in placement, with the child’s/youth’s personal belongings stored and maintained in the same or better condition.

F. The facility is also responsible for creating a written policy should any belongings be left behind at the time of discharge by the child/youth, their parent(s) or guardian(s) or custodian(s), or the county department of human or social services working with the child/youth. The policy or acknowledgement must include the length of time the personal belongings are held onto or stored and how many attempts or reminders the facility will conduct before property is disposed of. Notice must be provided to the child/youth, their parent(s) or guardian(s) and custodian(s), and the county department of human or social services working with the child/youth at least forty-eight (48) working hours before any personal property is disposed of. All attempts, reminders, and notices must be documented in writing and provided to the Department upon request.

This policy must be provided at the time of intake to the child/youth, the parent(s) or guardian(s) and custodian(s), and/or placing authority with signatures and dates from all involved parties acknowledging the policy.

G. Facilities must create and adhere to a policy that guides and governs the maintenance of child/youth records to ensure they are stored and maintained in accordance with all applicable federal and state confidentiality laws, including protections for cybersecurity for those records which are stored electronically. 7.705.64 Personnel Policies, Orientation, and Training A. Personnel Policies 1. The facility must have a written statement of personnel policies which a. Job descriptions for all positions required. The descriptions must describe duties of the job, qualifications for performance, and supervision to be provided as well as any training requirements of the position;

b. Salary range and provision for incremental increases;

c. Hours of work, holidays, paid time off, and any other types of leaves;

d. Conditions of employment, tenure, and promotion;

e. Employment benefits, including retirement plan, social security, medical benefits, hospitalization, and other insurances;

f. Employee performance evaluation procedures;

g. Grievance procedures which may be used by staff; and h. Termination of employment procedures.

2. A copy of the personnel policies must be given to each staff member at the start of their employment, and written verification of receipt of the personnel policies must be maintained in each staff file. Within ten (10) calendar days of a change to a personnel policy, all staff members must be provided a copy of the changed policy and written verification of receipt maintained in each staff file.

B. Orientation and Training 1. The facility must have a comprehensive written policy for the hiring, retention, orientation, initial and ongoing training, and professional development of staff.

a. The facility must provide an introductory training and orientation program for all facility staff. This program must include orientation to emergency and safety procedures, professional boundaries and the general and specific duties and responsibilities of the job. The introductory training and orientation training must be completed within thirty (30) days of hire and before working alone with children and youth in care. The orientation training must include the facility’s policy on required boundaries between staff members and the children/youth cared for or discharged from the facility.

C. Qualified residential treatment programs must develop and adhere to policies and procedures for supervision of clinical professionals that address the requirements outlined in Section 7.705.206.B.

D. Qualified residential treatment programs must have a written policy on how the program staff will be trained to facilitate family engagement and participation in the child’s/youth’s treatment and follow requirements outlined in Section 7.705.207.A.

E. All training must include requirements outlined in sections 7.714.92 and 7.714.93. 7.705.65 Medical and Health Services Policies A. Medication 1. The facility must have policies and procedures for documenting that required medication information was given to the child/youth before the child/youth took the medication. When information is given to the child/youth, the documentation must include an assessment regarding whether the child/youth understood. The policy must be consistent with the child/youth rights enumerated in Sections 19-7-101(2)(g)(III-V), C.R.S. for children/youth in foster care or participating in the foster youth in transition program.

2. The facility must have a written policy that addresses the process for when the count of a controlled substance is found to be inconsistent with the documentation. The policies must include the notification of administrative staff, and, if necessary, the prescribing provider and local law enforcement of the discrepancy and the actions taken.

B. Medical and Health Services 1. The facility must have and follow policies and procedures for informing the child/youth, parent(s) and/or guardian(s) of any follow up dental procedures as prescribed.

2. The facility must have a medical policy including staff training, which includes the screening of the child/youth for child abuse and signs of illness requiring immediate medical attention. 7.705.66 Safety Policies A. Supervision of Children/Youth 1. The residential child care facility must have a written policy for the standard supervision of children/youth in the program based on the identified population described in the admission policies.

2. The facility must adhere to the policy, and it must include supervision of children/youth while at the facility, during transportation, and while off the premises.

3. The policy must be approved by the Department on an annual basis.

4. When a child’s/youth’s individual needs require deviation from the supervision policy, it must be documented in the individual child’s/youth’s plan.

5. As outlined in 19-7-101(2)(D)(II), C.R.S., children/youth in foster care or participating in the foster youth in transition program have a right to be free from unreasonable searches, limitation of use, or taking of personal belongings or other unreasonable invasions of privacy.

B. Recreation and Leisure 1. A residential child care facility must have a written policy for ensuring that a range of indoor and outdoor recreational and leisure opportunities are provided for children/youth in care. Such opportunities must be based on the individual interests of the children/youth with personal and treatment needs being considered.

C. Transportation 1. The facility must have a written policy concerning under what circumstances a vehicle may be driven by a licensed resident alone or with one resident passenger. Such driving privileges, if granted, must be a

part of the child’s/youth’s individual plan.

D. Contraband 1. All facilities must have a written policy and procedures for conducting searches and control of contraband regarding children/youth, staff members, or visitors.

a. Searches involving children/youth must be completed upon admission to the facility, upon return from an unsupervised setting, when there is reason to believe that there is a safety risk to the facility, or when contraband may be present.

b. Searches must be conducted in the least intrusive manner possible for the reason the search was being conducted.

c. All contraband must be disposed of in accordance with the facility’s written policy and procedures.

d. All searches must be documented, including the reason for the search, the person(s) conducting the search, and the results.

e. The policies and procedures must include and be in alignment with

Section 7.714.51.A.

E. Feedback and Discipline 1. The facility must have written policies and procedures regarding preventative, supportive, and corrective feedback that must be explained in a manner appropriate for children/youth and provided to all parent(s), guardian(s), staff, and placing entities. Preventative and supportive feedback is designed to reinforce positive behavior, and coach the child/youth to develop alternative behaviors to those that interfere with positive treatment outcomes. 7.705.67 Written Policies for Physical Restraint A. Each facility utilizing physical restraint is to have a written policy and practices consistent with these rules.

All policies must be consistent with applicable federal and state laws, including the child’s/youth’s rights and requirements outlined in Section 19-7-101, C.R.S. if the youth is in foster care or participating in the foster youth in transition program.

The facility’s written policies must include, at a minimum, the following information:

1. Documentation of the nationally recognized, research-based type of deescalation, physical restraint model to be used in the facility. The physical restraint model must be in accordance with the requirements provided in Sections 7.714.53 through 7.714.536.

2. Documentation of the actual physical restraint that occurred in the physical restraint situation.

3. Documentation of which staff members by name and position will be approved by the facility to use physical restraint with children/youth in 4. Documentation of the training/certification staff members approved to use physical restraint and the type and number of initial hours of training each staff member is required to take as required by the model and traumainformed prior to restraining a child/youth.

5. The type and number of hours of ongoing training each staff member will be required to take and how often they will need to become recertified, not to exceed more than every six (6) months.

6. Documentation of the individualized preventive and de-escalation techniques, trauma-informed practices or interventions considered or utilized, and positive behavioral intervention must be used by staff prior to utilizing physical restraint.

7. How the facility continuously monitors physical restraint, how the facility will be physically present, such that the staff member is able to immediately respond to the needs of the child/youth in the physical 8. The type of written documentation the facility maintains of each physical restraint that describes the details of the incident and the staff involvement.

9. The type of written documentation the facility maintains that describes the debriefing with the child/youth and staff following the physical restraint.

10. Evaluation by an objective, internal professional of the documentation of each physical restraint to determine appropriateness and effectiveness of preventive and de-escalation strategies or interventions used and effectiveness and appropriateness of the physical restraint itself. Such evaluation must also include:

a. Whether there was a true imminent threat and if the situation was a true emergency;

b. Whether the physical restraint was more dangerous than the behavior it was attempting to contain;

c. The documentation of avoidance of the use of movement or transport during physical restraint except to move from extreme danger (i.e., a child/youth in the middle of a busy street or road);

d. If the use was justified according to Section 26-20-103, C.R.S.

11. The requirement that staff must not utilize physical restraint in any setting outside of the licensed facility. Staff must call law enforcement if there are any circumstances outside of the licensed facility that may pose a threat to the health and safety of a child/youth.

12. The requirement that staff not restrain children/youth away from the facility to include but not limited to: other businesses, public areas where people in the community are present, or private property.

13. Notification to the parent(s) and/or legal guardian(s) and child/youth in advance of the facility's physical restraint policy and methodology and following the use of the physical restraint.

14. How the facility monitors the physical well-being of the child/youth during and after the physical restraint, including but not limited to breathing, pulse, color, and signs of choking or respiratory distress.

15. Emergency medical procedures, including First Aid, that will be used if a child/youth or staff member is seriously injured during a physical restraint.

16. The internal review process of the facility to assess carefully any injuries, bruising, or death.

17. The requirement of staff to report to the county department of human/social services or local law enforcement any injury, bruising, or death that occurs as a result of the physical restraint pursuant to Colorado state law.

18. The requirement of staff to report any critical incident or child abuse and/or neglect pursuant to Colorado state law and Section 7.701.52 and Section 7.701.53.

19. A written policy around debrief of the physical restraint that is specific to the population served and included in the trauma-informed care plan. The debrief will be done in accordance with the individual needs of the child/youth and will be documented in the physical restraint report. 7.705.68 Written Policies for Seclusion A. A psychiatric residential treatment facility (PRTF) which is approved to use seclusion must have a written policy and practices consistent with these rules.

All policies must be consistent with applicable federal and state laws, including the child/youth rights and requirements outlined in Section 19-7-101, C.R.S. if the youth is in foster care or participating in the foster youth in transition program.

The program’s written policies must include at a minimum the following:

1. A purpose and use of the room, the intake process, the evaluation of child/youth while in the room, emergency procedure while a child/youth is in seclusion and method for a child’s/youth’s grievance regarding the use of the room.

2. Documentation of the type of behavior management system utilized by the 3. Which staff members will be approved by the facility to use seclusion with children/youth in care.

4. The type of training/certification staff members approved to use seclusion will be required to have prior to secluding a child/youth.

5. The type and number of hours of ongoing training each staff member will be required to take and how often they will need to become recertified, not to exceed more than every six (6) months.

6. What preventive/de-escalation techniques and positive behavioral intervention must be used by staff prior to utilizing seclusion.

7. The release criterion (e.g. a stated period of calm behavior) that is of short duration and that is client-driven or initiated.

8. How the facility observes and evaluates the use of seclusion on a child/ 9. The type of written documentation the facility maintains of each seclusion that describes the details of the incident and the staff involvement.

10. The type of written documentation the facility maintains that describes the debriefing with the child/youth and staff following the seclusion.

11. Evaluation by an objective, internal professional of the documentation of each seclusion to determine appropriateness and effectiveness of preventive and de-escalation strategies or interventions used and effectiveness and appropriateness of the seclusion itself. Such evaluation must also include:

a. Whether there was a true imminent threat and if the situation was a true emergency;

b. Whether the seclusion was more dangerous than the behavior it was attempting to contain;

c. If the use was justified according to Section 26-20-103, C.R.S.

12. Notification to the parent(s) and/or legal guardian(s) and child/youth in advance of the facility's seclusion policy and methodology and following the use of the seclusion.

13. How the facility monitors the physical well-being of the child/youth during and after the seclusion.

14. Emergency procedures, including First Aid, that will be used if a child/youth or staff member is seriously injured during seclusion.

15. The internal review process of the facility to assess carefully any injuries, bruising, or death.

16. The requirement of staff to report to the county department of social services or local law enforcement any injury, bruising, or death that occurs as a result of the seclusion pursuant to Colorado state law.

17. The requirement of staff to report any critical incident in accordance with

Section 7.701.53.

18. The method for the child’s/youth’s right to grieve the use of the seclusion room.

19. A written policy around debrief of the seclusion that is specific to the population served and included in the trauma-informed care plan. The debrief will be done in accordance with the individual needs of the child/youth and will be documented in the physical restraint report.

7.705.7 SPECIAL RULES AND REGULATIONS FOR SHELTER CARE

SERVICES 7.705.71 Requirements of Shelter Care Services for Placements A. Applicability of Rules 1. Any residential child care facility may provide shelter care services for children/youth in need of short-term placement resulting from such circumstances as child abuse and neglect.

2. The acceptance of children/youth for shelter care services must be stated in the written purpose of the facility and the admission policy. The facility must have a prescribed number of beds relative to each population it serves:

a. Residential child care services;

b. Homeless youth; and/or c. Shelter care services.

3. Residential child care facilities must make every effort to assure that shelter care service placements do not exceed sixty (60) days.

Exceptional circumstances must be documented in the case file. No child/youth may remain in a shelter care service program for longer than ninety (90) days. Review of placement will be required every thirty (30) days.

4. These rules are specifically for shelter care services. The following rules are in addition to corresponding regulations in Sections 7.705 through 7.705.6. However, if there is a conflict between those rules and these shelter care service rules, these rules shall apply.

B. Admission to Shelter Care Service Programs 1. At the time of shelter care service placement of a child/youth, the facility must obtain at least the following information: name, birth date, if available, physical description of the child/youth, date and time of the admission, name and authority of person bringing child/youth to the facility, and reason for placement. On the next working day following shelter care service placement of the child/youth, the facility shall obtain from the county department of social or human services or the parent(s) or guardian(s) a signed, written authorization to obtain medical care for the child. The county department is authorized to give this authorization on the next working day following placement.

a. A child/youth who has reached the age of fifteen (15) or older may consent to shelter and services for a period not to exceed twentyone (21) days when the following criteria are met:

1. The child/youth shall voluntarily and knowingly sign a consent form that includes:

a. All services the child/youth may receive during their stay at the shelter and the total number of days the child/youth may consent to remain in the shelter;

b. Legal limits to confidentiality;

c. How and when the parent(s), legal guardian(s), and/or child welfare agencies will be notified of the child’s/youth’s stay;

d. An explanation that services provided by the shelter are provided free of charge to the child/youth without exchange of any goods, services, or sexual acts.

2. The consent form shall be explained in the child’s/youth’s preferred language or mode of communication, including augmented or facilitated communication, if necessary, and shall take into consideration the child’s age, ability level, and cultural and religious background.

3. The consent form shall be signed within twelve (12) hours of admission.

2. The facility must ensure that each newly admitted child/youth is checked at the time of admission by facility staff or a physician for signs of illness, signs of abuse or neglect, and the presence of parasitic infections.

a. The facility must have a medical policy, including staff training, which includes the screening of the child/youth for child abuse and signs of illness requiring immediate medical attention.

3. If a child/youth remains in a shelter care service program for longer than fourteen (14) days, a medical examination must be completed in compliance with Section 7.714.82.B. 7.705.72 Homeless Youth Shelter Care A. Applicability of Rules 1. Any residential child care facility may provide shelter to homeless children/youth ages eighteen (18) and under for up to twenty-one (21) consecutive days. A residential child care facility may provide shelter to a homeless child/youth between the ages of eighteen (18) and twenty-one (21), if such services will not negatively impact the health, safety, and welfare of the other children/youth in care. The facility shall obtain approval from the department prior to accepting a homeless child/youth between the ages of eighteen (18) and twenty-one (21).

2. The acceptance of homeless children/youth must be stated in the written

purpose of the facility and the admission policy.

3. These rules are specifically for shelter care of homeless children/youth.

The following rules are in addition to corresponding regulations in Sections 7.705 through 7.705.6. However, if there is a conflict between those rules and these shelter care rules, these rules shall apply.

B. Notifications and Referrals 1. Pursuant to Section 26-5.7-105(4), C.R.S., when a youth under fifteen (15) years of age is admitted to a licensed child care facility or licensed homeless youth shelter, the director of the facility, shelter, or other person in charge shall notify the county department within seventy-two (72) hours of the youth’s admission.

2. Pursuant to Section 26-5.7-106(2)(a), C.R.S., upon admission of a youth to a licensed child care facility or licensed homeless youth shelter, the facility or shelter shall notify the youth’s parent, legal guardian, or appropriate county department of the youth’s placement within twenty-four (24) hours. The person making the report must also report on the physical and emotional condition of the youth, the youth’s whereabouts, and the circumstances surrounding the youth’s placement within twenty-four (24)

3. Pursuant to Section 26-5.7-105(7), C.R.S., if a youth who is at least eleven (11) years of age but less than fifteen (15) years of age has been served up to twenty-one (21) days and returns to the licensed child care facility or licensed homeless youth shelter after leaving the facility or shelter, the director of the licensed child care facility or licensed homeless youth shelter or other person in charge must make a referral for services to the county department. The director or other person in charge should interview the child/youth and report the referral to the child’s/youth’s county of residence.

4. Pursuant to Section 26-5.7-105(5), C.R.S., if the director of the facility, shelter, or other person in charge determines that a referral for additional services needs to be made, the director or other person in charge shall make the referral to the appropriate county department, notify the county department of the facility’s relationship to the youth pursuant to Section 19-1-307-(2)(e.5)(i), C.R.S. and notify the county department of the date when the twenty-one (21) day shelter time period will expire.

5. For a child/youth under the age of eighteen (18), if reconciliation with the child’s/youth’s family has not occurred within seventy-two (72) hours following admission to the shelter, and the director of the shelter or other person in charge does not anticipate that reconciliation will be achieved within twenty-one (21) consecutive days, the director or other person in charge must provide the child/youth and the child’s/youth’s parent with a written statement identifying:

a. The availability of counseling services;.

b. The availability of longer-term residential arrangements; and, c. The possibility of referral to the county department.

6. If the facility staff know the child/youth is away from home without permission, the facility must notify the child’s/youth’s parent(s)/legal guardian(s) or law enforcement within twenty-four (24) hours of providing shelter if the child/youth refuses to provide the shelter with contact information for the child’s/youth’s parent(s) or legal guardian(s), the child’s/youth’s parent(s) or legal guardian(s) is deceased, or the shelter director or other person in charge believes that notifying the parent(s) or legal guardian(s) would not be in the child’s/youth’s best interest due to an imminent risk of abuse or neglect by the parent(s) or legal guardian(s), the shelter shall notify the appropriate county department. The notification must include the child’s/youth’s whereabouts, physical and emotional condition, and the circumstances surrounding the child’s/youth’s 7. Pursuant to Section 26-5.7-106, C.R.S. the facility or licensed homeless youth shelter shall notify the youth’s parent(s) or legal guardian(s) that it is the paramount concern of the facility or shelter to achieve a reconciliation between the parent or legal guardian and the youth, to reunify the family, and to inform the parent(s) or legal guardian(s) about the available alternatives.

a. The facility or shelter shall arrange transportation for the youth to the residence of the youth’s parent(s) or legal guardian(s) when the youth and parent(s) or legal guardian(s) agree that the youth shall return to the home of the youth’s parent(s) or legal guardian(s). The parent(s) or legal guardian(s) shall reimburse the party who paid for the transportation costs to the extent of the parent’s or legal guardian’s ability.

b. The facility or shelter shall arrange transportation for the youth to an alternative residential placement facility when the youth and the youth’s parent(s) or legal guardian(s) agree to such placement. the parent(s) or legal guardian(s) shall reimburse the appropriate person for transportation costs to the extent of the parent’s or legal guardian’s ability. 7.705.73 Education and Treatment A. The facility shall ensure that each child/youth is provided with an educational program in accordance with federal, state, and local laws. Any educational program provided by a facility providing shelter care services shall comply with all applicable state and local laws.

B. Daily routine schedules must be established by the facility to ensure a stable, orderly, and supportive environment for children/youth in care. 7.705.74 Case Plan and Permanency Plan A. If a child/youth is receiving shelter care services, the rules in this section supersede Section 7.714.4.

B. A case plan must be developed for each child/youth who stays in shelter care services longer than two (2) weeks. The case plan must be started immediately upon admission.

1. The plan will include, at least, goals regarding personal and group living skills, family contact and involvement, how family contact and involvement are to occur, and the nature and goals of care, including any specialized services or specialized treatment to be provided.

2. The child/youth must be involved in the establishment of the goals.

3. The comprehensive assessment, as found at Section 7.714.4.A, must serve as the basis for the plan.

C. A case plan must include the development of a permanency plan within thirty (30) days of admission for any child/youth receiving shelter care services.

D. A permanency plan must address options for the child/youth to discharge to a safe and stable environment, the availability of counseling and other community services that may support the permanency plan, and the anticipated discharge date and plan for the child/youth following discharge. 7.705.75 Personnel A. A residential child care facility that provides shelter care services must maintain the staff ratio described at Section 7.705.46.D.

B. A residential child care facility that provides shelter care services must have awake staff during the children's/youth’s sleeping hours.

C. A residential child care facility that provides shelter care services must make adequate provisions to ensure that additional staff can be physically present at the facility within sixty (60) minutes in the event of an emergency or crisis.

D. Training programs for staff in shelter care service programs must reflect special emphasis on the following areas:

1. Desescalation techniques.

2. Trauma-informed care.

3. Crisis and Emergency Procedures. 7.705.76 Records A. A record for a child/youth accepted for care in a shelter care services program 1. Information obtained at admission pursuant to Section 7.705.71.B;

2. Statement from the physician about the child's/youth’s physical examination pursuant to Section 7.705.71.B.3;

3. Comprehensive assessment and permanency plan;

4. Record of medication given to the child/youth while in care;

5. Record of services provided while the child/youth was in care; and 6. Date of discharge, the name to whom the child/youth was discharged and a copy of their identification, their relationship to the child/youth, and physical description of the child/youth at time of discharge.

7.705.100 REQUIREMENTS OF A PSYCHIATRIC RESIDENTIAL TREATMENT

FACILITY (PRTF)

Psychiatric Residential Treatment Facility (PRTF) services are a Medicaid benefit statewide when provided in accordance with the provisions of the following sections. 7.705.101 Applicability of Rules A. "Psychiatric residential treatment facility (PRTF)" pursuant to Section 25.5-4- 103(19.5), C.R.S., means a facility that is licensed as a residential child care facility, as defined in Section 26-6-903, C.R.S., that is not a hospital, and that provides inpatient psychiatric services for individuals who are less than twentyone (21) years of age under the direction of a physician licensed pursuant to

article 240 of title 12, and that meets any other requirement established by the State Board.

B. These rules are specifically for psychiatric residential treatment facilities. A psychiatric residential treatment facility must maintain a license as a residential child care facility and comply with the Rules Regulating Residential Child Care Facilities in Sections 7.705 through 7.705.63, the General Rules for Child Care Facilities in Section 7.701, the Quality Standards for Twenty-Four (24) Hour Care for Children and Youth in Section 7.714, and the Rules Regulating Special Activities in Section 7.719. However, if there is a conflict between those rules and these psychiatric residential treatment facility rules, these rules shall apply.

C. A PRTF shall comply with all rules promulgated by the Medical Services Board in the Colorado Department of Health Care Policy and Financing for clients of Psychiatric Residential Treatment Facilities (10 CCR 2505-10 Sections 8.765.1 through 8.765.12 and Section 8.765.2) (2024), which are hereby incorporated by reference. No later editions or amendments are incorporated. These regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman Street, Denver, Colorado 80203 during regular business hours. These statutes and regulations are also available at no cost through the state’s website at https://www.sos.state.co.us/ccr/generaterulepdf.do?ruleversionid=6329&filename =10%20ccr%202505-10%208.000.

D. A PRTF shall comply with all Conditions of Participation required by the Centers for Medicaid and Medicare Services (CMS) and regulated by the Colorado Department of Public Health and Environment (CDPHE). A PRTF shall comply with 42 C.F.R. Section 483.350 through 376 Subpart G (2025) for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age Twenty-One (21), and 42 C.F.R. Section 441.151-184 (2025), General Requirements for Psychiatric Residential Treatment Facilities, which are hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman Street, Denver, Colorado 80203 during regular business hours. These statutes and regulations are also available at no cost through the CMS website at https://www.ecfr.gov/current/title-42/chapteriv/subchapter-g/part-483/subpart-g . The facility shall be designated by the Department to provide such services using the state-prescribed designation methods.

7.705.102 ACCREDITATION

The facility shall be accredited by one of the following: Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), or by any other accrediting organization with comparable standards that is recognized by the state and approved by the U.S.

Department of Health and Human Services. A copy of the facility’s national accreditation certification and report shall be maintained in the facility file and made available to the 7.705.200 REQUIREMENTS OF A QUALIFIED RESIDENTIAL TREATMENT PROGRAM (QRTP) 7.705.201 Applicability of Rules A. A qualified residential treatment program (QRTP) means a facility that is licensed as a residential child care facility, as defined in Section 26-6-903(29), C.R.S. All QRTPs shall also follow all rules as outlined in 10 CCR 2505-10 Section 8.765.8 through Section 8.765.14 (2024), as incorporated by reference in Section 7.705.101.C.

B. The program shall maintain a license as a residential child care facility (RCCF) and be in compliance with the regulations in Sections 7.701, 7.705, 7.714, and 7.719. 7.705.202 Accreditation and Attestation A. The program shall be accredited by one of the following organizations:

1. The Commission on Accreditation of Rehabilitation Facilities (CARF).

2. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

3. Any other accrediting organization with comparable standards that is recognized by the state and approved by the U.S. Department of Health and Human Services.

4. A copy of the facility’s national accreditation certification and report must be maintained in the facility file and made available to the Department B. All QRTPs in the state of Colorado that plan to enroll with Health First Colorado are required to submit a signed attestation form with their Health First Colorado enrollment application that follows attestation guidelines outlined in 10 CCR 2505-10 Section 8.765.14.B (2024), as incorporated by reference above in

Section 7.705.101.C. 7.705.203 Quality Improvement Plan A. The program must develop and implement a quality improvement (QI) plan that is designed to monitor and improve safety, quality of care, trauma-informed practices, and treatment outcomes and meets the following criteria:

1. Utilizes a data-driven approach to identify patterns and trends in the data;

2. Analyzes the data to determine what improvements and changes must be implemented; and 3. Is reviewed and/or modified no less than quarterly based on outcomes data.

B. The QI plan must be submitted to the Division of Child Welfare (DCW), Provider Services Unit when requesting approval for the trauma-informed treatment model.

C. The QI plan and all documented quarterly reviews must be submitted to the department for review on an annual basis from the date the initial plan was approved, and the QI plan and all subsequent quarterly reviews must be made available to the Department upon request. 7.705.204 Nursing Professionals A. The QRTP must have a nursing professional who is at least a registered or licensed nurse pursuant to Section 12-255-101 through 12-255-135, C.R.S. who:

1. Provides care within the scope of their practice as defined by state law;

2. Is on-site according to the trauma-informed treatment model, as approved by the Division of Child Welfare (DCW), Provider Services Unit; and 3. Is available on site, via phone, or via video call twenty-four (24) hours a day, seven (7) days a week.

B. The QRTP may contract for nursing services. These contracted services and individuals must adhere to the rules in Section 7.701.400.B. Contracted individuals are considered staff of the facility during the hours stated in the contract. Contracts must list the duties of the contracted individual with whom the program is contracting and must list the scope of services to be provided. For nursing services, there must be duties outlined in the contract that assure the services are being administered on site, via phone, or via video call twenty-four (24) hours per day, seven (7) days per week. Any contracts for nursing services must be made available to the Department upon request.

C. The QRTP may utilize licensed physicians, licensed physician assistants, or licensed nurse practitioners in lieu of licensed nursing staff, in accordance with the trauma-informed treatment model as approved by the Division of Child Welfare (DCW), Provider Services Unit.

D. Professional nursing staff files are the property of the facility and must remain on site and be made available to the Department upon request and remain in compliance with all federal and state confidentiality statutes and regulations. 7.705.205 Clinical/Mental Health Professionals A. The QRTP must have clinical staff who provide mental health services. The QRTP must have at least one (1) of the following licensed mental health professionals providing clinical services:

1. A licensed psychologist pursuant to Section 12-245-301, C.R.S. through

Section 12-245-309, C.R.S.;

2. A licensed clinical social worker (LCSW) pursuant to Section 12-245-401, C.R.S. through Section 12-245-410, C.R.S.;

3. A licensed marriage and family therapist (LMFT) pursuant to Section 12- 245-501, C.R.S. through Section 12-245-506, C.R.S.;

4. A licensed professional counselor (LPC) pursuant to Section 12-245-601, C.R.S. through Section 12-245-607, C.R.S.;

5. A licensed addiction counselor (LAC) pursuant to Section 12-245-801, C.R.S. through Section 12-245-806, C.R.S.

B. The QRTP may utilize provisionally licensed mental health professionals pursuant to Section 12-245-208, C.R.S. Any provisionally licensed mental health professionals must be supervised by a licensed mental health professional who is associated with the QRTP. If the QRTP chooses to utilize provisionally licensed mental health professionals, they must also employ/contract with a licensed mental health professional who provides clinical supervision to the provisionally licensed individual and must adhere to clinical supervision in

Section 7.705.206 of this section.

C. The QRTP may contract with licensed clinical professionals or provisionally licensed clinical professionals for the required mental health services. These contracted services and individuals must adhere to the rules of Section 7.701.400.B. Contracted individuals are considered staff of the facility during the hours stated in the contract. Contracts must list the duties of the contracted individual with whom the program is contracting and must list the scope of services to be provided. For clinical services being provided by contracted staff, the contract must outline the manner in which the clinical services are being administered. There must be assurance of the scheduled hours face-to-face onsite as well as being available via phone or video call. There must be assurance of their services being available twenty-four (24) hours a day, seven (7) days a week. Contracted professional staff must be involved in the development and review of the child’s/youth’s individual plan and comply with all requirements outlined in Section 7.714.4.B any contracts for clinical professionals must be made available to the department upon request.

D. The licensed mental health professional and any provisionally licensed mental health professional must be at least a part-time employee and/or contractor of the QRTP and be responsible for the coordination and oversight of the mental health services provided in the QRTP.

E. Clinical/mental health professional files are the property of the facility and must remain on site and be made available to the department upon request and remain in compliance with all federal and state confidentiality statutes and F. Clinical/mental health notes and any documentation of mental health services provided to youth residing in the QRTP are the property of the QRTP and must remain on site and be made available to the Department upon request and remain in compliance with all confidentiality statutes and regulations. 7.705.206 Administrative and Clinical Supervision of Clinical Professionals A. The QRTP must ensure that all licensed and provisionally licensed clinical personnel providing mental health services receive supervision as defined in this

section.

B. The QRTP will develop and adhere to policies and procedures for supervision of clinical professionals that address the following:

1. Develop and maintain the clinical professional’s mandatory disclosure statement that is required as part of the intake process for children/youth admitted to a QRTP;

2. Define who is providing supervision to the clinical professionals employed by the QRTP;

3. Develop and define the requirements for regular evaluation of the clinical professional’s performance with regard to clinical services provided;

4. Documentation and frequency of supervisor reviews and feedback provided;

5. For provisionally licensed professionals, the fully licensed clinical professional must provide clinical supervision at a minimum, of one (1) time every week, and, at a minimum;

a. Meet the standard qualifications for clinical supervision as defined by their professional practice board;

b. Deliver clinical supervision within the supervisor’s professional practice license and ethical standards;

c. Dedicate time between the licensed professional and the provisionally licensed professional to instruct, model, and encourage self-reflection by the personnel receiving supervision regarding acquisition of clinical and administrative skills. The licensed clinical supervisor will determine skills through observation, evaluation, feedback, and mutual problem solving;

d. Address ethics and ethical dilemmas as aligned with the appropriate professional practice board;

e. Provide professional direction based on experience, expertise, and/or for ethical or safety concerns;

f. Ensure that safety and crisis management plans are followed and that clinical supervisors are available to personnel for assistance in crisis situations and processing the crisis event afterwards;

g. Document date, duration, and the content of supervision session for their supervisees, which may include a professional development plan. All documents pertaining to clinical supervision in a QRTP must be provided to the supervisee and the Department upon 7.705.207 Family Engagement A. The program must have a written plan on how the program staff will facilitate family engagement and participation in the child’s/youth’s treatment.

1. All staff who participate in the child/youth plan must be trained in family engagement strategies at orientation and annually.

2. The program must have a written plan that provides services that are aligned with the family’s schedule. The provider must make reasonable efforts to facilitate the family’s participation in treatment.

3. If the family or other primary support system is clinically or legally contraindicated, then this shall be documented in the child’s/youth’s file.

B. The program must have a written plan that facilitates approved contact between the child’s/youth’s family of origin or primary support system. The plan shall be designed to provide support to the family to ensure clinically indicated frequency of contact. This plan shall be individualized for each child/youth as determined by the family engagement and permanency team or the court.

1. All efforts to arrange contact, including visits, telephone calls, or video conferences must be documented, including any reasons contact was not able to be completed.

2. Contact with family or primary support systems should, in alignment with the approved plan, be used as a primary intervention when the child/youth requests contact.

C. The program must document efforts to maintain sibling connections unless clinically contraindicated or ordered by the court. Such orders of communication must be contained within the child’s/youth’s file and added to the individual 7.705.208 Placement Requirements A. Independent Assessment (IA)

1. A child/youth referred to a QRTP by a county department or the Division of Youth Services shall have an independent assessment (IA) completed.

2. The state-approved assessment shall be administered by the provider every ninety (90) days beginning with the date of placement and within fourteen (14) days of discharge to demonstrate the need for continued QRTP services.

B. The facility must request a copy of the initial state-approved assessment upon admission using the state-prescribed form and submission to the BHA.

C. The results of the initial state-approved assessment must be utilized, if made available, in the development of the individual child’s/youth’s plan.

D. The results of the ninety (90) day reviews must be shared within five (5) days of completion with the placement authority and department through the Department-approved method.

E. All staff completing the state-approved assessment must complete the stateapproved training and pass the state-approved certification test before administering the tool. All staff completing the assessment must be recertified annually. Documentation of the training must be kept in the staff’s file. 7.705.209 Clinical Record Requirements A. In addition to Section 7.701.63 and Section 7.701.64, a QRTP designated by the Department to provide mental health services must maintain current, organized, legible, chronological, clinical records for each child/youth. Treatment records 1. A mental health diagnosis;

2. Copies of any assessments pertaining to the child’s/youth’s current need for mental health services;

3. All plans of care and revisions for the current treatment episode;

4. Documentation of the child’s/youth’s attendance at, participation in, and outcomes of QRTP mental health services;

5. Documentation that the child/youth and/or the legal guardian was provided a copy of the plan of care;

6. Correspondence to and from agencies and individuals involved in the child’s/youth’s treatment;

7. An explanation whenever any member of the multidisciplinary team, child/youth, parent(s), or guardian(s), does not sign the plan of care;

8. The name of the licensed mental health professional responsible for the formulation, implementation, review, and revision of the child’s/youth’s plan of care;

9. Signed releases of information when necessary;

10. Documentation of any unplanned discharges without advance notice and any discharges against the agency’s or licensed mental health professional’s advice;

11. Treatment entries that are signed and dated by the person providing treatment/therapy, including title or position of the person providing treatment/therapy. If the clinical services are provided by a provisionally licensed therapist, the supervisor must also sign entries;

12. All changes in diagnoses need to be documented with changes to the independent assessment;

13. All members of the clinical staff must be trained annually in the development and review of plans of care, and there must be documentation of such;

14. Clinical supervisors who are providing supervision to provisionally licensed therapists (SWP, LPP, MFP, PSP) must document supervision hours provided to supervisees. 7.705.210 Comprehensive Assessment Qualified residential treatment programs (QRTPs) must complete a comprehensive assessment on the child/youth admitted to the program in accordance with Section 7.714.4.A. 7.705.211 Individual Child’s/Youth’s Plan in a QRTP A. In addition to Section 7.714.4.B, the following is required for an individual child’s/youth’s plan in a residential child care facility designated by the Department to provide mental health services.

1. The licensed mental health professional responsible for providing clinical care must develop the mental health component of the individual 2. The multidisciplinary team must develop and finalize a comprehensive individual child/youth plan, as covered in Section 7.714.4.B, within fourteen (14) calendar days after the determination that mental health services are required. The plan must be signed and dated or include written documentation of participation and review by the parties listed in

Section 7.714.4.b.B. The plan must be signed and dated by the mental health professional. If a provisionally licensed mental health professional is providing the services, that person and their licensed supervisor must also sign the individual child’s/youth’s plan. The plan must:

a. Address all areas listed at Section 7.714.4.B, together with mental health services and other needs including the child’s/youth’s presenting symptoms, physical health, emotional status, behavior support needs, community supports, available resources, and discharge/aftercare plan;

b. Include specific goals and measurable objectives, expected dates of achievement, specific discharge and transitional/aftercare and follow-up services, criteria to be met for termination of treatment, and specific treatment goals, including, but not limited to:

1. Expected reduction in the symptoms that necessitated mental health services and the specific functional achievement and skills development to be obtained in measurable terms, and 2. Indications that planned services can reasonably be expected to improve the child’s/youth’s condition;

c. Specify the type, frequency, and duration of mental health services, rehabilitation services, medication management, emergency services, initial assessment, documented treatment modifications, and other services determined to be necessary to meet the child’s/youth’s individualized mental health service goals;

d. Specify that all RCCF mental health services are necessary to meet the needs of the child/youth and that the mental health services are necessary to treat the child’s/youth's current diagnosis;

e. Identify the provision of, or the referral for, services other than RCCF mental health services and must document any courtordered treatment, including identifying the agency responsible for providing the court-ordered treatment.

3. There must be a review of each plan every thirty (30) days to evaluate progress and whether goals and objectives have been achieved and/or not achieved and barriers to treatment, if applicable. The individual child’s/youth’s plan and the discharge plan must be revised by the designated licensed, or provisionally licensed, professional person as appropriate.

4. There must be documentation of the child’s/youth’s response to treatment approaches and changes in the individual child’s/youth’s plan with the reasons for such changes.

5. In addition to Section 7.714.4.A and Section 7.714.4.B, QRTPs must include the following components for the individual child’s/youth’s plan:

a. The findings of the assessment/evaluation, including the strengths and needs of the child/youth to be addressed in the individual child’s/youth’s plan. The findings of the assessment must identify which needs of the child/youth must be resolved for the child/youth to move to a less-restrictive setting/successfully discharge from the facility;

b. Goals must be individualized, relevant to the placement of the child/youth, and address any diagnosis given. Objectives must be specific, measurable, achievable, and relevant to the goals, individualized, and time-limited. the goals and objectives must support the child’s/youth’s progress toward discharge;

c. A plan for fostering and maintaining positive family relationships with the child/youth and their family;

d. Specification of the therapeutic services, specialized services, and strategies for positive behavior intervention that will be provided directly or arranged for, frequency of services, and method for ensuring their proper integration with the child’s/youth’s ongoing program activities;

e. Discharge plan, including aftercare, medication management, and referrals to community services;

f. Identification of all persons responsible for implementation of the plan;

g. Signature or written documentation of participation and review by a representative of the facility, a representative of the placing agency, if applicable, the child/youth, and the child’s/youth’s parent(s) or guardian(s);

h. Written documentation by the facility that the plan and any subsequent revisions are explained to the child/youth in care and their parent(s) or guardian(s) in a language or manner of communication the child/youth and parent(s) or guardian(s) can understand;

i. A review of each individual child’s/youth’s plan must occur to evaluate the child’s/youth’s progress toward achieving the goals and objectives. The review must include which goals and objectives have been achieved and which are remaining in the individual 7.705.212 Short-Term Placements A. In the event the anticipated length of stay for the child/youth is less than fourteen (14) calendar days, and a service to be provided includes mental health treatment of the child/youth, the facility must complete an initial assessment and an individual child’s/youth’s plan for short-term placements within seventy-two (72) hours of admitting the child/youth. For short-term placements, Section 7.714.4.A and Section 7.714.4.B are not applicable.

1. The multidisciplinary team must gather historical and current information to assess and evaluate the child/youth in at least the following areas:

a. Reason for referral;

b. Safety needs of the child/youth;

c. Presenting needs;

d. Medical health and allergies, including a health history of the child/youth and child's/youth’s family;

e. Mental health, including treatment history and history of psychotropic medications, utilizing the state-approved assessment results if required and if able to be obtained;

f. Family and community relationships;

g. Treatment/placement history; and h. Alcohol/substance use history.

B. Upon admission, the facility and placing authority must create an individualized child’s/youth’s plan for short-term placements that addresses safety and risk considerations, triggers, early warning signs, and strategies to assist with emotional regulation or sensory modulation strategies.

C. The stabilization plan must include at least one (1) goal to include objectives to support the goal. The findings of the independent assessment must be incorporated.

D. The individual child’s plan must address any safety issues identified in the E. In the event that the child’s/youth’s length of stay is determined to extend to more than fourteen (14) calendar days, all requirements of Section 7.714.4 must be completed prior to the thirtieth (30) day of stay. updates to the state-approved assessments must be completed according to the required timeframes for those facilities required to complete them. 7.705.213 Mental Health Services in a QRTP A. Services must be provided to all children/youth admitted to the facility, and documentation of services provided to the child/youth must be kept in the file and made available to the Department upon request.

B. Services must be individualized to the needs of the child/youth and family, as determined by the individual child’s/youth’s plan.

C. The assessment needs to assess for mental health services, and the information obtained from the assessment needs to be included in the individual child’s/youth’s plan, unless contraindicated for the child/youth as determined by the individual child’s/youth’s plan.

D. Other mental health services may include group therapy or other services as determined by the individual child’s/youth’s plan specified by the comprehensive E. Services must include medication assessment and management, if appropriate and applicable. 7.705.214 Discharge and Aftercare A. Discharge 1. Qualified residential treatment programs must follow Section 7.714.85 for discharge of children/youth from the facility.

2. Within five (5) business days of when a child/youth is removed from placement, the facility must complete and send to the placing agency, a summary of the child’s/youth’s discharge from the facility, to include all components listed in Section 7.714.85.I. For QRTPs, the summary must also include a statement of an aftercare plan and identification of who is responsible for follow-up services and aftercare.

3. Copies of a child’s/youth’s file, including discharge information but excluding all medical information covered by HIPAA, as incorporated in

Section 7.701.14, or educational information covered by FERPA, as incorporated in Section 7.701.14, must be provided to parent(s) or guardian(s) upon request or to others by written consent pursuant to

Section 7.701.61.

4. If the child/youth prematurely discharges from the facility, the facility is responsible to follow through with providing aftercare services in accordance with the child/youth individualized plan. In instances where the child/youth discharges due to elopement, hospitalization, or to receive higher levels of care, the facility is responsible to ensure the next provider receives appropriate information regarding discharge and aftercare for the child/youth within five (5) business days of when a child/youth is removed from placement.

B. Aftercare 1. Within forty-five (45) calendar days of admitting a child/youth into care, the program must develop a discharge and aftercare plan, in collaboration with the county department of human/social services or placing entity, the child/youth, and the family engagement and permanency team.

2. The aftercare plan must describe the services and resources needed by the subsequent care provider to meet the needs of the child/youth and how those services and resources will be provided.

3. The program must provide or make referrals for family-based aftercare support for at least six (6) months post-discharge as determined in the plan utilizing the same clinician, if possible, and documenting efforts if unable to coordinate.

4. The plan must be reviewed and/or modified by the licensed clinician or provisionally licensed clinician with review and signature by the supervising licensed clinician no less than monthly during the child’s/youth’s placement and during aftercare services. Changes to the plan must be documented in the child’s/youth’s individual file.

5. The plan must be incorporated into the discharge summary as outlined at

Section 7.714.85.I.

6. The program must update the state-approved-assessment no more than fourteen (14) days prior to the planned discharge date of the child/youth as outlined in Section 7.714.85.

7. The program may revise the terms of aftercare support and services with the placing entity of any child/youth not placed by a county department of human/social services or the Division of Youth Services (DYS) and must provide after-care support in accordance with the contract established with the placing entity.

8. Programs may refer to other entities to provide aftercare services and must clearly document in the aftercare plan whom they contracted with, contact information, and the specific services to be provided.

7.705.300 REQUIREMENTS OF THERAPEUTIC WILDERNESS PROGRAM

SERVICES 7.705.301 Applicability of Rules A therapeutic wilderness program means a facility that is licensed as a residential child care facility, as defined in Section 26-6-903(29), C.R.S. These rules are specifically for therapeutic wilderness program services. The following rules are in addition to corresponding regulations in Sections 7.701, 7.705, 7.711, 7.714 and 7.719. However, if there is a conflict between those rules and regulations and these special rules and regulations, these rules and regulations shall apply. 7.705.302 Personnel A. There must be a chief administrator of a therapeutic wilderness program that meets the qualifications for an administrator of a residential child care facility as stated in Section 7.705.42. The chief administrator must have at least one (1) year of verified full time experience working with children/youth in a therapeutic wilderness program and three (3) years of verified experience in staff supervision and administration. The chief administrator may also function as the field director.

B. When the administrator of a therapeutic wilderness program is not available, an assistant or acting director who meets the same requirements as the administrator must be available.

C. There must be a field director who is primarily responsible for the coordination, supervision, and management of field operations, field staff, and the field office.

The field director must be at least twenty-five (25) years of age and must have a minimum of thirty (30) semester hours in recreational therapy or related experience, or at least one (1) year (1,820 hours) of experience working with children/youth in a therapeutic wilderness program.

D. There must be at least one (1) senior field staff member working directly with each group of children/youth. The senior field staff must be qualified as follows:

1. Be at least twenty-one (21) years of age;

2. Be qualified as stated in Section 7.705.44.A;

3. Have at least six (6) months full-time experience or training in a field related to recreation and adventure activities;

4. Have a minimum of forty (40) twenty-four (24) hour field days of program experience or equivalent working in outdoor wilderness programs; and 5. Have current Wilderness First Responder (WFR) First Aid and CPR E. Child care field staff must:

1. Be at least twenty-one (21) years of age;

2. Be qualified as stated in Section 7.705.44.A;

3. Have completed staff training and field course work as required in Sections 7.705.311 and 7.714.92;

4. Have completed, at a minimum, a standard First Aid and CPR course.

F. Program consultants and other multi-disciplinary resources 1. A multi-disciplinary team that has knowledge of the physical and emotional demands of the program must be available for consultation and recommendations regarding the program participants.

2. At a minimum, the multi-disciplinary team must consist of:

a. A physician licensed to practice in Colorado; and b. A licensed mental health professional licensed to practice in Colorado, including either a licensed psychologist, licensed clinical social worker, licensed marriage and family counselor, or licensed professional counselor. 7.705.303 Staff to Child/Youth Ratios A. At a minimum, the following staff to child/youth ratios must be maintained:

1. There must be at least one (1) staff member for every four (4) children/youth in care at all times;

2. There must be at least two (2) staff present per group of eight (8) children/youth at all times;

3. Where the gender identity or biological sex of a group is mixed, there must be staff members who represent the gender identity and/or biological sex of the members of the group at all times; and 4. A therapeutic wilderness program must ensure the immediate availability of additional staff from the field office to be physically present in the event of an emergency or crisis. In the event of an emergency, local emergency services must be called immediately. 7.705.304 Field Office Operations and Communications A. A therapeutic wilderness program must have a base camp and/or field office in Colorado, hereafter referred to as a “field office”. At a minimum, the field office must:

1. Be staffed twenty-four (24) hours a day when there are children/youth in care;

2. Maintain current staff personnel files;

3. Maintain a current list of the names of staff and children/youth in each field group;

4. Maintain a master map of all activity areas used by the program and GPS coordinates for each campsite;

5. Maintain copies of each group’s expeditionary route including schedule and itinerary, which must be made available to the department, local law enforcement, and land use agencies upon request or as required;

6. Maintain logs of all communication with each field group when away from the field office.

B. There must be a communication system between the field office and each group away from the field office that includes:

1. Additional, fully-charged battery packs for each group;

2. Plan for re-establishing communication in the event regular communications fail;

3. A global positioning system (GPS) with each group when away on all expeditions;

4. Verbal communication between each group and the field office must occur at least two (2) times in each twenty-four (24) hour period, unless alternative arrangements have been made, and documented in a log maintained at the field office. 7.705.305 Emergency and Safety A. A therapeutic wilderness program must establish a written policy and specific procedures for emergencies, including, but not limited to, evacuations, natural disasters, medical emergencies, casualties, and missing children/youth. At a minimum, the written policy must include:

1. Designation of authority and staff assignments;

2. Transportation and relocation of program participants when necessary;

3. Instruction to all participants on how to respond in the event of an emergency;

4. Notification to the field office of the nature of the emergency and accounting of each participant’s location and status;

5. Supervision of program participants after an evacuation or relocation; 6 Arrangements for medical care and notification of a child’s/youth’s parent(s) or guardian(s) and physician if necessary;

7. Written procedures for emergency air evacuation if necessary and written agreement for air evacuation services in the event of an emergency.

B. A therapeutic wilderness program must have written procedures regarding safety and the use of wilderness and survival equipment. The procedures must be reviewed at least annually. The written procedures must include:

1. Instruction of each program participant on environmental hazards and precautions;

2. Instructions on the proper use and storage of tools and other equipment used as a part of the program;

3. The maintenance of a First Aid kit with sufficient supplies available at all times, which must:

a. Include supplies specific to the location, environment, and activities of each group;

b. Be inventoried after each expedition and restocked as needed;

c. Be reviewed with each new staff member for contents and use;

d. Be reviewed at least annually with all staff members for content and use. 7.705.306 Admission and Assessment of Children/Youth A. A preadmission assessment must be done for each child/youth by a licensed mental health professional familiar with the therapeutic wilderness program prior to enrollment. The assessment must include all requirements found in Section 7.714.4.A.

B. Subsequent assessments must be done prior to the child/youth leaving for the adventure portion of the program, away from the field office or main base of operations. The assessment must include:

1. An interview with the child/youth conducted prior to entrance into the field program; and 2. If previously conducted, the psychological evaluation(s) must be obtained and reviewed by an appropriate licensed mental health professional prior to the child’s/youth’s entrance into the field portion of the program.

C. Each child/youth must have a physical examination within thirty (30) days prior to entrance into the therapeutic wilderness program. The program must provide a form to the examining licensed health care provider that clearly describes the type and extent of physical activity, environment, and conditions the child/youth will experience in the program. The exam must be completed by a licensed healthcare provider, who signs the form. The physical exam must, at a minimum, 1. A complete blood count (cbc);

2. A urinalysis;

3. An electrolyte screen;

4. A physical assessment to determine fitness given the climate and activities in which the child/youth will be participating, and the child’s/youth’s age, weight, and physical condition;

5. A determination whether drug and/or alcohol detoxification is indicated for the child/youth prior to entrance into the field portion of the program;

6. Documentation of this exam signed and dated by the licensed health care provider must be reviewed prior to the child’s/youth’s entrance into the field portion of the program.

D. The therapeutic wilderness program must request information regarding the last dental exam the child/youth had prior to entering the field program. If the child’s/youth’s last dental exam is over four (4) months prior to entrance into the program and the child’s/youth’s length of stay in the therapeutic wilderness program exceeds one hundred and twenty (12o) days, the facility must schedule or complete a dental exam for the child/youth within fourteen (14) days after the child’s one hundred twentieth (120) day of admission. If the child/youth is in the custody of a county department of human/social services or the Division of Youth Services, the therapeutic wilderness program must complete dental exams in compliance with Section 7.714.82.E. If a child/youth has dental care needs, these needs must be addressed timely, as per doctor’s orders, while in care. 7.705.307 Health Care and Medication A. Children/youth must be observed daily for hydration, conditions of their skin and extremities, and general physical condition. The evaluation must be recorded by field staff in the daily log. Children/youth with an illness or physical complaint needing care or treatment beyond what can be provided in the field must be immediately transported to an appropriate medical care facility.

B. Children’s/youth’s feet, legs, hands and arms must be observed at least two (2) times daily for signs of pain, swelling, blisters, red streaks running from cuts or abrasions, frostbite, and hydration.

C. Complaints or reports by a child/youth of illness and injury must be recorded in the daily log along with any treatment provided.

D. First Aid treatment must be provided in as prompt a manner as the location and circumstances allow.

E. There must be no adverse consequences imposed on a child/youth for reporting an injury or illness or for requesting to see a healthcare professional.

F. At least every fourteen (14) days, each child’s/youth’s physical condition must be assessed by a Wilderness First Responder (WFR), an Emergency Medical Technician (EMT), or a qualified medical professional. The results of the assessment must be recorded and at a minimum include:

1. Blood pressure;

2. Heart rate;

3. Condition of the extremities;

4. Condition of the skin;

5. Hydration level;

6. Allergies, if any;

7. General physical condition;

8. Provision of appropriate medical treatment, if needed.

G. Prescription and over the counter medication, including vitamins and supplements, must be stored in a locked container, safe guarded from children/youth and the elements. Controlled medications must be double locked, and the keys to the locks must be under the control of the staff member responsible for administering medications at all times. Medications taken on field outings must be in the immediate control of a staff member qualified to administer medications at all times.

H. The administration of psychotropic medication must be prohibited in a therapeutic wilderness program unless a qualified medical professional determines that the medication is clinically indicated. Under no circumstances will psychotropic medication be administered for disciplinary purposes, for the convenience of staff, or as a substitute for appropriate treatment services.

I. Prescribed medications must not be stopped or changed in dosage or administration without consulting with the prescribing physician and obtaining a written order. If the prescribing physician is not available, a qualified medical professional must be consulted. Results of the consultation and any resulting medication changes must be recorded in the child’s/youth’s record.

J. All controlled substances must be counted at least two (2) times per day by two (2) different staff members, and a log must be maintained that includes the signature of the individual conducting and documenting the count.

K. All unused and expired medications must be secured until appropriately disposed of and documented. 7.705.308 Nutrition A. There must be a written menu, approved on an annual basis, as required in

Section 7.705.31. The registered dietitian must have knowledge of the program activity levels and environmental factors. The menu must list the necessary food supplies and caloric intake for each group. The current menu must be available, and any change or substitution must be noted on the menu. menus must be dated and maintained on file for six (6) months.

B. At least two (2) times per week, the fruits and vegetables offered in the approved menus must be fresh fruits and vegetables.

C. Requiring a child/youth to consume food in under five (5) minutes is prohibited.

D. Child care field staff must monitor the intake of water for each child/youth daily to ensure adequate hydration. If a child/youth exhibits signs of dehydration, this information must be reported to the field office immediately. hydration supplements with electrolytes must be available to children/youth. 7.705.309 Participant Clothing, Equipment, and Supplies A. Each program participant must have clothing, equipment, and supplies appropriate for the types of activities, terrain, and weather conditions likely to be encountered.

B. Clothing, equipment, and supplies must include, at a minimum:

1. Sunscreen; 2 Insect repellent;

3. A commercially available backpack or the materials to construct a safe backpack and/or bedroll;

4. Personal hygiene items necessary for cleansing;

5. Appropriate feminine hygiene supplies;

6. Appropriate sleeping bag, pad, and/or sleep system for each child/youth;

7. Clothing appropriate for temperature changes generally expected for the area;

8. Each child/youth must be provided a clean change of clothing at least once a week or have an opportunity to wash their clothes at least once a week;

9. Each child/youth must be provided clean undergarments, including socks.

Additional clean undergarments and socks must be provided to a child/youth, as may be needed for health and sanitary reasons;

10. Each child/youth must be provided a means to clean their body at least two (2) times per week;

11. Appropriate well-fitting footwear for the weather, activity, and terrain the program will experience;

12. Synthetic or wool socks must be designed for outdoor activity. 7.705.310 Outings and Hiking Limits and Requirements A. Hiking must not exceed the physical capability of any member of the group.

B. There must be no hiking when the temperature is above ninety (90) degrees fahrenheit or below fifteen (15) degrees fahrenheit, including windchill. If hiking in temperatures below thirty-two (32) degrees fahrenheit (including windchill), breaks must be taken at least every thirty (30) minutes in a sheltered/warmer environment.

C. Copies of maps, routes, and anticipated schedules, including departure and arrival times, must be maintained with each group and at the field office when a group is on an outing away from the base camp.

D. Staff must closely monitor children/youth for acclimation to the temperature, climate, altitude, environment, and situation.

E. The maximum pack weight must not exceed thirty (30) percent of the child’s/youth’s physical weight.

F. If the facility participates in special activities other than those for which regulations are found in this section, the facility must follow a written policy which includes all Sections from 7.719.1.D. 7.705.311 Training Requirements A. Each program staff must have completed training in each of the areas listed in

Section 7.714.92.

B. Each program staff must have an additional eighty (80) hours of training specific to therapeutic wilderness programs within the first thirty (30) days of employment and prior to working unsupervised with children/youth. The training must not be considered completed until the staff have demonstrated to the field director their proficiency in, at a minimum, the following areas:

1. Counseling, teaching, and supervisory skills;

2. Water, food, and shelter development;

3. Environmental conservation skills and procedures;

4. Instruction in emergency and safety procedures including, but not limited to, medical, emergency evacuation, weather, signaling, fire, flood, and runaway or lost children/youth;

5. Instructions on safety procedures for the use of fuel, fire, and other related tools;

6. Sanitation procedures including water, waste, food, and toileting;

7. Health issues related to acclimation, exposure to the environment, and other environmental issues;

8. The contents of the First Aid kit, storage, maintenance, and use;

9. Local environmental precautions including terrain, weather, poisonous plants, wildlife, and response to adverse situations;

10. Required documentation, including the development and maintenance of logs and journals.

C. Prior to a staff person being included in ratio in accordance with the requirements found in Section 7.705.46, initial staff training and demonstration of proficiency must be completed and documented.

D. Ongoing training must be provided to staff to improve proficiency in knowledge and skills in therapeutic wilderness settings and to maintain certifications. 7.706 RULES REGULATING DAY TREATMENT CENTERS [Rev. eff. 6/1/12]

All day treatment centers must comply with the “General Rules for Child Care Facilities” found at Section 7.701, et seq., the restraint and seclusion rules found at Section 7.714.53, et seq., the applicable definitions in Section 7.714.1, and these “Rules Regulating Day Treatment Centers”. 7.706.1 DEFINITIONS [Rev. eff. 10/1/15]

A “day treatment center” is a facility which provides less than twenty-four (24) hour care for groups of five or more children from three (3) to twenty-one (21) years of age.

Nothing prohibits a day treatment center from allowing a person who reaches twentyone (21) years of age after the commencement of an academic year from attending an educational program at the day treatment center through the end of the semester in which the twenty-first birthday occurs or until the person completes the educational program, whichever comes first. The center will provide a structured program of various types of psycho-socio and/or behavioral treatments to prevent or reduce the need for placement of the child out of the home or community.

This definition shall not include special education programs operated by a public or private school system or programs which are licensed by other regulations of the Colorado Department of Human Services for less than twenty four (24) hour care of children, such as day care centers or centers for developmentally disabled children.

“De-escalation” is the use of therapeutic interventions with a child during the escalation phase of a crisis. The interventions are designed to allow children to contain their own behavior so that acute physical behavior does not develop that would lead to the need to use a physical management.

“Reasonable” as used in these rules means appropriate and suitable, or not excessive or extreme. 7.706.11 Governing Body A. The governing body is the individual, partnership, corporation or association in whom the ultimate authority and legal responsibility is vested for the conduct of the day treatment center.

B. The governing body shall be identified by its legal name. The names and addresses of individuals who hold primary financial control, members of the board of directors and officers of the governing body shall be disclosed fully to the Colorado Department of Human Services. When changes of persons holding any of these positions occur, the department shall be informed of the names and addresses of the new individuals annually. 7.706.12 Statement of Purpose Each day treatment center shall formulate a written statement which includes the

purpose and objective of the day treatment center, description of the services to be offered by the day treatment center, ages of children and type of children to be accepted by the day treatment center, and the geographic area in which children may reside for acceptance by the day treatment center. 7.706.13 Financial Operation A. An annual budget reflecting anticipated income by source and expenses by

purpose, plus an accompanying balance sheet, must demonstrate that the agency has assured resources to carry out its defined purpose through its first year of operation and must be submitted with the original license application.

B. The center shall maintain a competent accounting system, and the financial records of the center shall be available for inspection by staff members of the department.

C. Each day treatment center whose total annual expenditures exceed $100,000 shall provide for an annual audit of all accounts by a certified public accountant who is not an employee of the center nor a member of the governing body.

Centers with less than $100,000 total annual expenditures may submit unaudited financial statements compiled by agency personnel. 7.706.14 Personnel A. Each staff member of the day treatment center shall evidence an interest in and knowledge of children and concern for their proper care and well-being.

B. Each staff member of the day treatment center shall obtain a physical examination which shall be performed during the six-month period preceding employment by the center. This examination shall have been performed by a physician or a qualified nurse practitioner licensed to practice in the State of Colorado and shall verify that she/he suffers from no illness or communicable disease, including tuberculosis, that would adversely affect children in care. A statement, signed by the physician or nurse practitioner, shall be submitted to the center and retained in the personnel files. Subsequent statements shall be submitted annually and as required in a written plan signed by the physician.

C. There shall be at least one written reference regarding each staff member of the center verifying the individual's character and suitability to work with children.

This reference shall be retained in the staff member's personnel file.

D. The administrator of the day treatment center shall have received a bachelor's degree from an accredited college and have completed two years of verifiable work experience with children in the field of psychiatry, psychology, social work, child development and child care, education, nursing, or other allied professions.

The director and governing body shall be responsible for assuring that the Rules Regulating Day Treatment Centers are being met.

E. There shall be at least one treatment leader on the staff of the day treatment center who shall be responsible for the coordination of treatment of each child registered at the day treatment center. The treatment leader shall have at least a master's degree in the behavioral science field such as social work, psychology, psychiatric nursing; or the treatment leader shall be a psychiatrist who is qualified and licensed to practice in the State of Colorado. In addition to education, the treatment leader shall have completed three years of treatment-oriented experience.

1. If properly qualified, the treatment leader and the administrator may be the same individual.

2. The treatment center may contract with a recognized agency for the provision of treatment services. The staff IT Member of the agency who is to fulfill the responsibility of treatment leader must meet the requirements stated in Section 7.706.14, E.

3. There shall be at least one treatment leader employed by the day treatment center for each 25 children enrolled at the day treatment center.

The treatment leader(s) shall be employed and actively involved in the services prescribed for each child through supervision or direct service for the number of hours per day the treatment program operates.

F. There shall be counselors hired by the day treatment center, sufficient in number, to supervise the children and carry out the program of the day treatment center.

Each counselor shall have completed a bachelor's degree in behavioral sciences or four years of experience with appropriate-aged children and be at least 21 years of age. The counselors shall work under the supervision of the treatment leader.

1. The ratio of counselors and/or treatment leader(s) to children in care shall be not less than the following schedule:

Age of Children Staff Necessary 5 years-13 years 1 staff member: 8 children 13 years-16 years & over 1 staff member: 10 children 2. There shall be at least one counselor or treatment leader on duty at the day treatment center at any time children are present. If only one counselor is on duty, there shall be a second staff member on call and immediately available to be summoned in case of emergency.

3. Substitute counselors shall be of the same minimum qualifications as regularly assigned counselors.

G. Para-professionals must be at least 21 years of age and, under direct supervision, may assist the director, teachers, counselors, and treatment leaders with the children.

H. There shall be one staff member on duty at the center at all times who holds a current Red Cross first aid card or equivalent and CPR card. 7.706.15 Child Care Services [Rev. eff. 6/1/12]

A. Admission of the children to the day treatment center shall be limited to and in keeping with the stated purpose and goals of the center.

1. Intake policies of the center shall be clearly defined in writing and shall be reviewed and modified as necessary.

2. At intake the center shall obtain:

a. Identifying information necessary for the child's record as required at Section 7.706.18, A.

b. Psycho-social history of the child.

c. A statement about the health history of the child which includes at least the immunization record; information and instruction for care of each child who has a chronic or handicapping problem such as seizures, asthma, diabetes, allergies, heart or respiratory illness or drug addiction; date of last physical examination. If child has not had a physical examination within the past twelve months, such examination shall be completed within thirty days of admission to the program. Subsequent examinations shall be obtained as required by a physician or nurse practitioner licensed to practice in Colorado.

d. The center shall obtain written permission for the following from the person or agency having custody:

1) Permission to treat the child.

2) Permission to obtain emergency medical care in the event that the child has an accident or illness requiring medical attention when parent or guardian is unavailable.

3) Permission to provide transportation to and from the center or for center-sponsored activities if necessary.

4) Permissions for physical management, restraint and seclusion as required in Section 7.714.53, et seq.

B. For each child in the day treatment program, long range and short term goals shall be established and a case plan written which includes anticipated behavioral changes of the child and projected length of participation in the day treatment program. Goals and case plans shall be evaluated at least monthly.

The discharge plans shall become part of the case plan and shall describe the child's behavior at the time of discharge from the day treatment program. The treatment leader shall be responsible for establishment and signing the case plans.

1. Persons to be involved in the process of case planning and periodic evaluation shall include a staff member of the agency having referred the child, the parent or guardian, as appropriate, and staff members of other agencies serving the child.

2. A monthly progress report shall include a description of the child's behavior, summary of the treatment activities, and revision of the case plan. The report shall be forwarded to the referring agency and reviewed with parent or guardian monthly for the first six months that the child is in the center and quarterly thereafter.

3. The center shall maintain open communication with parents, guardians and/or referring agency and include each party in the treatment plan and reviews, as may be appropriate for each family and student.

C. Treatment shall be provided to each child enrolled in the center pursuant to his/her case plan. Treatment sessions with members of the child's family shall be included, as deemed necessary and as part of the case plan. Each child and/or his/her family shall participate in at least two weekly sessions of individual therapy, group therapy or family therapy. All services shall be documented in the child's file.

D. If the child is attending a school operated by the day treatment program, a plan shall be established with appropriate school personnel of the school most recently or currently attended and with the child's parent(s) or guardian(s) for the education of the child based upon his/her particular needs and special ability.

E. Each day treatment center shall establish a schedule or a plan of activities which shall indicate the plan for educational and treatment services, as well as other services such as recreation and employment as appropriate for children in care.

F. Outdoor and indoor recreational equipment and material shall be provided in sufficient variety and quantity so the center may adequately sponsor and supervise necessary recreational activities. Games, toys, equipment, and arts and crafts material shall be selected according to age, number of children, and with consideration of the needs of children to engage in both active and quiet play. All equipment and materials shall be of quality to assure safety, and shall be of a type which allows for imaginative play and creativeness.

1. The center shall establish a written policy related to the participation of children in potentially dangerous recreational activities which include the use of such equipment as trampolines, trail bikes, snowmobiles, boats, bodybuilding equipment and such activities as archery, riflery, horseback riding and backpacking (see Rules Regulating Children's Camps).

2. A staff member shall be assigned the responsibility for supervision and coordination of the total recreational program including training and supervision of staff and volunteers.

G. As appropriate to the child's age and ability and as indicated in the case plan, the child shall be offered guidance and help in obtaining paid or voluntary work assignments. If employment services are part of the program of the day treatment center, one center staff member shall be assigned the responsibility of coordinating such work arrangement and shall know the employer of the child, the specific type of work and conditions of employment.

H. Each child shall receive assistance or supervision needed to help him/her establish good habits of personal care, grooming and hygiene.

I. Only prescribed medicines labeled with the child's name, name and strength of the medicine, directions for use, date filled, prescription number and name of practitioner shall be given with the written consent from the child's parent or guardian. Medicines must be in the original container. A record of medication administered which includes the child's name, the date and time the medication was administered, the name and dosage of the medication, and the name or initials of the staff person who administered it shall be maintained in the child's file. There shall be one staff member on duty at all times designated to administer and record all medication. The responsible staff person must have completed State approved medication administration training and have documentation on file. All medicines and drugs shall be kept in a locked storage area inaccessible to children.

J. Children who are in the day treatment center for more than four hours, day or evening, shall receive a meal.

1. If the facility provides the meal, menus shall be kept for at least a two week period, and there shall be a documented review periodically by a qualified nutritional consultant. Children shall not be given foods which are contrary to their religious beliefs or which are known to cause an allergic reaction or health hazard.

2. Drinking water shall be freely available to children.

K. Any vehicle used for transportation of children and the vehicle driver shall meet the following regulations:

1. Vehicles shall be licensed in accordance with Colorado state law, and drivers shall comply with applicable laws of the Colorado State Department of Revenue, Motor Vehicle Division, and ordinances of the municipality in which the day treatment center is located.

2. The drivers shall hold a valid Standard First Aid Certificate or equivalent and CPR card.

3. Only enclosed vehicles shall be used to transport children except an enclosed pickup truck shall not be permitted. All seats must be forwardfacing and shall be securely fastened to the vehicle body. A seat belt or booster seat for children under 40 pounds shall be provided for each seat.

Only the number of passengers that can be comfortably seated on passenger seats shall be permitted in the vehicle. Each occupant shall be sitting when the vehicle is moving. Passengers shall not sit on the floor.

4. Each vehicle shall be equipped with a first aid kit, an operable fire extinguisher and seat belts in the front seats.

5. The day treatment center shall carry public liability insurance on vehicles used for transportation of children in the day treatment program.

6. The staff ratio required at the day treatment center shall be maintained in any vehicle when transporting children from the day treatment center. The driver may be considered in the staff ratio.

7. The center shall receive written permission from parents or guardians for transportation of a child to and from a center or for center-sponsored excursions. 7.706.16 Behavior Management [Rev. eff. 6/1/12]

A. Each day treatment center will have written documentation of policies and procedures that describe the treatment model upon which the behavior management system is based and who shall be responsible for disciplinary measures.

B. The behavior management system must be explained to parents/guardians and to children taking into account the child's developmental and cognitive level.

C. The behavior management system must include, at a minimum:

1. Positive constructive or educational components including but not limited to diversion, withholding of privileges, talk with the child about the situation, positive reinforcement, skill training, and skill development.

2. Clear rules and expectations with predictable, consistent consequences or interventions that will be used by staff members to reinforce positive behaviors and to address disruptive, off-task or unsafe behaviors in the 3. A continuum of de-escalation and redirecting techniques to deal with disruptive, escalating or unsafe behaviors.

4. A review process for addressing chronic behavior problems or serious acute problems in which a child is not responding to the behavior management program as being implemented.

D. The program will have a monitoring process of the behavior management system to assure both consistency in implementation and for continuous quality improvement as needed to address changing client needs and behaviors.

E. Physical management will be considered an extreme level of intervention at the day treatment level. The occurrence of restraints for a particular child will require a review as described in Section C, 4 above. The goal of these reviews will be to eliminate restraints for the child by reassessing the identified problem, adjusting the treatment plan, utilizing additional resources or other such interventions including the evaluation of whether day treatment is a level of care at which the child can successfully function.

F. The behavior management system will include, but not be limited to, any of the 1. No child shall be punched, shaken, pinched, bitten, roughly handled or struck by an inanimate object by staff members of the day treatment center.

2. Authority to discipline shall not be delegated to other children.

3. Separation when used as discipline shall be brief and appropriate to the child's age and circumstances, and the child shall be within hearing and visual observation of an adult in a safe, lighted, well-ventilated room. No child shall be secluded in a locked room or closet.

4. No child shall be punished for toileting accidents.

5. Verbal abuse or derogatory remarks about the child, his family, his race, religion or cultural background shall not be used or permitted.

6. No child shall be force-fed.

7. Meals may be provided individually, but deprivation of meals shall not be used as punishment.

8. No child shall be subjected to physical harm or humiliation.

9. Seclusion.

G. Disregard of any of the foregoing disciplinary rules or any disciplinary measure resulting in physical injury or abuse of any child shall be grounds for the denial, revocation, suspension, or making probationary of the license. 7.706.17 Physical Management [Rev. eff. 6/1/12]

Any physical management, restraint and seclusion shall comply with the rules found at

Section 7.714.53, et seq., and the applicable definitions in Section 7.714.1. 7.706.18 Records A. A record of admission shall be completed for each child prior to, or at the time of, admission to the day treatment program and shall include:

1. Necessary identifying information including the child's name, address, telephone number, birth date, sex; name, address, telephone number of parent(s) or guardian(s); name and relationship of person with whom child is living, if different from parent(s) or guardian(s); address and telephone number at the location person(s) responsible for child can be reached when child is participating in the treatment program; name, address and telephone number of individual to contact in emergency if parent(s) or guardian(s) is unavailable; name, address and telephone number of referring agency and referring worker; physical description of the child, description of child's behavior and personal habits, health and immunization record; name and address of individual who may call for the child if the child is not to leave the center on his own; name, address and telephone number of child's physician or the clinic where medical care is obtained.

2. A current medical statement, records of medication provided to the child and records of all injuries occurring while in care at the center.

3. Written permissions as required at Section 7.706.15, A, 2, d.

4. A case plan, a summary of the periodic evaluations of the child's progress and resultant changes in the case plan. The evaluation summary shall include the date and the individuals who participated, as well as a description of the child's progress toward the objectives outlined in the case plan.

5. A summary of the discharge of the child from the center which includes at least the date of the discharge and reason for child's discharge from B. A daily attendance chart indicating the names of children who attended each session each day shall be maintained.

C. Personnel record for each staff member which includes the following shall be maintained: name, address, telephone number, birth date, education and training, work experience, employment reference, statements of physician or nurse practitioner; names, addresses and telephone numbers of persons to be notified in event of an emergency; date of employment; copy of first aid card or equivalent and CPR training, and medication administration training, if appropriate.

D. Administrative records which shall be on file at the center include: current health department inspection report, current fire department inspection report, a list of current staff members and substitutes, and a staffing pattern. 7.706.19 Physical Requirements for a Safe and Adequate Center [Rev. eff. 4/1/15]

A. The day treatment center must declare to the Colorado Department of Human Services the address of each building which will be used by the day treatment center, the anticipated hours of use of the building by the day treatment center, and the type of use of each building by the day treatment center.

B. The licensing representative must inspect and approve the entire premises of each facility to be used or in use by the day treatment center, including, but not limited to, the building, the grounds surrounding the building, the basement or attic, if accessible, any other buildings on the grounds, such as garage, storage areas and carports.

C. Each facility used by the day treatment center must be equipped with adequate heat, light and ventilation for safe and comfortable occupancy.

D. All heating units must be installed and maintained with safety devices to prevent fire, explosions, and other hazards. No open-flame gas or oil stoves, hot plates or un-vented heaters must be used or heating purposes.

E. Closets, attics, basements, cellars, furnace rooms and exit routes must be kept free from accumulation of extraneous material such as discarded furniture, furnishings, newspapers or magazines. Combustibles, such as cleaning rags, mops, cleaning compounds, must be labeled and stored in well-ventilated areas.

Storage of gasoline, kerosene, fuel oil and other flammable materials must meet requirements of the safety and fire code.

F. In each facility there must be at least two approved, alternate, widely-separated means of egress from each floor of the building to safe and open space at the ground level.

G. No lock or fastening to prevent free escape from the inside of the room or building used by children must be permitted. Exit hardware must be of the singleaction type.

H. Exit doors must be obvious and marked by exit signs.

I. The route to each exit must be conspicuously indicated in such a manner that each occupant of a building or structure who is physically and mentally capable will readily know the direction of the escape from any point. Each path of escape must be so arranged or marked in such a manner that the way to a place of safety outside is unmistakable. Exitways and pathways to exitways must be unobstructed at all times.

J. Any accessible areas beneath stairways which will be used as exitways by children must be enclosed with one-hour fire resistant material.

K. In each building used by the treatment center, fire alarm facilities must be provided to warn occupants of the existence of a fire so that they may escape, or to facilitate the orderly conduct of fire exit drills.

L. Each facility must have a telephone, and near the telephone must be located the numbers of an emergency medical facility, the local fire and police departments, and other emergency numbers including poison control, if available.

M. If weapons are on the property of the facility, they must be rendered totally inoperable and must be locked up to prevent unauthorized use. Ammunition, projectiles such as arrows or other items which can be used to make the weapon operable, must be; locked separately. Weapons must not be transported in any vehicle in which children are riding unless the weapons are made inoperable and inaccessible.

N. When a swimming pool is provided, it must meet the requirements of the Colorado Department of Public Health and Environment or local unit. Safety precautions must include protective fencing, nonskid surface of at least four feet adjoining pool sides, and winter coverage which must exclude plastic or inflatable-type domes. A lifeguard, who holds an advanced life saving certificate, must be in attendance at all times when the pool is in use.

O. The Colorado Department of Human Services will establish the number of children who may be served at any one time in the building(s) used by the day treatment center for school, recreation or therapy, established on the basis of one child per twenty square feet of space within the rooms which are to be used.

Areas within the building which are to be used for bedroom, kitchen, office, hallways, or bathroom cannot be counted as space available for use by the children at the day treatment center.

P. Within the buildings to be used by children in the day treatment program, there must be one toilet and one lavatory for every thirty children in attendance.

Q. Arrangement must be made for personal belongings of each child while in attendance at the center. 7.707 RULES REGULATING FAMILY CHILD CARE HOMES [Repealed eff.

7.708 RULES REGULATING FAMILY FOSTER CARE HOMES

All foster care homes must comply with the “Rules Regulating Foster Care Homes” and the “General Rules for Child Care Facilities”. 7.708.1 FOSTER CARE HOMES [Rev. eff. 1/1/16]

A. “Foster care home” (refer to Section 7.000.2 in 12 CCR 2509-1), as defined at

Section 26-6-102, C.R.S., means a facility that is certified by the county department or a child placement agency for child care in a place of residence of a family or person for the purpose of providing twenty-four (24) hour family care for a child under the age of eighteen years who is not related to the head of such home, except in the case of relative care. The term includes any foster care home receiving a child for regular twenty-four (24) hour care and any home receiving a child from any state operated institution for child care or from any child placement agency.

The number and age of foster children for which a certificate may be issued is determined by the following factors:

1. No foster child/youth shall be placed in a foster home if that placement will result in more than six foster children/youth in that home, or a total of ten children/youth (foster and non- foster), or more than two children under two years of age, except in those instances in which the placement of a sibling group in a foster care home would exceed the limits. If the placement of a sibling group results in exceeding the above limits, no other foster children/youth can be placed in the home.

a. When a foster care home is certified for more than four children/youth in foster care, each foster parent shall demonstrate sufficient skills to meet the individual physical, mental, social, behavioral, and other trauma needs of each child/youth placed in the home, including identification of:

1) Parenting experience, parenting style and the ability to meet the supervision needs of each child/youth;

2) Ongoing assessment of needs shall be conducted by the certifying agency during support visits in the foster care home. The certifying agency shall provide more frequent contact during the month when that is an identified need;

3) Sufficient supports, including those provided by the certifying agency to meet the daily needs of each child/youth placed in the home as identified in the family services plan. Supports could include transportation, child care, respite, and coaching for the child/youth and/or foster parent(s); and, 4) Training needed to provide care to the populations served, including any increased and/or specialized training identified in the training development plan.

b. Space requirements in section 7.708.22 shall be maintained.

c. The preferences of foster parents identified in section 7.708.61 shall be maintained.

2. A foster care home may serve children enrolled in Children’s Habilitation Residential Program (CHRP) if the certifying agency determines the foster home providers have the knowledge and supports to safely meet the needs of all of the children in the home. Emergency placements will not exceed maximum capacities.

CERTIFIED FOSTER HOME MAXIMUM CAPACITY

CHRP Non-CHRP Total Children 1 3 4 2 2 4 3 1 4 3. Foster care providers who are serving foster children enrolled in the Children’s Habilitation Residential Program (CHRP) waiver shall be in compliance with rules contained within the Department of Health Care Policy and Financing’s Medical Assistance Manual at Section 8.508 (10 CCR 2505-10).

4. Foster care may be provided to children from birth to eighteen (18) years of age and to those persons to 21 years of age who are placed by court order prior to their eighteenth birthday.

5. When a foster care home only provides temporary emergency care for foster children/youth, the home may be certified for up to six foster children/youth. No more than two children under two years of age may reside in the foster care home, including the foster parent’s children under two years of age and any children under two years of age being placed into foster care. An exception is allowed when the placement of a sibling group of twins or triplets (multiple births), etc., who are under two years of age, would exceed the limits. There can be no more than a total of six foster children/youth in the home except in sibling placements. The number of additional foster children under six years of age to be cared for shall be specified on the certificate and in the home study. Such a foster care home shall be designated as a receiving home. The designation shall appear on the certificate.

a. No foster child/youth shall remain in that foster care home at the receiving home rate longer than 90 consecutive days, in accordance with the requirements of Section 7.417.3.

b. The number of foster children/youth to be cared for at the receiving home rate and any foster children/youth to be cared for at the regular foster care home rate shall be included on the certificate.

c. Each receiving home parent shall have two years of experience as a foster parent, although the certifying agency may take into account other relevant education and experience.

d. Each receiving home parent shall complete 32 hours of on-going training every year as identified in his/her training development plan. This training shall include the following competencies:

1) Issues regarding emergency and crisis placement of children/youth with unknown histories; and, 2) Dynamics of victimization issues, with emphasis on appropriate age and developmental levels; and, 3) Cultural, spiritual, and religious awareness, consideration for, sensitivity to, and tolerance of each child/youth individually.

e. Because receiving homes are likely to have quick turn-over of the children/youth in care, supervision and monitoring of the receiving home shall be carried out according to the following:

1) One face-to-face contact shall be made with the receiving home parent(s) at least every week when children/youth are in placement in the home, with a minimum of two visits per month occurring in the receiving home.

2) Documentation of such contact shall be in the provider file, as well as in each file of all foster children/youth in the home.

3) The purpose of the contact is to address any questions the receiving home parent has about the children/youth in care, to observe child care when appropriate and to provide support to the receiving home parent.

f. A receiving home shall have a comprehensive annual evaluation, which includes a review of any critical incidents, any allegations of institutional abuse, and the skills, needs, and competencies of the receiving home parent(s).

6. A foster care home may not be operated without a license or a certificate as required by law and Section 7.701.4 of these rules, and the number of foster children cared for in such facility may not exceed the number authorized by such license or certificate.

B. Foster care homes may be licensed host family homes.

1. A foster home may be a licensed host family home pursuant to the rules at

Section 7.721.

2. Pursuant to 26-5.7-105(6), C.R.S., a foster care home approved as a licensed host family home shall not accept a homeless youth for placement under this section if there are any foster children currently placed in the home. No foster children may be placed while a homeless youth resides at the foster home.

3. A foster care home acting as a host family home for homeless youth shall receive additional training regarding homeless youth services and shall be designated as a host family home on the foster home certificate.

4. Pursuant to Section 26-5.7-105(5), C.R.S., if the county or child placement agency referring the youth to the host family home or the host home parents determine that a referral for additional services needs to be made, they shall make a referral to the county of reference of the parents of the 5. Notification Pursuant to Sections 26-5.7-105(4) and (7), C.R.S:

a. When a youth under fifteen years of age is admitted to a host family home, the county or child placement agency referring the youth to the host family home or the host family home’s parents shall notify the county department of residence of the parents of the youth within seventy-two (72) hours of the youth’s admission.

b. If a youth who is at least eleven (11) years of age but less than fifteen (15) years of age has been served up to twenty-one (21) consecutive days and returns again to the licensed host family home after leaving the home, the county or child placement agency referring the youth to the host family home or the host family home shall notify the county department of residence of the parents of the youth within seventy-two (72) hours of the youth’s admission. 7.708.11 Definitions [Rev. eff. 1/1/16]

“Certifying authority” means licensed child placement agencies and county departments of human or social services that have the authority to certify foster care homes, including kinship foster care homes.

“Child specific foster care” is care where the foster child has a prior relationship to the foster parent(s).

“County designee” is the representative of a county department designated by the county executive director to make certain key decisions regarding foster children.

“De-escalation” is the use of therapeutic interventions with a foster child during the escalation phase of a crisis. The interventions are designed to allow foster children to contain their own behavior so that acute physical behavior does not develop which would lead to the need for use of a physical restraint.

The “Family Service Plan” is a case services plan completed by a county caseworker jointly with the foster child, parents, and foster parents within 60 calendar days of placement for each foster child receiving services from a county department of social/human services.

“Kin”: Refer to Section 7.000.2 (12 CCR 2509-1) for the definitions of “kin” and “noncertified kinship care”.

“Reasonable”, as used in these rules, means appropriate and suitable, not excessive or extreme.

“Religion”, where used in these rules, includes traditional religious beliefs and spiritual beliefs such as those of Native Americans.

“Therapeutic foster care” means a program of foster care that incorporates treatment for the special physical, psychological, or emotional needs of a child placed with specially trained foster parents.

“Treatment Foster Care” means a clinically effective alternative to residential treatment facilities that combines the treatment technologies typically associated with more restrictive settings with a nurturing and individualized family environment.

“Whole Family Placement”, also known as “shared family care”, is a situation in which adult parent(s) and foster child(ren) are placed together in the home of a family trained to mentor and support the biological parents as they develop skills and supports necessary to care for their foster child(ren) and move toward living independently.

7.708.2 REQUIREMENTS FOR CERTIFICATION OF FAMILY FOSTER CARE

HOMES 7.708.21 Character, Suitability, and Qualifications of Family Foster Parents A. A certificate shall be denied in accordance with Section 7.500.312, D.

B. Each foster parent in the foster care home shall demonstrate an interest in, and a knowledge of, foster children and a concern for their proper care and well-being.

C. A certificate may be denied or revoked if the foster parent(s)’ own children have been placed in foster care or a residential treatment facility under circumstances which demonstrated that the foster parent or another resident of the home was abusive, neglectful, or a danger to the health, safety, or well-being of those foster D. The foster care home parents shall be able to provide for a foster child's proper physical, mental and character development.

E. Applicants shall demonstrate stability in family relationships within the home where foster care is to be provided.

F. The licensing or certifying authority must receive at least three written statements which describe the applicant's character, interpersonal relations, and ability to provide care for foster children from references provided by the applicant, at least two from a source/person who are not related to the applicant and who have known the applicant one year or longer (references need not be residents of Colorado). Licensing or certifying representatives may contact others who may have knowledge or information regarding the applicant's character or suitability.

G. The foster home parent shall possess basic knowledge of child care and good nutrition, and shall cooperate with the licensing or certifying agency in programs designed to increase such knowledge.

H. Licenses or certificates shall not be granted to applicants who are less than twenty one years of age on the date of application for such license or who lack adequate physical stamina to care for children.

I. Foster parents shall protect children/youth in foster care from exposure to second hand smoke. Smoking includes the use of electronic nicotine delivery systems, also known as e-cigarettes, e-cigs, vape pens, e-hookahs, e-pipe, tanks, mods, and vapes.

1. Smoking is prohibited inside the foster care home at all times when a child/youth is in placement in the foster care home.

2. Smoking is prohibited in a foster parent’s, alternative care’s (natural support), or substitute caregiver’s motor vehicle when a child/youth is in placement in the foster care home.

3. Smoking is prohibited in the presence of a child/youth who is in placement in the foster care home.

J. The financial resources of foster parents shall be adequate to assure that the home where the care is provided is maintained in safe repair and in conformity with standards and that the requirements of these regulations can be fulfilled.

K. A license or certificate shall not be granted for a foster care home unless the applicant has demonstrated the ability to manage a household so that the licensing or certifying authority may determine that the applicant is able to acquire food, materials and other equipment as may be required for child care and to maintain records pertaining to foster children, including records required by statute or regulations.

(L) each foster parent must have a health assessment, to include a current vaccination record, within one year prior to certification or within 30 calendar days after certification and thereafter as required, in writing, by a licensed health care professional. the reports of the medical examinations shall be dated and signed by the examining physician or nurse practitioner and shall be provided to the certifying. authority. reports shall include a statement of the evaluation of the person's physical ability to care for foster children and a copy of their current vaccination. Record if the provider is providing care for infant(s) under 6 months of age, the provider must be current on the influenza and pertussis vaccinations. a medical exemption is allowed when an individual has a medical condition that prevents them from receiving a vaccine a non-medical exemption is allowed when an individual has religious beliefs whose teachings are opposed to immunizations or a personal belief that is opposed to immunizations.

M. Children of the foster home parents and any other persons not placed by the agency and living in the foster care home shall obtain a medical statement from a licensed health care professional verifying that each such person suffers from no illness or communicable disease which would adversely affect foster children in care. This statement shall be obtained annually or as required in writing by an approved health care professional. A licensed health care professional is defined as a physician, nurse practitioner, or a physician's assistant. This statement shall have been signed within the twelve month period preceding the original license or full certificate granted to the home.

N. Applicants will not use illegal substances under state law, will use legal prescription medications as prescribed by a licensed health care professional, and will use over the counter medications as recommended by the manufacturer or the licensed health care professional.

O. The use of legal substances must not inhibit the foster parent’s ability to provide care that is consistent with the needs of the child/youth.

P. A foster parent must be able to communicate sufficiently to provide care for the child/youth, including the ability to communicate with the guardian ad litem (gal) and/ or counsel for youth and case worker. If needed, a foster parent may use an interpreter to assist. A child may not be used to interpret. This must be documented in the home study and updated annually.

Q. A foster parent must be able to read and comprehend the instructions for the child’s/youth’s medical and mental health requirements, including but not limited to, prescription medications and the licensed health care practitioner’s instructions. A foster parent may use an interpreter to assist. A child may not be used to interpret. This must be documented in the home study and updated annually.

R. if, in the opinion of the licensed health care professional or the assessment worker, an emotional or psychological condition exists which would have a negative impact on the care of foster children, the issuance of a license must be conditioned upon the satisfactory report of a licensed mental health practitioner. 7.708.21.1 Health History Assessment:

A. All household members must disclose to the certifying agency their current mental health and/or substance use and/or abuse issues.

B. All household members must provide information about their physical and mental health history, including any history of drug and/or alcohol abuse or treatment. 7.708.22 Physical Requirements for a Safe and Adequate Foster Care Home [Rev. eff. 1/1/16]

A. Licensing or certifying representatives are authorized but not required to consult the state or county department of health regarding sanitary standards and to consult local fire departments regarding questions of fire safety. A license or certificate may be denied or revoked in the event an applicant or licensee refuses to permit an investigation by these authorities if requested by a licensing or certifying representative, or if such authority advises, that a license or certificate not be issued.

B. The following shall be required of all foster care homes:

1. There shall be an outdoor play space free from hazards of not less than 75 square feet per child in care who is between 12 months and five years of age. This area shall be fenced or otherwise protected. If the area is not fenced, outdoor play shall be supervised by the foster care provider or designee and a specific plan for how safety is to be assured shall be documented in the case file.

2. The presence of firearms and ammunition is strongly discouraged in any home in which foster children are 'cared for. Any weapons such as firearms, air rifles, bows, hunting knives or hunting sling shots shall be unstrung and unloaded at all times when foster children are in the home and shall be stored in locked containers out of the reach of foster children.

Ammunition and arrows shall be stored in separate locked containers.

Firearms which are solely ornamental are excepted from the storage requirement. Weapons shall not be transported in any vehicle in which foster children are riding unless the weapons are made inoperable and inaccessible. Law enforcement professionals are exempted from the requirements of this section if conditions of their employment require them to carry weapons.

3. At least 35 square feet of usable indoor space exclusive of halls, baths and sleeping area shall be available for each child. However, when a sibling group is placed together in a single foster home, a variance from the minimum space standards is permitted.' All floor space shall have carpets, tile or smooth finish which may be easily cleaned, interior walls shall be constructed of solid material and be free from holes. Unfinished basements must be inaccessible to foster children when safety hazards are present.

4. Exterior doors shall be maintained in such a manner which would permit easy exit. Interior doors shall be designed to prevent children from being trapped.

5. A basement which will be used regularly in the care of children in any manner shall be equipped with more than one exit; such exit may be an accessible window. See Section 7.708.31.E, for additional requirements for nighttime care.

6. The foster care home shall have a kitchen with a sink that has an operating faucet, refrigerator, stove, and oven, or a way to heat and/or reheat food. Provisions shall be made for the washing, rinsing, and storing of dishes in a safe and sanitary manner.

7. The foster care home shall have at least one (1) operating toilet, sink, and either a bathtub, and/or shower. Provisions shall be made for the privacy of the toilet, bathtub, and/or shower.

8. Toys and outdoor play equipment meeting the requirements of Section 7.708.31. D.2.a shall be available.

9. A comfortable bed or crib in a clean, well-ventilated room, which is not customarily used for other purposes such as a kitchen, dining room, hall, or bathroom, shall be available for all children/youth who are in foster care in the home. There shall be a minimum of forty (40) square feet of floor space for a bed for each child/youth in foster care, and the bed should be placed at least two (2) feet apart when arranged in parallel.

10. No foster care home shall be used for a rental income business an adult foster care facility. A business of a nature which might hazardous to the health, safety, morals or welfare of foster children shall not be operated on the premises of the foster home. In order to support youth with an independent living stipend, a foster care home may provide a home for a youth that previously resided in foster care in the home on or before the youth’s eighteenth (18th) birthday. The youth shall solely occupy a bedroom and shall not occupy a bedroom with a child or youth in foster care. The foster care home may accept a negotiated portion of the independent living stipend. Negotiation shall include the youth, caseworker, and foster parent(s).

11. Mobile homes used as foster care homes shall have at least two (2) exits, be skirted, and properly installed and stabilized.

12. If there is a trampoline on the foster care home property, safety issues regarding its use must be agreed upon with the foster parents and addressed in writing in the case file.

13. Safety issues related to swimming pools shall be assessed by the certification worker, any state or local requirements addressed by the county or state health department as necessary, and documented in the case file.

Use and/or access to swimming pools, including in-ground, on-ground, and above-ground models, hot tubs and spas must be safe, appropriate, hazard-free, and consistent with the age, development, and abilities of the children/youth in the foster care home. The following are required:

a. In-ground, on-ground, and above-ground swimming pools must meet state or local safety requirements and demonstrate compliance with recommendations from the Consumer Product Safety Commission. Swimming pools must meet the following requirements to ensure they are safe and hazard free.

1) Swimming pools must have a barrier on all sides.

2) Swimming pools must have their methods of access through the barrier equipped with a safety device, such as a bolt lock.

3) Swimming pools must be equipped with a life saving device, such as a ring buoy, float, and/or a retrieval/extension pool pole that is available and easily accessible.

4) Swimming pools that cannot be emptied after each use must have a working pump and filtering system.

b. Hot tubs/spas Hot tubs/spas must meet state and local safety requirements.

1) Hot tubs/spas must have safety covers and must remain locked when not in use.

2) Hot tubs/spas must have a working pump and filtering system if the hot tub/spa cannot be emptied after each use.

3) When children/youth are using the hot tub/spa, the water temperature must not exceed 104 degrees Fahrenheit. The length of time that children/youth may be in a 104 degree water temperature in the hot tub/spa must not exceed the recommendations of the manufacturer or a licensed health care professional.

4) Only children/youth who can stand on the bottom with their head completely out of the water are allowed in the hot tub/spa without being held or supervised by an adult in the hot tub/spa. If the child/youth is unable to stand with their head completely out of the water, the child/youth must be held by an adult at all times that the child/youth is in the water.

5) An adult must provide direct supervision at all times when children/youth are in the hot tub/spa.

C. Temporary wading pools that have a water depth of less than two (2) feet are exempt from pool and hot tub/spa requirements. Children/youth shall be supervised at all times.

D. A certificate shall be denied, suspended, revoked or made probationary for failure to repair or otherwise comply with any of the preceding requirements when a defect or noncompliance with such requirement has been noted by the licensing or certifying representative and brought to the attention of the licensee or applicant in writing. 7.708.23 Foster Home Site [Rev. eff. 1/1/16]

A. The foster care home must be located in an area that is accessible to health resources, public and private utilities, adequate and safe water supplies, sewage B. The foster care home must comply with local zoning department requirements.

C. The entire premises of the foster care home are subject to inspection for licensing or certification purposes, including, but not limited to, me residence where care is to be provided, the grounds surrounding the foster care home, the basement, the attic (if accessible), any storage buildings, and a garage or carport, if applicable.

D. The foster care home, including indoor and outdoor space, shall be maintained in a clean and safe condition free from hazards to health and safety. 7.708.24 Foster Home Maintenance [Rev. eff. 1/1/16]

A. The foster care home shall be kept in good repair and maintained in a safe, clean, and sanitary condition.

B. All areas of the foster care home available to foster children's activities including equipment, materials and furnishings shall be of sturdy, safe construction, easy to clean, and free of hazards, such as sharp points or comers, splinters, protruding nails, broken play and recreational equipment, or paint that contains lead or other poisonous materials and might be dangerous to the life or health of foster children.

C. All areas of the foster care home shall be kept free from accumulation of significant amounts of non-essential materials such as furnishings, newspapers, or magazines that could pose a fire or health hazard.

D. Provision shall be made for collection, storage, and disposal of trash to prevent infestation by rodents. 7.708.25 Fire Safety A. Fire hazards, such as defective electrical appliances and electric cords, B. The foster care home shall contain at least one U.L-approved fire extinguisher, highly visible, easily accessible, and in working condition, weighing not less than five pounds, that has a rating of 2A, 10BC. This requirement may be waived if more extensive fire-control measures are required by a local fire department.

C. A smoke detector and a carbon monoxide detector or a combination smoke/carbon monoxide detector, in working condition, must be installed on each level of the foster care home and near sleeping areas.

D. No gas space heaters, open-flame gas or oil stoves, hot plates, or un-vented heaters shall be used in the foster care home for heating purposes. No electric space heaters shall be used in the foster care home for permanent heating E. Flammables aerosol paints, insecticides, chemicals, and other dangerous materials shall be locked or stored so they are inaccessible to foster children and must be stored in areas separate from sleeping or living areas. Flammables shall be stored in an approved container.

F. Heating devices such as radiators, registers, fireplaces, wood-burning stoves, and steam and hot water pipes that pose a fire or bum hazard to foster children shall be screened or otherwise protected.

G. Flammable material must not be stored near a furnace, hot water heater, or other heating device.

H. There shall be no candles or other burnable objects permitted in foster children's sleeping areas. Foster children shall not be permitted to smoke inside the foster care home or in any vehicle used to transport children.

I. Exit doors shall be clearly identified to all foster children. No lock or fastening to prevent free escape from the inside of any room used by the foster children shall be permitted.

J. Exit routes shall be kept free of discarded furniture, furnishings, laundry, and evacuation of the foster care home.

K. A written emergency evacuation plan must be posted in a prominent place in the foster care home. 7.708.26 General Comfort and Safety A. All hazardous chemicals, tools, and other equipment, including matches, plastic bags, paints, gasoline, medicines, insecticides, and cleaning and laundry materials, shall be stored out of reach of young foster children. Products which could cause poisoning or contamination shall not be stored in areas where food is stored or prepared.

B. Water from any source other than a regular municipal water supply shall be tested annually for compliance with water quality requirements.

C. The foster care home shall be equipped with adequate light, heat, ventilation, and plumbing for safe and comfortable occupancy.

D. The foster care home must be equipped with hot and cold running water.

E. All stairways containing more than four steps shall be equipped with a handrail.

F. The foster care home shall have immediate access to a working telephone, and emergency numbers shall either be posted in a prominent location, including those related to medical care, fire, law enforcement, and poison control, where available. Numbers for the agency or person having legal custody of each child/youth in foster care shall also be readily available.

7.708.3 REQUIREMENT FOR THE ONGOING OPERATION OF FOSTER CARE

HOMES 7.708.31 Care of Children/Youth Who Are in Foster Care A. Foster parents shall provide supervision and care appropriate to each child's/youth’s age, level of development, and ability to accept independence and responsibility.

B. Within twenty-four (24) hours of arrival at the foster care home, a child/youth in foster care shall be given an orientation to the home consistent with the age of the child/youth and ability to participate, which includes at least the following:

1. Tour of the home and instruction on fire alarm and emergency evacuation plan or procedures, escape routes and exits.

2. The rules/regulations of the home.

3. Procedures affecting the foster child’s behavior, including limiting or restricting a foster child’s rights where allowed, the type of discipline used in the foster care home, and consequences for certain behaviors.

4. The complete foster children’s rights and foster children’s grievance procedures as developed by the foster care home or by the certifying

authority.

C. Health Care 1. Concerning behaviors which are observed by foster parents shall be reported to the certifying authority and the child’s/youth’s caseworker so that appropriate care may be obtained.

2. Where pets or other animals are present, additional precautions shall be taken as required to insure both safety and good hygiene. Dogs and cats shall be vaccinated as required by State law or as designated by a veterinarian. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the pet vaccinations cannot be completed as required by law or veterinarian, the vaccinations must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

Children/youth in foster care shall not be permitted to mistreat animals.

Any animal that poses a threat to a child’s/youth’s safety or health must be confined in a place away from the child(ren)/youth in foster care.

D. Home Environment and Family Activity 1. It is the purpose of foster care to provide constructive family living experiences for children/youth during the period of placement. 2 Daily activities shall be designed to encourage normal physical, mental, social and emotional development of children/youth in foster care. This requirement shall be met in the following manner:

a. Materials and equipment appropriate for the age of children in care shall be available for both active and quiet play.

b. An effort shall be made to provide for contact and friendship between children in foster care and other children of a comparable age. Opportunities shall be provided for both group and individual play.

c. Children shall be encouraged to relate or to communicate with each other and with adults.

d. Outdoor activity shall be available to each child in foster care each day, weather permitting.

3. Foster parents or a designated representative from the certifying authority with knowledge of the child/youth shall attend Administrative Reviews for the children/youth in their care and participate in the planning for such children/youth. They shall receive a copy of the child’s/youth’s Family Services Plan for each child/youth in their care.

E. Nighttime Care Requirements 1. Children/youth in foster care shall be provided with a bed, cot, or crib as required by Section 7.708.22.B.8.

2. Two (2) sheets and suitable warm covering shall be provided to each child/youth. Sheets shall be changed weekly or more frequently if needed, and no child shall be allowed to remain sleeping in a wet bed.

3. Except for emergency placements, children in foster care over the age of eighteen (18) months shall not sleep in the same room as unrelated adults on a regular basis. Sleeping rooms for unrelated children/youth in foster care shall not be shared by children/youth in foster care of the opposite sex when one child/youth in foster care is over four (4) years old. Siblings of the opposite sex that are over the age of four (4) years and share bedrooms shall do so only with the written approval of the certifying

authority and the county designee. The written documentation must be maintained in the child’s/youth’s and provider’s file. Adolescent parents and their children may share a room.

4. Each child/youth in foster care shall be provided with adequate sleep wear and a complete set of clean sleep wear shall be available in the event that a change is necessary.

5. Sleeping rooms for children in foster care who are under five (5) years of age shall be near the bedroom of the foster parents or other responsible person. Monitoring systems may be utilized to ensure safety. Children in foster care who are under twelve (12) years of age shall not be permitted to sleep in a detached structure unless a responsible person sleeps in the same structure. Youth in foster care who sleep in a detached structure must have written approval of the county department that placed the youth, following an assessment of the youth’s abilities and needs.

F. Infant Care 1. No more than two (2) children, whether birth, adoptive, or children in foster care under the age of two (2) years, shall be cared for in a foster care home, except under unusual circumstances such as multiple births.

2. In addition to the applicable provisions of paragraphs A through E, above, infant care shall include the following:

a. Infants shall be held during bottle feeding and at other times during the day. Infants shall not be confined but shall be allowed freedom of movement insofar as practical and shall be provided with an environment designed to stimulate their senses.

b. Diapers shall be changed as required and used diapers cleaned or disposed of consistent with the practices of good hygiene. Toilet training shall not be attempted with any child in foster care less than eighteen (18) months of age and shall be done in a nondisciplinary manner.

3. Safe Sleep and Co-sleep a. Infants are children who are up to one (1) year of age. They must be placed to sleep in a crib, as identified by the Consumer Product Safety Commission. A bassinet, as identified by the Consumer Product Safety Commission, may be used in lieu of a crib, only until the infant reaches the maximum weight or age as identified by the bassinet manufacturer.

1) Drop side cribs and stacking cribs are prohibited.

b. Infants must not be placed to sleep on soft surfaces including, but not limited to, a bed, chair, futon, bean bag chair, couch, sofa, waterbed, pillow, quilt, sheepskin, or blanket.

c. Infants must not be placed to sleep in the same crib as another infant or child.

d. Infants must not sleep on the same sleep surfaces as the foster parent(s). Sleep surfaces include, but is not limited to, a floor, mattress, bed, sofa, recliner, or chair.

e. A foster parent must not sleep while holding an infant. This includes, but is not limited to, while sitting on a recliner or couch.

f. Soft bedding or materials that could pose a suffocation hazard are not permitted in cribs. Soft bedding means, but is not limited to, any soft sleep surface such as bumper pads or breathable mesh liners, pillows, blankets, quilts, comforters, sleep positioning devices, sheepskins, flat sheets, cloth diapers, bibs, plush toys, and stuffed animals.

g. Infants who fall asleep in places other than a crib, including but not limited to, a car safety seat, bouncy seat, infant seat, activity infant swing (based on the manufacturer’s recommendations), jumping chair, highchair, or any other piece of equipment not approved for sleep, must be moved to a crib as soon as reasonably possible.

The child may not be left to sleep in the device overnight and must be supervised at all times.

h. Infants must be placed on their back for sleeping unless there is a different recommendation from the American Academy of Pediatrics and the latter shall be followed.

1) Alternate sleep positions, and any alternate sleep surface must be used only with the written approval signed by the child’s physician, physician assistant, or nurse practitioner.

i. Before swaddling is used, the certifying agency must document in the foster parent’s file that the foster parent completed the state’s web-based safe sleep training. The certifying agency may require additional training as appropriate. Swaddling must be discontinued as soon as the infant tries to roll unswaddled, except where a health care professional provides written direction allowing swaddling to continue. A health care professional is a licensed physician, physician assistant, or a nurse practitioner.

j. All sleep equipment must be safe, sturdy, and free from hazards including, but not limited to, broken or loose slats, a torn mattress, chipping paint, or loose screws.

k. Approved sleeping equipment and mattresses must be firm and must fit snugly ensuring no more than two (2) adult fingers are able to be inserted between the mattress and the side of the approved sleeping equipment.

7.708.31.1 SUBSTITUTE CARE, RESPITE CARE, AND ALTERNATIVE CARE

A. Substitute care is provided in the foster care home where the child/youth in foster care resides. Respite care is provided in another foster home. Alternative care is provided in the home of a natural support identified by the foster parent. These caregiving services provide opportunities for foster parents to have or take breaks of varying lengths. The following apply:

1. At least 72 business hours’ notice must be provided to the caseworker, gal and/or counsel for youth and child/youth. if an emergency or an urgent situation arises, the foster parent or the certifying agency shall provide notice to the caseworker, gal and/or counsel for youth, and child/youth as soon possible.

2. Caregivers may not consent to activities requiring a consent form or safety gear for high risk activities as defined by the custodial county. Current procedures must be followed by the foster parent to obtain these permissions prior to the activity occurring.

3. Caregivers must ensure that all requirements related to family time, sibling time, treatment for the child/youth placed in foster care, school for the child/youth placed in foster care, and contact between child/youth and county department caseworker and GAL, are met unless other arrangements are agreed upon and consistent with court orders.

B. Substitute care in the foster care home occurs when a foster parent is unable to provide supervision and care. The foster parent shall arrange for a qualified substitute who is familiar with these rules and with the children/youth in foster care in order to provide temporary supervision and care to the children/youth in the identified foster care home.

1. If care is to be provided for up to eight (8) hours in the foster care home, the substitute care provider must be at least sixteen (16) years of age.

Exceptions based on age and maturity of the potential substitute care provider and the individual needs of the child/youth placed in foster care can be made with concurrence of the foster parent and the certifying

authority, but in no case should the provider of substitute care be less than fourteen (14) years of age. The age exception must be documented in the foster parent’s file.

2. If care is provided for more than eight (8) hours in the foster care home or for overnight care in the foster care home, the substitute care provider must be at least eighteen (18) years of age, currently certified in First Aid and CPR, and the following completed checks of the substitute care provider must be placed in the foster parent’s file:

a. Colorado Bureau of Investigation (CBI);

b. Federal Bureau of Investigation (FBI);

c. Comprehensive Child Welfare Information System (CCWIS); and, d. CBI sex offender name and address check and National Sex Offender Public Website name and address check.

3. A copy of the substitute care provider’s driver’s license, vehicle registration, and insurance must be given to the certifying agency before the substitute care provider can drive the child/youth in foster care.

4. Potential caregivers with background checks consistent with Section 7.701.33.d.7 cannot be used.

C. Respite Care Respite care is provided in a foster care home, other than the current foster care home where the child/youth in foster care resides. Respite care is used to allow the foster parent a temporary break from providing care. Respite care is also used when children/youth in foster care need a temporary break from their current foster care home.

1. a non-emergency respite care occasion may not exceed 30 calendar days, with a maximum of 60 days per calendar year. exceptions in excess of 60 days per year may be allowed and must be approved by the certifying agency, caseworker, child/youth and guardian ad litem and/or counsel for youth.

2. Non-emergency respite care may not exceed the identified capacity of the respite foster care home.

a. A sibling group may be considered a single placement; and, b. Space requirements in Section 7.708.22.b.8 apply.

3. Emergency respite care that causes the foster care home to exceed the identified capacity shall not occur for more than seven (7) consecutive days per month and not exceed 28 days in a calendar year. The respite foster care home may not exceed more than two (2) children/youth in foster care above their identified capacity and age range.

4. The respite foster care home must be in compliance with all other applicable rules regulating foster care homes.

D. Alternative Care is Provided Outside of the Foster Care Home An alternative care provider is an individual with whom the foster parent has a personal association or relationship that is typically developed in the community.

This is known as a natural support and it enhances the quality and security of life, including but not limited to, family relationships, friendships, and relationships developed through participation in clubs, organizations, and other civic activities.

1. Alternative care (natural support) may be provided outside of the foster care home for up to 72 consecutive hours with a maximum of seven (7) days a month, unless approved by the certifying agency, caseworker, child/youth. and gal and/or counsel for youth.

a. An alternative care (natural support) provider must be familiar with the child/youth placed in foster care; and, b. Be at least eighteen (18) years of age.

2. Before alternative care (natural support) is used overnight, the foster parent shall introduce the alternative care provider and the child/youth placed in foster care and arrange for the child/youth to visit the alternative care provider’s home.

3. An alternative care (natural support) consent form (state prescribed) must be completed between the foster parent and the alternative care provider prior to the care being provided to the child/youth.

4. The certifying agency must review the consent form and complete background checks for all adults residing in the home in Colorado Courts (state judicial database), CBI sex offender name and address check, and National Sex Offender Public Website name and address check. A CBI and FBI fingerprint-based criminal history record information check is required only if the adult has resided in Colorado less than five (5) years.

a. When the county department is the certifying agency, staff will complete a child abuse/neglect background check in the CCWIS for the alternative care (natural support).

b. When the foster parent is certified by a child placement agency, the alternative care (natural support) must submit a request for a CCWIS check from the Background Investigation Unit.

5. A copy of the alternative care (natural support) provider’s driver’s license, vehicle registration, and insurance must be given to the certifying agency before the alternative care provider can drive the child/youth.

6. Potential alternative care (natural support) with background checks consistent with Section 7.701.33.d.7 cannot be used. 7.708.32 Suspected Child Abuse Where child abuse is suspected, the foster parent shall be alert for evidence of signs of abuse and report such evidence promptly to the county department of social/human services. A written report of any external signs of injury, such as bruising, scratching or swelling, shall be placed in the foster child's record. If there is any suspicion of abuse or illness, the foster child shall be seen by medical personnel immediately. 7.708.33 Foster Children’s Rights A. The certifying authority shall have written policies and procedures that address and ensure the availability of each of the following core rights for foster children in residence. These rights may not be restricted or denied by the foster care home or certifying authority. Every foster child has the right to:

1. Enjoy freedom of thought, conscience, cultural and ethnic practice, and religion.\ 2. A reasonable degree of privacy.

3. Have his or her opinions heard and considered, to the greatest extent possible, when any decisions are being made affecting his/her life.

4. Receive appropriate and reasonable adult guidance, support and supervision.

5. Be free from physical abuse or neglect and inhumane treatment. Every foster child has the right to be protected from all forms of sexual exploitation.

6. Receive adequate and appropriate medical care.

7. Receive adequate and appropriate food, clothing, and housing.

8. Live in clean, safe surroundings.

9. Participate in an educational program that will maximize his/her potential in accordance with existing law.

10. Communicate with “significant others” outside the foster care home, such as a parent or guardian, caseworker, attorney or guardian ad litem and/ or counsel for youth, current therapist, physician, religious advisor, and, if appropriate, probation officer.

B. The following foster children's rights may be limited; to reasonable periods during the day or restricted according to routine of the foster care home to ensure the protection of the foster children and foster family. Every foster child has the right to:

1. Have access to letter-writing materials, including postage, and to have a foster parent(s) assist him/her if unable to write, prepare, and mail correspondence.

2. Have access to telephones to both make and receive calls in private.

3. Have convenient opportunities to meet with visitors.

4. Wear his/her own clothes, keep and use his/her own personal possessions, and keep and be allowed to spend a reasonable sum of his/her own money.

5. Receive and send sealed correspondence.

C. Foster care homes must develop a plan, in conjunction with the certifying

authority, regarding the following rights of foster children and these rights must be explained to the foster children upon admission. The notification must be communicated in a language or mode of communication the foster child can understand. There must be plans for:

1. How and when telephone, including cell phone use, and written communications, including, but not limited to, social networking and other electronic communication, will take place.

2. Extenuating circumstances and emergency situations affecting the foster child and his/her family. 7.708.34 The Prohibited Use of Cruel and Aversive Therapy [Rev. eff. 1/1/16]

The foster care home shall refrain from engaging in all cruel and aversive behavior management, treatment or therapy including, but not limited to, the following:

A. Any intervention designed to or likely to cause a foster child physical pain B. Releasing noxious, or toxic, sprays, mists, or substances in proximity to the foster child's face.

C. Any intervention that denies a foster child sleep, food, water, shelter, access to bathroom facilities, adequate bedding, or appropriate physical comfort.

D. Any intervention or type of treatment that subjects a foster child to verbal abuse, ridicule, humiliation or that can be expected to cause excessive emotional trauma.

E. Interventions that use a device, material, or object that is designed to simultaneously immobilize all four of the foster child's extremities.

F. Any treatment intervention that deprives a foster child of the use of his/her senses, including sight, hearing, touch, taste, or smell.

G. Physical management, restraint and seclusion except as described at Sections 7.708.36 and 7.714.53.

H. Use of rebirthing therapy or any therapy technique that may be considered similar to rebirthing therapy as a therapeutic treatment, as defined by Section 12- 43-222(1)(t)(IV), C.R.S. 7.708.35 Discipline [Rev. eff. 1/1/16]

A. The foster care home or certifying authority shall have written policies and procedures regarding discipline that must be explained to all foster children, parent(s), guardian(s), staff, and placing agencies. These policies must include positive responses to a foster child's appropriate behavior.

B. Discipline shall be constructive or educational in nature and may include talking with the foster child about the situation, praise for appropriate behavior, diversion, separation from the problem situation, and withholding privileges.

C. Basic rights shall not be denied as a disciplinary measure.

D. Separation when used as discipline must be brief and appropriate to the foster child's age and circumstances. The foster child shall always be within hearing of an adult in a safe, clean, well-lighted, well-ventilated room in the foster care home that contains at least fifty (50) square feet of floor space. No foster child shall be isolated in a bathroom, closet or pantry.

E. Foster children in care at the foster care home shall not discipline other foster F. A foster care home shall prohibit all cruel and unusual discipline including, but not limited to, the following:

1. Any type of physical hitting or any type of physical punishment inflicted in any manner upon the body of the foster child, such as spanking, striking, swatting, punching, shaking, biting, hair pulling, roughly handling a foster child, striking with an inanimate object, or any humiliating or frightening method of discipline to control the actions of any foster child or group of foster children.

2. Discipline that is designed to, or likely to, cause physical pain.

3. Physical exercises such as running laps, push-ups, or carrying heavy rocks, bricks, or lumber when used solely as a means of punishment.

4. Assignment of physically strenuous or harsh work that could result in harm to the foster child.

5. Requiring or forcing a foster child to take an uncomfortable position such as squatting or bending, or requiring a foster child to stay in a positron for an extended length of time such as standing with nose to the wall, holding requiring or forcing a foster child to repeat physical movements when used 6. Verbal abuse or derogatory remarks about the foster child his/her family, his/her race, religion, or cultural background.

7. Denial of any essential/basic program service solely for disciplinary 8. Deprivation of meals or snacks, although scheduled meals or snacks may be provided individually.

9. Denial of visiting or communication privileges with family, clergy, attorney, or caseworker solely as a means of punishment.

10. Releasing noxious, toxic, or otherwise unpleasant sprays, mists, or aerosol substances in proximity to the foster child's face.

11. Denial of sleep.

12. Requiring the foster child to remain silent for a period of time inconsistent with the foster child's age, developmental level, or medical condition.

13. Denial of shelter, clothing or bedding.

14. Withholding of emotional response or stimulation.

15. Discipline associated with toileting, toileting accidents or lapses in toilet 16. Sending a foster child to bed as punishment. This does not prohibit a family foster care home from setting individual bed times- for foster 17. Force feeding a foster child.

18. Physical management, restraint and seclusion. 7.708.36 Physical Management and Seclusion [Rev. eff. 1/1/16]

A. Seclusion is prohibited.

B. Physical management to attain and maintain control or for behavior management, treatment, or therapy is prohibited and/or seclusion is prohibited, unless the foster care home is pre-approved by the certifying authority to perform physical management and/or seclusion and the foster care home is in compliance with Section 7.708.61, K, 2, Section 7.714.53, et seq., and the applicable definitions found in Section 7.714.1. The foster care home must notify the placing caseworker when a child is subject to physical management and/or seclusion. 7.708.37 Religion [Rev. eff. 1/1/16]

A. The foster care home shall demonstrate consideration for, and sensitivity to, the religious backgrounds of foster children in care. The foster care home shall assist a foster child's involvement in religious activities appropriate to the foster child's religious background and based upon the needs and interests of the foster child.

B. Foster children in care at the foster care home shall be allowed and encouraged to celebrate their religious holidays.

C. Opportunity and assistance shall be provided for each foster child to practice the chosen/preferred religious beliefs and faith of his/her family. If the family has no preference, the individual preference of the foster child shall be respected. This includes, but is not limited to, making necessary arrangements for attendance of foster children at the appropriate religious institution or at a study group for D. A foster child may be invited to participate in religious activities of the foster care E. A foster child shall not be coerced or forced to participate in the religious activities of the foster care home or to attend religious services.

F. Any form of religious intervention used by the foster care home to control or change a foster child's behavior, or treat or heal a medical condition, must be approved, in writing, by the legal guardian(s) of the foster child prior to the use of the intervention.

G. A foster care home cannot deny medical care to a foster child because of religious beliefs.

H. The foster child's family and/or guardian must be consulted prior to any planned change in religious affiliation made by the foster child while he/she is in care at the foster care home. 7.708.38 Education [Rev. eff. 1/1/16]

A. Foster children shall attend educational/vocational programs in the most appropriate and least restrictive educational setting for the foster child, including, but not limited to, attending regular classes conducted in accredited elementary, middle, and secondary schools within the community.

B. Regular school attendance or an educational plan is required for each foster child according to school attendance laws; a suitable, quiet, well-lighted place for study shall be provided together with necessary books, papers, pencils and other equipment which are reasonably required by school-age children. Foster parents shall review grade reports and other information received from teachers or school authorities with foster children in care and shall counsel and assist foster children regarding adequate classroom performance. The parent, guardian or authority with responsibility for the foster child shall be advised of school performance.

Reasonable efforts shall be made to involve a foster child in extracurricular activities. The foster parents shall attend school staffings, conferences, and Individualized Educational Plan meetings when possible.

C. Foster children attending school shall be permitted to participate in school extracurricular activities to the extent of their interests and abilities and in accordance with each individual foster child's plan.

D. In order to ensure that all students who may have disabilities are provided an appropriate education, the foster care home, in cooperation with the certifying

authority, shall ensure that adequate “Child Find” procedures are utilized. Such procedures shall be developed cooperatively with Local Education Agencies (LEA) in accordance with Exceptional Children's Educational Act rules and regulations and LEA procedures. Child Find includes a process for screening, referring, assessing and staffing students suspected of having a disabling condition. 7.708.39 Community Participation [Rev. eff. 1/1/16]

A. Community activities shall be supported. The foster parent shall receive training in how to determine whether to approve a child’s or youth’s participation in an extracurricular, enrichment, cultural, or social activity, based upon the criteria in

Section 7.701.200.

B. The foster care home shall consider and be sensitive to identity of the child and/or youth, including, but not limited to, cultural, spiritual and/or religious needs. The foster care home shall involve a foster child in activities appropriate to his/her identity, including, but not limited to, consideration of the child's family, community, neighborhood, school activities, friends, and the child's and family's primary language.

C. The foster care home shall utilize available services, facilities, and activity programs of the community, and foster children shall be given opportunities to participate as individuals or as a group in agency-sponsored recreational and cultural programs.

D. With the approval of the certifying authority, the foster care home may deduct reasonable sums from a foster child's allowance as restitution for damages done by the foster child. Restitution must be negotiated with the foster child and based on the foster child's ability to pay. A written record of damages and any restitution paid by a foster child must be maintained by the foster care home and certifying

authority.

E. Chores at the foster care home are considered part of the participatory responsibility of living together. They shall provide constructive experiences in accordance with the age and ability of the foster child.

F. All chores shall be scheduled so as not to conflict with other essential scheduled G. The foster care home shall comply with all child labor laws and regulations in making work assignments, with consideration for agricultural work assignments in those communities.

H. Paid or voluntary work assignments outside of the foster care home shall be approved by foster parent(s) and the county designee for the foster child, who shall know the employer, the specific type of work, and the conditions of I. A foster child shall not be exploited. A foster child may not participate in solicitation on behalf of the foster care home or certifying authority for a fundraising activity without the written permission of the parent(s) or guardian(s) for each specific activity, and the foster child must be willing to participate in the activity.

7.708.4 PERSONAL CARE AND SAFETY OF THE FOSTER CHILD 7.708.41 Medical and Health Services A. A general medical examination for each foster child/youth must be completed or scheduled with a physician or a nurse practitioner prior to or within fourteen (14) calendar days following placement at the foster care home. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the medical exams cannot be completed for the child/youth in the required time frame, the medical exam must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency. If the child/youth has received a medical examination within the previous twelve (12) months, another medical examination is not required during that year as long as the foster home has written documentation of the previous medical exam. A statement from the examiner shall be retained in the foster child's/youth’s file. This exam shall include the following:

1. An examination for physical injury and disease.

2. Vision and hearing screening.

3. A current assessment of the foster child's/youth’s health, including immunizations.

B. Whenever indicated, a foster child/youth shall be referred to an appropriate specialist for either further assessment or treatment.

C. Subsequent physical and other examinations shall be done annually or as directed, in writing, by the physician or other qualified health professional.

D. Dental examinations, appropriate to the age of the foster child/youth, must have been completed within four months prior to placement or scheduled or completed within eight (8) weeks following placement. The foster care home or governing body shall ensure that each foster child/youth receives a dental examination every six months or as required in writing by a dentist. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency the dental exams cannot be completed for the child/youth in the required time frame, the dental exam must be completed as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

E. At all times there shall be First Aid supplies readily available at the foster care home. Each foster parent must be certified in first aid, or the equivalent, and CPR for all ages of foster children/youth in care.

1. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency, the foster parent(s) cannot take the first aid class in a classroom with the first aid trainer, the first aid training may be completed online. The foster parent(s) must then complete the classroom training with first aid trainer as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

2. If the governor or local government declares a disaster or emergency, and because of the declared disaster or emergency, the foster parent(s) cannot take the cpr class in a classroom with the cpr trainer, and the foster parent(s) has successfully completed a cpr class within the last five (5) years, the foster parent(s) may take the cpr class online. The foster parent(s) must then complete the classroom training with a cpr instructor as soon as possible, but no later than 45 calendar days after the declared conclusion of the disaster or emergency.

F. The foster care home, in conjunction with the parent(s) or guardian(s), shall make every effort to ensure that a foster child/youth needing corrective devices such as glasses, hearing aids, etc., is provided with the necessary equipment.

The placing authority for the foster child/youth shall assist with obtaining resources as necessary to fulfill this requirement.

G. The foster care home has the right to request a statement regarding the foster child's/youth’s general health from a medical examiner. In a potentially lifethreatening situation, the foster care home shall refer the foster child's/youth’s care to the appropriate medical and legal authority. If a foster child/youth wishes an exemption from a medical examination or medical treatment due to religious beliefs, the foster child/youth shall submit a written statement signed by his/her parent(s) or guardian(s) which states the reasons for such an exemption. The foster care home has the right to refuse admission to a foster child/youth whose parent(s) or guardian(s) refuses medical treatment or examination based upon religious convictions.

H. Foster parents shall be aware of and shall observe foster children for signs of illness or disease and shall respond to and care for a foster child suffering from illness, accident or injury. If contagious, the foster child affected should be isolated from other children in the home and made as comfortable as possible.

First aid care shall be provided as required. If additional care, medical attention or removal from the home is indicated, the appropriate person with responsibility for the foster child shall be contacted and medical assistance shall be obtained without undue delay. A written record of any illness or injury to a foster child shall be retained in each foster child's individual record.

I. The foster care home shall regularly maintain and update a foster child's Human Services Health Passport, or a document containing all the information listed in the Health Passport, for foster children placed by a county department of human or social services. This document is to be photocopied regularly and submitted to the foster child's caseworker. The original of the document shall be given to the caseworker upon the foster child's discharge so that it can be given to the foster care home where the foster child is being admitted or to the foster child's parent(s), guardian(s), or family member(s) with whom the foster child is placed.

J. Medications shall be administered and stored in the following manner 1. When a foster child first goes into care, the foster care home shall ascertain all medication the foster child is currently taking.

2. All medication must be kept in a clean storage area inaccessible to foster children and stored according to pharmacy instructions.

3. All prescriptive medications shall be administered only upon the written prescription of a physician. The foster care home shall also obtain written authorization from the prescribing physician to administer any nonprescriptive medication.

4. In an emergency situation, non- prescriptive medication may be administered on the verbal authorization of a physician. Written confirmation must then be obtained for the verbal authorization.

5. The foster care home shall maintain for each foster child a cumulative record of all medication, both prescriptive and non-prescriptive dispensed to that foster child, including:

a. The name of the foster child.

b. The name and dosage of medication.

c. The time and date the medication was dispensed.

d. The name or initials of the person administering the medication. 7.708.42 Food and Nutrition A. The foster care home shall provide nutritious foods in the variety and amounts as appropriate for the age, appetite, and activity of each foster child in care.

B. At least three nourishing, wholesome, well-balanced meals a day shall be offered at regular intervals except when foster children receive their morning and/or noon meal(s) at school. No more than fourteen (14) hours shall elapse between the evening and morning meals. Nourishing snacks shall be part of the daily food provided.

C. Family meals including all children and adults present in the home shall be provided whenever possible.

D. Foster children shall be encouraged to eat a variety of the food served but shall not be subjected to undue coercion, including forced feeding, or punished for refusal to eat.

E. All food shall be from sources approved or considered satisfactory by the health

authority. All foods shall be stored, prepared, and served in such a manner as to be clean, wholesome, free from spoilage, and safe for human consumption. Only pasteurized milk shall be served. Fruits, vegetables and meats may be frozen.

F. There shall be a record made of the special diets prescribed and prepared for a foster child.

G. Foster children must not be given foods that are contrary to their religious beliefs, or of their family, or are known to cause an allergic reaction or a health hazard.

H. Water shall be readily accessible to foster children.

I. Common drinking cups shall not be permitted. 7.708.43 Personal Hygiene and Daily Routine [Rev. eff. 1/1/16]

A. The foster care home shall ensure that foster children receive training in good habits of personal care, hygiene, and grooming appropriate to their age, gender, and identity.

1. There shall be supervision by foster parents to provide for proper grooming and physical cleanliness of the foster children.

2. The foster care home shall ensure that foster children are provided with necessary and appropriate toiletry items, including clean, individual towels and washcloths, toothbrush, toothpaste, comb, hair brush, soap, skin lotion, and shampoo.

3. Foster children shall be encouraged or assisted to maintain cleanliness or good hygiene: teeth shall be brushed each day and more frequently when possible.

B. The foster care home shall have basic daily routines for foster children in care.

1. Daily routines shall not be allowed to conflict with the implementation of a foster child's Family Services Plan.

2. Daily routines shall be established for mealtimes, waking, and bedtimes.

3. Opportunity for physical exercise shall be planned for each foster child. 7.708.44 Clothing and Personal Belongings [Rev. eff. 1/1/16]

A. The foster care home shall allow a foster child in care to bring his/her personal belongings to the program, as defined by the foster care home policy, and to acquire belongings of his/her own. However, the foster care home shall, as necessary, limit or supervise the use of these items while the foster child is in care. Where extraordinary limitations are imposed, the foster child shall be informed of the reasons, in a language or manner of communication the foster child can understand.

B. The foster care home shall ensure that each foster child in care has adequate clean, proper-fitting, attractive, and seasonable clothing as required for health, comfort, and physical well-being and as appropriate to age, gender, individual needs, and identity.

1. Each foster child's clothing shall be distinguished as his/her own.

2. A foster child's clothing shall be kept clean and in good repair. The foster child shall be involved, as appropriate, in the care and maintenance of his/her clothing. As appropriate, laundering, ironing, and sewing facilities shall be accessible to the foster child.

C. The foster care home in conjunction with the placing authority shall ensure that discharge plans make provisions for clothing needs at time of discharge. The wardrobe for each foster child shall go with him/her at time of discharge. 7.708.45 Emergency Drills [Rev. eff. 1/1/16]

A. There shall be a plan for foster parent(s) and foster children to follow in case of emergency or disaster. The plan shall include provisions for roles and responsibilities during an emergency, evacuation of the foster care home and the assignment of a central meeting place where each individual may be accounted for.

B. Fire exit drills must be held often enough so that all occupants are familiar with the drill procedure and their conduct during a drill is a matter of established routine.

C. Drills must be held at unexpected times and under varying conditions to simulate the conditions of an actual fire.

D. Drills must emphasize orderly evacuation under proper discipline rather than speed. Running or horseplay shall not be permitted.

E. Drills must include suitable procedures for ensuring that all persons in the foster care home actually participate.

F. A record of fire drills must be recorded by the foster care home.

G. Smoke alarm devices shall be regularly used in the conduct of drills.

H. The foster care home shall make special provisions for the evacuation of any foster child with a disability in the foster care home.

I. The foster care home shall take special care to help emotionally disturbed or perceptually handicapped foster children understand the nature of such drills.

J. If appropriate to the location of the foster care home, tornado drills must be held often enough so that all occupants are familiar with the drill procedure and conducting a drill is a matter of established routine. A record of tornado drills must be recorded by the foster care home. 7.708.46 Transportation [Rev. eff. 1/1/16]

A. A foster care home or certifying authority shall ensure that each foster child is provided with the transportation necessary for implementing the foster child's family service plan.

B. A foster care home shall have means of transporting foster children in cases of C. Any vehicle used by the foster care home in transporting foster children in care, whether such vehicle is operated by a foster parent or any other person acting on behalf of the foster care home, shall be property licensed, and the vehicle shall be maintained in accordance with Colorado law.

D. Any foster parent or other person acting on behalf of the foster care home operating a vehicle for purpose of transporting foster children shall be properly licensed to operate the class of vehicle in accordance with Colorado law.

E. Foster children must be properly fastened into a restraint system that conforms to all applicable Federal Motor Vehicle Safety Standards and that are pursuant to F. A foster care home shall not allow the number of persons in any vehicle used to transport foster children to exceed the number of available seats in the vehicle.

G. The vehicle shall be enclosed and provided with door locks.

H. A foster care home shall ascertain the nature of any need or problem of a foster child which might cause difficulty during transportation, such as seizures or a tendency toward motion sickness. The family foster care home shall communicate this information to the driver of any vehicle transporting foster children in care.

7.708.5 RECORDS AND REPORTS 7.708.51 Records A. The foster care home, in conjunction with the certifying authority, shall maintain complete records as required for the licensing or certification of the foster care home in accordance with the rules regulating foster care homes.

B. Records for foster children shall be retained for at least three years. Retention of records for a longer period may be desirable when they reflect an accident, injury or other unusual circumstance.

C. A record of admission shall be completed for each foster child in care prior to or at the time of placement. The admission record shall be maintained at the foster care home where the foster child resides and shall contain:

1. Foster child’s name, date and place of birth (verified by a birth certificate when possible), gender, race, religious preferences of parent(s) or foster child, date and reason for placement.

2. Foster child’s address and telephone number, parent(s) or guardian(s) address and telephone number if different from the foster child.

3. Name, address, day and nighttime telephone number of individual or agency placing the foster child with the name of individual arranging the 4. Any documents pertaining to the foster child’s legal status such as court orders, including the appointment of a Guardian ad litem and/or counsel for youth, legal guardianship, or custody agreements.

5. A copy of the placement agreement pursuant to 7.708.61, K.

6. Health records including a health history, chronic medical problems of the foster child, illnesses the foster child has had during the last six months and a complete list of all medications the foster child is taking.

D. Each foster child’s file shall also include:

1. Current medical and dental reports, accident, injury, or illness reports, record of medication administered and necessary medical care provided to the foster child while in placement.

2. Copies of educational records and reports of school work, including scholastic performance, certificates of achievement or award, copies of school pictures, extracurricular interests.

3. The foster child’s Family Services Plan, a summary of the periodic evaluations of the foster child’s progress and resultant changes in the Family Services Plan.

4. Psychiatric and psychological summaries, when available.

5. Summary recording of significant contacts with parent(s), guardian(s) and 6. If requested by the provider, a written notice to employees of the Department of Human Services and of county departments or other individuals with a need to know, if the foster parents do not want personally identifiable information provided to adult members of the foster child's family. Written notice may be subsequently provided to the parties aforementioned for release of personally identifiable information to the foster child's family which shall include the consent to release information, the foster parent's signature, and the date. 7.708.52 Reports [Rev. eff. 1/1/16]

The following information shall be reported consistent with the requirements in Section 7.701.52 (12 CCR 2509-8).

A. The foster care home shall immediately notify the foster child’s parent(s), guardian(s), and/or the responsible agency of any serious illness or serious injury resulting in medical treatment away from the foster care home, hospitalization or death involving a foster child in care.

B. The foster care home shall notify the parent(s), guardian(s), or placing authority as soon as possible upon discovery that a foster child has run away.

C. A report about a death must include:

1. The foster child’s name, birth date, address, and telephone number.

2. The names of the foster child’s parent(s) or guardian(s) and their address and telephone number if different from that of the foster child.

3. Date of the fatality.

4. Brief description of the incident or illness leading to the death.

5. Names and addresses of witnesses or persons who were with the foster child at the time of death.

6. Name and address of police department or authority to whom the report D. The foster care home shall notify the certifying authority of any change in the status of the foster care home, police intervention or moving traffic violations that could affect care and safety of foster children.

7.708.6 CERTIFYING AUTHORITY REQUIREMENTS 7.708.61 Admission Requirements [Rev. eff. 1/1/16]

A. Admission of a foster child to a foster care home shall be in keeping with the stated purpose of the foster care home and shall be limited to those foster children for whom the foster parent(s) is qualified and by the needs of foster children already in residence to provide the care necessary. Care must be provided in the least restrictive, most appropriate setting in order to meet the foster child's needs.

B. Each foster care home or its certifying authority shall have a written admission policy which at a minimum must include:

1. The policies and procedures related to intake.

2. The age range and sex of foster children accepted/admitted for care.

3. The needs, problems, situations or patterns best addressed by the foster 4. Any pre-placement requirements for the foster child, the parent(s) or guardian, and/or the placing agency.

5. The anticipated problems or situations that would result in the foster care home or certifying authority requesting removal of a foster child from placement prior to the planned discharge.

C. The written description of admission policies and criteria shall be provided to referring agencies.

D. Information regarding the prospective foster child shall be discussed with the foster parent(s) as early as possible prior to placement. The foster care home shall accept a foster child into care only after a preliminary assessment/screening of presenting problems in areas such as social, physical health, mental health, psychological concerns, previous physical or sexual abuse, and concerns about previous delinquent, assaultive, or destructive behavior, if appropriate, has been conducted.

E. It is desirable for the foster child to visit and become familiar with the foster parents, the foster care home and other persons living in the home prior to F. For each foster child referred for placement, the foster care home shall be provided with a current comprehensive intake assessment, including a social, health, and family history, developmental assessment, mental health, and a psychological summary, if determined to be necessary by the foster care home or certifying authority. Educational records shall be provided if appropriate. As much of this information as possible shall be provided to the foster parent prior to admission, but the total assessment shall be completed by the placing authority within one month after admission. If the foster care home or certifying authority is unable to obtain this information within these time periods or is totally unable to obtain the information, the certifying authority must document its attempts to obtain the information and reasons for not obtaining the information.

G. At the time of placement, the foster parent(s) shall be provided with a record of admission as outlined in Section 7.708.51.C. The Medicaid card shall be given to the foster parent(s) for Medicaid eligible foster children as soon as possible after placement. If a foster child is placed at the foster care home as an emergency placement, the foster care home shall be provided with at least the following information: name, birth date, if available, and physical description of the foster child, date and time of the admission; name, address telephone number and

authority of person bringing the foster child to the foster care home, and the reason for placement. Any other information that may be available should be recorded at the time of placement or as it becomes available. The date that placement terminates shall also be recorded.

H. For all placements of foster children, previous medical records should be obtained and pertinent information from those records, including immunization records shall be given to foster parents within four weeks of the initial placement.

The medical history shall contain, to the maximum degree possible, the information listed in the Colorado Department of Human Services Health Passport.

I. Preparation of the foster child for admission shall be in a manner consistent with the foster child's age and ability to participate in the plan and to understand the reason for the placement.

J. Prior to placement of the foster child at the foster care home, the, guardian(s), and/or placing agency must be notified of the religious practice, philosophy, and affiliation of the foster care home.

K. The placement agreement shall be developed with the involvement of the foster child, the parent(s) or guardian(s) and the representative of the placing agency.

Where the involvement of any of these is not feasible or desirable, the reasons for the exclusion shall be recorded by the certifying authority. The placement agreement shall include by reference or attachment at a minimum the following:

1. Discussion of the foster child's and the parent's or guardian's expectations regarding: family contact and involvement: how family contact and involvement are to occur; the nature and goals of care, including any specialized services or specialized treatment to De provided: the religious orientation and practices of the foster child and, or family; and the anticipated planned discharge date and plan for the foster child following 2. The policy and procedure to be followed regarding the use of physical management in an emergency pursuant to Section 7.714.53, et seq., and

Section 7.708.36.

3. A delineation of the respective roles and responsibilities of all agencies and persons involved with the foster child and his/her family.

4. Written authorization for care and treatment of the foster child.

5. Written authorization to obtain routine medical and dental care for the foster child and to obtain emergency medical and dental care.

6. Legal status or custody of the foster child.

7. If a foster child is being placed by a Colorado county department of human or social services, the appropriate state form or contract shall be completed. This form or contract may provide some of the required authorizations and shall require that the foster parent is trained in how to apply the reasonable and prudent parent standard. 7.708.62 Foster Children’s Grievance Procedure [Rev. eff. 1/1/16]

The certifying authority must establish a written grievance procedure that provides adequate due process safeguards, spells out the appeal process, and assures that foster children and parent(s) or guardian(s) are entitled to report any grievance and shall not be subject to any adverse action as a result of filing the grievance.

A. The foster care home and/or certifying authority for the foster care home must follow grievance procedures without alteration, interference, or unreasonable delay.

B. If a grievance is filed with the foster care home, the grievance shall be recorded in the foster child’s official case record along with the investigation findings and resulting action taken by the foster care home or certifying authority. Information regarding the grievance must be sent to the individual or agency holding legal custody of the foster child. 7.708.63 Comprehensive Program for Medical Care for the Foster Child [Rev.

eff. 1/1/16]

The certifying authority shall ensure the availability of a comprehensive program of preventive, routine, and emergency medical and dental care for each foster child in care. Every reasonable effort shall be made to obtain routine and corrective dental care.

The certifying authority shall have a written plan for providing such care. This plan shall include at a minimum:

A. Ongoing appraisal of the general health of each foster child, including immunizations, in accordance with state law and regulations.

B. Procedures for obtaining diagnostic services, emergency care, including the availability of emergency medical care on a 24-hour, seven-day-a-week basis, corrective care, recuperative care, and immunization updates.

C. Provision of health education, which includes sex education, and birth control information and education, age appropriate to the foster child.

D. Provision that any medical treatment administered will be explained to the foster child in a language or manner of communication understandable to him/her.

E. The provision of dental care by a Colorado-licensed dentist, who is available to the foster care home.

F. Procedures for dispensing medication, storage of medication, documentation of administration of all medication, disposing of medications when not needed or no longer in use, and notification to a primary physician in cases of medication 7.708.64 On-Going Health of Foster Care Parents [Rev. eff. 1/1/16]

A. A certifying authority shall not certify or continue to certify any person whose health, or emotional or psychological makeup impairs his/her ability to properly protect the health and safety of foster children.

B. A certifying authority shall not allow a foster parent provide care for foster children if the foster parent, upon examination or as a result of tests, shows indication of a physical condition which could be hazardous to a foster child, or self, or which would prevent performance of duties.

C. If in the opinion of a licensed health care professional or licensed mental health practitioner, a medical, emotional or psychological condition exists at any time which may jeopardize the health and/or safety of foster children or adversely affect the ability of foster home parents to care for such foster children, the issuance of a certificate shall be conditioned upon the satisfactory report of the licensed health care professional and, if foster children are in care, the certifying

authority shall contact the appropriate social/ human services personnel to make satisfactory arrangements for the temporary care of foster children.

D. The unfavorable report from any medical evaluation concerning the physical, mental health or emotional stability of any foster care parent or applicant must be evaluated and may be grounds for denial, revocation or making probationary of a foster care certificate. 7.708.65 Orientation, Training, and Certification [Rev. eff. 1/1/16]

A. The certifying authority shall have a comprehensive written plan for the orientation, pre-certification training, certification, and ongoing training of foster parents.

1. The certifying authority shall have an introductory training and orientation program for all foster parents. This program shall include, at a minimum, twenty-seven hours of initial core training consisting of at least twelve (12) hours prior to placement of a child and the remaining hours to be completed within 3 months after placement, including the reasonable and prudent parent standard, orientation to emergency and safety procedures and the general and specific duties and responsibilities of being a foster parent.

2. If a child is placed with a foster care family on an emergency basis, twelve (12) hours of core training must be completed and the remaining hours of training competed within 4 months from the date of placement. An emergency means that a child’s safety is subject to actual or likely harm, immediate or emerging, serious or sever, which requires control.

3. The certifying authority shall maintain written documentation of specific inservice training held, foster parents participating, the hours involved, and/or other on-going training activities in which foster parents were involved.

B. The certifying authority shall create a training development plan for each foster parent(s) to document the strengths and competencies of the foster parent(s) and to identify those areas in which additional training is needed.

C. The certifying authority shall document that foster parents receive quality, appropriate, competency-based training in the following areas that builds on basic competencies of the foster parent(s) established through life experiences and pre-certification training.

1. The foster care home’s emergency and safety procedures, including but not limited to fire evacuation drills, tornado drills, where appropriate, and flood evacuation drills, where appropriate, on at least a semiannual basis.

2. The principles and practices of child care, including developmentally appropriate practices.

3. The certifying authority’s administrative procedures and overall program goals.

4. Acceptable behavior management techniques that comply with these rules and, if applicable, Section 7.708.36 and Section 7.714.53, et seq.

5. Acceptable discipline techniques that comply with these rules.

6. Appropriate boundaries (both physical and emotional) between foster parents and foster children while in placement at the foster care home and after discharge.

7. Positive and constructive methods of dealing with the foster child, including but not limited to, physical structuring of the environment and deescalation of crisis situations.

8. The foster parent is trained and knowledgeable, and has the competencies required to apply the reasonable and prudent parent standard based upon the criteria in Section 7.701.200.

9. Annual review of these regulations by foster parents.

D. Training requirements for the initial year of certification are as follows:

1. Twenty-Seven (27) hours of Core training, as identified in Section 7.708.65, A; and, 2. CPR and First Aid training; and, 3. Twenty (20) hours of ongoing specialized training.

E. Annually, each foster parent, except therapeutic foster parents or treatment foster parents, must complete twenty hours of on-going specific training as required in his/her training development plan. Training must include at least the areas listed above. Therapeutic or treatment foster parents providing therapeutic services must complete an additional twelve hours of on-going training annually for a total of thirty-two hours of training in such areas as dynamics of victimization issues, with emphasis on appropriate age and developmental levels; and the individual needs of the foster children in care. All providers serving children funded by the Children's Habilitation Residential Program (CHRP) must complete thirty-two (32) hours of ongoing specific training as identified in their training development plan. 7.708.66 Transportation Policy [Rev. eff. 4/1/12]

The certifying authority shall have a written policy in compliance with Colorado statute(s), Department of Revenue and Department of Motor Vehicle requirements concerning the circumstances a vehicle may be driven by a licensed foster child alone or with a passenger. Such driving privileges shall be a part of the foster child’s family services plan. 7.708.67 Limitation of Foster Children’s Personal Belongings [Rev. eff. 1/1/16]

The decision and reasons why a foster care home would limit a foster child’s access to his/her personal belongings brought to the foster home upon admission shall be recorded in the foster child’s case record maintained by the placing authority. 7.708.68 Personal Allowance and Work Opportunities Foster children shall be provided personal allowance and/or work opportunities according to the established policy of the certifying authority and shall have opportunities appropriate to the foster child’s age and development to experience the use and value of money by making purchases for items according to their own choice.

A. Money earned, received as a gift, or received as allowance by a foster child in care shall be deemed to be that foster child’s personal property.

B. Limitations may be placed on the amount of money a foster child may possess or have access to when such limitations are considered to be in the foster child’s best interests. 7.708.69 Confidentiality of Records and Reports A. The certifying authority shall have a policy as to the maintenance, storage and confidentiality of records.

B. Records shall be the property of the certifying authority and shall be protected against loss, tampering, or unauthorized use.

C. Facts learned about foster children and their families shall be kept confidential, with the following exceptions:

1. In medical emergencies, and then only when the assistance and/or expertise is required of that unauthorized person; or, 2. The foster child, his/her parent(s) or guardian(s) and their respective legal counsel(s), a court having jurisdiction over the foster child, or an authorized public official, or certifying/licensing representative in performance of his/her mandated duties; or, 3. If the parent(s) or guardian(s) has given voluntary, written consent.

7.708.7 AUTHORITY TO WAIVE NON-SAFETY CERTIFICATION STANDARDS

FOR KINSHIP FAMILY FOSTER CARE PROVIDERS [Rev. eff. 1/1/16]

Pursuant to Section 26-6-106(6)(a), C.R.S., a county director or his/her designee may waive non-safety certification standards for prospective or current kinship foster care providers defined in Section 7.708.11 (12 CCR 2509-8). The safety and well-being of the child and/or youth shall not be compromised. The following non-safety certification standards may be waived case-by-case:

A. Certification of Foster Care Homes 1. Two (2) of three (3) references are not related to the applicant referenced in Section 7.708.21, F.

2. Certificates shall not be granted to applicants who are less than twentyone (21) years of age on the date of application referenced in Section 7.708.21, H.

3. A license or certificate shall not be granted for a foster care home unless the application has demonstrated the ability to manage a household so that the certifying authority may determine that the applicant is able to acquire food, materials, and other equipment as may be required for child care referenced in Section 7.708.21, K.

4. Each foster parent shall have a health assessment within one (1) year prior to certification or within thirty (30) calendar days after certification and thereafter as required, in writing, by a licensed health care professional. The reports of the medical examinations shall be dated and signed by the examining physician or nurse practitioner and shall be provided to the certifying authority. Reports shall include a statement of the evaluation of the person's physical ability to care for children and youth in foster care.

If, in the opinion of the licensed health care professional or the assessment worker, an emotional or psychological condition exists which would have a negative impact on the care of children and youth in foster care, the issuance of a license shall be conditioned upon the satisfactory report of a licensed mental health practitioner referenced in Section 7.708.21, L.

B. Facility Standards 1. A minimum of seventy-five (75) square feet per child in foster care who is between twelve (12) months and five (5) years of age referenced in

Section 7.708.22, B, 1.

2. Archery bows that require professional stringing must be unstrung referenced in Section 7.708.22, B, 2.

3. A child or youth shall sleep in a crib or bed in a clean, well-ventilated room, which is not customarily used for other purposes such as a kitchen, dining room, hall, or bathroom. There shall be a minimum of forty (40) square feet of floor space for the bed for each child or youth in foster care, and they should be placed at least two feet apart when arranged in parallel referenced in Section 7.708.22, B, 8.

4. No foster care home shall be used for rental income referenced in Section 7.708.22, B, 9.

5. All stairways containing more than four (4) steps shall be equipped with a handrail referenced in Section 7.708.26, E.

C. Ongoing Operation of Foster Care Homes 1. Except for emergency placements, children and youth in foster care over the age of eighteen (18) months shall not sleep in the same room as unrelated adults on a regular basis. Sleeping rooms for unrelated children and youth in foster care shall not be shared by others in foster care who are of the opposite sex when one of the individuals in foster care is over four (4) years old as referenced in Section 7.708.31, G, 3.

2. Not more than two (2) infants, whether birth, adoptive, or foster children under the age of two (2) years, shall be cared for in a foster care home, except under unusual circumstances such as multiple births, referenced in

Section 7.708.31, H, 1.

3. Personal Care and Safety of the Foster Child a. Home pressure-canned fruits and vegetables and canned meats cannot be served, referenced in Section 7.708.42, E.

b. Each foster child's clothing shall be distinguished as his/her own clothing, referenced in Section 7.708.44, B, 1. 7.708.71 Procedures for Waiving Non-Safety Certification Standards [Rev. eff. 1/1/16]

A. Each waiver shall be considered case-by-case; and, B. Shall be documented on the prescribed State Department form; and, C. The documentation shall contain a description of the applicability of the waiver to the safety or well-being needs of the child and/or youth with a kinship/relative relationship to the prospective or current kinship foster care provider; and, D. The documentation shall be placed in the certification record; and, E. A summary of the waiver information shall be documented on the certificate. 7.708.72 Special Conditions, Restrictions, or Requirements for Certification of Prospective Current Kinship Foster Care Providers [Rev. eff. 1/1/16]

A county director or his/her designee may take the following actions to address the safety or well-being needs of a child or youth:

A. Require special conditions for certification;

B. Limit or restrict a certificate; and/or, C. Require a written agreement for compliance. 7.708.73 Circumstances When Certification Standards Shall not be Waived [Eff. 12/1/12]

A. The safety or well-being of a child or youth is compromised.

B. Background checks, including:

1. A fingerprint-based criminal history check of CBI and FBI records;

2. A child abuse/neglect records check in every state where the adult has resided in the five (5) years preceding the date of application for each adult eighteen (18) years of age and older) living in the home;

3. A comparison search in the Colorado State Courts data access, using the name and date of birth with available criminal history information for each adult eighteen (18) years and older living in the home;

C. Twenty-seven (27) hours of initial pre-certification training and ongoing training referenced in Section 7.708.65, C and D; and/or, D. Required denials of applications or certificates referenced in Section 7.500.312, D and 26-6-104 (7)(a)(I)(A-F), C.R.S. 7.708.74 Appeals of Decisions [Rev. eff. 1/1/16]

Prospective and current kinship foster care home providers do not have the right to appeal the decision made by a county director or his/her designee related to waivers of non-safety certification standards. 7.709 RULES AND REGULATIONS FOR SPECIALIZED GROUP FACILITIES [Eff. 11/1/2008]

All Specialized Group Facilities must comply with the “Quality Standards for 24-Hour Child Care”, the “Rules Regulating Specialized Group Facilities”, the “General Rules For Child Care Facilities”, and the “Rules Regulating Special Activities”. 7.709.1 DEFINITIONS [Eff. 11/1/2008]

A. The “Specialized Group Facility” (SGF) is sponsored and supervised by a county department of social/human services henceforth to be known as the county) or a licensed child placement agency (henceforth to be known as the agency) for the

purpose of providing 24 hour care for three (3) or more children, but fewer than 12 children from three years old to sixteen years old and for children from 16 to 18 years old and those persons 21 years old who are placed by court order prior to their eighteenth birthday whose special needs may best be met through the medium of the small group. The two types of specialized group facilities are the specialized group home and the specialized group center.

1. A “specialized group home” is located in a house owned or otherwise controlled by the group home parents who are primarily responsible for the care of the children and reside therein.

2. A “specialized group center” is located in a house owned or controlled by a governing body that hires the group center parents or personnel who are primarily responsible for the care of the children.

3. The “sponsoring agency” is the county or agency that is responsible for supervising the SGF and providing support and evaluation of the facility every week by a qualified staff member.

4. The “governing body” is the individual, partnership, corporation or association in whom the ultimate authority and legal responsibility is vested for the conduct of the specialized group center and the center's relationship with the supervising agency. The sponsoring agency and the governing body may be the same.

B. A specialized group facility may accept children five years old and over in an emergency for a short period of time. Special rules necessitated by the emergency placement regarding intake, records, placement planning and staffing are found at Section 7.709.26.

C. No more than two children less than five years old may be cared for in a specialized group facility at one time.

D. In specialized group facilities, the number of natural and relative children less than sixteen years old of the caretaker plus the foster children shall not exceed eleven children. 7.709.2 REQUIREMENTS OF A SPECIALIZED GROUP FACILITY [Rev. eff. 6/1/12] 7.709.21 Operation of Specialized Group Homes or Specialized Group Centers [Rev. eff. 6/1/12]

A. The specialized group facility shall be sponsored and supervised by a county or B. The supervisory responsibilities of the sponsoring agency are:

1. To be knowledgeable with the Rules Regulating Specialized Group Facilities; and, 2. Participate in the development and application process to include verifying that the original application submitted is complete with all required signatures and submitted in a timely manner; and, 3. Ongoing assessment of the specialized group facility for quality of care issues; and, 4. Annual evaluations of the governing body, unless the governing body and the sponsoring agency are the same agency.

C. The sponsoring agency shall be responsible to ensure that state rules are followed regarding:

1. The hiring, training and scheduling staff; and, 2. Placement decisions including, but not limited to, appropriateness of placement and least restrictive environment; and, 3. Documentation, reporting and corrective action of critical incidents. 7.709.22 Personnel Qualifications and Role of a County Department of Social Services or a Licensed Child Placement Agency to Establish and Supervise a Specialized Group Home or Center [Rev. eff. 11/1/15]

A. The Specialized Group Home or Center shall be supervised by a paid staff member of the agency who holds a Master of Social Work degree or a master's degree in behavioral science with an emphasis in child development and/or family relations and a minimum of two years paid full time or equivalent part-time experience in social work; or if the staff member does not have the aforementioned education and experience, then he/she must have a bachelor's degree with a major in social work, sociology, psychology or closely related field and be directly supervised by an agency staff member holding the master degree and experience described above.

B. In establishing a new group home or center the agency shall, with the group home parents or governing body, complete a financial feasibility study reflecting actual and realistic cost factors as well as adequate resources to insure its ongoing operation.

C. A statement of purpose and function which includes a description of the characteristics of the youth population which is to be served by the facility shall be written by the agency and the group home parents or the group center governing body.

D. The agency and the group home or center parents or personnel shall develop and adhere to written policies and procedures regarding the care of children which shall be reviewed annually and shall include the following:

1. Provision for emergency procedures including illness, accident, fatality and fire.

2. Participation in special activities in compliance with Section 7.719.

E. The group home or center parents or personnel and the agency shall develop and adhere to written policies and procedures regarding personnel including: pay (when appropriate), provision of relief time and vacation time, annual performance evaluation, training opportunities, selection of personnel and maintenance of personnel records.

F. The agency staff member who supervises the group home or center shall obtain, provide and/or coordinate the following services for children in care:

1. Group and/or individual counseling for children and their families.

2. For each child, long range, intermediate and short term goals shall be established and a case plan written. The goals and case plan must include a plan for discharge and must be developed and evaluated pursuant to

regulation Section 7.714.4, C,D. Goals and case plan for children three and four years old shall be evaluated monthly.

3. Records for the home or center as required in Section 7.709.27.

4. Psychiatric, psychological or developmental evaluations and consultations as required.

5. Specialized educational resources as required.

6. All necessary legal representation of child.

7. Consultation with the home or center parents or personnel about methods of work with the children.

8. Assessment of quality of care with the home or center parents or G. The agency staff member shall meet in each specialized group facility with the primary caregivers and other personnel, if available, a minimum of two hours per week exclusive of counseling services, to discuss individual children, problems, program and/or special needs.

H. The agency shall ensure that adequate records be maintained about group home or center income and expenses, the provision of clothing, allowances, dental and medical services and medicine.

I. Staff designated to authorize participation in activities is trained and knowledgeable, and has the competencies required to apply the reasonable and prudent parent standard based upon the criteria in Section 7.701.200. 7.709.23 Character, Suitability and Qualifications of Group Home or Group Center Parents or Personnel [Eff. 11/1/2008]

A. The group home or group center parent's or personnel's own children shall not have been placed in foster care or a residential treatment facility under circumstances tending to show that the parent is unable or unwilling to care for his/her own children unless the placement was primarily for such reasons as the physical illness of the parent, physical or mental disability of the child or the relinquishment of an infant child for adoption.

B. The group home or group center parents or personnel shall be able to demonstrate through satisfactory past experience and references the ability to provide for the proper physical, mental and character development of children in C. The group home or group center parents or personnel shall demonstrate stability in family or marital relationships, where applicable, within the home where the care is to be provided.

D. The group home or group center parents or personnel shall hold a high school diploma or General Equivalency Diploma (GED).

E. The group home or group center parents or personnel shall not be less than 21 years of age, shall be appropriate for the age of children in care and shall possess the adequate physical stamina to care for children. An individual such as the son or daughter of the group home or group center parents, who is well acquainted with the children in care and is between the ages of 18 and 21 years old may be a child care personnel and assist in the care of the children with the approval of the agency F. Children of the group home parents or group center parents or personnel and any other persons not placed by the agency and living in the group home or group center shall obtain a physical examination annually or as required in writing by an approved health care professional.

G. The group home or group center parents or personnel shall include at least one primary caregiver who is a full-time employee of the facility, provides some direct care for children, supervises other child care personnel and holds major responsibility for child care.

H. The primary caregiver shall have had verifiable working experience with children of the age to be cared for in the group facility. Such experience shall be from one or more of the following:

1. One year of experience as a foster home parent.

2. Two thousand hours work experience with children of the age to be cared for in the group facility.

3. One year of experience as a child care worker in a residential facility for children; and, 4. The group home primary caregivers who have not previously received 12 hours of “core” training shall receive 12 hours of training within the first twelve (12) months following the submission of the applications.

I. Other child care personnel in the group center or group home shall be supervised by a primary caregiver.

J. The group home or group center parents or personnel who are the primary caregivers shall be evaluated by a board-eligible psychiatrist, a certified psychologist or a Licensed Clinical Social Worker, and shall obtain a statement from the evaluator which evaluates the persons.

1. Psychosocial history to include family of origin style under which they were parented; relationships with parents and siblings; and, 2. Child abuse and neglect assessment to include prior history of physical emotional, verbal, sexual abuse or neglect; and, 3. Relationships with extended family, significant romantic relationships, marriages, engagements, failed relationships and estrangements; and, 4. Work history and reason for wanting to work with children in a specialized group facility; and, 5. Assessment of finances; and, 6. Children, both biological and adopted, and relationships with children, including adult children; and, 7. Support systems available to the primary caregiver; and, 8. Areas of interest, hobbies, and activities; and, 9. Tolerance and intolerance to include stressors, coping skills, expectations, negative experiences, survival of crisis in their life experiences and religious issues; and, 10. Health history and medication history to include substance abuse, drugs, alcohol history and issues and current medication; and, 11. Previous or current psychological issues including the history of the issues or therapy; and, 12. Previous child care responsibilities and experiences; and, 13. Legal and criminal background and/or history; and, 14. Involvement or experiences with child protective services of a county department of social/human services as a child or as an adult; and, 15. Education and training; and, 16. Any existing condition which may jeopardize the health or well-being of children or impair the care of the children.

K. The licensing or certifying authority must receive at least three statements which describe the primary caregiver's character and ability to provide care for children from references, provided by the primary caregiver, who are not related to the caregiver and have known the caregiver one year or longer. References need not be residents of Colorado.

L. References shall be obtained by the group home or center for other personnel.

References shall be kept on file at the facility or the agency. 7.709.24 Physical Requirements for a Safe and Adequate Specialized Group Facility [Rev. eff. 6/1/12]

A. The following shall be required of each specialized group care facility:

1. In facilities licensed after May 1, 1984, all furnaces shall be separated from living areas by one-hour fire resistive material, provided with adequate outside combustion air, installed and maintained with safety devices to prevent fire, explosions and other hazards. The space around the furnace shall not be used for storage.

2. Electrical wiring systems throughout the facility shall be in good repair.

There shall be no three-way plugs or extension cords in use. There shall be no exposed wiring.

3. Household materials which may be dangerous to children, such as matches, plastic bags, cleaning and laundry supplies as well as household tools and equipment which may present a danger to children, shall be stored out of their reach when appropriate.

4. In each facility licensed after May 1, 1984, there shall be at least two approved, alternate, widely separated means of egress from each floor of the building to safe and Open space at the ground level.

5. No lock or fastening to prevent free escape from the inside of any room or building used by the children shall be permitted. Exit door hardware shall be of the single-action type.

6. Exit doors shall be obvious, and where this is not so, exit signs shall be installed.

7. The local fire department shall determine the adequacy of exits and other Uniform Building Code and the National Fire Protection Codes. In cases of practical difficulty or unnecessary hardship, the local fire department may grant exceptions from the Uniform Building Codes or the National Fire Protection Codes, but only when it is clearly evident that reasonable safety is thereby secured.

8. In new facilities licensed after May 1, 1984, any accessible areas beneath stairways shall be enclosed with one-hour fire-resistant material.

B. Living areas for children in a specialized group home or center shall include:

1. Separate sleeping rooms for boys and girls. In sleeping rooms that accommodate two to four children, 60 square feet of floor space per child shall be provided. There shall be no more than four children in any bedroom. Each room for single occupancy shall have a minimum of 80 square feet of floor space. Closet space and drawer space for personal items sufficient for the occupants in each sleeping room shall be provided.

2. Each child shall be provided suitable sleeping facilities consisting of individual beds or bunks complete with mattresses in good repair and constructed so as to facilitate cleaning while in use by residents, and upon each change of occupancy. Single beds shall be spaced not closer than 36 inches laterally or end to end. Triple-deck bunk facilities are prohibited.

Beds being used by children shall have a mattress cover, clean sheets, pillows and pillowcases and blankets as appropriate.

3. Sleeping rooms above or below the floor of exit travel shall not be used for sleeping purposes for children who have physical handicaps which limit mobility. Children less than eight years old shall sleep on the same floor as the group home or center parents or personnel. Children under 12 years of age shall not be permitted to sleep in a detached structure unless a responsible person sleeps in the same structure.

4. Bedrooms, separate from those used by children, shall be provided for the group home or center parents or personnel who sleep at the facility.

5. Facilities shall provide living areas of no less than 35 square feet per occupant of usable indoor space exclusive of halls, baths and sleeping areas which shall be available for such things as dining, recreation, reading, visiting. Interior walls and ceilings shall be constructed of solid material and shall be in good repair.

6. There shall be a ratio of at least one toilet, lavatory and bathtub or shower for every six foster children living in the home or center. Toilet, lavatory and bath or shower facilities shall be in the same building(s) as the children's sleeping quarters and shall be accessible from the inside of the building.

7. There shall be a towel rack for each child in residence in bathroom or bedrooms.

C. The group home or center's kitchen shall be equipped with the following:

1. Adequate space for receiving, storage and refrigeration of food.

2. Adequate space for eating in kitchen or adjacent room for all children to eat at the same time.

D. The facility must have laundry facilities with adequate storage for linens.

E. The group home or center, if located in the same building as or immediately adjacent to other residential facilities such as another group home or center, an adult treatment center or a nursing home, shall be so arranged that the care and activities of the children residing in the group home can be completely separate and independent from the other residential facility. No group home or center shall be used for purposes of a rooming or boarding house. A specialized group facility may not be operated adjacent to or on the premises of a business of a nature which might be hazardous to the health, safety, morals or welfare of children and the operation of the specialized group facility. The group home or center shall house only unrelated children of the ages mentioned on the license or certificate and of the type described in the statement of purpose. The facility shall not also be used by unrelated adults.

F. Mobile homes shall not be used for group homes or centers.

G. When a swimming pool is provided, it shall meet the requirements of the Colorado Department of Public Health and Environment or its local unit. Safety precautions shall include protective fencing, a nonskid surface of at least four feet adjoining poolsides, and winter coverage which shall exclude plastic or inflatable-type domes. A certified lifeguard shall be in attendance at all times when the pool is in use. 7.709.25 Care of Children [Rev. eff. 11/1/15]

A. Group home or group center parents or personnel shall provide supervision and care appropriate to each child's age, level of development, ability to accept independence and responsibility, and according to the group home or group center's policies, procedures and the child's case plan.

1. The group home or group center parents or personnel shall know the intended whereabouts of each child in care at all times.

2. Children less than 14 years old shall not be left without adult supervision in the home or center. Children over 14 years old may be allowed to stay alone occasionally for short periods of time in the home or center pursuant to a case plan and the facility policy.

3. Children who are less than 16 years old who are sleeping away from the group home or center, such as during a camping trip or a slumber party, must have adult supervision.

4. When all the children are away from the group home or center, the adult parent or personnel on duty may be away from the home or center for short periods of time.

B. The following staff pattern shall be maintained:

1. If the primary caregiver is married, one spouse may be working full time outside the home or center. The spouse or one child care personnel shall assist the primary caregiver during times when the number and/or needs of the children require additional supervision as determined by tie group facility and the supervising agency; or, 2. If the primary caregiver is single, she/he must be at the home or center full time. There shall be one child care personnel assisting the primary caregiver during times when the number and/or needs of children require additional supervision as determined by the group home and the supervising agency; and, 3. A relief staff member who is knowledgeable about the policies and practices of the home or center shall be available to provide child care when the primary caretaker is gone from the home and as determined by the group home or center and supervising agency. An adult shall be available in the event of an emergency; or, 4. If the group center has rotating staff, there shall be at least one child care personnel on duty during each shift. The primary caregiver shall work together with the other child care personnel to provide modeling and supervision for at least 16 hours a week during the hours the children are at the facility.

5. If the group home or center and supervising agency determine that additional personnel are necessary, a mutually agreed upon written plan for staffing the group home shall be followed.

C. Health Care, Hygiene, Meals, Safety 1. There shall be a written agreement with a health care facility or medical personnel who has agreed to provide emergency medical care to children in the group home or center.

2. Necessary medical care shall be obtained pursuant to the policy and procedures of the group home or center.

3. Menus shall be kept for at least a two-week period, and there shall be a documented review periodically by a qualified nutritional consultant.

4. One group home or center parent or personnel shall be responsible for meal planning, and a parent or personnel shall be assigned responsibility for food preparation for each meal. Children may help when appropriate.

5. Only pets permitted by local codes are acceptable at the group facility.

Pets shall be housed, cared for and vaccinated according to health department regulations and other local codes. Precautions shall be taken as required to ensure both safety and good hygiene. Children shall not be permitted to mistreat animals. Animals shall not be permitted to eat in kitchen or eat from dishes in which food is prepared, served, stored or from which it is eaten.

6. An evacuation plan shall be posted in a conspicuous place.

D. School and Recreation 1. Regular school attendance is required for each child according to school attendance laws. A suitable, quiet, well-lighted place for study shall be provided together with necessary books, papers, pencils and other equipment which is reasonably required by school-age children.

2. Outdoor and indoor recreational equipment and materials shall be provided in sufficient variety and quantity to offer some choice of activities.

Games, toys, equipment and arts and craft materials shall be selected according to age, number of children, and with consideration of the needs of children to engage in both active and quiet play. All equipment and materials shall be of quality to assure safety, and shall be of a type which allows for imaginative play and creativeness.

E. Participation in Community Activities Participation in community activities shall be supported. Along with the requirements in Section 7.714.7 (12 CCR 2509-8), at least one (1) specialized group facility staff shall be trained how to determine whether to approve a child’s or youth’s participation in an extracurricular, enrichment, cultural, or social activity is consistent with the reasonable and prudent parent standard based upon the criteria in Section 7.701.200. 7.709.26 Required Records [Eff. 11/1/2008]

There shall be a personnel file maintained for each parent or personnel by the facility or the agency. The file shall include identifying information, references, statement from physician or qualified nurse practitioner, name and telephone number of person to contact in emergency, and verification of education and experience. The personnel file for the primary caregiver shall include a statement from a psychiatrist, a certified psychologist or a Licensed Social Worker II. The personnel records shall be maintained pursuant to the personnel policy and procedures. If personnel records are at the agency office, there shall be maintained at the facility the address, local phone number and name, address, and phone number of persons to call in an emergency. 7.709.27 Special Rules for Emergency Placement and Care of Children [Eff. 11/1/2008]

A. Emergency placement indicates that due to circumstances beyond the agency's control a child needs placement, yet pre-placement admission requirements have not been completed. The acceptance of a child in such an emergency status shall only be done if it is a part of the admission policy and procedures of the facility.

B. During placement at the facility as much evaluation of the child shall be completed as possible and as is necessary for future planning for the child. As much data as possible shall be collected pursuant to the admission record.

C. A specialized group facility which accepts only children by emergency admission shall have on duty one child care personnel for each six children or fraction thereof at the facility during the daytime and swing shift. One child care staff member will be sufficient during sleeping hours.

D. Information gathered at the time of emergency placement and during placement shall become part of the child's file. The file shall also include the date the child was discharged from the facility, to whom the child was released, and a description of the physical condition of the child at the time of discharge.

E. A specialized group facility operating as a shelter care facility or which accepts only children by emergency admission shall make every effort to assure that emergency placements do not exceed sixty days. Exceptional circumstances must be documented in the case file for any placement lasting over 60 days.

Reimbursement at the shelter care rate shall not exceed 90 days.

7.710 RULES AND REGULATIONS FOR CHILD PLACEMENT AGENCIES

All child placement agencies shall comply with the “General Rules for Child Care Facilities” and “Rules and Regulations for Child Placement Agencies” and shall comply with the “Rules Regulating Foster Care Homes” for any homes certified by the Child Placement Agency, “Rules Regulating Host Family Homes” for any host home certified by the Child Placement Agency, and the “Specialized Group Facilities” rules for any Specialized Group Facility sponsored by the Child Placement Agency.

7.710.1 GENERAL DEFINITIONS

“Arrange for placement” means to act as an intermediary by assisting a parent or guardian or legal custodian to place or plan to place a child with other than persons related to the child for the purpose of foster care or for the purpose of adoption.

“Average sufficient cash reserve” means the computed monthly average cost over the recent ongoing twelve-(12) month period to determine the amounts spent on operating expenses for the agency including, but not limited to, staff salaries; contract reimbursements; employment, unemployment, and other taxes; insurance and retirement benefits; foster care payments; other provider reimbursement fees; health, therapy, transportation and support services for children in care; foreign country fees, office mortgage or rent payments; transportation costs; communications; or, any other expense needed for the agency to function, including a line of credit. The minimum allowable average sufficient cash reserve that an agency must maintain at all times is at least two months’ of the average monthly cost.

“Background checks” means a set of required records that are obtained and analyzed to determine whether the history of a prospective foster parent, kinship foster parent, noncertified kin, or adoptive parent meets legal and safety criteria when considering the placement or continued placement of children and in the care of the person(s). The checks include all adults residing in the home. The following individual checks are required pursuant to 19-3-406 C.R.S, 19-3-407 C.R.S, and 26-6-103, C.R.S:

1. CBI and FBI finger-print based criminal history record information;

2. Court case management system;

3. State automated case management system and child abuse and/or neglect registries in all states that adults living in the home have resided in the five years preceding the date of application; and, 4. The CBI sex offender registry and national sex offender public website operated by the United States Department of Justice using the following minimum criteria:

a. Known names and addresses of each adult residing in the home b. Address only of the residence “Bonding” means an insurance bond issued through a financial or insurance entity.

“Certification” means the process by which the county department of social/human services or a child placement agency approves the operation of a foster care home and/or a licensed host family home.

“Child placement” means to coordinate, arrange, and approve the process of a child entering an unrelated home or facility to be cared for on a temporary, long-term, or adoptive basis.

“Child Placement Agency (CPA)”, defined at Section 26-6-102(2), C.R.S., means any corporation, partnership, association, firm, agency, institution, or person unrelated to the child being placed, who places, facilitates placement for a fee, or who arranges for placement, any child under the age of eighteen (18) years with any family, person, or institution for the purposes of foster care, treatment and/or adoption. The natural or adoptive parents or legal guardian of any child who places that child for care with any facility licensed as a “family care home” or “child care center,” as defined by this section, shall not be deemed to be a CPA.

“Conflict of interest” means a situation that has the potential to undermine the impartiality of an individual because of the possibility of a clash between the individual’s self interest or other professional-interest.

“Cradle care home” means a facility that is certified by a child placement agency for the care of a child, or children in the case of multiple-birth siblings, who is twelve (12) months of age or younger, in a place of residence for the purpose of providing twentyfour (24) hour family care for six (6) months or less or children pursuant to Article 5 of Title 19, C.R.S., or while a county department prepares an expedited permanency plan for an infant in its custody.

“Current reference” means a reference dated within one (1) year of the time of application for employment with agency.

“Foster care home” (refer to Section 7.000.2 in 1 CCR 2509-1).

“Generally Accepted Accounting Principles” (GAAP) means the standard framework of guidelines for financial accounting.

“Licensed host family home” is defined as a home that is certified by the county department or a child placement agency as meeting the requirements for providing shelter to homeless youth.

“Licensing” means the process by which the Colorado Department of Human Services approves a facility or agency for the purpose of conducting business as a child care facility or child placement agency.

“Multi-service agency” is an organization that provides additional community services and programs other than foster care and adoption.

“Program director in a multi-services agency” is the person responsible for overseeing the foster care and/or adoption program of the organization.

“Quality improvement program” means a review of the services and outcomes of such services provided to applicants and a procedure for tracking such outcomes to determine if changes need to be made to the system to improve delivery of such “Relative”, except as used in the definition of foster care home, means any of the following relationships by blood, marriage, civil union or adoption: parent, grandparent, son, daughter, grandson, granddaughter, brother, sister, stepparent, stepbrother, stepsister, stepson, stepdaughter, uncle, aunt, niece, nephew, or cousin.

“Risk assessment” means a review and assessment by an insurance or financial specialist to determine the liability an agency carries for the services it offers and the work it performs.

“SAFE (Structured Analysis Family Evaluation)” is the tool used to create a home study assessment on a family or individual, who are seeking to provide foster care or adopt a “SAFE Home Study Addendum” is the format used to record and evaluate changes to the home study assessment as new information is known to the agency.

“SAFE Home Study Update” is the format used to document the annual agency review and evaluation of the home study assessment.

“Social and behavioral sciences” includes sociology, psychology, social work, criminal justice, human services, human development, and counseling.

“Specialized Group Facility Supervisor” means the professional, paid staff member of the Child Placement Agency who oversees the services provided and staff of the specialized group facility.

“Unreasonably high” means the fees, wages, or salaries paid to the directors, officers, and employees of the agency are excessively high in relation to the services actually rendered, taking into account the area in which the services are provided and norms for compensation within the community, including factors such as the location, number, and qualifications of staff, workload requirements, budget; and size of the agency or person.

“Well-being plan” means a written plan that lists the temporary changes to the child’s or youth’s daily routines or treatment plan, due to behavioral, safety, medical, or mental health needs of the child or youth. Such plan shall be signed by members of the treatment team, including the child or youth, and shall be time limited only to the duration needed to ensure the safety of the child or youth. Such plan shall be reviewed daily and overseen by the placement supervisor.

7.710.2 GOVERNING BODY

A. Any agency from out of state assisting with, facilitating for a fee, or placing a child within Colorado for the purpose of adoption must meet the ICPC requirements of the sending state, or be licensed as a CPA by the Colorado Department of Human Services (the State Department) unless the placement services are coordinated with and provided by a county department of social services or a CPA licensed by the State of Colorado.

B. A CPA may not be operated without a license, as required by law, which license is to be issued by the State Department in conformity with all rules and regulations contained within Section 7.710, et seq.

C. Any Colorado entity, other than a CPA licensed in Colorado, or individual, other than a biological or legal parent of a child, may not assist or arrange for the placement of a child with a Colorado family for the ultimate purpose of adoption without first being licensed as a CPA.

D. A child placement agency may only accept applications from and certify families for foster care within the State of Colorado.

E. The governing body shall be the corporation, partnership, association, firm, agency, institution or person in whom the ultimate authority and legal responsibility is vested for the conduct of the CPA.

F. The governing body shall be identified by its legal name. Each not-for profit child placement agency shall have a board of directors. If the board has community members, such community members shall neither be employed by or contracted to the CPA, nor related to any individual employed by or contracted to the CPA.

Persons whose children are currently in placement (either voluntarily or involuntarily) through the CPA may serve on the board, but may not vote on any measure or issue related to the care of their child during the time such children are in placement. Minutes from all board meetings shall be maintained for a period of at least five (5) years and must be available to the State Department G. The governing body of the CPA shall:

1. Maintain the written purpose and policies for the general operation and management of the agency. When such purpose and policies are reviewed and revised, the State Department shall be advised of such changes. The purpose and policies as a minimum shall include:

a. Statement of purpose of the CPA as to what type of placement of children in which the agency intends to engage, the geographic area the agency expects to serve, the ages of children to be placed, and any other specific factors regarding the children to be placed or the homes in which the children shall be placed.

b. Personnel policy including, but not limited to, job description; qualifications for position; required documentation for position; requirement for a criminal history fingerprint background check (per

section 7.701.33); a child abuse/neglect check through the State Department’s designated database (per Section 7.701.32); and a name and address check of both the National and CBI Sexual Offender Registries (per section 7.701.33).

c. Foster care policy including, but not limited to, types of foster care homes to be certified; geographical area of proposed foster homes; good faith efforts and due diligence to be used in recruiting families who reflect the communities of all children in care; assessment, training, certification, supervision and monitoring of certified foster homes.

d. Adoption policy which includes types of adoption in which the agency will participate and policy and procedure for each adoption e. Fee policy.

f. Volunteer policy.

2. Be responsible for the protection of the legal rights of children served by the CPA.

3. Be responsible for approval of the CPA budget and any budgets for Specialized Group Facilities sponsored by the CPA, including obtaining funds and dispersal of funds, as required in 7.710.21.

4. Appoint an executive director who meets requirements of Section 7.710.22 and be assured that staff members responsible for placement of children and/or certification of foster homes meet the requirements as stated in Section 7.710.22.

5. The Board or Chief Operating Officer, in the case of a multi-service agency, in which the program director is the person responsible for overseeing the foster care and/or adoption program shall conduct an evaluation, at least annually, to determine if the executive director is fulfilling all responsibilities as required in Section 7.710.25.

6. Inform the department, in writing, of:

a. A change in the executive director of the CPA; and, b. Each agency office or change of agency office in which child placement is carried out at that location; and, c. The hours of operation that each CPA office is open each week and available for inspection of CPA records.

7. Provide copies to the department of any legal action brought against the CPA which affects any child or children in care, personnel or conduct of the CPA.

8. Maintain professional liability insurance in amounts reasonable related to its exposure to risk. The agency must provide a current risk assessment to the State Department if requested.

9. Maintain and monitor a quality improvement program appropriate to the size and circumstances of the agency through which it makes systemic efforts to improve services if needed.

10. Ensure that the fees, wages, or salaries paid to the directors, employees, and officers of the agency not be unreasonably high in relation to the services actually rendered.

11. Ensure that the agency’s Chief Executive Officer, Chief Financial Officer, Executive Director, and other officers or employees with direct responsibility for financial transactions or financial responsibility be bonded.

12. Ensure that the agency maintains an average sufficient cash reserve or assets to meet its operating expenses, less foster parent payments, for two (2) months, taking into account the agency’s projected volume of cases and its size, scope, and financial commitments.

H. The governing body shall be responsible for completing the licensing renewal requirements by:

1. Completing and submitting the license renewal application at least ninety (90) calendar days prior to the annual expiration date of the child placement agency license; and, 2. Completing, signing and submitting the required verification of compliance form; and, 3. Paying the prescribed fee pursuant to Section 7.701.4; and, 4. Cooperating with on-site monitoring visit(s) to assess the agency's compliance with the rules for child placement agencies.

I. The governing body shall ensure when the Child Placement Agency accesses the state automated case management system as part of the foster home certification back ground investigation, it must do so only as listed at section 19- 1- 307 C.R.S. Any violation of such access may result in individual fines as listed at section 19-1-307 (1)(C), C.R.S. and agency fines as listed at section 26-6-114 (1), C.R.S. 7.710.21 Financial Operation A. Each CPA shall develop an annual budget reflecting anticipated income by source and expenses by purpose, plus an accompanying balance sheet, which demonstrates that the CPA has assured resources to carry out its defined

purpose. The budget shall be approved by the Board of Directors and recorded in the minutes of the Board of Directors. The first year's budget shall be submitted with the original license application.

B. The purpose of these requirements is to provide assurance the CPA has adequate accounting and budgeting information available to allow management to maintain a financially viable enterprise and to demonstrate financial accountability to the County and State Departments of Human Services for the use of public funds.

C. Each CPA must have a double entry accounting system and all financial transactions must be posted to this system. Financial statements, prepared from information provided by this system, shall be presented in conformity with U.S.

Generally Accepted Accounting Principles (GAAP). Books and records of the CPA shall be subject, at any time the CPA office is open, to inspection, audit or copying by appropriate Federal, State or county personnel, or such independent auditors or accountants as may be designated by these personnel.

D. Annual Audits Each CPA whose total annual foster care or adoption expenditures are $100,000 or more shall provide for an annual audit by an independent Certified Public Accountant in accordance with appropriate generally accepted auditing standards. CPAs with less than $100,000 total annual expenditure may submit an audit as described above or may submit compiled or reviewed financial statements, prepared in accordance with generally accepted accounting principles. All Hague accredited international adoption agencies shall submit audits as required for Hague accreditation.

1. Every CPA shall submit supplementary information as prescribed by the state on the required supplementary information form and the administrative expenses for foster care as defined by the State 2. The supplementary information submitted shall contain an affidavit signed by the CPA’s Executive Director and an officer of its board attesting to the grounds for suspension of the CPA license.

3. The audit and supplementary information shall be submitted to the State Department within six (6) months of the CPA’s fiscal year end.

4. CPAs that are a subsidiary of a parent organization must submit separate audited financial statements for the subsidiary that detail each of the CPA's facilities or programs that provide services for the State or county department.

5. If a CPA does not submit its annual audit or refuses to disclose financial information regarding the operation of the program in a timely manner, the State Department may send notice to withhold payment until the audit and/or requested information is submitted.

6. Upon receipt of adequate written notice that a county department or the State Department plans to recover or withhold unallowable or misused funds from a CPA, a CPA may file a written request for review of the decision with the State Department.

a. The written request for review must be submitted within thirty (30) calendar days of the receipt of the notice to recover or withhold the misused funds.

b. The State Department shall convene a committee to review the written request from the CPA. The committee shall consist of three members representing:

1) The State Department's Child Care Division; and, 2) The State Department's Child Welfare Division; and, 3) An independent representative of an auditor from another State Department or a certified independent accountant referred from the Colorado Society of Certified Public Accountants.

c. The State Department reserves the right to receive legal consultation regarding the written request for review.

d. The committee shall review all relevant information and make a decision within sixty (60) calendar days of receipt of the request.

e. The committee shall send its findings to the Executive Director of the State Department or his/her designee, who shall make the final agency decision for the State Department.

E. Allowable Expenditures 1. A Child Placement Agency expenditure shall be considered allowable if it meets all of the following criteria:

a. Reasonable The expenditure is reasonable in nature or amount and does not exceed the cost that would be incurred by a prudent person under the circumstances prevailing at the time the decision was made to incur the cost.

b. Ordinary and Necessary The expenditure is of a type generally recognized as ordinary and necessary for the operation of a CPA or the performance of a contract for CPA services.

c. Prudent The individuals concerned acted with prudence in the particular circumstances, considering their responsibilities to the CPA, its employees, clients, foster families, foster children, the public at large, the State and the CPA's responsibilities pursuant to the contract for services, and must not be contrary to Federal or State d. Documented A CPA has the responsibility to ensure that proper documentation procedures are followed for the funds that they control, and to ensure that only authorized expenditures are made. Lack of appropriate documentation will be considered cause for nonpayment or non-reimbursement of expenditures. Expenditures must be adequately documented in writing. Documentation requirements shall include all of the following information:

1) Descriptive verification that the expenditure was for a business purpose directly related to the foster care or adoption program.

2) Date of event for which the funds were used.

3) Names of persons attending when an expenditure has the “appearance of personal benefit”.

4) Location of event or place where funds were spent.

5) When documentation includes purchases for multiple items and only some of the items relate to an appropriate expenditure for the CPA, a detailed itemization and reconciliation of the expenditures shall be evident on the face of the document.

e. Made in Accordance with GAAP An expenditure must be recorded in accordance with Generally Accepted Accounting Principles (GAAP).

2. Generally Allowable Expenditures The following list of expenditures shall be a general list of expenditures that would be permissible for CPAs to incur in order to further the goals and objectives of their agencies. This list includes, but is not limited to, the categories described below, and shall be used as a reference for guiding the expenditure of CPA funds.

When a specific expenditure is not listed, yet management deems it to be in the best interests of the CPA to make the expenditure of the funds, then the criteria above for an allowable expenditure shall be followed. The CPA shall document the purpose of the expenditure, as listed at 7.710.21, E, 1, d, so that a “reasonable person” test can be made in the event the expenditure is audited. Each CPA shall allocate expenditures in accordance with its internal policies.

a. Salaries and wages, and related benefits, employment taxes, unemployment taxes, worker's compensation taxes, retirement benefits, and insurance benefits.

b. Retention and recruitment of staff, contractors, foster care parents, and volunteers, including advertising, background checks and other evaluations, recruiting, relocation, recognition, and food bank administrative expenses.

c. Foster care, including provider reimbursement, respite for foster parents, child enrichment, clothing, health services, therapy, transportation, and other supportive services.

d. Professional fees, including audit and accounting fees, consulting, legal fees, and other professional fees. These fees must be consistent with what the market would pay if paid to a related party.

e. Contracted services, including contract labor, human resource services, payroll services, and temporary employment agencies.

f. Occupancy expenditures, including office rent comparable to given market rates, meeting room rental, electricity and gas, water and sewer, janitorial service, property repair and maintenance, storage unit rent, and waste removal. If the CPA owns the building, then reasonable depreciation shall be allowed based on the estimated useful life of the building.

g. Depreciation and amortization, based on estimated useful life of the asset, and prorated if the CPA only uses a portion of that asset.

h. Child care during client meetings, support groups, or training functions.

i. Training for staff, foster parents, and volunteers, including honorariums and conference registration fees.

j. Travel and transportation provided that there is some contemporaneous record to support the expense, including airfare, fuel, lodging, meals, mileage, parking, per diem, travel incidentals, vehicle rental, and vehicle repair and maintenance.

k. Telephone, including cellular and paging, data communication services, and telephone services.

l. Postage and shipping.

m. Office services, including coffee, tea, and water.

n. Printing and supply expenditures, including computer and office supplies, printing, and program supplies.

o. Dues, memberships, licenses, and subscriptions, including accreditation fees, dues and memberships, licenses and fees, and subscriptions and publications.

p. Insurance, including automobile, directors and officers, volunteer, general and professional liability commercial packages, and umbrella.

q. Marketing and promotion, including advertising, booths and fairs, graphics and editorial, and printed material/mailing house.

F. Unallowable Expenditures A CPA expenditure shall be unallowable if it does not meet the criteria and documentation requirements as specified under the definition of an allowable expenditure as referenced in Section 7.710.21, E, or is a direct violation of federal law.

G. Remedies Remedy for unallowable expenditures may include any or all of the following solutions:

1. Repayment to the State or Counties of identified unallowable expenditures.

2. Reclassification of the accounting entry to record the expenditure correctly, if the transaction can be appropriately reallocated to another cost center of the CPA, or affiliated agency, parent company, etc.

3. “Adverse licensing action” which could result in the denial, suspension, or revocation of a license issued, pursuant to the Child Care Licensing Act or the demotion of such a license to a probationary license.

4. Any other appropriate remedy based upon the facts and circumstances of the unallowable expenditure.

H. Intentional Mis-Use of Funds Intentional mis-use of funds implies that the individual(s) making the expenditure decision had deliberate, willful, and intentional disregard for the fiduciary responsibility for how public funds are to be used for purposes of placing children in foster care or adoptive homes, or arranging for the placement of children in foster care or adoptive homes, considering their responsibilities to the CPA, its employees, clients, foster families, foster children, the public at large, the State Department’s and the CPA'S responsibilities pursuant to the contact for services.

These rules do not preclude the State or county department(s) from pursuing other remedies available at law; for example:

1. Referral for prosecution; or, 2. Referral to the Internal Revenue Service for issues that violate Internal Revenue codes; or, 3. Repayment to the State and/or counties of identified unallowable expenditures; or, 4. “Adverse licensing action” which could result in the denial, suspension, or revocation of a license issued, pursuant to the Child Care Licensing Act, or the demotion of such a license to a probationary license. 7.710.22 Personnel Requirements A. Each CPA shall have staff members in sufficient number to meet the needs of individuals served. Such staff members shall meet the following requirements:

1. The Executive Director and placement supervisor must:

a. Reside in Colorado.

b. Submit proof of qualifications and certified transcripts from a regionally accredited college or university to the State Department within thirty (30) calendar days of accepting the position.

2. The Executive Director or in a multi-services agency, the program director, shall possess a knowledge of the type of child welfare services in which the CPA engages and shall be able to demonstrate administrative skill and leadership qualities. The Executive Director must have:

a. Graduated with a Bachelor’s degree from a regionally accredited college or university with a minimum of thirty (30) semester credits or equivalent quarter credits in the social or behavioral sciences, b. At least five (5) years' full time or equivalent part time work experience in an administrative capacity, obtained after the Bachelor’s degree was conferred, at least two (2) of which included supervision of professional staff and budget or fiscal management; or, c. Graduated with a Master’s degree or greater from a regionally accredited college or university with a minimum of thirty (30) semester credits or equivalent quarter credits in the social or behavioral sciences, and have two (2) years full time or equivalent

part time work experience in an administrative capacity, all of which must have included supervision of professional staff and budget or fiscal management; a minimum of nine (9) semester hours or equivalent quarter hours in business or finance classes from a regionally accredited college or university may substitute for budget or fiscal management experience.

3. Administrative capacity includes, but is not limited to, policy and procedure development and implementation, strategic planning, budget responsibility, fiscal management, quality assurance, networking, human resources management, program development and oversight, and business management.

4. The State Department must receive at least three (3) current written statements or telephone references from individuals unrelated to the applicant, at least one (1) of whom has been the employer or supervisor of the applicant, which describes the executive director's character, reliability, knowledge of child welfare services and ability to perform the tasks of the Executive Director as outlined in the duties of the Executive Director at

Section 7.710.25, A. If the Executive Director or in a multi-service agency, the program director, is also to have responsibility for placement supervision, she/he shall also meet the requirements for placement supervisor as set forth in Section 7.710.22, A, 6.

5. References checked through a telephone call must include the:

a. Name and position of individual called; and, b. Name and position of individual spoken with; and, c. Agency; and, d. Telephone number; and, e. Time and date the call(s) was made; and, f. Relationship of individual providing reference for prospective employee (all references must be from individuals unrelated to the applicant); and, g. Whether this was a personal or professional reference; and, h. Summary of conversation that describes the character, reliability, knowledge, experience, and ability to perform the tasks of the position as outlined in the job description; and, i. Name, position, date and signature of individual checking the reference.

6. Placement supervisors shall have, at a minimum, a Bachelor’s degree in the social or behavioral sciences, and three (3) years full time child placement experience obtained after the bachelor’s degree was conferred.

a. If the placement supervisor has a Master’s degree in the social or behavioral sciences, the placement supervisor must have a minimum of one (1) year of child placement experience.

b. The State Department must receive at least three (3) current written statements from individuals unrelated to the applicant, one (1) of whom has been the employer or supervisor of the applicant, which describes the character, reliability, knowledge of child welfare services and the ability to perform the tasks of the placement supervisor as outlined in the duties for that position at Section 7.710.25, B.

7. If additional placement workers are necessary to fulfill the placement responsibilities of the agency, such workers shall be supervised by a qualified placement supervisor and shall hold a Bachelor degree in the social or behavioral sciences from a regionally accredited college or university. If an individual has a Bachelor's degree in a non-related field, he/she shall have at least two (2) years experience supervised by an individual with a Master of Social Work or other Master's degree in the social or behavioral sciences.

B. There shall be a sufficient number of placement supervisors and placement workers to meet the needs of the individuals being served in a timely manner.

Each placement supervisor shall not supervise more than nine (9) FTE.

C. There shall be sufficient support staff to comply with record keeping, bookkeeping and reporting requirements as necessary.

D. Foster care paraprofessionals, interns or trainees who do not meet placement worker qualifications may assist qualified placement workers, but may not complete family or child assessments or conduct home supervision.

Qualifications shall be established by the CPA.

E. there shall be a sufficient number of Specialized Group Facility supervisors to meet the needs of the individuals being served in the group facilities in a timely manner. Each Specialized Group supervisor shall not supervise more than five (5) specialized group facilities. 7.710.23 Personnel Policy A. A written statement of personnel policy shall be provided to each employee or qualified applicant. This statement shall, as a minimum, contain the following information: a job description which outlines the duties, responsibilities, qualifications; policy on outside agency employment; and educational requirements for the position, as well as an organizational chart for the agency.

B. The Board of Directors must approve a conflict of interest policy regarding outside employment.

C. If an individual is employed or contracted, as a placement supervisor at more than one (1) child placement agency, the total number of individuals supervised by the placement supervisor at all agencies may not exceed nine (9) FTE.

D. The agency must have a written policy regarding the use of volunteers. The policy must include:

1. The duties the volunteers may perform;

2. The requirement of background checks, including CBI and FBI criminal fingerprint histories, child abuse and neglect records, and CBI and National Sexual Offender Registry checks as listed in 7.701.32 and .33;

3. Mandatory reporting of child abuse and neglect;

4. The requirement to maintain confidentiality. 7.710.24 Personnel File A. A personnel file shall be maintained or each employee and contract worker and shall be available to authorized representatives of the State Department.

B. Each file for the employees and contract WORKERS shall include:

1. Original certified transcript from a regionally accredited college or university if a degree is required by the position.

2. Employment application showing qualifications and experience.

3. A minimum of three (3) current written signed statements obtained from previous employers and personal references at the time of hire to show that the person has the qualifications required in Section 7.710.22.

4. Evaluations of job performance.

5. Results of the review of records and reports of child abuse or neglect as listed at Section 7.701.32 and criminal record check as listed at Section 7.701.33.

C. Each file for the volunteers shall include a signed copy of the agency policy regarding the use of volunteers, a signed copy of the agency confidentiality agreement, signed mandatory abuse reporting requirement form, and copies of the CBI and FBI fingerprint history and record checks, child abuse and neglect background records checks, and CBI and National Sexual Offender Registry Checks as applicable in 7.701.32 and .33. 7.710.25 Duties of the Executive Director, Placement Supervisor, Placement Worker, Paraprofessionals/Trainees A. The responsibilities of the Executive Director are:

1. Human resources management; and, 2. Policy and procedures development and implementation; and, 3. Accountability for being in compliance with regulations; and, 4, Fiduciary requirements; and, 5. Quality assurance; and, 6. Regulatory compliance and accountability; and, 7. Overall professionalism of the agency; and, 8. Responsibility for the daily operation of the agency; and, 9. In a multi-service agency, the program director may have responsibility for administering the adoption and/or foster care unit and may not be responsible for the budget and accounting duties.

B. The responsibilities of the placement supervisor are:

1. To oversee the study of potential foster or adoptive families using the Structured Analysis Family Evaluation (SAFE) instrument(s) to determine the character and suitability of the applicant(s), appropriateness of the home, and child care practices; and, 2. To ensure certification of foster care homes and placement of children in foster care homes; and into specialized Group Facilities sponsored by the CPA, and/or, 3. To oversee the study of the child for adoption; and, 4. To oversee the placement of children in homes for adoption; and, 5. To complete the SAFE Supervisor training and then review, sign, and maintain final authority of the SAFE assessment, post placement reports, and the issue certificate form;

6. To ensure oversight of appropriate medical services for the children placed in the care of any facility certified or sponsored by the CPA; and, 7. To provide supervision of placement workers at least monthly to review, at a minimum, all SAFE assessments in process, certifications in renewal status, and current placement activity; such supervision shall be documented in writing by the placement supervisor.

8. To approve and monitor well-being plans developed for children in foster homes or group facilities.

C. The placement worker, under the direct supervision of the placement supervisor, is responsible for the monitoring and protection of children, and may:

1. Provide case management for individual children; and, 2. Coordinate services for child(ren) and their family; and, 3. Provide monitoring and support to foster homes; and, 4. Conduct SAFE assessments to determine the ability of foster homes to meet children's needs.

D. The placement worker in an adoption agency may function as an adoption caseworker or birth parent counselor as listed in 7.710.52.

E. Foster care paraprofessionals, interns, or trainees may assess the physical environment for foster homes for compliance with regulations; act as a liaison with courts, schools, foster parents and all peripheral parties under the direct supervision of a placement supervisor or placement worker.

7.710.3 CERTIFICATION OF FOSTER CARE HOMES 7.710.31 Legal Base A. Licensed Child Placement Agencies are authorized under Section 26-6-102, Colorado Revised Statutes, to certify foster care homes.

B. A foster care home certified by a CPA may not accept placements from any source other than the certifying CPA as to each such child, unless the certifying CPA gives written consent and approval for the placement.

C. A child placement agency shall complete a background check for foster care homes and kinship foster care homes pursuant to Sections 26-6-106.3(5), (6), and 19-3-406, C.R.S.; and the results shall be documented in the resource

section of the state automated case management system. No children and/or youth may be placed in the foster care home or kinship foster care home until the checks have been completed. Failure to comply shall result in a corrective action process, and may result in sanctions described in Section 7.701.12. In addition, county departments of human or social services, as part of their contracting responsibilities, may take action to recoup foster care payments from the agency if a background check was not completed pursuant to statute. 7.710.32 Minimum Regulations A. Operation 1. The regulations for operation of a foster care home shall be met before a certificate can be issued.

2. The CPA shall audit the foster care home files on an annual basis to verify that all required information is present in the file. The CPA shall attest in writing that the required information is present.

3. The CPA shall notify the Colorado Department of Human Services in writing within three (3) business days of the closure of a foster home, either verbally or in writing or via email, due to a confirmed report of child abuse or neglect.

4. The CPA shall notify the Colorado Department of Human Services in writing within three (3) business days when a determination is made by the CPA to continue to certify a foster care home that the CPA has received notice, either verbally or in writing, of a confirmed report for abuse or neglect. The written notice shall include the justification for continuing to certify the foster care home.

B. Certification The law states that foster care certificates issued by CPAs are considered licenses; the regulations which are established by the State Department for foster care homes are therefore applicable to any such facility being certified by a licensed CPA. Copies of these rules shall be made available to each applicant for certification and to each foster care home.

C. Conflict of Interest 1. Staff members or members of the governing board or relatives of staff members or relatives of any officer, executive or member of the governing board of a CPA shall not be certified by the CPA to operate a foster care home, except for a person who is employed for the sole purpose of providing foster care and who serves in no other capacity for the agency.

2. No owner, officer, executive, member of the governing board, or employee of a CPA or any relative of said owner, officer, executive, member or employee shall hold a beneficial interest in any property operated or intended to be operated as a foster care home when the property is certified by the CPA as a foster care home.

3. A licensed CPA may not provide birth parent counseling, home study assessments, or post placement assessments on any officer, owner, board member, staff member, contract staff member, or relatives of such individuals.

4. An individual certified for foster care services by a CPA may not function as a staff member or volunteer at any specialized group facility sponsored by the same certifying child placement agency.

D. A CPA:

1. Must demonstrate to the State Department that it provides child placement services ethically and in accordance with Colorado state regulations and statutes, interstate compact requirements, intercountry requirements and Hague accreditation, as applicable, to ensure that foster and adoptive placements take place in the best interests of children.

2. Shall not knowingly and willfully:

a. Disseminate or cause directly or indirectly to be disseminated, statements regarding services which are untrue, deceptive, or misleading; or, b. Make any statement or prepare or use any document that is known to be false; or, c. Conceal or misrepresent any material fact in connection with the provision of services to birth parents, foster or adoptive parents, foster or adoptive parent applicants, or children. 7.710.33 Application and Inspection for Certification of Foster Care Homes A. Any application accepted by the CPA from an individual(s) or couple who wishes to be certified to operate a foster care home shall be on the Department approved form and shall include:

1. The names and addresses of child placement agencies and county departments of social services that had previously certified the applicant.

Information as to whether the applicant has been licensed or certified for child care in the past or is licensed or certified for child care at the time of the application, what agency issued the certificate or license, and the type of child care the license or certificate authorizes.

2. Information about an applicant or individual living in the proposed foster care home who has been convicted of a felony or charged or convicted of child abuse or an unlawful sexual offense.

3. Information about whether the applicant is currently licensed by the State Department to provide day care.

4. A statement on the application for certification as a foster care home that states:

“Any applicant who knowingly or willfully makes a false statement of any material fact or thing in this application commits perjury in the second degree as defined in Section 18-8-503, C.R.S., and, upon conviction thereof, shall be punished accordingly.”

5. The social security number or individual taxpayer identification number issued by the government for each applicant.

B. No application shall knowingly be accepted from an individual who is currently certified by another county or CPA to operate a foster care home until that individual has terminated the certification by the other county or CPA, or the current certifying CPA has given written notice to the foster homes of the agency’s closure.

C. No board member, director or staff member of a CPA shall knowingly contact or recruit foster homes currently certified by another county department or CPA.

D. A CPA must take an application from an applicant(s) before the CPA has

authority to complete the family assessment, and background checks.

E. An applicant may apply to become a dual care provider to operate a family child care home as well as a foster care home. The foster home will be certified by the CPA and the family child care home will be licensed by the Colorado Department of Human Services. Both sets of standards shall be met. The CPA will monitor the foster care standards and the State Department will monitor the family child care home standards. The CPA shall counsel the family if it believes such a situation is not in the best interest of any foster child who may be placed in the home. The CPA must approve the home to be licensed as a family child care home when the home is certified for foster care.

F. A home that is licensed as a family child care home may only be certified for foster care for one child or for a group of siblings. A foster care home dually licensed as a family child care home shall not be certified as a host family home providing shelter to homeless youth.

G. A CPA that has a foster/adoptive home that is certified for foster care and also licensed as a family child care home must notify the Division of Child Care when any of the following situations occur in the foster/adoptive home:

1. A complaint is received; or, 2. A child abuse investigation occurs; or, 3. A Stage II investigation occurs; or, 4. A foster/adoptive child is placed in the home; or, 5. A foster/adoptive child(ren) is removed from the home because of abuse allegations; or, 6. The foster home certificate is changed to probationary; or, 7. The foster home certificate is revoked or closed.

H. A CPA that has a foster/adoptive home that is certified for foster care and also licensed as a family child care home must submit the following reports to the Division of Child Care:

1. All complaint investigation reports; and, 2. All child abuse investigation reports; and, 3. All Stage II investigation reports.

I. Reference checks for the applicant and all adults residing in the home:

A CPA shall conduct a reference check of each applicant and all adults residing in the home by contacting all of the previous certifying authorities listed on the application or for whom an application was submitted before issuing the certification for that foster care home. The CPA shall sign an affidavit that certification is appropriate.

J. Initial Training for Foster Care Homes 1. Each applicant listed on the application must complete a minimum of twenty-seven (27) hours of initial training consisting of at least twelve (12) hours of core training prior to the certificate being issued and completion of the remaining training within three (3) months after the placement of a child. The training shall be provided through the statewide core curriculum training, by the CPA, or by a county department. The core training shall include the following ten primary topic areas:

a. General overview of foster care; and, b. Administrative and legal issues; and, c. Why children get placed in out-of-home care; and, d. Parenting and family dynamics; and, e. Key concepts of child growth and development; and, f. Importance of the team approach; and, g. Individual differences such as ethnicity and culture; and, h. Discipline; and, i. Effects of fostering on the foster family; and, j. Working with the biological family; and, k. Reasonable And Prudent Parent Standard.

2. For homes dually certified as a family foster care home under this Section and Section 7.708, and a host family home under Section 7.721, an additional three (3) hours of training specifically related to the subject of providing shelter to the homeless youth populations is required.

K. Cradle Care applicant listed on the application must complete a minimum of twenty (20) hours of initial training prior to the certificate being issued. The training shall include the following primary topic areas:

1. Attachment/bonding issues; and, 2. Loss and grief issues, as applicable for all parties to the adoption; and, 3. Adoption as a lifelong issue as it pertains to all parties to the adoption;

4. Key concepts of child growth and development; and, 5. Limit setting and safety; and, 6. Caring for a child of a different cultural or racial background, if applicable;

7. Understanding adoption laws and procedures, including termination of parental rights and the expedited relinquishment process pursuant to

Section 19-5-103.5, C.R.S., if applicable; and, 8. Possible current and/or future use of community resources, including help with parenting techniques; and, 9. Infant care to include, but not be limited to, basic care and feeding of the infant and Shaken Baby Syndrome; and, 10. Fetal alcohol/substance abuse syndrome, if applicable; and, 11. General overview of the adoption process; and, 12. Why children get placed for adoption; and, 13. The importance of the team approach; and, 14. Effects of fostering on the cradle care family; and, 15. Potential communication with biological family and/or adoptive family.

The cradle care provider must also hold a current infant/toddler CPR and first aid card and complete four (4) hours of on-going training a year on topics related to L. After the application is received and prior to the certificate being issued, a family assessment using the Structured Analysis Family Evaluation (SAFE) instrument(s) to determine the character and suitability of the applicant(s), appropriateness of the home, determination of the behaviors, diagnoses, and disabilities of the foster children that the foster parents could care for, and child care practices must be completed.

1. An assessment of character and suitability must include at least a review of the State Department's automated system as to applicants and persons who reside in the home of the applicants with written consent of the individuals. A review of all existing child placement agency and county department case records including the automated system must be completed. An investigation of any concerns raised from the application and/or the aforementioned sources of information and a personal assessment of the applicant must be conducted. A review of the CBI and National Sexual Offender Registry must be completed as listed at section 7.701.33. A review of the abuse and neglect records must be completed as listed at section 7.701.32.

2. The agency will require any applicant or any person eighteen (18) years of age or older who resides in the foster care home to submit a complete set of fingerprints taken by a qualified law enforcement agency. The fingerprints and appropriate processing fee must be submitted to the Colorado Bureau of Investigation (CBI) to obtain any record of arrest or conviction which is held by the CBI and FBI.

a. The agency must send an applicant card (FD 258) to the individual required to provide fingerprints. The fingerprints must be taken by a police or sheriff's department. The individual or agency must send the card to the CBI with a certified check or money order for the amount of the current processing fee for both the CBI and FBI records. The CBI report must be sent to the child placement agency certifying the foster home.

b. A certificate cannot be issued to a foster care home until the fingerprints and current processing fee are submitted to the CBI and a clearance or hit/match is received from both the CBI and the FBI. If a hit/match with a criminal history arrest is received, the formal court disposition must be received and reviewed before a decision is made to issue a certificate.

3. The family assessment must be completed using the Structured Analysis Family Evaluation (SAFE) home study format. The SAFE home study assessment must be completed using all the tools and processes required by the SAFE format. Persons completing the home studies must be qualified, as a minimum, as a placement worker, with a bachelor’s degree in the social or behavioral sciences, and must complete the Departmentrequired training prior to performing the home studies. Persons approving the home studies must be qualified as a placement supervisor and must comply with the Department-required training prior to reviewing and approving the home studies.

4. Other Requirements a. The application and medical records must be reviewed; and any issues that are identified be discussed with the applicants. No physical examination shall be required of any person who in good faith relies upon spiritual means or prayer in the free exercise of religion to prevent or cure a disease unless there is a reason to believe such person’s physical condition is such that he/she would be unable to care for a child, or such person has a communicable illness.

b. The agency shall not perform a family home assessment on its own staff member, board member, or family member of a staff member or board member or relatives of such.

c. A current photograph of the family shall be requested and maintained in the file.

d. In kinship care, the ability to provide a permanent home through adoption, guardianship or permanent custody, including the ability to meet the individualized needs of the specified child(ren), assessment of the relationship with birth parents and extended family members as they impact capacity of the applicants to care for the child(ren), and The ability to set boundaries with birth parents to maintain safety for the child(ren) in care.

e. Statements from references and physician must be obtained.

5. As part of the assessment, the agency must:

a. Conduct a minimum of one joint interview with a couple, one individual interview with each adult member of the household and an age/developmentally appropriate interview with all children residing in the home. For single applicants, a minimum of two (2) interviews will be required.

b. Conduct at least one (1) interview in the applicant's home.

c. Ensure the second interview, and any subsequent interviews, of the adults shall not be performed until at least three (3) calendar days after the previous interview.

6. Following the completion of the assessment, a narrative report must be completed that summarizes and evaluates the information obtained and lists the characteristics of child(ren) the home is approved for. Age, sex, race, legal risk, and special needs (such as medical, physical, behavioral, emotional) and any limitations or restrictions on placement of a child(ren).

7. If there are changes to the marital or civil union status, or significant change of health status for persons in the foster family, or additions of adults or children to the foster family, a visit to the home must be conducted and such persons interviewed. A re-evaluation of the family must be completed and the safe assessment revised in the form of an addendum. If there are changes in the age, sex, and special characteristics of child(ren) which will be considered for placement with the foster family, the SAFE home study assessment must be revised in the form of an addendum. Such addendums shall be signed by the applicants or a notice provided to the applicants to inform them of their option to review such addendum.

8. An on-site home inspection is required to determine its compliance with the Rules Regulating Foster Care Homes and, if the applicant is applying to be dually certified as a foster home and licensed as a family child care home, with the rules regulating Family Child Care Homes. Written documentation of the home inspection including square footage measurements of the sleeping areas shall be in the foster care home file at the child placement agency.

M. An annual on-site, unannounced, home inspection must be made to the foster care home to determine compliance with the Rules Regulating Foster Care Homes and, if the foster care home is dual certified, with the rules regulating Family Child Care Homes. A written report of the supervisory visit must be given to the foster parent and a copy maintained at the child placement agency. A written notice of noncompliance with the regulations will be left with the foster parents or sent to the foster parents within fifteen (15) calendar days of the supervisory visit if there is noncompliance. Compliance must be achieved within the time frames indicated on the written compliance notice. 7.710.34 Issuance/Denial of Certificate A. After the completion of the family assessment/home study, one of the following certification actions must be taken:

1. A one (1) year time-limited certificate will be issued when it is determined that the applicant is competent, has completed the necessary training, and has met the Rules Regulating Foster Care Homes. The certificate issue date is the date that the assessment/study is completed and the foster home is in compliance with the Rules Regulating Foster Care Homes.

2. A provisional certificate may be issued, upon the written approval of the State Department for a kinship foster care home or child specific placement when requested by a county department of social/human The reasons for the issuance of a provisional certificate must be displayed on the certificate. The provisional certificate will be issued for up to ninety (90) calendar days from the date it is determined that time will be needed to comply with the appropriate kinship foster care home or child specific regulations. Only one original provisional certificate may be issued to a foster care home at one location address.

3. The original application will be denied. The renewal application will not be acted upon. The applicant will not be certified as a foster home.

B. Upon issuance of the certificate, the child placement agency shall submit data entry information to the department on forms prescribed by the State C. The application will be withdrawn when the applicant no longer chooses to pursue certification.

D. An applicant shall be denied if the person(s) applying for the certificate has been determined to be insane or mentally incompetent by a court of competent jurisdiction and, should a court enter an order pursuant to Part 3 or Part 4 of

Article 14 of Title 15, C.R.S., or Section 27-65-109(4) or 27-65-127, C.R.S., specifically finding that the mental incompetency or insanity is of such degree that the applicant is incapable of operating a family child care home, foster care home, child care center, or child placement agency, the record of such determination and entry of such order being conclusive evidence thereof.

“Convicted” means a conviction by a jury or a court and shall also include a deferred judgment and sentence agreement, a deferred prosecution agreement, a deferred adjudication agreement, an adjudication, and a plea of guilty or nolo contendere for E, 1-6, below. This does not apply to a diversion, deferral or plea for a juvenile who participated in diversion (defined in 19-1-103(44), C.R.S.), and does not apply to an adult who successfully completed the child abuse and/or neglect diversion program (defined in 19-3-310, C.R.S.).

E. The application must be denied if the person(s) applying for the certificate has been convicted of any issues as listed AT 7.701.33,D,7.

F. The application may be denied for one (1) or more of the following reasons if the applicant(s), an affiliate of the applicant, or any person living with or employed by the applicant(s) has:

1. Been determined to meet any of the criteria as listed at 7.701.33,F.

2. Been assessed by the certifying agency to not meet the character and suitability requirements.

G. The denial of the original application must be carried out in accordance with the Colorado Revised Statutes, Section 26-6-108.

H. The agency shall not deny to any person the opportunity to become a foster/adoptive parent on the basis of race, color, religion, sex, age, sexual orientation, gender identity, or national origin of the person or of the child involved. 7.710.35 Renewal or Continuation Notice A renewal notice must be sent to the foster parents at least ninety (90) calendar days prior to the expiration of the certificate.

A. If the foster parents wish to continue to provide care, the renewal notice must be completed and returned to the child placement agency prior to the expiration of the certificate.

B. If the renewal notice is received by the child placement agency prior to the expiration of the certificate, the renewal notice is timely, and the certificate continues valid until action is taken by the child placement agency.

C. If the renewal notice is received after the expiration of the certificate, the renewal notice is untimely, and the certificate is no longer valid. The untimely renewal notice must be acted upon as an original application. 7.710.36 Recertification Action A. Upon receipt of a timely renewal application for a certificate, and prior to the expiration of the current certificate, the child placement agency must complete the following actions:

1. Evaluate the foster care homes' current and past compliance with the Rules Regulating Foster Care Homes.

2. Conduct an unannounced inspection of the foster care home in accordance with Section 7.710.33, M.

3. Review the following information, for the applicants) and all individuals residing in the home, to determine if continued certification is appropriate:

a. Any child abuse allegations or investigations in the previous year;

b. Any arrest or conviction records in the previous year;

c. Any information from the local county department concerning county involvement with the foster family, including information from caseworkers;

d. Current health status of each household member;

4. Review and update the SAFE home study assessment in the form of an update. The update shall include at least one (1) home visit. Such updates shall be signed by the applicants or a notice provided to the applicants to inform them of their option to review such update.

5. Conduct a search on the CBI sex offender registry and national sex offender public website operated by the United States Department of Justice, and include a copy in the provider record using the following criteria at a minimum:

a. Known names and addresses of each adult residing in the home;

b. Address only of the home.

6. If the foster parent or any adult living in the foster home left the state for three (3) consecutive months or longer, a new FBI fingerprint-based criminal history record information check shall be conducted.

B. At the time of the renewal of the certificate, one of the following must be completed:

1. A provisional certificate for a kinship or child specific placement will be changed to a one year time-limited certificate as soon as the foster family has completed the items listed as reasons for the provisional certificate.

2. A new one (1) year time-limited certificate is issued. The certificate issue date will be the date that the foster care home is in compliance with the Rules Regulating Foster Care Homes, as found at Section 7.708.

3. The renewal application for the certificate is denied. The process for denial of a renewal application is the same as the process for denial of an original application as listed at 7.710.34.

C. Upon issuance of the one (1) year time-limited certificate, the child placement agency must submit data entry information to the department on forms prescribed by the department.

D. A foster care home certificate is no longer valid whenever one of the following situations exists:

1. A certified foster family moves to a new address.

2. A foster family decides to withdraw from the foster care home program and confirms same in writing.

3. A certificate has been revoked or denied.

4. A certificate has expired.

7.710.4 PLACEMENT OF CHILDREN IN FOSTER CARE 7.710.41 Acceptance of Children for Placement A. No agency shall accept a child for placement, except as provided in paragraph B below, from any source other than the child's parent(s) or guardian(s), a court of competent jurisdiction or a county or tribal department of social services and upon a specific written authorization by one of these to place the child, as only these have the right under the law to contract for a child's placement.

B. If a law enforcement officer places a child in case of an emergency, when the parent or guardian cannot be located, in a facility which has been designated as a shelter facility in accordance with the law, and the law enforcement officer is unable to locate the child's parent, guardian or the persons with whom the child was living, the agency shall petition the appropriate court within forty-eight (48) hours for legal custody.

C. If a child placement agency no longer chooses to place children in the foster care home, the child placement agency shall follow one of the following procedures:

1. A provisional certificate may be allowed to expire if the foster family chooses not to submit a renewal application; or, 2. The child placement agency must send a written statement to the foster home explaining that the agency will no longer place children in the home for foster care, that the home must not accept any children for care from any other source; or, 3. The child placement agency must meet with or send a letter to the foster parents requesting them to sign a statement that they are withdrawing from the foster home program. 7.710.42 The Placement Process A. In addition to an agency's responsibility to inspect and to supervise the ongoing operation of certified foster care homes, agencies shall comply with the following minimum standards applicable to the placement process.

B. When accepting a referral, the agency shall conduct an assessment to determine whether placement of an individual child is appropriate and desirable. The following shall be included in this determination:

1. The reason(s) for placement; and, 2. Information relating to the child's natural parents or family situation including religious, educational, economic and cultural background and other factors which should include, but are not limited to, consideration of the child's family, community, neighborhood, faith or religious beliefs, school activities, friends, and child's and family's primary language; and, 3. Information relating to the child's legal status, medical or health history, his/her physical condition, personality, school placement and adjustment, previous placements outside the home, attitude toward removal from the home, and family relationships, and preferences of the child when age and developmentally appropriate; and, 4. Coordination with other social service agencies or departments which may have information relating to the child; and, 5. Additional information, if any, designed to assist the agency in determining what type of placement, if any, will best meet the needs of such child.

C. The agency must make available the original written family assessment, home study, and background checks of the foster parent(s) to the placing authority upon request. Updates to the family assessment, home study, and background checks must be sent to the placing authority.

D. A child who is to be placed in a foster care home or child care center pursuant to Sections 7.500.21 and 7.500.22 respectively shall only be placed in a home or center that is licensed by the State Department or certified by a licensed placement agency or a county department of social services.

E. The agency shall discuss information deemed necessary regarding a prospective foster child with foster parents as early as possible prior to placement. It is desirable for the child to visit and become familiar with the foster parents and other persons living therein prior to the time of placement.

F. At the time of foster placement, the agency shall complete a record of admission for the foster care home parents as outlined in, Section 7.708.51, C, and be assured that the foster care home parents have a copy of a signed authorization for foster parents to obtain emergency medical care for the foster child, if necessary.

G. No placement shall be continued where it is not in the best interest of the child.

H. If a child is placed in a family child care home, the placement agency shall be assured that the child's admission record and all admission procedures as stated Sections 7.707.5 and 7.707.51, are completed. 7.710.43 Responsibility of Placement Agency While the Child is in Care A. The placement agency shall work as closely as possible with the child's natural parent(s), guardian(s), individual or agency with legal responsibility for each child with the view to maintaining a child in his own home, placing the child in foster care temporarily or appropriate permanent substitute care.

B. The placement agency shall be assured that care is provided the child in placement in accordance with the applicable regulations, which shall include but not be limited to applicable medical, dental and optical care, and participation in appropriate educational and recreation experiences.

C. The placement agency shall require the foster home to maintain written documentation of all medical, dental, and optical care appointments of foster children, including the need for follow-up, next visit scheduled, and the reason the child was taken to the doctor. The written documentation shall be submitted by the foster home to the agency on at least a monthly basis. The agency is responsible to send the written documentation of the medical appointments to the caseworker for each foster child in care on a at least a monthly basis.

D. The agency shall provide on-going training for foster care parents to help improve their ability to care for children in placement. The training may include orientation and group meetings, publications, institutes, workshops, and consultation with experts.

E. Professional staff of the agency shall visit the home at least monthly to observe the interaction of the foster children with the foster parent(s) and to generally assess the safety of the home. Such visits shall be documented and maintained in each foster child’s file.

F. The agency is responsible to notify all placing agencies when a child is removed from care because of concern for the child's health, welfare, and safety and other children remain in care.

G. The agency and/or the foster parent(s) shall attend Administrative Reviews in person or by conference call.

H. The reimbursement rate for child maintenance agreed upon between the CPA and the county department shall be paid to the CPA foster parents for the care of the child.

I. The reasonable and prudent parent standard requirements for any foster parent to approve activities for a child or youth in foster care requires the following action:

1. The child placement agency shall train foster parents how to determine whether to approve a child’s or youth’s participation in an extracurricular, enrichment, cultural, or social activity consistent with the reasonable and prudent parent standard based upon the criteria in section 7.701.200.]

J. Child placement agencies contracting for foster care services when a county department of human/social services does not have a foster care certification program and it involves the placement of a child or youth for foster care through the interstate compact placement for children (ICPC) shall take the following steps:

1. Contract with the sending state to provide all services for a private placement; or, 2. Enter into a written agreement with the county department of human/social services with ICPC responsibility that includes but is not limited to, the services and duration of the services to be provided by the child placement agency. 7.710.44 Termination of Placement A. The agency shall counsel and assist parent(s) or guardian(s), foster parents and foster children in preparing for the termination of placement.

B. When a placement is terminated, the child shall be released only to his parent(s) or guardian(s) or to a court of competent jurisdiction. If a child has been received for care upon court order, the child shall be released only upon direction of the court.

C. Upon termination of placement, the agency shall provide the parents or the agency receiving the child with pertinent health information and other records, such as school reports, which may be useful to persons with responsibility for such child. 7.710.45 Required Records A. A placement agency shall be responsible for maintaining an individual case record for each child accepted for care. Records for siblings in care shall be individual and not co-mingled. All records are confidential and shall be protected from unauthorized examination.

B. The State Department staff shall have access to such records upon request, C. Foster care home parents are to receive necessary information regarding the foster child in care pursuant to Section 7.710.42; and such foster parents shall be given detailed instructions regarding the confidential nature of information which they receive.

D. The agency record for each child shall contain at a minimum:

1. Report of the original intake study; and, 2. An agreement signed by the parent or guardian authorizing the agency to place the child in foster care and consenting to necessary medical and surgical care. A court order transferring legal custody to the agency will fulfill this requirement; and, 3. If the child is placed in a foster care home or specialized group facility, a copy of the record of admission form as required in Section 7.708.51, C;

4. Documentation of the legal custody and responsibility for the child; and, 5. Reports completed by the care provider of the child's progress under care;

6. School reports including records of scholastic achievement and social adjustment; and, 7. Individual medical records for each child including reports of the admission examination and a complete and continuous record of illness, immunization, communicable diseases and follow-up treatment and examination; and, 8. Reports of psychological tests, psychological or psychiatric examination and follow-up treatment if obtained; and, 9. Record of visits to the child and record of the contacts with child's own family and services to be provided or for which arrangements have been made; and, 10. Copy of the treatment plan for the child in specialized group care, or the family services plan for the child in foster home care.

E. The record for each child placed by the agency in foster care shall be maintained at least three (3) years after foster care has been terminated.

F. Each placement agency shall maintain a separate record for each foster care home certified by the agency. This record shall include: the application; all relevant information obtained at the time of certification and recertification summary reports of subsequent visits to the home; and, a list of the children placed in the home, including names, birth dates, dates of placement and reasons for removal. This record shall be available to the staff of the State Department for inspection.

G. Records relating to foster care homes whose certificates have expired shall be retained for at least FIVE (5) years after the expiration of the last-issued certificate. 7.710.46 Personnel Qualifications and Duties as Sponsoring Agency of Specialized Group Facilities A. The specialized group home or center shall be supervised by a paid staff member of the agency (specialized group facility supervisor) who holds a Master of Social Work degree or a Master's degree in behavioral science with an emphasis in child development and/or family relations and a minimum of two years paid full time or equivalent part-time experience in social work. If the staff member does not have the aforementioned education and experience, then he/she must have a Bachelor's degree with a major in social work, sociology, psychology or closely related field and be directly supervised by an agency staff member holding the Master degree and experience described above.

1. The placement supervisor may serve as the specialized group facility supervisor.

2. The placement supervisor is responsible to approve all placements into the specialized group facility.

B. The specialized group facility supervisor shall obtain, provide and/or coordinate the following services:

1. Group and/or individual counseling for children in care and their families.

2. For each child, intermediate, short term, and long term goals shall be established and a case plan written. The goals and case plan must include a plan for discharge and must be developed and evaluated pursuant to

regulation section 7.714.70, D. Goals and case plan for children three and four years old shall be evaluated monthly.

3. Staff records for the home or center as required in section 7.709. 26.

4. Psychiatric, psychological or developmental evaluations and consultations as required.

5. Specialized educational resources as required.

6. Consultation with the home or center parents or personnel about methods of working with the children.

7. Assessment of quality of care with the home or center parents or 8. Children’s records as required in 7.714.932.

C. The specialized group facility supervisor shall meet with the group home or center parents or primary caregiver a minimum of two hours per week exclusive of counseling services, to discuss individual children, discharge planning including any barriers, problems, program and/or special needs. Such supervision of the group facility shall be documented in writing by the specialized group supervisor and shall be available to the department upon request. 7.710.47 Role of a Licensed Child Placement Agency to Establish and Supervise a Specialized Group Home or Center A. The supervisory responsibilities of the sponsoring agency are:

1. To be knowledgeable with the rules regulating specialized group facilities;

2. To participate in the development and application process to include verifying that the original application submitted is complete with all required signatures and submitted in a timely manner;

3. To provide ongoing assessment of the specialized group facility for quality of care issues; and 4. Provide annual evaluations of the governing body, unless the governing body and the sponsoring agency are the same agency.

5. To provide training to all staff members on the Reasonable and Prudent Parent Standard to approve activities for a child or youth in care. Such training shall include how to determine whether to approve a child’s or youth’s participation in an extracurricular, enrichment, cultural, or social activity consistent with the Reasonable and Prudent Parent Standard based upon the criteria in section 7.701.200.

B. The sponsoring agency shall be responsible to ensure that state rules are followed regarding:

1. Hiring, training and scheduling of staff;

2. Placement decisions including, but not limited to, appropriateness of placement and least restrictive environment; and 3. Documentation, reporting and corrective action of critical incidents.

C. The sponsoring agency, governing body, and group home or center parents or primary caregiver shall develop and adhere to a statement of purpose and function, which includes a description of the characteristics of the child or youth population which is to be served by the facility.

D. The sponsoring agency and the group home or center parents or primary caregiver shall develop and adhere to written policies and procedures regarding the care of children which shall be reviewed annually and shall include the 1. Provision for emergency procedures including illness, accident, fatality and fire; and 2. Participation in special activities in compliance with section 7.719.

E. The group home or center parents or personnel and the sponsoring agency shall develop and adhere to written policies and procedures regarding personnel including: pay, provision of relief time and vacation time, annual performance evaluation, training opportunities, selection of personnel and maintenance of personnel records.

F. Financial operation and oversight of the sponsored specialized group facilities shall include:

1. Each CPA shall ensure that each specialized group facility that is sponsored by the CPA develops an annual budget reflecting anticipated income by source and expenses by purpose, plus an accompanying balance sheet, which demonstrates that the Specialized Group Facility has resources to carry out its defined purpose. The budget shall be approved by the Executive Director of CPA and documentation of such maintained at the CPA primary office. The first year's budget shall be submitted with the original license application and to the CPA annually thereafter at the time of license continuation.

2. Each specialized group facility sponsored by a CPA whose total annual foster care or adoption expenditures are $100,000 or more shall provide for an annual audit by an independent certified public accountant in accordance with appropriate generally accepted auditing standards.

Specialized group facilities sponsored by a CPA with less than $100,000 total annual expenditure may submit an audit as described above or may submit compiled or reviewed financial statements, prepared in accordance with generally accepted accounting principles.

A. The supplementary information submitted shall contain an affidavit signed by the child placement agency Executive Director, the primary care provider of the specialized group facility, and the governing body authority of the specialized group facility attesting to the authenticity of the information. Submission of falsified information shall be grounds for suspension of the child placement agency and specialized group facility licenses.

B. The audit and supplementary information shall be submitted to the state department within six (6) months of the specialized group facility’s fiscal year end.

C. If a specialized group facility sponsored by a CPA does not submit its annual audit or refuses to disclose financial information regarding the operation of the program in a timely manner, the state department may send notice to withhold payment until the audit and/or requested information is submitted.

D. Upon receipt of adequate written notice that a county department or the state department plans to recover or withhold unallowable or misused funds from the CPA sponsoring a specialized group facility, the CPA may file a written request for a review of the decision with the state department as listed at 7.710.21, d, 6, a-e.

E. Allowable expenditures are listed at 7.710.21, e.

F. Unallowable expenditures are listed at 7.701.21, f.

G. Remedies are listed at 7.710.21, g.

H. Intentional misuse of funds are listed at 7.701.,21, h.

3. The CPA shall ensure proper vehicle, property, and business insurance for each specialized group facilities they sponsor, and maintain current copies of such at the licensed child placement agency location.

7.710.48 RULES REGULATING THE CARE OF CHILDREN IN FOSTER HOMES

WHEN CARE IS ALSO PROVIDED FOR ADULTS WITH DEVELOPMENTAL

DISABILITIES

A. No agency shall accept a child for placement from any source other than the child's parent(s) or guardian(s), a court of competent jurisdiction or a county or tribal department of social/human services and upon a specific written authorization by one of these to place the child. Such written authorization must contain notification that the child is to be placed in a foster home where adults with developmental disabilities are also receiving care.

B. The foster home shall meet all regulations as listed in 7.710.33.

C. The capacity of the foster home when adults with developmental disabilities are also in care shall not exceed a total of five persons requiring care through the foster care system and/or the adult intellectual and developmental disabilities (IDD) system.

1. When a foster child turns eighteen and is eligible for the adult residential system through the Division of Intellectual and Developmental Disabilities, the child shall be considered an adult receiving care for the

purpose of capacity. If the county/state Department of Social/Human Services has legal responsibility for the care and placement of the foster child turning eighteen, the individual will be considered a child for the

purpose of capacity.

2. For foster children/youth enrolled in the Children’s Habilitation Residential Program (CHRP), a maximum of three children receiving CHRP waiver services, and a total of two other persons requiring care, either an adult with developmental disabilities or a non-CHRP child/youth is allowed.

3. All children under the age of eighteen residing in the home count in the total foster home capacity of eight (8) people needing care. Also refer to 7.708.1A.

D. When a foster child in the home turns eighteen, if such child is eligible for the adult host system, such person must complete background checks as listed at 7.701.32 and 7.701.33, and a home study addendum as listed at 7.710. 33, l, 7 must be completed. 7.710.49 Rules Regulating Host Family Homes Child placement agencies are authorized to certify host family homes to provide shelter to homeless youth. All child placement agencies that certify host family homes must follow the rules regulating host family homes as listed at 7.721.

7.710.5 PLACEMENT OF CHILDREN FOR ADOPTION 7.710.51 Legal Basis A. A CPA that places children or arranges for the placement of children for the

purpose of adoption shall comply with the provisions of the Child Care Licensing Act, Sections 26-6-101 through 26-6-114, C.R.S., and the Colorado Children's Code, Sections 19-5-101 through 19-5-403, C.R.S.

B. A CPA must be approved in writing by the State Department for the type of adoption in which it engages, either domestic and/or intercountry, prior to engaging in that type of adoption. The agency must have current written policies and qualified staff at all times if engaging in intercountry and/or domestic C. A CPA cannot work with a facilitator to place or arrange for the placement of a child if that facilitator is not licensed as an adoption agency in Colorado or the resident state of the birth mother or adoptive parent(s).

D. In the case of intercountry adoptions, a child placement agency is permitted to work with an in-country coordinator who resides in the foreign country and is authorized by the foreign country to provide in-country services.

E. Foreign visiting children’s programs in which children who are eligible or may become eligible for adoption and who reside with Colorado families must comply with all applicable child placement agency rules and regulations. All families participating in such programs must meet all required standards and be certified as foster parents during such time the children reside with them. 7.710.52 Adoption Definitions “Adoption exchange” is an agency whose membership includes county departments and child placement agencies and is an organized means of sharing information among agencies about children for whom an adoptive resource is not immediately available and about potential adoptive families for whom an agency does not have a child waiting.

The purpose of an exchange is to facilitate permanence as quickly as possible so that a child does not wait while an agency develops a resource.

“Administrative notice procedure” applies only to expedited relinquishments filed under

Section 19-5-103.5, C.R.S., and allows the CPA counseling the birth mother to provide notice to the presumed Birth father of an anticipated expedited relinquishment prior to the filing of the relinquishment petition. The notice to the presumed birth father cannot be made more than sixty (60) days prior to the birth of the child.

“Agency adoption” means an adoptive placement in which the CPA is responsible to counsel the birth parent(s), place the child(ren), supervise the placement, and provide reports to the court as required by law. The CPA is granted custody of the child(ren) with the right to place for adoption either as legal risk placement or through relinquishment or termination of parental rights by court order and places the child(ren) for adoption with adoptive parent(s) who have a CPA approved adoptive family An “adoption caseworker” must be qualified as a placement worker and may complete family assessments, place a child with a family, provide post placement supervision and training for adoptive parents, all under the direct supervision of a placement supervisor.

“Birth parent counseling”, here-in-after referred to as “counseling”, means the required decision making counseling that shall be provided to a birth parent(s) or legal parents prior to a decision regarding whether or not to relinquish a child(ren) as required at 7.710.57.

A “birth parent counselor” must be qualified as a placement worker and may have responsibility for relinquishment/decision making counseling with birth parent(s) dealing with an unplanned or crisis pregnancy or the relinquishment of a child, all under the direct supervision of a placement supervisor.

“Closed adoption” means an adoptive placement when the adoptive parent(s) and the birth parent(s) do not share identifying information or communicate with each other before or after the finalization of the adoption.

“Concurrent adoption” means more than one (1) adoption being processed simultaneously either through the same agency or multiple agencies.

“Convention” means the Convention on protection of children and cooperation in respect of intercountry adoption done at the Hague on May 29, 1993.

“Convention adoption” means the adoption of a child resident in a Convention country by a United States citizen or an adoption of a child resident in the United States by an individual or individuals residing in a Convention country when in connection with the adoption the child has moved or will move between the United States and the Convention country.

“Convention country” means a country that is a party to the Convention and with which the Convention is in force for the United States.

“Country of origin” means the country in which a child is a resident and from which a child is emigrating in connection with his or her adoption.

“Designated adoption” means an adoptive placement in which adoptive parent(s) have been designated by the birth parent(s) prior to either parties involvement with a CPA licensed for adoptions. The CPA is responsible for completing the birth parent(s) counseling and to ensure an adoptive family assessment is completed for the designated parent(s). The CPA is granted temporary custody of the child for the

purpose of placement.

“Dissolution” means the termination of the adoptive parent(s)’ parental rights after an “Disrupted adoption” means the interruption of a placement for adoption during the postplacement period.

“Domestic adoptions” means collectively identified or designated adoptions, interstate adoptions, and intrastate adoptions.

“Expedited Relinquishment” means the legal process which a parent desiring to relinquish his or her child under one (1) year of age may follow to obtain an expedited order terminating his or her parent-child legal relationship without the necessity of a court hearing.

“Facilitator” means a person, partnership, corporation, association, firm, agency or institution, other than an adoption exchange, county department or child placement agency, who offers, gives, charges or receives any money or other consideration or thing of value in connection with locating or identifying for purposes of adoption any child, birth parent, expectant natural parent or prospective adoptive parent.

“Foreign national” means a child who was born outside the United States of America (U.S.A.), at the time of placement lacks U.S.A. citizenship, and is a resident outside the U.S.A.

“Foreign visiting children’s program” means a program in which children visit Colorado from other countries and may or may not be available for adoption.

“Foster care adoption” means a placement in which the child(ren)'s parental rights have not been terminated at the time of the foster care placement. The placement is made as a long-term foster care placement with the intention of adoption if or when the parental rights are terminated.

“ICPC” means the Interstate Compact for the Placement of Children which is an agreement that has been enacted into law by all fifty (50) states in the United States and the District of Columbia, which controls the lawful movement of children from one state to another for the purposes of adoption. Both the originating state, where the child is born, and the receiving state, where the adoptive parents live and where the adoption of the child will take place, must approve the child's movement in writing before the child can legally leave the originating state. This Compact regulates the interstate movement of both foster children and adoptive children. For further information or to obtain a copy of “Guide to the Interstate Compact on the Placement of Children”, contact the:

American Public Human Services Association, 1133 Nineteenth Street, NW, Suite 400, Washington, DC 20036. Phone: 202-682-0100; Fax: 202-289-6555.

“Intercountry adoption” means the placement of children emigrating from their country of origin. The placement for the purpose of adoption of foreign national children with approved adoptive parents in Colorado is considered an incoming or immigrating case.

The adoption may be finalized in Colorado or in the foreign country depending on the requirements of the foreign country. If the foreign country in this instance is party to the Hague Convention on Intercountry Adoption, the adoption must be in compliance with the Intercountry Adoption Act of 2000 and with federal regulations 22 CFR Parts 96, 97, and 98. U.S. children placed in a foreign country for the purpose of adoption is considered an outgoing or emigrating case. If the foreign country is party to the Hague Convention, the adoption must be in compliance with the Intercountry Adoption Act of 2000 and Federal Regulations 22 CFR Parts 96, 97, and 98.

“Interstate adoption” means a placement of a child into or from Colorado with a person(s) for the purpose of adoption. Placement shall be in conformity with Colorado Revised Statutes, including the Child Care Licensing Act, the Colorado Children's Code and the Interstate Compact on Placement of Children. Services to the child and adoptive family shall be provided under the laws of each state.

“Intrastate adoption” means an adoptive placement of a Colorado child with a person(s) who is a resident of Colorado.

“Legal risk adoption” means an adoptive placement where parental rights have not been relinquished and/or terminated and the child(ren) is not yet legally free for adoption at the time of placement. This includes infants placed directly after birth. The child(ren) is placed in an approved adoptive home. If the adoptive family resides in Colorado, the home shall be certified as a foster home. The placement is with the intention of adoption when or if the child becomes available for adoption. The placement remains a legal risk placement until parental rights have been relinquished or terminated.

“Non-agency adoption” means a placement in which the child(ren) is placed by the birth parent(s) with person(s) unrelated to the child(ren). The placement is made with the intention of adoption. There has been no CPA participation, birth parent counseling, or adoptive family assessment completed before the placement of the child(ren). In order for the adoption to be finalized, the birth parent counseling and approved family assessment shall be completed by a CPA or county department of social services.

“Open adoption” means an adoptive placement where the adoptive parent(s) and the birth parent(s) choose to communicate with each other and share identifying information. The communication and sharing of information may occur before and/or after the finalization of the adoption. The degree of openness is determined by the parties involved.

“Relative adoption” means a placement for the purpose of adoption in which a child(ren) is placed with a person(s) related to the child(ren) as a grandparent(s), aunt, uncle, brother(s), or sister(s).

“Selected agency” means the non-public agency selected by, the State Department, pursuant to Section 19-5-205.5, C.R.S., to perform the administrative review and approval or denial functions required by the Interstate Compact on the Placement of Children (ICPC) and statutes governing foreign adoptions. Agencies selected by the State Department to provide these functions shall hereafter be referred to as “selected agencies”.

“Semi-open adoption” means an adoptive placement when the adoptive parent(s) and the birth parent(s) choose to share non-identifying information with each other either before and/or after the finalization of the adoption. The amount of information shared is determined by the parties involved. All information shared is sent to the adoption CPA.

“USCIS” means the United States citizenship and Immigration Services. 7.710.53 Disclosure and Fee Information A. Prior to signing the adoption services contract or other specific agreement for adoptive services or payment of any fees, each agency must provide in writing the following information to any applicant(s) approaching the agency with an interest in adopting a child(ren). The information must be easily understandable to any applicant. Applicants must sign a statement affirming that they have received the following information:

1. The most current child care license for the agency; and, 2. The philosophical perspective and/or religious affiliation of the agency;

3. Information as to where any prospective adoptive parent may obtain:

a. A list of all licensed adoption agencies in the State of Colorado;

b. Information as to how to review the official licensing file for the agency; and, c. Information as to how to file a complaint regarding the agency with the Colorado Department of Human Services; and, d. Information as to how to obtain the rules regulating child placement agencies in the State of Colorado.

4. For what programs the agency has been approved (foster care, domestic adoption, intercountry adoption) by the State Department including a detailed description of the services offered and the agency’s role in those services; and, 5. A statement that parents are paying for services provided by the agency, not for children; and, 6. A copy of the most current annual report submitted to the State Department as found at Section 7.710.73, A; and, 7. A fee schedule listing all the costs of the adoption itemized by services; including incidental fees, additional expenses, and post-finalization fees if included in the cost for the adoption, as listed in Section 7.710.53, C; and, 8. Average time frame for the different services provided, including the family assessment and for the complete finalization of the adoption; and, 9. Description of required training for adoptive parents, as required in Section 7.710.55; and, 10. The process of sharing available information regarding the child and the birth family as provided in accordance with Colorado statute pertaining to identifying and non-identifying information; and, 11. Provide information about the birth parent contact preference form and the medical history statement that the birth parent can file with the State Registrar, including the ability of the birth parent to change the preference form at a later date; and, 12. Any policy that would result in the denial of services or would preclude placement of a child with an adoptive family; and, 13. The grievance/appeal process of the agency; and, 14. Post adoption services offered or required by the agency as found at

Section 7.710.62 and the cost of such services; and, 15. The right to seek legal counsel to further understand Colorado adoption laws; and, 16. Process of record storage and maintenance in the event of closure of the agency; and, 17. Any service if provided or offered by the CPA is provided by another agency, entity, or individual; and, 18. That applicants who reside in Colorado and whose adoptions will be finalized in the State of Colorado must apply for and be certified as foster care parents until the finalization of the adoption; and, 19. The agency’s policy on concurrent adoptions; and, 20. That only pregnancy related expenses may be paid to a birth parent and all payments made on behalf of a birth parent must be processed through the agency; and, 21. The requirement of the agency to collect fees and submit court documents after the completion of an intercountry adoption to validate such adoption in the United States court.

B. Prior to the provision of services, or for some items during the birth parent or legal parent counseling, each agency must provide the following information in writing to any parent(s) approaching the agency with an interest in the possible relinquishment of a child(ren) for the purpose of adoption. The written information must be easily understandable to any parents in language or manner they can understand. Disclosure items 1 through 8, below, must be provided prior to service. Disclosure items 9 through 18 may be provided to the parent(s) prior to service and/or during the parents’ counseling process.

1. Information as to whether the birth or legal parent(s) is required to sign a contract or agreement with the agency.

2. A list of birth or legal parent rights under current Colorado law including, but not limited to:

a. All of the legal options related to the relinquishment procedures presented in an accurate, competent, unbiased manner; and, b. A fair and balanced picture of adoption presented; and, c. Decision-making related to the possible relinquishment of a child in an atmosphere free from coercion and undue pressure; and, d. Option, by law, to change the decision about relinquishment and to choose to parent the child. The decision can be changed at any time prior to the final order of relinquishment being signed by the court, unless otherwise limited by a court order if a court hearing is held; and, e. Written grievance procedure for the agency; and, f. Philosophy and/or religious affiliation of the agency; and, g. Referral to helping organizations in the community if a decision is made to parent the child; and, h. Termination of the relationship with the agency parent counselor at any point during the counseling relationship; and, i. To seek independent counsel on any issue related to the relinquishment of a child(ren), including the right to seek independent counseling for an expedited relinquishment procedure.

3. The following must also be provided to birth parents considering relinquishment of a newborn infant:

a. The right to receive a copy of any document signed by the birth parent(s) and to receive a copy of the original birth certificate; and, b. The right to have all of the legal options related to a pregnancy presented in an unbiased manner; and, c. The right to receive, in writing, the process by which an expedited relinquishment affidavit is withdrawn, including a personal meeting with a representative of the agency and the signing of a statement of withdrawal which is witnessed and signed by an agency representative; a copy of the statement with original signatures must be provided to the birth parent(s); and, d. The right to withdraw an affidavit for expedited relinquishment at any time before the affidavit is filed with the court. In the case of expedited relinquishment, the petition for relinquishment may not be filed until at least four (4) calendar days after the birth of the 4. Range of available adoptive families, to include religion, race and ethnicity.

5. Information as to where any parent considering relinquishing a child for adoption may obtain:

a. A list of all licensed adoption agencies in the State of Colorado.

b. Information as to how to review the official licensing file for the c. Information as to how to file a complaint regarding the agency with the Colorado Department of Human Services.

d. Information as to how to obtain the rules regulating child placement agencies in the State of Colorado.

6. Copy of the most current annual report submitted to the State Department as described in Section 7.710.74.

7. Policy regarding the payment of pregnancy related expenses and that only pregnancy related expenses may be paid to a birth parent. All payments made on behalf of a birth parent must be processed through the child placement agency.

8. Information about whether the birth parent(s) have the right to choose the adoptive family.

9. Requirement for birth parent counseling; topics covered.

10. Information about the different types of adoption services the agency provides.

11. Types of communication between birth parents and adoptive parents, including a statement that the adoption agency cannot enforce any voluntary agreements written or unwritten entered into between birth parent(s) and adoptive parent(s).

12. How parental rights are terminated in Colorado; legal process; mother and father, including the option of expedited relinquishment and administrative notice to the presumed birth father.

13. The process for identifying and serving legal, alleged, and/or presumed birth father(s).

14. Any policy or requirement that would preclude the agency placing a child for adoption.

15. Provide information on the Birth Parent Contact Preference Form and Medical History Statement that can be filed with the State Registrar.

16. Process of record storage and maintenance in the event of closure of the 17. The process of sharing available information regarding the child and the birth family as provided in accordance with Colorado statute, Section 19-5- 301, C.R.S., pertaining to identifying and non-identifying information.

18. The grievance and/or appeal process of the agency.

C. The agency provides to all applicants, prior to application, a written schedule of expected itemized total fees and itemized total expenses, along with a written explanation of the conditions under which fees or expenses may be charged, waived, reduced, or refunded, and when and how the fees and expenses must be paid.

1. For intercountry adoptions, the agency must provide, in writing, a detailed listing of the following expenses:

a. Home study fee; and, b. Adoption expenses in the United States; and, c. The foreign country program expenses; and, d. The care for the child in the foreign country expenses; and, e. Translation and document expenses; and, f. Contributions to humanitarian or other welfare services programs in the foreign country; and, g. Post-placement and post-adoption report expenses; and, h. A written explanation of when the fees may be charged, waived, reduced, or refunded; and, i. To whom the fees are paid, and when must also be provided to the applicant.

2. For intercountry adoptions, the agency may not customarily charge any additional fees and expenses beyond those disclosed in the adoption services contract and must have a written policy to this effect. In the event that unforeseen additional fees and expenses are incurred in the foreign country, the agency may charge such additional fees and expenses only when it notifies the prospective parents of such. The agency shall obtain specific written consent from the prospective parents prior to expending funds in excess of one thousand dollars ($1,000) for which the agency will hold the adoptive parents responsible. The agency must provide written receipts to the prospective parents for fees and expenses paid directly by the agency, on behalf of the prospective parents, in the foreign country.

D. The agency returns any funds to which the prospective adoptive parents may be entitled within sixty (60) days of the completion of the delivery of services.

E. For intercountry adoptions, the agency must set up an escrow or other passthrough account for all monies that prospective adoptive applicants are required to pay directly to a foreign country to complete an intercountry adoption. These fees may not be deposited into any agency account or used for any purpose other than the foreign country fees. If the applicants request a refund of the monies to be paid to the foreign county, the agency must refund all monies paid by the applicants into the escrow or pass-through account, but not yet transferred to the foreign country, within thirty days of the applicant(s)’ request for refund.

F. For intercountry adoptions, the agency may only collect fees from the applicants for the actual services being rendered. Such fees may not be collected more than thirty (30) days prior to the event date of the service being initiated. All fees, scheduled payments, and anticipated completion dates of service must be in writing and provided to applicants at each time fees are paid.

G. If the agency requires the prospective adoptive parents to sign a waiver of liability, the waiver shall be limited and specific, based on the risks that have been discussed with and explained in writing to the client in the adoption services contract or other written agreement for adoption services.

H. The agency shall provide to all applicants for the foreign visiting children’s program the following information:

1. The total cost of the program, including all fees for the background checks, home assessment, and care of the children while in care of the applicants.

2. The child(ren) in the applicant’s care may not be available for adoption, and if the child(ren) are available for adoption, the applicants may not be the family approved to adopt the children.

3. The foreign visiting children’s program is not an adoption program and if the applicants desire to adopt a child, either from the visiting children’s program, or other program, they must apply and complete the adoption process, which includes a full home study and assessment.

4. The child(ren) in the applicant’s care must be cared for by the applicants and any emergency care must be approved by the placement supervisor.

5. The applicants must be certified as foster parents for the duration of the time the children are in care. 7.710.54 Adoption Procedure A. Adoptions Finalized in Colorado For all adoptions to be finalized in Colorado in which a child is placed in Colorado with an adoptive applicant(s) residing in Colorado, the agency must:

1. Complete an assessment of each adoptive family in which a child is to be placed for adoption as detailed at Section 7.710.56.

2. Provide training to each adoptive family as detailed at Section 7.710.55.

3. Provide birth or legal parent counseling to any parent prior to a decision regarding whether or not to relinquish a child as detailed at Section 7.710.57.

4. Complete a study of the child for adoption as detailed at Section 7.710.58.

5. Provide all necessary services for the adoptive family while the family is present in the foreign country as detailed at Section 7.710.64.

6. Complete all requirements that must occur at the time of placement of a child for adoption as detailed at Section 7.710.59.

7. Provide post placement services to the adoptive family and child until a decree of adoption is granted as detailed at Section 7.710.6.

8. Receive a completed and signed State-approved foster care application from the adoptive family.

9. Submit a completed State-approved foster care certification form to the Division of Child Care prior to the child being placed in such adoptive home. A completed State-approved closure form must be submitted to the Division of Child Care upon finalization of the adoption.

B. Adoptions Finalized in a Foreign Country For all adoptions of foreign nationals that will be finalized in the child’s country of origin and jurisdiction, the agency must:

1. Complete an assessment of each adoptive family in which a child is to be placed for adoption as detailed at Section 7.710.56.

2. Provide training to each adoptive family as detailed at Section 7.710.55.

3. Complete a study of the child for adoption as detailed at Section 7.710.58.

4. Complete all requirements for United States Citizen and Immigration Services (USCIS) as detailed at Section 7.710.94.

5. Provide all necessary services related to the adoption while the family is present in the foreign country as detailed at Section 7.710.64. Such services may be provided by another licensed child placement agency or by a contract staff member or approved entity in the foreign country. If the services are provided by another licensed child placement agency or approved entity in the foreign country, a signed agreement detailing the services and costs of such services must be signed by both the Colorado agency and the other agency or approved entity prior to the adoptive family traveling to the foreign country. Such services must be disclosed in writing to the adoptive family as listed at 7.710.53, A, 17.

6. Provide post adoption services to the adoptive family and child, if required by the foreign country, as detailed at Section 7.710.62.

7. Notify the selected agency when the family returns to Colorado with the child adopted in the foreign country.

8. Submit validation documentation to the Colorado court of jurisdiction after completion of intercountry adoption within thirty (30) days of the child arriving in Colorado.

C. United States Children Emigrating to a Foreign Country For all adoptions in outgoing cases, the agency, if acting as the placing agency, must:

1. Be Hague accredited if the child is emigrating to a convention country.

2. Complete a child background study in compliance with Section 7.710.58 and with Federal Regulation 22 CFR Part 96 Section 96.53.

3. Ensure that all consents have been obtained in compliance with Federal Regulations 22 CFR Part 96, Section 96.53, and Colorado statutes; and meets all rules pertaining to birth parents and birth parent counseling as found in Section 7.710.57.

4. Except in the case of adoption by relatives or in cases in which the birth parents have identified specific prospective parents, make reasonable efforts to find a timely adoptive placement for the child in the U.S.

5. Take all appropriate measures to determine whether the placement will be in the best interest of the child.

6. Ensure that the home study on the prospective adoptive parent(s) is prepared in accordance with the laws of the receiving country, which includes:

a. Information on the prospective adoptive parent(s)’ identity, eligibility, and suitability to adopt; and, b. Background; and, c. History; and, d. Social environment; and, e. Reasons for adoption; and, f. Ability to undertake an intercountry adoption; and, g. The characteristics of the children for whom they would be qualified to care; and, h. The results of a criminal background check. 7.710.55 Training A. The adoptive agency shall verify and document that all adoptive applicants have completed training provided or approved by the agency as a part of the adoption process.

1. All adoptive applicants shall complete sixteen (16) core hours of training provided in face-to-face format.

2. Reasonable effort must be made to complete all required hours of training prior to the placement of a child(ren)/youth.

3. All training must be completed by each adoptive applicant prior to the finalization of the adoption.

4. Applicants adopting children over twelve (12) months of age or completing an intercountry adoption must complete training topics as listed at Section 7.710.55.C.

5. Training must be separate from and in addition to the family assessment.

6. If an adoptive applicant(s) is completing a subsequent adoption through the same agency or has complete, documented training from their previous agency, the core training need not be repeated if documentation of the prior training is on record with the current agency.

7. All training must be documented in writing, including dates, number of hours and topics covered.

B. Core training must include all of the following topics:

1. Attachment/bonding issues.

2. Loss and grief issues, including infertility, as applicable for all parties to the adoption.

3. Adoption as a lifelong issue as it pertains to all parties to the adoption.

4. Key concepts of child growth and development.

5. Boundary setting and discipline.

6. Parenting a child of a different cultural or racial background infancy through adulthood, if applicable.

7. Disclosure issues including the accuracy of family history information regarding the child and birth parent(s)’ family, discussion with the child and sharing information with others.

8. Understanding adoption laws and procedures, including termination of parental rights and the expedited relinquishment process pursuant to

Section 19-5-103.5, C.R.S., and the administrative notice for any other birth parent or possible birth parent pursuant to Section 19-5-103.7, C.R.S., if applicable.

9. On-going contact and/or communication of child and adoptive family with biological family and/or significant individuals, if applicable.

10. Possible current and/or future use of community resources, including help with parenting techniques.

11. Medical and health issues including, but not limited to, shaken baby syndrome, parental substance abuse, relevant environmental issues, and genetic risk factors.

12. Expectations of adoption and adoptive process.

13. Basic core and supervision appropriate to the age of the child.

14. Reasonable and Prudent Parent Standard.

C. Additional Areas of Training 1. For families that will be adopting a child who is either medically fragile, over twelve (12) months of age or any intercountry adoption, four (4) additional hours from the following topics must be completed as applicable and appropriate for the age(s) of the child(ren) being adopted for a total of twenty (20) hours. These four (4) hours of training may be approved in formats other than face-to-face training at the agency’s discretion.

a. Parenting a child that has been abused or neglected.

b. Parenting the physically, mentally, developmentally, or emotionally delayed child.

c. The impact of frequent moves and multiple caregivers on the development of a child.

d. Possible physical, mental, emotional, and behavioral issues pursuant to Section 19-5.5-303, C.R.S. concerning:

1. Identity, loss, and trauma that a child/youth may experience before, during, or after adoption;

2. A child/youth leaving familiar ties and surroundings;

3. The effect that the access to resources, including health insurance, may have on the ability of an adoptive parent to meet the needs of a child/youth;

4. Causes of disruption of an adoptive placement or dissolution of an adoption and resources available to help avoid disruption or dissolution.

2. For families that are only completing an intercountry adoption, an additional four (4) hours of training on all topic areas listed below must be completed as applicable for a total of twenty-four (24) hours. These four (4) hours of training may be provided in formats other than face-to-face at the discretion of the agency and must be completed prior to travel.

a. U.S. immigration requirements and the laws and procedures of the foreign country, including reporting requirements such as any postplacement or post adoption reports required by the expected country of origin.

b. Cultural heritage of the child, including available community resources.

c. Information on the long-term implications for a family that has become multicultural through intercountry adoption, including:

1. The child’s history and cultural, racial, religious, ethnic and linguistic background; and, 2. The known health risks in the specific region or country where the child resides. Any general characteristics and needs of children awaiting adoption and the in-country conditions that affect children from the expected country of origin.

d. Any other medical, social and other data known about the particular e. The impact of a child leaving familiar surroundings as appropriate to the expected age of child.

f. The impact of frequent moves and multiple caregivers on the development of a child and data on institutionalized children and the impact of institutionalization on children, including the effect on children depending on the length of time spent in an institution and of the type of care provided in the expected country of origin.

D. Applicants participating in the foreign children’s visiting program must complete training in the following areas prior to a child/youth being cared for in the home:

1. CPR and first aid training for all adult applicants in the home.

2. Mandatory reporter training.

3. Any known health risks in the specific region or country where the child/youth resides.

4. The child/youth’s history, cultural, racial, religious, ethnic and linguistic background. 7.710.56 Assessment of the Adoptive Family and Report A. Any individual, couple or family who desires to be considered to have a child(ren) placed for the purpose of adoption or second parent adoption must participate in an assessment regarding his/her suitability, appropriateness, and readiness for an adoptive placement.

B. Any individual that is planning a second parent adoption must notify the agency and include the individual involved with the second parent adoption to participate in the home study, if the home study will be used in the next six months for a second parent adoption.

C. An agency must complete the assessment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin of the person or the child/youth involved in the adoption, except as provided in 7.710.12, C, and 19-5- 206, C.R.S.

D. The agency must include in the assessment all members of the household.

E. The agency shall not conduct an assessment for any paid or volunteer member of its staff or any member of the board of directors for the agency.

F. As part of the assessment, the agency must conduct a minimum of three face-toface joint interviews with a couple, one face-to-face individual interview with each adult member in the household, and a face-to-face age/developmentally appropriate interview with all children residing in the home. For single applicants a minimum of three face-to-face interviews will be required.

G. The agency must conduct at least one interview in the applicant's home.

H. A family assessment shall be completed using the Structured Analysis Family Evaluation (SAFE) home study format. The SAFE home study must be completed by using all required tools and processes required by the SAFE format. Persons completing the home studies must be qualified, at a minimum, as a placement worker, with a Bachelor’s degree in the social or behavioral sciences, and must complete the Department-required training prior to performing the home studies. Persons approving the home studies must be qualified as a placement supervisor and must comply with the Departmentrequired training prior to reviewing and approving the home studies.

1. Joint interviews of the adoptive applicants must be held on separate days.

2. The second interview, and any subsequent interviews of the adults, shall be conducted during weekly meetings at least three (3) calendar days apart I. The assessment for a domestic adoption shall be updated annually and the assessment for an international adoption shall be updated as required by United States Citizenship and Immigration Services regulations. If the assessment is not required to be updated by USCIS, the intercountry assessment shall be updated every 24 months from the time of initial approval. An update shall include at least one home visit and a review of the current medical status. During each subsequent addendum applicants shall be questioned regarding any child abuse investigations during the previous year. The update shall be completed using the prescribed format.

J. If there are changes in adults or children to the household, changes in the residence, marital or civil union status, criminal history, finances, or the age, sex, and special characteristics of child(ren) which will be considered for placement with the adoptive family, a re-evaluation of the family must be completed and the family assessment revised in the form of an addendum. Such addendums shall be signed by the applicants or a notice provided to the applicants to inform them of their option to review such addendum.

K. As a part of the family assessment the agency must obtain:

1. A completed, dated and signed formal application for adoption, including a signed fee agreement and a disclosure agreement as outlined at Section 7.710.53, A.

2. A current photograph of all members of the household.

3. A copy of a current marriage license or civil union license, if applicable.

4. A copy of a divorce decree(s) or civil union dissolution, if applicable.

5. The results of a current fingerprint-based criminal history record check through both the Colorado Bureau of Investigation (CBI) and Federal Bureau of Investigation (FBI) on all adult members of the household, processed through the current Colorado child placement agency license number. The results of the National Sex Offender Registry check on all adults in the household. The results of the child abuse or neglect records checks from the State Department and appropriate entity in each state in which the adult(s) in the household resided in the five years preceding the date of the application to adopt.

A. If adoptive applicants transfer from one Colorado agency to another, the new agency must process fingerprints through the applicant’s license number prior to any certification or placement of children into a home.

B. The agency shall report to the court any case in which a fingerprintbased criminal history record check reveals that the prospective adoptive parent was convicted at any time of a felony or misdemeanor in one of the following areas:

1) Child abuse or neglect; or, 2) Spousal abuse; or, 3) Any crime against a child, including child pornography; or, 4) Any crime, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as defined in Section 18-6-800.3, C.R.S.; or, 5) Violation of a protective order, as described in Section 18-6- 803.5, C.R.S.;

6) Any crime involving violence, rape, sexual assault, or homicide;

7) Any felony physical assault or battery conviction or felony drug-related conviction within, at a minimum, the past five years.

C. No person convicted of a felony offense specified in items Section 7.710.56, K, 5, d, a shall be allowed to adopt a child, except a person may be allowed to adopt a child if:

1) The applicant has had no further arrests or convictions subsequent to the original conviction; and, 2) The applicant has not been convicted of a pattern of misdemeanors, as defined by rule of the State Board of Human Services at Section 7.701.33, D, 7, f, 1-3; and, 3) The court enters a finding consistent with Section 19-5- 210(2)(d), C.R.S., that the adoption is in the best interest of the child.

6. A minimum of three (3) personal references from individuals, unrelated to the applicant(s), that have knowledge of the applicant(s) character and suitability to parent a child. The references must be obtained in writing using the prescribed SAFE format instrument for the type of adoption the applicant has requested.

7. Verification of current health insurance coverage or a statement of intent that health insurance coverage will be obtained for the child upon 8. A dated physician’s statement current within one year from the time of application for adoption for each member of the household, certifying that the applicant(s) and all members of the household are free from communicable disease or a physical condition that would impair his/her/their ability to care for children. Subsequent medical statements shall be required upon the written direction of the physician or within one year of the last dated and signed statement if not specified by a physician.

No physical examination shall be required of any person who in good faith relies upon spiritual means or prayer in the free exercise of religion to prevent or cure disease unless there is a reason to believe such person's physical condition is such that he/she would be unable to care for a child.

L. A family assessment using the Structured Analysis Family Evaluation (SAFE) instrument(s) shall be completed using the current and appropriate SAFE format for the type of adoption for which the applicant(s) has requested.

M. If an applicant desires to be considered for another adoption with the same agency:

1. If the period of time since the last family assessment is within three (3) years of the original approval date of the original family assessment, a subsequent update using the SAFE instrument shall be completed. The assessment update shall include at least one joint interview, coupled with one documented individual interview with each adult member of the household, and an age/developmentally appropriate interview with all children. At least one interview with the family must be conducted in the home. The individual interviews with the adoptive applicants must be completed on the same date.

2. If the period of time since the approval of the original family assessment is longer than three (3) years, a full and complete family assessment using the SAFE instrument shall be completed.

N. The agency must update the previously completed family assessment in order to address significant changes in the time period subsequent to the original family assessment, including, but not limited to:

1. Criminal history charges or convictions; and, 2. Child abuse investigations; and, 3. Marital or civil union status; and, 4. Changes in family structure; and, 5. Employment/financial resources; and, 6. Health changes/status; and, 7. Place of residence; and, 8. Other significant changes within the family.

O. If an applicant desires to be considered for an adoption through a different licensed child placement agency, and the full SAFE assessment is received directly from the originating agency and along with an update with an approval date of less than one year old, the new agency may either complete:

1. An update of the original family assessment using the SAFE instrument that addresses all categories as listed in Section 7.710. 56,K; or, 2. A full SAFE assessment. If the assessment or update approval date is more than one year old, a complete assessment using the SAFE instrument must be completed.

P. Following the completion of the family assessment, a narrative report must be completed according to the SAFE instrument and training guidelines.

Q. For families applying for an intercountry adoption, the agency must complete the adoptive family assessment using the international SAFE template and must:

1. Maintain on file at the agency a written copy of the home study requirements for each foreign country for which a child placement agency approves a family.

2. Ensure that the family assessment submitted to the foreign country:

a. Is a reasonable, true, and responsible assessment of the family concerning the requirements of the foreign country; and, b. Is provided to the foreign country, including any and all information obtained during the assessment process; and, c. Does not knowingly provide false or inaccurate information or knowingly withhold or exclude information from the foreign country, which is grounds for suspension of the child placement agency’s R. At the conclusion of the family assessment process:

1. The family shall be offered the opportunity to review the assessment with an agency staff member and submit corrections to the agency of any inaccuracies to the data contained in the assessment.

2. The applicant(S) must either:

a. Sign a statement that they have been given the opportunity to read and review the final draft of the family assessment, excluding the confidential references, or b. Sign the SAFE home study assessment section indicating they have read and reviewed the final draft of the home study.

S. If at any time after the receipt of a formal application the agency becomes aware that it will not be able to continue to provide services or to recommend the applicant(s) for approval for an adoptive placement, or the adoptive family withdraws from the service provided by the agency, the agency must:

1. Notify the applicant(s) in writing within five business days with the reason(s) for the discontinuation of services or confirmation of the family’s request for withdrawal from services.

a. If the agency is discontinuing the services, include with the notification letter a copy of the agency’s process for filing a grievance with the adoption process or assessment as required at

Section 7.710.71; and, b. That the agency shall submit a copy of the denial or withdrawal confirmation letter to the Division of Child Welfare at the same time it is submitted to the applicants.

2. In the case of an intercountry adoption with an approved I600A or I800A, the agency shall notify USCIS, the selected agency and the State T. The approved SAFE family assessment, signed by the placement supervisor and notarized, and supporting documentation is a part of the official adoption record of the agency and shall be released upon the written authorization by the applicant(s):

1. To another licensed adoption agency, a Colorado county department of social/human services, or an entity licensed in other states to provide adoptive placement services or, 2. When required by a foreign country to complete an intercountry adoption, to the adoptive applicant(s), to accompany them when traveling to the foreign country, if each page of the family assessment contains the agency raised seal and the pages are numbered according to the full number of pages in the document; and, 3. Shall be transmitted within thirty (30) calendar days of the written request or of when the original agency receives full payment of all fees for services rendered by the agency.

U. If agency policy allows for prospective adoptive parent(s) to apply for concurrent adoptions within their agency, or through both their agency and another Colorado licensed CPA or county department of social/human services, the following applies:

1. At least one of the concurrent adoptions does not require the adoptive applicant(s) to be certified for foster care; and, 2. If two CPAs are providing services to the adoptive applicant(s), the applicant(s) shall sign a release of information for both CPAs prior to the agencies exchanging any information; and, 3. The family assessment completed for the initial adoption must be updated to address the reason(s) for the concurrent adoption; and, 4. All agencies involved are aware of the concurrent adoptions; and, 5. The assessment or update(s) shall be completed in the correct format for the type of concurrent adoption being pursued; and, 6. The assessment or update(s) completed for the second adoption shall:

a. Address the reason for the concurrent adoption; and, b. The type of child the adoptive applicant(s) are approved for in the second adoption; and, c. If more than one agency is involved, that both agencies are aware of the concurrent adoptions; and, d. That the original assessment/update(s) may be shared with the second agency, with written approval from the adoptive applicants.

7. Updates to both assessments must be completed within one year of the original assessment if no adoptive placement has occurred.

8. Both assessments must be submitted separately for ICPC or USCIS approval, if applicable.

9. If one agency places a child(ren) for adoption, either foreign or domestic, the second agency shall:

a. Wait a minimum of six (6) months before placing another child(ren) into the home; and, b. Complete a home study update to assess the appropriateness of placing an additional child(ren) into the home.

10. The agency placing the child(ren) into the home shall also complete a home study update to assess the ability of the family to adopt an additional child(ren).

11. The adoptive applicant(s) must sign a statement for each potential adoption agreeing to notify the other agency of when a placement of a child(ren) occurs.

V. The agency shall complete a home and safety check on all applicants for the foreign children’s visiting program, which shall include, at a minimum:

1. An interview with all adults and children who will reside in the Home during the time the child is in care.

2. Background checks as listed at 7.710.56, K, 5.

3. A review of the house and grounds of the property to ensure there are no safety hazards.

4. A determination that all weapons, including guns, are stored separately from ammunition. Both the weapons and ammunition must be locked and inaccessible at all times the children are in care.

5. All medications must be stored in areas that are inaccessible to children. 7.710.57 Birth Parent Counseling and Report [Rev. eff. 5/1/10]

A. Any person who plans to petition the court for relinquishment of his/her child must obtain counseling about the relinquishment from a licensed Colorado child placement agency or a Colorado county department of social/human services. A court may refer a petitioner to a licensed child placement agency for counseling.

B. An agency must provide counseling regarding possible relinquishment to birth parent(s) residing in Colorado in face to face interviews. In providing counseling services to an expectant parent(s), the agency must provide counseling prior to the birth of a child(ren) and following the birth of the child(ren).

C. An agency must provide counseling to birth or legal parents without regard to age, race, color, national origin, religion, sex, or disability of either birth parent.

D. An agency shall ensure that only pregnancy related expenses are paid on behalf of birth parent(s) by the CPA, the prospective adoptive parents, or agent acting on behalf of the prospective adoptive parents. All expenses paid on behalf of birth parents shall be processed through the agency. An agency cannot require birth parent(s) to repay pregnancy related or cradle care expenses except in the case of criminal fraud.

E. The agency must conduct a comprehensive and diligent search for the legal father and/or the presumed birth father, or the birth mother if applicable. The agency must take seriously and promptly investigate any claims of paternity prior to the final orders of relinquishment or termination. Efforts to locate the birth father or birth mother must be documented.

F. The agency must include in the counseling the legal, alleged and/or presumed birth father(s) if he can be located and is willing and interested in participating in the counseling.

G. At the beginning of the counseling, the agency must ascertain if the birth parent(s) is receiving counseling from any other agency in Colorado.

H. At the beginning of the counseling, the agency must provide, in writing, to the birth parent(s) a list of birth parents rights as found at Section 7.710.53, B.

I. The content of the counseling must include at least the following:

1. Discussion of the birth parent(s) motivation to consider relinquishment of the child(ren).

2. Discussion as to whether the birth parent(s) have been pressured or coerced to relinquish the child.

3. Discussion as to whether the birth parent(s) have been promised or received money, goods, or services or anything of value to motivate the relinquishment of the child(ren).

4. Discussion of alternatives to relinquishment and the resources available in the community if the birth parent(s) choose to parent the child(ren).

5. Discussion of the permanency of the decision to relinquish a child(ren).

6. Discussion of life long loss and grief issues that include, but are not limited to, helping the birth parent(s) identify and understand the present emotional impact of the relinquishment decision and gain an understanding of possible future grief-related emotions and behaviors.

7. Discussion of the life changing effect of pregnancy and birth of a child.

8. Discussion of the birth parent(s) and birth families social developmental

history and medical history, including the gathering of information regarding previous losses and life stability.

9. An assessment of the birth parent(s) ability to understand the consequences of the relinquishment decision and her/his ability to intellectually and emotionally understand the options.

10. Discussion regarding the identification of the presumed birth father(s), the serious ramifications of failing to provide known information and the possible impact to the relinquishment and/or finalization of the adoption.

11. Discussion of whether the birth mother or the presumed birth father is a member of or are eligible to be a member of a Native American Tribe and any applicable ramifications of such information.

12. Discussion that the birth mother may only be reimbursed by the agency for verified and documented pregnancy related expenses.

13. Discussion of the legal relinquishment options available, including being present at the termination or relinquishment hearing or the expedited relinquishment procedure of filing an affidavit with the court without the possible necessity of a court hearing.

14. Discussion of the time frame for withdrawal of the expedited relinquishment petition and affidavit, including that the petition for relinquishment may not be filed with the court until at least four calendar days after the birth of the child.

15. Discussion of the administrative procedure that the birth parent(s) information will be released to a presumed birth father(s) or published in an official publication of the last known address of the presumed birth father(s).

16. Discussion that the filing of the administrative procedure notice to the presumed birth father(s) does not obligate the birth mother to file a petition for relinquishment.

17. Discussion of the right of the birth parent to complete the contact preference form and the right to change the form at any time.

18. Discussion of the right of the birth parent to complete a medical history statement form to be filed with the State Registrar and the right to update this information every three years.

J. The agency must submit an affidavit that includes a thorough written report of the counseling, directly to the court. The report must contain at least the following information:

1. Identifying information of the birth parent(s) including the legal and/or the alleged or presumed birth father(s), which shall include at least full name, address, and birth date of parent(s).

2. The name, address and qualifications, including the level of education and the number of years of adoption experience, of the individual that provided the counseling.

3. Confirmation that venue is appropriate.

4. The dates and hours on each date that significant face to face counseling occurred, excluding labor and delivery. The agency must document the number of counseling hours provided pre and post delivery.

5. The total number of hours of counseling. If under extenuating circumstances some counseling was done in a manner other than face to face, the agency must specify how the other counseling was provided and the number of hours of the other counseling.

6. An individualized narrative description of the specific content of the counseling covering required topic areas listed at Section 7.710.57, I, that were discussed during the counseling.

7. If the birth parent(s) choose the expedited relinquishment procedure, the counseling report and affidavit must include a statement that all legal options for relinquishment were presented including both the benefits and the detriments of attending the court relinquishment hearing or filing the expedited relinquishment petition with the court, including the time frame for withdrawal of the petition and affidavit if the birth parent(s) changes his/her mind.

8. Summary of social and medical history of the birth parent(s) and the reason for relinquishment.

9. Description of and documentation to support the diligent efforts of the agency to locate the alleged, legal, and/or presumed birth father or birth mother and the cooperation or lack of cooperation of that parent, including the results of the anticipated notice procedure to the presumed birth father(s) pursuant to 19-5-103.7(8), C.R.S.

10. The results of contact and counseling with the alleged, legal, and/or presumed father(s).

11. Whether the Indian Child Welfare Act as stated in Section 7.309 applies to the results of the agency’s investigation, including the documentation of efforts made to locate or contact the tribe and the tribe’s response.

12. An itemized account of all expenses, including financial and material aid, the agency paid to the birth parent(s); the agency must also report any financial or material aid if they became aware it was paid to the birth parent(s) by another individual. Documentation must include justification as to how each expense is pregnancy related.

13. The specific recommendation as to whether the relinquishment and/or termination should be granted by the court. 7.710.58 The Child Available for Adoption A. Any CPA involved in assisting relinquishing parents and/or prospective adoptive parents must obtain all available information regarding each child available for adoption. Such information must be obtained from the relinquishing parent, and/or the CPA or county department involved in an original adoption, where applicable. Documentation must include but need not be limited to:

1. A report of a physical examination performed by a medical professional licensed pursuant to Sections 12-240-101, C.R.S. through 12-240-145, C.R.S. conducted within the six (6) months prior to adoptive placement.

2. A history of the child/youth including as much of the following information, including available records, as can be obtained:

a. Physical appearance;

b. Physical, mental, emotional, and behavioral health, and cognitive

history;

c. The child’s medical history, including immunization, medication and birth records when available;

d. Family background; including, but not limited to, racial or ethnic, cultural, religious, and linguistic backgrounds;

e. Gender identity and background;

f. Educational background;

g. Interest/hobbies/talents;

h. Developmental history;

i. Region of origin;

j. Personal qualities;

k. Any previous written assessments;

l. United States immigration status;

m. Information available from the federal government on the process for the child/youth to acquire United States citizenship where applicable;

n. Whether the child has been separated from a sibling or other significant relation;

o. Previous adoption(s) or out-of-home placement(s) and the reason(s) the adoption(s) or placement(s) ended;

p. Trauma and attachment history; and q. History of abuse or neglect, including adverse childhood/youth experiences such as malnutrition or drug/alcohol exposure.

3. Any other matter a child placement agency considers material to the 4. A statement documenting the chronological history of a child's family background in as much detail as available, including verification of the child/youth’s birth date and place and reasons for relinquishment or termination of the parent-child legal relationships, as listed on the petition of relinquishment or international equivalent and signed by the birth or legal parent(s), including a personal description written by the birth or legal parent(s), if available.

5. All non-identifying information that has been obtained by the agency or provided to the agency regarding the child/youth or child/youth’s birth family.

6. All available information regarding the child/youth’s birth family including birth parents, extended family, and siblings as applicable, including as much of the following information as can be obtained:

a. Physical appearance;

b. Health/medical history;

c. Race or ethnic origin;

d. Religious background;

e. Cultural background;

f. Linguistic background;

g. Educational background;

h. Occupation;

i. Hobbies/interests/talents;

j. Mental health;

k. Substance use/misuse; and l. Personal qualities.

7. Medical, therapeutic, and educational resources, including language acquisition training, available to the adoptive parent and child after placement for adoption or adoption to assist in responding effectively to physical, mental, emotional, or behavioral health issues and available records relevant to the information in Subsection 7.710.58.A.2.a-q of this

Section.

B. Any CPA involved in assisting relinquishing parent(s) and/or prospective adoptive parent(s) must provide all information obtained specific to the child/youth to the prospective adoptive parent(s) to provide historical context for the child/youth’s experience and to support the adoptive parents with resources to effectively respond to the needs of the child/youth. Such information must include, but may not be limited to:

1. The potential effect on the child of:

a. A previous adoption or out-of-home placement;

b. Multiple previous adoptions or out-of-home placements;

c. Trauma, insecure attachment, fetal alcohol exposure, or malnutrition;

d. Neglect, abuse, drug exposure, or similar adversity;

e. Separation from a sibling or significant caregiver;

f. A difference in ethnicity, race, or cultural identity between the child and the prospective adoptive parent or other child of the parent;

2. Information available from the federal government on the process for the child to acquire United States citizenship; and 3. Any other matter a child placement agency considers material to the 4. The guidance and instruction must be provided:

a. For adoption of a child/youth residing in the United States within seventy-two (72) hours of receipt of the information before the adoption is finalized; or b. For an intercountry adoption, in accordance with the federal law.

c. The CPA must further provide the adoptive parents with resources to effectively respond to the needs of the child/youth after placement for adoption or upon the finalization of an adoption. Such information must include, but may not be limited to:

1. Medical, therapeutic, and educational resources;

2. Language acquisition training to assist in responding effectively to physical, mental, emotional, or behavioral health issues; and 3. Available records relevant to the child/youth. 7.710.59 Placement [Rev. eff. 5/1/10]

A. The assessment of the adoptive applicant(s), as required at Section 7.710.56, K, must be completed prior to placement.

B. As permitted under Colorado law, prior to placement as much information as possible shall be obtained and disclosed in writing to the adoptive parent regarding the child(ren) as required at Section 7.710.58, B.

C. An effort shall be made to place siblings with the same adoptive applicant(s). If the county department locates an appropriate, capable, willing, and available joint placement for all of the children in the sibling group, there should be a rebuttable presumption that placement of the entire sibling group in the joint placement is in the best interests of the child(ren). Such presumption may be rebutted by the county by a preponderance of evidence that placement of the entire sibling group in the joint placement is not in the best interest of a child or the children. If this cannot, or should not, be done in the best interests of the children involved, the record shall contain the reasons and supporting evidence for such separate placements.

D. The agency shall not place a child in an adoptive home that would be detrimental to the child's well-being.

E. The agency shall immediately inform the adoptive applicant(s) in writing of the relinquishing parent’s decision to discontinue the adoption plan and the plan for returning the child to the birth or legal parent.

F. A written contract between the placement agency and the adoptive applicant(s) shall be executed at the time of placement. The contract must include an agreement that the adoptive applicant(s) will:

1. File an adoption petition in accordance with Colorado law.

2. Participate in supervision by the placement agency of the child(ren) in the adoptive home until such time as a decree of adoption becomes final.

3. Agree to allow the placement agency to complete and submit a report to the court regarding the findings of the post-placement visits.

4. Prior to finalization, the adoptive parent(s) must obtain permission of the placement agency or birth parent, as appropriate, prior to removing the child from the state.

5. Agree that the child may be removed from the adoptive placement at the discretion of either the agency or the adoptive parent(s) with good cause before the finalization of the adoption.

7.710.6 RESPONSIBILITY OF THE AGENCY AFTER PLACEMENT

A. The placement agency having legal custody is responsible for the welfare of the child until a decree of adoption is granted and shall:

1. Assume financial and planning responsibility for the child in the event that a child's adoptive placement is disrupted.

2. Assume financial and planning responsibility for the child where a court refuses to grant a decree of adoption.

3. Maintain a copy of the final decree of adoption from the court in the agency file on each child.

B. Placements shall be supervised from the time a child(ren) is placed until court finalization to ensure:

1. The physical and emotional well-being of the child(ren);

2. Successful attachment between the child and parents;

3. Positive adjustment of all family members; and, 4. Adoption related issues are resolved as necessary.

C. For adoptions to be finalized in Colorado the agency must provide post placement services until court finalization, and must provide at least a six (6) month period of post placement services between the time of placement and the finalization of the adoption and shall maintain at least monthly contact with the adoptive family and child(ren) until court finalization of the adoption. The supervision shall include:

1. For children of less than one (1) year of age at time of placement, no less than three (3) face-to-face supervisory visits, including at least two (2) visits to the adoptive home, one (1) visit to the adoptive home must be within the first two (2) weeks after placement. Visits in the adoptive home should include all adoptive family members.

2. For children of one (1) year of age or older at time of placement, at least one (1) visit per month with no less than half (1/2) of the visits as face-toface visits in the adoptive home. The first (1st) visit must be within two (2) weeks after placement of the child(ren). Visits in the adoptive home should include all adoptive family members.

D. During the period of supervision the placement agency shall maintain records that include:

1. Legible, well organized case/contact notes of all contacts. These must be placed in the adoptive applicant’s case file in a timely manner and must be available for review by the State Department.

2. Two (2) formal post placement reports shall be completed for the court, one (1) at three (3) months after placement and the second (2nd) at the time of finalization, or more frequently if required by the court, and must include information regarding:

a. The physical health and emotional well-being of the child.

b. Adjustments of the family and child to the adoption.

c. Financial changes.

d. Changes in family composition.

e. Other adoption issues that have arisen.

f. Recommendation on the continued placement of the child.

g. Recommendation on the finalization of the adoption.

E. The agency may obtain a progress report, if appropriate or as necessary, from a school official or child care provider for each adoptive child that is attending child care or school.

F. The placement supervisor of the Colorado CPA shall be responsible for removing the child from the home, at the request of the adoptive family, or in accordance with state law, if the placement is not in the best interests of the child.

G. If any information becomes known or can be obtained before an adoption is finalized that had not already been reported, the CPA must provide any and all information to the prospective adoptive parent(s).

H. On request of a child who was placed for adoption or the child's adoptive parent, the CPA or the county department, as referenced in Section 7.306.55, shall provide information about how to obtain adoption assistance and resources:

1. To assist the child or parent to respond effectively to adjustment, behavioral health, and other challenges; and 2. To help preserve the placement or adoption. 7.710.61 Finalization [Rev. eff. 5/1/10]

A. The agency that has custody of the child(ren) must provide written consent to the court for the adoption if it is in the best interest of the child.

B. A certified copy of the final decree must be placed in the adoptive applicant's file at the placement agency.

C. Send written notification of the final decree of adoption to the court in which relinquishment took place. Such notification shall not disclose the name or address of the adopting parents. 7.710.62 Post Adoption A. Any and all previously issued certificates of birth, to include certificates of foreign birth, must be provided to the child’s adoptive parent(s) upon finalization of adoption, where applicable.

B. If the CPA does not provide post adoption services, the agency must provide resource and referral information regarding post adoption services available to the birth parent(s), adoptive family, and child, if appropriate.

C. Post adoption services may include, but not be limited to:

1. Consultation.

2. On-going support and education.

3. Resources for counseling or medical needs.

4. Search or reunification resources.

5. Networking with other adoptive families.

6. Adoption education and support groups.

7. Providing to the adoptive family additional social and/or medical background information obtained after placement that could significantly impact the child.

D. For intercountry adoptions, the agency must provide post adoption services including, but not limited to, completion of written reports on the adoptive family and child if required by the foreign country.

E. If any information becomes known or can be obtained after an adoption is finalized that had not already been reported, the child placement agency must make reasonable efforts to provide any and all information to the adoptive parent(s). 7.710.63 Interstate Adoptions [Rev. eff. 5/1/10]

A. An agency may participate in an Interstate adoption under at least one (1) of the following conditions:

1. The adoptive placement is arranged and carried out by a child placement agency licensed by the state of residence of the child in accordance with

Section 7.710.1, A, 1.

2. The adoptive services are performed pursuant to an order of the court of jurisdiction of the child.

3. The adoptive services for public adoptions are performed at the request of the State Department through the ICPC of children located at the State 4. The adoptive services for non-public adoptions are performed at the request of non-public agencies through the ICPC at the non-public agency selected and monitored by the State Department.

B. An agency which participates in an interstate adoption shall perform at least the 1. Send all studies or reports for public adoptions through the ICPC at the State Department unless otherwise authorized.

2. Send all studies or reports for non-public adoptions through the ICPC at the non-public agency selected and monitored by the State Department (see Interstate Non-Public Adoptions, Section 7.710.93).

3. Comply with all rules and laws of the Interstate Compact on Placement of Children, as found at Section 24-60-1801, C.R.S. et seq., and Section 7.307 of the Program Area 7 rules (12 CCR 2509-4).

C. Any agency which participates in an interstate adoption must have direct knowledge of and comply with all applicable laws and procedures of the other state in which they are working at all times. 7.710.64 Intercountry Adoptions [Rev. eff. 5/1/10]

A. An agency that wants to provide intercountry adoption services must apply for, and be approved by the State Department, to provide intercountry adoptions prior to initiating such service with adoptive applicants.

B. Agencies approved for intercountry adoptions must have a current, dated, written policy detailing:

1. What services will be provided to or coordinated for the adoptive family while in the foreign country.

2. Whether the adoptive family will owe additional fees to be paid in country for services.

3. Whether the services will be provided or coordinated by the agency or by another United States licensed placement agency pursuant to an interagency contract.

C. For each foreign country, agencies approved for intercountry adoptions must either:

1. Have direct knowledge of and be able to comply with all applicable laws and procedures of the foreign national child’s country of origin, and be able to provide services listed in Section 7.710.54, B; or, 2. Have an interagency contract in writing with another United States licensed placement agency that:

a. States that the other agency is licensed as a placement agency in accordance with the laws of the state of their principle place of business, and attaches a copy of the license.

b. States that the other agency has direct knowledge of and is able to comply with all applicable laws and/or procedures of the child’s country of origin.

c. States that the other agency is authorized to conduct adoptions in the foreign country and, if applicable, attaches a copy of any license or accreditation issued by the foreign country.

d. Lists in detail what services will be provided or coordinated by the other agency to the adoptive families while in the foreign country.

e. Lists what projected fees and expenses the adoptive family will owe for services provided to them while in the foreign country.

D. For each country in which the agency is directly providing or coordinating all adoption services, the agency shall keep on file:

1. An English language translation of any agreements entered into with the foreign government.

2. An English language translation of any document that evidences approval, accreditation or certification by the foreign government to conduct adoptions, if required by the laws of the foreign country.

E. For each country in which the agency is providing or coordinating services through an interagency agreement with a foreign provider, the agency shall keep on file the original signed interagency agreement and applicable attachments.

The interagency agreement must include:

1. If the foreign provider is providing adoption services, it states that the foreign provider is authorized to provide adoption services in the foreign country, and, if applicable, attaches a copy of documents to verify authorization.

2. List in detail what services will be provided or coordinated by the foreign provider.

3. List what projected fees and expenses the adoptive family will owe for services provided to them by the foreign provider.

F. Each agency that provides intercountry adoption services must have a separate pass-through or escrow account for which required foreign country fees paid by parents are maintained and available for refund if fees are not paid in the foreign country on behalf of the adoptive parents. Foreign country fees may not be comingled or otherwise used by the agency for any purpose other than direct payment to the foreign entities on behalf of the adoptive parents.

G. Agencies providing adoption services for intercountry adoptions in Hague Convention countries, in either incoming or outgoing cases, must meet the federal regulations pertaining to intercountry adoptions with Hague countries. 7.710.650 Unregulated Child Custody Transfer - Applicability A. The transfer of custody of a child/youth by a parent, guardian, or custodian of the child/youth, or an individual with whom a child/youth has been placed for adoption, to any of the following individuals is not unregulated child custody transfer:

1. A parent of the child/youth;

2. A stepparent of the child/youth;

3. An adult who is related to the child/youth by blood, marriage, adoption, or other relationship recognized by other law of this state;

4. An adult who, at the time of the transfer, had a meaningful and safe relationship with the child/youth for a period of at least six (6) months prior to the transfer, and whom the parent, guardian, or custodian reasonably believes, at the time of the transfer, to be a fit custodian of the child/youth;

5. An Indian custodian as outlined in the Indian Child Welfare Act (ICWA) and its implementing regulations, incorporated by reference in Section 7.701.14.

B. The transfer of custody of a child/youth by a parent, guardian, or custodian of the child/youth, or an individual with whom a child/youth has been placed for adoption, to any individual other than those listed under 7.710.650.A, is unregulated child custody transfer unless the transfer occurs through one of the following legal processes as outlined in 19-5.5-203(2), C.R.S.:

1. A l egal adoption or guardianship proceeding;

2. Judicial award of custody;

3. Other judicial or tribal action; or 4. Colorado's safe haven law as described in Section 19-3-304.5, C.R.S. 7.710.651 Prohibited Unregulated Child Custody Transfers Unregulated child custody transfers are prohibited, as follows:

A. A parent, guardian, or custodian of a child/youth or an individual with whom a child/youth has been placed for adoption may not transfer custody of the child/youth to another person with the intent, at the time of the transfer, to permanently abandon the rights and responsibilities concerning the child/youth.

B. A person may not receive permanent custody of a child/youth or act as an intermediary if permitted under other law of this state, in a transfer of custody of a child/youth if the person knows or reasonably should know the transfer violates

Section 7.710.651.A. This prohibition does not apply if the person notifies the state department of the transfer or takes appropriate action to establish custody under Section 7.710.650.B within seventy-two (72) business hours. 7.710.652 Prohibited Solicitation or Advertising A. A person may not solicit or advertise for the purpose of:

1. Identifying a person to whom to make a transfer of custody in violation of

Section 19-5.5-203 (1), C.R.S.;

2. Identifying a child/youth for a transfer of custody in violation of Section 19- 5.5-203(3), C.R.S.; or 3. A cting as an intermediary or facilitator, if permitted under other law of this state, in a transfer of custody in violation of Section 19-5.5-203(3), C.R.S.;

B. Engaging in prohibited solicitation or advertising is a class six (6) felony as identified. 7.710.653 Suspected Unregulated Custody Transfer A. When a CPA suspects an unregulated transfer of custody of a child/youth has occurred, the CPA must report all known information regarding the suspected transfer to the appropriate county department of human/social services. The county department of human/social services will determine appropriate action to protect the welfare of the child/youth as provided in other areas of rule, regardless of any additional concern of abuse or neglect. if an assessment is completed regarding concerns of an unregulated custody transfer of an adopted child/youth, and it is determined that a person has transferred or intends to transfer custody in violation of Section 19-5.5-203, C.R.S., then the county department of human/social services shall:

1. Provide notice of the assessment to the Colorado Department of Human Services when it involves an unregulated custody transfer of an intercountry adopted child/youth; and 2. In any circumstance where there is an allegation of unregulated custody transfer, the county department of human/social services shall send the referral to the appropriate law enforcement agency or agencies.

7.710.7 GRIEVANCE PROCESS, CONFIDENTIALITY, RECORDS AND

REPORTS 7.710.71 Grievance Process [Rev. eff. 5/1/10]

A. Each agency must have a written grievance and appeal process for adoptive applicants and for birth parents that provides adequate due process. This information must be provided as required in the Disclosure and Fee Information found at Section 7.710.53, A-B.

B. Reports of grievances filed and the outcome must be available to the State Department for review upon request.

C. The agency must follow the grievance procedure without alteration, interference, or unreasonable delay.

D. If a grievance is filed with the agency, the grievance shall be recorded in the adoptive family or birth parent file with the investigation findings and resulting action taken by the agency. 7.710.72 Confidentiality and Disposition of Adoptive Records [Rev. eff. 5/1/10]

A. All records required by the foregoing sections shall be treated as confidential and shall be protected from unauthorized examination. They shall be immediately available to the staff of the State Department, and for non-public adoptions, they shall be available to the appropriate staff of the selected non-public agency upon B. When a child is legally free for adoption, legal documents and records must be maintained in accordance with Title 19, Article 5, C.R.S., “Relinquishment and Adoption”.

C. The records and papers in relinquishment and adoption proceedings are open for inspection only upon order of the court for good cause shown. The court and the agency are required to act in a manner so as to preserve the anonymity of birth parents, child, and adoptive parents except in the case of a designated adoption.

D. An agency engaged in adoption placement of children shall not be licensed unless they possess adequate, secure storage facilities for records. Records shall be maintained in a locked, secured room.

E. The agency shall develop and implement a written policy and procedure which assures that records are protected from destruction, loss and unauthorized removal or access.

F. The agency shall develop and implement a written plan to ensure annual scanning of their adoption records, including birth parent, adoptive applicant, and children’s records. The plan must address scanning any closed files already in storage. Scanned records must be maintained in a current State Department approved technological format for the purpose of transferring those records to the State Department upon closure of the agency.

G. The agency record for any Colorado adoptive family shall contain as a minimum: the signed formal application for adoption; signed fee and disclosure agreement; medical examinations for all household members; a copy of a current marriage license; a copy of a divorce decree where applicable; the results of the State Department’s automated abuse and neglect background system check for all adults residing in the household; the original home study assessment with updates as appropriate; any subsequent family assessments; and, all signed and dated adoption agreements or contracts.

1. For adoptions finalized in the United States, the agency record shall also contain: signed petition for domestic adoption; post placement supervisory reports; post adoption correspondence, including any correspondence from the birth parent(s); the type of adoption and communication agreed upon at time of finalization; final decree of adoption; post-adoption reports if applicable; and, validation of foreign adoption if applicable.

2. For adoptions finalized in a foreign country, the agency record shall also contain: all legal documents; all medical and social history information; all foreign documents; all post adoption reports; arrival notification to stateselected agency; consent of termination of parental rights; notification to central authority; USCIS Forms I800, I600, I600A, and I171H, as applicable; and, validation of foreign adoption if applicable.

3. For all adoptions, the results of the CBI and FBI background checks for all adults, eighteen (18) years of age and older residing in the household. For intercountry adoptions finalized in the foreign country, a copy of the approval issued by USCIS may substitute for the FBI background check.

4. The agency record for an adoptee shall contain at a minimum: social and medical histories; birth record; certified birth certificate; birth parent consent for placement; ICPC files; record of admission or intake summary of the child to be adopted.

5. The agency record for a parent(s) relinquishing a child(ren) shall contain at a minimum: signed disclosure agreement and birth parent rights; intake forms; birth parent counseling report and/or counseling affidavit; case notes; the type of adoption completed and the communication agreed upon at time of finalization between the birth parents and adoptive parents, and a copy of such contract if available, including the preference form completed by the birth parent at the time of relinquishment; and, all legal documents related to the relinquishment.

6. For Colorado child placement agencies that provide Intercountry adoption services for families who reside outside of Colorado, the agency must maintain a record that contains, at a minimum: the name, address, and phone number of the adoptive family; the name, address, phone number, and copy of the license of the agency or agencies used to complete the adoption; a copy of the USCIS form granting approval of the home study; a copy of the final decree of adoption; the birth name, adoptive name and the date of birth of the adopted child.

7. Files must be indexed and cross referenced in the following sections:

a. Adoptive parent name; and, b. Adoptive child name; and, c. Adoptive child birth name; and, d. Birth parent name; and, e. Child’s date of birth; and, f. Year adoption is finalized.

H. In the event that a child placement agency ceases operations, two (2) copies of all adoption records shall be forwarded to the State Department in a current State Department approved technological format of not less than 100 years storage capability.

I. The records of birth parents, adoptive applicants and children, that do not result in an adoptive placement shall be maintained for a period of at least three (3) years.

J. The agency shall have an appropriate secure procedure for confidential record destruction.

K. The Colorado agency shall be responsible for maintaining a case record for each approved adoptive family, each parent who relinquishes a child for adoption, and each adoptee. The record for each client must be kept current from the point of intake to termination of completion of services. All correspondence and written communications including, but not limited to, e-mails, memos, and letters must be maintained in the file.

L. The entire case file, including all worker notes or other documents, is the property of the agency and the entire case must be maintained in secure storage at the main office. Any and all duplicate files maintained by contract or staff worker(s) during the completion of an adoption must be maintained in locked secured storage at all times and all items, including worker notes or other documents, must be returned to the main office at the completion of services.

Contract or staff workers may not keep duplicate copies of any documents. 7.710.74 Required Reports [Rev. eff. 5/1/10]

An annual report shall be made to the State Department regarding the adoption services provided by the agency. The report shall be submitted on the State prescribed form within sixty (60) days following the end of the calendar year and shall provide the following information:

A. The types of adoptions, as defined at Section 7.710.52, in which the agency was involved, including the total number of:

1. Agency adoptions:

a. Domestic (non-relative) adoptions finalized in Colorado.

b. Domestic adoptions finalized outside of Colorado.

c. Foreign national finalized outside United States and placed in Colorado.

d. Foreign nationals finalized in Colorado.

e. Foreign nationals finalized outside United States and placed outside Colorado.

f. U.S. national finalized outside United States and placed outside United States.

g. Total number of adoptions involving Hague countries, incoming and outgoing.

h. Number of boys in domestic adoption.

i. Number of boys in foreign national adoption.

j. Number of girls in domestic adoption.

k. Number of girls in foreign national adoption.

2. Non-agency adoptions as required by the courts.

3. Domestic relative adoptions.

B. The number of children whose domestic adoption was finalized within the previous calendar year as delineated by (do not duplicate numbers):

1. White, not-Hispanic or Latino children.

2. Hispanic or Latino children.

3. Black/African American children, not Hispanic or Latino.

4. Asian children.

5. Native Hawaiian/Pacific Islander children.

6. Alaskan/Native American children.

7. Children that were of two (2) or more races.

C. The total number of birth parent counseling cases completed by the agency in a calendar year delineated by:

1. The total number of birth mothers counseled.

2. The total number of presumed birth fathers counseled.

D. The total number of birth mother counseling cases completed by the agency that resulted in relinquishment of a child(ren).

E. The total number of approved SAFE home study assessments completed by the agency within the calendar year, including those completed for (do not duplicate number of applicants):

1. White, not Hispanic or Latino applicant(s).

2. Applicant(s) of Hispanic or Latino ethnicity.

3. Black/African American, not Hispanic or Latino applicant(s).

4. Native Hawaiian/Pacific Islander applicant(s).

5. Asian applicants 6. Alaskan/Native American applicant(s).

7. Applicants of tow (2) or more races (please specify races).

F. The total number of adoptive placements made by the Colorado agency within a calendar year which resulted in:

1. Disruption of the placement.

2. Dissolution of the adoption. 7.710.8 IDENTIFYING AND NON-IDENTIFYING INFORMATION [Rev. eff. 5/1/10]

Release of identifying information may occur only as listed in current statute or by court order.

A. Non-identifying information is defined as information which does not disclose the name, address, place of employment or any other material information which would lead to the identification of the birth parents. Non-identifying information includes only the following:

1. The physical description of the birth parents.

2. The educational level achieved by the birth parents.

3. The occupation of the birth parents at the time of the child’s birth.

4. Genetic information about the birth families.

5. Medical information about the adult adoptee's birth.

B. Child placement agencies authorized by the Colorado Department of Human Services, Division of Child Welfare, to release information shall be qualified as 1. Any agency selected shall be a non-profit agency which has been licensed for at least five years by the State Department to provide adoptive services and is in good standing with the State Department.

2. The agency will submit a written policy which includes the following:

a. A written statement, signed by the Executive Director of the agency, stating the agency shall maintain all information which identifies members of the birth family strictly confidential. In addition, the agency shall identify by name all staff involved in the provision of this service and shall furnish copies of statements agreeing to preserve confidentiality signed by members of he staff who will be handling the material.

b. Agreements for the physical security of any material.

c. Fees to be charged and a sliding fee schedule for low income persons.

d. Policy for releasing the information and type of material that is to be included. Information must be released in written form by placement workers on approval of the placement supervisor.

e. Time frame for response to requests.

f. Development of written information to be given to the persons seeking non-identifying information prior to providing the service which outlines the agency's procedures and fees for these services.

C. The agencies .selected shall agree to participate in any training provided by the State Department.

D. The agencies selected will return to the State Department the record and a copy of the material released within thirty (30) calendar days of release of the information.

7.710.9 NON-PUBLIC INTERSTATE AND INTERCOUNTRY ADOPTIONS 7.710.91 Non-Public Agency Pursuant to Section 19-5-205.5, C.R.S., the State Department is authorized to select a non-public agency to perform the administrative review and approval or denial functions required by the Interstate Compact on the Placement of Children (ICPC) and statutes governing foreign adoptions. The agency selected by the State Department to provide these functions shall hereafter be referred to as “selected agency”.

Agencies that perform or assist in obtaining adoptive placements shall hereafter be referred to as “placing agencies.” The Interstate Compact defines the persons and agencies who, when they place a child from one state into another state, shall follow ICPC procedures. These persons and agencies are referred to as “sending agencies”

(per Section 7.307.2, 12 CCR 2509-4) 7.710.92 Qualifying Criteria for Selection of a Non-Public Agency A. The agency selected to perform this administrative function shall be either a licensed child placement agency designated to facilitate adoptions or a nonpublic agency that meets the criteria to be a licensed child placement agency that facilitate adoptions.

B. A designated placement supervisor or an individual who meets the criteria to be a designated placement supervisor shall sign documents related to interstate or intercountry adoptions (see Section 7.710.22, A, 6).

C. Supervision of the position(s) responsible for performing this administrative function shall be provided from within the selected agency by a position(s) that is a designated placement supervisor or meets the criteria to be a designated placement supervisor.

D. The selected agency shall have been a licensed child placement agency in good standing with the State Department or have met the criteria to be a licensed child placement agency for at least five (5) years.

E. The selected agency shall not perform this administrative function regarding cases in which it is the placing agency or has any other vested interest in the outcome of the administrative review since such action would constitute a conflict of interest.

The selected agency shall submit such cases to a non-public agency with which it subcontracts to perform the administrative function. The agency with which the selected agency subcontracts must meet the same qualifying criteria as a selected agency pursuant to this section. 7.710.93 Interstate Non-Public Adoptions A. Where and How to Send Adoptive Placement Request Packets Adoptive placement request packets shall be sent in triplicate by the sending agency or other state’s ICPC office to the selected agency. The name and address of such agency shall be distributed by the State Department.

B. Time Frame for Processing Adoptive Placement Request Packets 1. Upon receipt of a complete request packet for an adoptive placement from another state ICPC office including the fee for the administrative services of the selected agency, the selected agency shall review the request packets and shall grant or deny permission for the placement to occur within three business days, excluding weekends and holidays.

2. Upon receipt of a complete set of request packets from a Colorado local agency for an adoptive placement into another state, including the fee for the administrative services of the selected agency, the selected agency shall review the request packets for compliance with Colorado laws and procedures, and the packets, including the accompanying 100-A, signed and dated by the authorized signer or the designee of that authorized signer, shall be sent on to the receiving state ICPC office within three business days, excluding weekends and holidays.

3. Permission for the placement to occur or denial of the placement request shall be signified by the dated signature of the authorized signer or the designee of that authorized signer on the Form 100-A that accompanied the request packets. If verbal permission for placement of the child who is the subject of the placement request is initially given to the sending state ICPC office, it shall only be considered a valid form of permission for placement if such verbal permission is immediately followed by the properly signed 100-A being sent by facsimile process to the sending state ICPC office. Within twenty-four (24) hours of such facsimile being sent, copies of the original 100-A and an accompanying memo from the authorized signer of the 100-A that is written on the letterhead stationary of the selected agency shall be mailed to the sending state ICPC office and its local sending agency.

4. The authorized staff in the selected agency shall work with the sending state ICPC office, and/or with Colorado's local sending agency, and with other parties involved with a requested adoptive placement to assist the sending party in bringing the request packets into compliance with applicable statutes and/or rules and regulations, as soon as possible.

While such compliance issues are being clarified and potentially resolved, the selected agency may either retain the submitted documents until compliance is achieved or return incomplete packets to the sending state ICPC office.

C. Materials Required in Adoptive Request Packets for Children for Whom an Adoptive Placement into Another State is Requested 1. Court documents showing the child is free for adoption. All birth parents who are residents of Colorado shall relinquish in a Colorado court and fulfill all Colorado statutory requirements for relinquishment. Adoption consent forms from other states signed by Colorado residents shall not be considered legal in Colorado.

2. Birth and discharge medical information on the child from the hospital where the child was born.

3. Birth Parent counseling report and affidavit from a licensed child placement agency in Colorado regarding the birth parents.

4. Genetic/medical/social background information regarding the birth parents 5. Written study regarding the adoptive parent(s) that has been completed and approved by a Colorado licensed child placement agency or individual legally approved by the receiving state to perform such studies. Adoptive studies or their updates shall be no more than one year old.

6. Itemized list of monies paid to attorneys, agencies and birth parents, including a statement that no money has been paid to locate for adoption the child who is the subject of the 100-A. This list shall separately specify all fees and costs charged for services associated with the review and approval of interstate adoptions.

7. Documentation of compliance with the Indian Child Welfare Act.

8. The name of any Colorado and/or out-of-state attorney involved in the requested placement.

9. If legal rights have not been terminated or legally relinquished by both birth parents, a legal risk statement shall be signed by the adoptive parents, accompanied by documentation certifying the initiation of relinquishment or termination court procedures.

D. Materials Required in Request Packets for Children to be Placed into Colorado from Another State The materials required in request packets for children to be placed into Colorado from another state are identical to the materials described in Section 7.710.93, C, with the following exceptions. If the sending state does not require proof of relinquishment counseling, Colorado shall not require this in order to approve an adoptive placement into this state. The fulfillment of the sending state's requirements regarding consent forms shall satisfy Colorado's requirements for purposes of approval of the adoptive placement. 7.710.94 Non-Public Intercountry Adoptions A. Requests for Approval of United States Citizenship and Immigration Services Recommendation For each adoptive family assessed for placement of a foreign national, the agency shall submit the following information to the selected agency:

1. Three (3) copies of the USCIS recommendation form with Section I completed, signed and dated.

2. Applicable fees.

3. An adoptive family assessment completed in accordance with Section 7.710.56.

4. Medical and/or legal documents of the foreign national, if available.

5. A statement of affirmation signed by the Executive Director that the Colorado licensed child placement agency has documentation as required in Section 7.710.64, C, 2.

6. Copies of any and all agreements that the Colorado licensed child placement agency has to verify compliance with Section 7.710.64, C and D.

7. A copy of the foreign country’s adoption eligibility requirements.

B. Time Frames and Procedures for Processing Requests for Recommendations The following case materials with the appropriate fees shall be forwarded to the selected agency for review. The name and address of the agency shall be distributed by the State Department.

1. Upon receipt of a properly completed recommendation form and attachments in accordance with Section 7.710.94, A, the selected agency shall review and grant or deny the approval within three (3) business days of receipt, excluding weekends and holidays.

2. In the event of an unresolved concern or dispute between the sending Colorado agency and the selected agency regarding the role of the selected agency, the selected agency may refer the case to the Colorado State Department for review and resolution after reasonable attempts to obtain needed clarifications or additional information have been unsuccessful.

3. After approving the recommendation, the original plus one copy shall be returned to the Colorado agency.

4. Authorized staff in the selected agency shall work with the Colorado sending agency, the foreign country authorities, and other parties involved with a requested adoptive placement to assist with bringing the request packets into compliance as soon as possible. While such compliance issues are being resolved, the selected agency may either retain the submitted documents until compliance is achieved or return incomplete packets to the Colorado local sending agency.

C. Notice of Arrival 1. As soon as possible, but no later than six (6) months after arrival in the U.S., the Colorado agency shall send to the selected agency a notice or arrival which contains the following information:

a. The adoptive parent(s)’ names and addresses.

b. The child’s birth name, adoptive name, sex and date of birth.

c. If at any time in the process the licensed agency or prospective adoptive family becomes aware that the child's adoption will not be finalized in the foreign country, the family and agency are to notify the state in writing of the changes with an explanation as to the reasons for the change in status. If the child returns to the state and was not legally adopted in the foreign country, all documents concerning the child's legal status and the type of visa which was issued allowing entrance into the United States shall be submitted to the Colorado Department of Human Services, Division of Child Care, for review by appropriate entities. The licensed adoption agency shall ensure that the home is certified as a foster home.

d. The name of the county in which the adoption will be either finalized or validated.

2. The agency shall send the selected agency the following documents with the notice of arrival:

a. An English translation copy of the child’s original birth certificate with child’s birth name.

b. An English translation copy of the foreign adoption decree or, if the adoption was not finalized in the foreign country, translated documents transferring guardianship to the agency and/or prospective adoptive parents.

3. Pursuant to Colorado statute, the selected agency shall generate a letter to the appropriate District Court and return the letter to the licensed agency for submission to the court. 7.710.95 Confidential Case Files and Data System The selected agency and the agencies with which they subcontract are prohibited from engaging in conflict of interest in the manner in which they conduct the administrative function associated with non-public interstate or intercountry adoptions and authorized by statute and rules. Conflict of interest is defined in Section EE of the Administrative Information that accompanies the contract between the Colorado Department of Human Services and the selected agency. 7.710.96 Conflict of Interest The selected agency and the agencies with which they subcontract are prohibited from engaging in conflict of interest in the manner in which they conduct the administrative function associated with non-public interstate or intercountry adoptions and authorized by statute and rules. Conflict of interest is defined in Section EE of the Administrative Information that accompanies the contract between the Colorado Department of Human Services and the selected agency. 7.710.97 Guidelines for Fees Charged by the Selected Agency to Provide the Administrative Function Associated with Non-Public Interstate or Intercountry Adoptions A. The selected agency shall charge a fee to provide the administrative function associated with non-public interstate and intercountry adoptions as authorized by statute and rules.

1. For interstate placement requests, the fee shall include the processing of all required materials and providing procedures necessary to process the 2. For intercountry adoptive requests the fee shall include authorization review, USCIS recommendation, processing the arrival notice and the court letter. If an approved family changes to another country after initial approval, there may be an additional charge.

B. The fee charged for this service shall reflect the cost to the selected agency of direct and indirect expenses associated with the provision of administrative services required by statute and rules for the review and approval of interstate and intercountry adoptive requests.

C. The fee covers indirect costs associated with initial inquiries prior to the establishment of an adoptive placement request or other inquiries about interstate or intercountry requests. 7.710.98 Standards by which the Colorado Department of Human Services Shall Evaluate the Delivery of Services by the Selected Non-Public Agency The Colorado Department of Human Services shall monitor the selected agency to determine compliance with Sections 7.710.91 - 7.710.97, in accordance with Section 19-5-205.5(2)(b), (I-X), C.R.S.

A. The State Department shall conduct a site visit to the selected agency and review interstate and intercountry adoption files that are a representative sample of pending, open and closed files.

B. The State Department shall conduct a site visit on at least a semi-annual basis.

1. Within thirty (30) calendar days following each site visit, the State Department will provide the selected agency with a written evaluation that indicates the following:

a. Whether or not the agency is in compliance with rules.

b. What corrections, if any, are necessary in order to be in compliance.

c. If there are corrections to be made, the time frame within which these corrections are to be made.

2. Failure by the selected agency to make corrections that have been indicated in the written evaluation of the site visit shall be grounds for the Colorado Department of Human Services to terminate the contract between it and the selected agency. 7.711 RULES REGULATING CHILDREN’S RESIDENT CAMPS [Repealed eff. 7.712 RULES REGULATING SCHOOL-AGE CHILD CARE CENTERS [Repealed eff.

7.713 MINIMUM RULES AND REGULATIONS FOR SECURE RESIDENTIAL

TREATMENT CENTERS [Rev. eff. 6/1/12]

All secure residential treatment centers must comply with the “General Rules for Child Care Facilities” found at Section 7.701, et seq., Section 7.714.53, et seq., and the applicable definitions in Section 7.714.1, and these “Rules Regulating Secure Residential Treatment Centers.” 7.713.1 DEFINITIONS [Rev. eff. 6/1/12]

The definition of a secure residential treatment center facility is found at Section 26-6- 102(9) of the Colorado Revised Statutes. 7.713.11 Governing Body A. The governing body is the individual(s), partnership, corporation, or association which holds the ultimate authority and legal responsibility for the conduct of the secure residential treatment center. The governing body shall be legally organized and authorized to do business in Colorado.

B. The governing body shall be identified by its legal name. The names and addresses of individuals who hold primary financial control, members of the board of directors, and officers of the governing body shall be disclosed fully to the Colorado Department of Human Services. The department shall be informed immediately of the names and addresses of the new individuals.

C. The Governing Body shall have by-laws which include but are not limited to the 1. Qualifications, rights, and duties of membership 2. Size of the governing body 3. Method of selection 4. Term of office of members and officers 5. Duties and responsibilities of officers 6. Quorum 7. Parliamentary procedures 8. Recording of minutes 9. Method of amending the by-laws 10. Conflict of interest provisions 11. Specification of the relationship of the chief executive to the governing body.

D. When the governing body does not include a board of directors, there shall be an advisory committee of at least two individuals who act in an advisory capacity to the governing body. The names of the advisory committee members shall be disclosed to the department. The advisory committee shall meet at regularlystated intervals.

E. The minutes of the Advisory Committee or the Board of Directors shall be maintained. The minutes shall be available to the Department upon request, except that the minutes containing confidential personnel information need not be shared with the department.

F. The functions of the governing body shall include but not be limited to:

1. The appointment of an administrator who shall be responsible, according to established performance criteria, to the governing body, which shall delegate to him/her the executive authority and responsibility for the administration of the secure residential treatment center according to its defined purpose.

2. The formulation and regularly-planned review of policies and procedures to be followed by the center.

3. The provision of necessary facilities, adequate financing, qualified children in accordance with these standards.

4. The adoption of a written description and organizational chart which reflects the current structure of authority, responsibility, and accountability within the center. 7.713.12 Purpose A secure residential treatment center shall have a written statement specifying its philosophy, purposes, and program orientation. The statement shall identify the types of services provided, the characteristics of the youth to be served by the program and the geographic area from which youth are accepted. The statement of purpose shall be available to the public on request. 7.713.13 Fiscal Management A. A secure Residential Treatment Center shall demonstrate that it is financially sound and manages its financial affairs prudently. All funds disbursed by the center shall be expended in accordance with the program objectives as specified by the governing body.

B. There shall be a written policy of fiscal management which includes an annual budget, collection, safeguarding and disbursement of monies, internal controls, petty cash, check signatures, and fiscal system accounts for all income and expenditures on an ongoing basis.

C. There shall be an annual financial audit conducted independent of the center.

D. If a center has a juvenile benefit fund, there shall be written policy and procedure which govern its operation.

E. There shall be a written policy and procedure for the management of personal funds of the resident which include accounting procedures to assure that the youth's funds are secured and the resident will have access to his/her funds at the time of discharge.

F. There shall be a written policy and procedure to regulate the operation of a youth's commissary, which includes but is not limited to inventory and accounting procedures for the commissary. 7.713.14 Insurance A. Every center shall carry public liability insurance. The applicant or licensee shall submit to the Department of Human Services the amount of the insurance and the name and the address of the insurance company providing the insurance for the facility. Information about the insurance should be maintained at the facility.

B. If a center operates its own transportation vehicles, it shall carry insurance in compliance with the minimum limits required by the Colorado Revised Statutes, Title 10, Article 4.

C. The center shall carry workman's compensation and unemployment insurance as required by law.

7.713.2 CHILD CARE SERVICES 7.713.21 Admission Policy and Procedures [Rev. eff. 6/1/12]

A. Admissions shall be in keeping with the stated purpose of the Secure Residential Treatment Center and shall be limited to youth who are adjudicated delinquent and who are guilty of an offense which would be a crime if committed by an adult.

B. The secure residential treatment center shall have a written admission policy which shall include but not be limited to the following:

1. Policies and procedures related to intake.

2. The age range and sex of the youth.

3. The youth's needs, problems, circumstances, or patterns of behavior best addressed by the center's program.

C. The written description of admission policies and criteria shall be provided to referring agencies upon request and shall be available to the parent(s) or guardian of any youth referred for placement.

D. A Secure Residential Treatment Center shall accept a youth into care only after an evaluation of presenting problems in areas such as social, physical health, mental health, education, and psychological concerns.

E. A secure residential treatment center shall obtain an account of the legal aspects of the youth's case, summary of the offense history, social, health and family

history, psychological evaluation, developmental assessment, mental health evaluation. Educational records shall be obtained. As much of this information as possible shall be obtained prior to admission, but the total evaluation shall be completed within one month after admission.

F. There shall be a placement agreement with the placement agency. The placement agreement shall include but not be limited to the following:

1. A delineation of the respective roles and responsibilities of all agencies and persons involved with the youth and his/her family.

2. Commitment order of the court.

3. Written authorization from the parent or custodian to obtain medical care for the youth.

4. Description of mutual expectations regarding program, records, financial agreements, general contractual agreements and reporting requirements.

G. Prior to placement, approval shall be obtained from the Colorado Department of Human Services, the Colorado Deputy Compact Administrator of the Interstate Compact on the Placement of Children (ICPC) for any youth, whose legal jurisdiction rests in a state other than Colorado.

H. There shall be a written procedure for classifying youth which includes the level of risk presented, the type of housing required, participation in facility and community programs, and the youth's special needs. The procedure shall be reviewed annually.

I. When a new resident arrives at the facility, the following shall occur 1. A search shall be completed of the youth and his/her possessions. There shall be a disposition of the youth's personal property. Any items held by the center's administration shall be recorded, with a copy of the record maintained in the youth's file and a copy given to the youth.

2. Each youth shall shower; each youth shall receive clothing, personal hygiene articles, and hair care services as necessary. The youth's personal clothing shall be washed or cleaned as appropriate and returned to the youth as soon as possible.

3. Each youth shall be assigned an identification number and personal data shall be recorded.

4. A medical screening shall be performed by a health trainee or qualified health care personnel on each youth upon arrival pursuant to Section 7.713.31, C.

5. The youth shall be classified according to the written procedure and placed in an appropriate situation within two weeks of admission.

Information gathered during classification shall be shared with staff members who must make determinations for the child.

6. There shall be a program, which is carried out with the youth, during the days while classification is occurring.

7. The youth shall be given an orientation. If the youth does not understand English, the orientation is to be in the youth's own language. Completion of orientation is documented by a statement signed and dated by the youth. Orientation shall include but is not limited to the following:

a. A tour of the facility including fire escape routes and exits.

b. A copy of written rules and regulations of the facility which include but are not limited to daily schedule, medical services, discipline, mail, visitation, grievance, and communication procedures.

c. A discussion about the procedures to assure the youth's understanding.

d. Assistance in notifying family members as to his/her arrival at the center and procedure for mail and visiting.

e. Notifying the individual, legal custodian, and if appropriate, the individual’s family and obtaining authorizations from the legal custodian to perform physical management, restraint and seclusion as delineated in Section 7.714.53.

J. The total number of residents admitted to the Secure Residential Treatment Center shall not exceed the licensed capacity. 7.713.22 Youth Rights and Grievance Procedures A. Each licensed center shall have written policy and procedure which addresses and insures the availability of each of the following rights for residents:

1. No youth shall be subject to discrimination based on race, religion, national origin, sex, or physical handicap.

2. There is equal access to programs and services for male and female youth in co-correctional centers.

3. Each youth has the right to reasonable enjoyment of privacy.

4. Each youth has the right to receive appropriate and reasonable adult guidance, support, and supervision.

5. No youth shall be subjected to corporal or unusual punishment, humiliation, mental abuse, or punitive interference with the daily functions of living, such as eating or sleeping.

6. Each youth has the right to be protected from all forms of sexual exploitation.

7. Each youth has the right to receive adequate and appropriate medical 8. Each youth has the right to receive adequate and appropriate food, clothing and housing.

9. Each youth has the right to live in clean, safe surroundings.

10. Each youth has the right to participate in an educational program which will maximize his/her potential.

11. Each youth shall have the right to communicate or correspond with persons or organizations subject only to the limitations necessary to maintain facility order and security.

12. Each youth shall have the right to participate in religious services and religious counseling on a voluntary basis, subject only to the limitations necessary to maintain order and security.

13. Each youth shall have reasonable access to the general public through the communications media, subject only to the limitations necessary to maintain order and security and protect the juvenile's rights. Media requests for interviews and juvenile consents shall be in writing.

14. No youth shall be required to participate in uncompensated work assignments unless the work is related to housekeeping, maintenance of the facility or grounds, personal, hygienic needs, or the work is part of an approved vocational or training program.

15. Each youth shall have access to recreational opportunities and equipment, including, when the climate permits, outdoor exercise.

16. Each youth has the right of access to the courts.

17. Each youth has the right to assistance in making confidential contact with attorneys and the attorneys' authorized representatives; such contact includes, but is not limited to, telephone communications, uncensored correspondence, and visits.

18. Each youth has the right to determine the length and style of hair, except in individual cases where such restrictions are necessary for reasons of health and safety.

19. Each youth has the right to keep facial hair, if desired, except in individual cases where such restrictions are necessary for reasons of health and B. If the secure residential treatment center enforces any restrictions upon the youth's rights, the center shall:

1. Inform the youth of the conditions of and reasons for restriction or termination of his/her rights.

2. Place a written report summarizing the conditions of and reasons for restriction or termination of the youth's rights in that youth's case record.

C. A center shall not bar a youth's attorney, clergyman, or an authorized representative of the responsible placing agency from visiting, corresponding with, or telephoning the child.

D. Written policies and procedures pertaining to visiting, mail and other forms of communication shall be established and implemented to encourage and maintain family and other relationships while ensuring the protection of the youth, staff and program from unreasonable and unnecessary intrusions and disruptions. Policies and procedures shall address, but not be limited to, the following:

1. Visits of the youth with relatives, friends, or others interested in his/her welfare, unless in the judgment of treatment staff and placement agency it would be detrimental to the youth and/or his family.

2. Reasonable access to the telephone to make and receive personal calls by youth.

3. The forwarding of first class letters and packages after transfer or release.

4. Reasonable access to publications by youth.

5. No limit on the volume of mail a youth may send or receive, except when the center provides postage or when there is clear and convincing evidence to justify such limitations.

6. Youth's letters, both incoming and outgoing, are not read, except where there is clear and convincing evidence to justify such actions; if correspondence is read, the youth is informed in advance and is present when the letter is opened; and the action is documented.

7. Inspection of youth's letters or packages for money or contraband.

8. All cash received through the mail is held for the youth in accordance with the procedures of the center.

9. Incoming and outgoing mail is forwarded within 24-hours and packages are forwarded within 48-hours, excluding weekends and holidays 10. Youth are permitted to send sealed letters to a specified class of persons and organizations, including but not limited to courts, counsel, officials of the confining authority, administrators of grievance systems, and officials of the placing agency.

11. The center shall provide postage for the mailing of a minimum of two letters per week for each youth, if requested, excluding legal correspondence.

E. The secure residential treatment center shall establish a written grievance procedure which provides adequate due process safeguards, spells out an appeal process of at least one level of appeal, and assures that youth are entitled to report any grievance and shall not be subject to any adverse actions as a result of filing the grievance.

1. Grievance procedures shall be processed without alteration, interference, or unreasonable delay.

2. This grievance procedure shall be made available and explained to each resident as provided for in the admission procedures.

3. If a youth files a grievance, it shall be recorded in the youth's record along with the investigation findings and resulting action taken by the center. 7.713.23 Program Description and Individual Treatment Plan [Rev. eff. 6/1/12]

A. A secure residential treatment center shall have a written overall program description which is submitted to the Colorado Department of Human Services for review prior to original licensing. Any significant change in this description shall be submitted to the licensing authority for review prior to implementation.

The written description shall include the following:

1. The position title and qualifications of the person who has overall responsibility for the treatment program.

2. Staff responsibility for planning and implementation of the treatment procedures and techniques.

3. Staff competencies and qualifications.

4. The range of services and techniques which shall include at least modes of therapy, behavior management, physical management, restraint and seclusion, education, medical and recreation.

B. Within thirty (30) days of admitting a youth into care, a secure residential treatment center shall conduct a comprehensive assessment of the youth.

1. The assessment shall be conducted by a planning team. This team shall include persons responsible for implementing the treatment plan on a daily

basis. At least one member of the team shall have a graduate degree in psychology, psychiatry, social work, or counseling plus two years of treatment-oriented experience.

2. The planning team shall complete an assessment in at least the following areas:

a. Social History b. Medical and Dental status c. Education d. Personal/Social development e. Family relationships f. Vocational training g. Recreation h. Life skills development i. Religious interests j. Mental health k. Delinquency history 3. All methods and procedures used in this assessment shall be appropriate to the age, cultural background, and dominant language or mode of communication of the youth.

C. On the basis of this assessment, a secure residential treatment center shall develop a written, time-limited, goal-oriented individual treatment plan.

1. A secure residential treatment center shall provide an opportunity for the following persons, in addition to staff members, to participate in the planning process:

a. The youth;

b. His/her parent(s) or guardian, if available and unless contraindicated;

c. Representative(s) of the placing agency;

d. Other persons significant in the youth's life.

2. Based on the assessment, the individual treatment plan shall include the following components:

a. A statement of long-term and short-term goals to be achieved by the youth and the method to be used for evaluating the youth's progress.

b. Strategies for strengthening positive family relationships.

c. Specification of the daily activities, including education and recreation, to be pursued by the program staff and the child in order to attempt to achieve the stated goals.

d. Specification of therapeutic and/or any specialized services that will be provided directly or arranged for, frequency of services, and measures for ensuring their proper integration with the child's ongoing program activities.

e. Goals and preliminary plans for discharge and aftercare.

f. Identification of all persons responsible for implementing or coordinating implementation of the plan.

3. The completed treatment plan shall be signed by the youth and the chief administrator of the center or his/her designee.

4. The treatment plan and any subsequent revisions shall be explained to the youth and documented by signature of youth and staff.

5. Each treatment plan shall be reviewed at least monthly to evaluate the degree to which the goals have been achieved. The treatment plan shall be revised as appropriate to the needs of the youth.

D. If the assessment process or the treatment plan requires the services of a specialist, such as a psychiatrist, psychologist, speech therapist or physical therapist, the specialist shall be currently certified or licensed according to state E. If an individual treatment plan requires the individual to be placed in seclusion for more than twenty-four (24) hours, the individual:

1. Shall be afforded living conditions and rights approximating those available to the general population, such as one hour of large muscle activity every twenty-four hours, the use of toilet and shower, the receipt and sending of mail, and the same meals as the general population.

2. Shall receive a counseling visit as soon as possible and a visit at least once every twenty-four hours, and an administrative review of the use of seclusion by the facility director or designee, who was not involved in the incident every twenty-four hours.

A record shall be kept pursuant to Section 7.714.53 and include documenting the actions taken while operating under this provision. 7.713.24 Discipline, Physical Management, Restraint, and Seclusion [Rev. eff. 6/1/12]

A. Discipline shall be constructive or educational in nature and may include diversion, withholding of privileges, separation from problem situation, talk with the youth about the situation, praise for appropriate behavior, physical management, and seclusion. Youth shall not be subjected to physical harm or humiliation.

B. A secure residential treatment center shall have written policies and procedures regarding discipline and control, and pursuant to Section 7.714.53, written policies and procedures regarding physical management, restraint and seclusion, which shall be explained to all youth, families, staff, and placing agencies. These policies shall include measures for positive responses to appropriate behavior.

C. A secure treatment center shall prohibit all cruel and unusual punishments including, but not limited to, the following:

1. Punishments including any type of physical hitting or any type of physical punishment inflicted in any manner upon the body such as punching, shaking, biting, or roughly handling a child.

2. Physical exercises such as running laps or push-ups, when used solely as a means of punishment, and when such activities are not approved in the treatment plan.

3. Requiring or forcing the youth to take an uncomfortable position, such as squatting or bending, or requiring or forcing the youth to repeat physical movements when used solely as a means of punishment.

4. Group punishments for misbehaviors of individuals except in accordance with the center's written policy.

5. Verbal abuse or derogatory remarks about the youth, his family, his race, religion or cultural background.

6. Excessive denial of on-grounds program services or denial of any essential program service solely for disciplinary purposes.

7. Deprivation of meals, although scheduled meals may be provid2d individually.

8. Denial of visiting or communication privileges with family solely as a means of punishment.

9. Denial of sufficient sleep.

10. Requiring the youth to remain silent for long periods of time.

11. Denial of shelter, clothing or bedding.

12. Extensive withholding of emotional response or stimulation.

13. Physical management, restraint and seclusion used as sanctions.

14. Assignment of physically strenuous or harsh work which could result in harm to the youth.

D. The secure residential treatment center shall have written rules for resident conduct which specify prohibited acts and the sanctions which may be imposed.

The written rules are given to each resident and are to be fully understood by all E. The secure residential treatment center shall have written guidelines for the informal resolution of minor behavior infractions. These guidelines shall include the opportunity for youths to have input into the problem solving and decision making that relate to their participation in the program and to the consequences for their minor behavior infractions.

F. Minor Rule Violations 1. Prior to privilege suspension or a room restriction sanction, the reasons for the sanction shall be explained and the youth shall have the opportunity to explain the behavior leading to the sanction.

a. Whenever possible, the discussion should take place in a private setting. When a private setting is not available, the youth shall be afforded as much privacy as is possible.

b. Staff shall advise the youth of the expectations of the program and of the youth's responsibilities in the situation.

c. Staff shall assist the youth in developing solutions and/or strategies for correcting the problematic behavior.

2. Room restriction or time-out in an unlocked room or area away from the group for minor misbehaviors shall not exceed sixty (60) minutes, to be continuously reviewed in fifteen (15) minute intervals. At the time that the restriction is imposed, the youth shall be informed that the restriction period will last between fifteen and sixty minutes, depending on his/her interaction with staff and participation in the counseling process during the restriction period.

3. Reports are prepared on each incident of a youth's behavior infractions resulting in room restriction or loss of privileges.

4. During room restriction or time-out in or out of an unlocked room, direct staff communication shall occur at least every fifteen minutes or more frequently, depending on the youth's emotional state. During this interaction with the staff, the youth should participate with staff in determining the end of the restriction or time-out period.

G. Major Rule Violations 1. When a youth is charged with violating a major rule of the facility which could result in a disciplinary action, the youth shall be insured the right to due process prior to any disciplinary sanction being imposed.

2. In an emergency, an individual may be placed in seclusion if less restrictive alternatives have failed. Seclusion shall occur in compliance with Section 7.714.53, et seq.

3. A youth charged with a major rule violation shall be given a written notice of charge(s) of the alleged violation as soon as possible, but at least within twenty-four (24) hours of the time that the infraction is discovered.

a. A written notice of the scheduled disciplinary hearing shall be provided to the youth at least twenty-four hours in advance of the hearing.

b. Although notice of the time and place of the hearing must be provided to the youth at least twenty-four hours in advance, the youth may consent in writing to waive the twenty-four hour notice and to proceed with an earlier hearing time.

4. A disciplinary hearing shall be conducted within seventy-two (72) hours of the discovery of an alleged violation.

5. The youth shall be present at the disciplinary hearing except when his/her behavior prior to or during the hearing justifies exclusion or he/she has waived the right to be present.

a. The youth may be temporarily excluded during the testimony of youths who wish their testimony to be given in confidence.

b. Reasons for the youth's absence or exclusion shall be documented in the youth's file.

6. The disciplinary hearing shall be conducted by an impartial person or committee.

7. A youth may request the assistance of a staff member to represent him/her at a disciplinary hearing. A staff member or another resident shall be appointed when it is apparent that a youth is not capable of presenting evidence on his/her own behalf.

8. The youth shall have the opportunity to make a statement, present evidence, and call witnesses. Any exceptions shall be clearly documented in the youth's file.

9. The disciplinary officer's/committee's decision shall be based solely on the information obtained in the hearing process, including staff reports, statements of witnesses, and evidence. Once it has been determined that a youth has violated a rule and prior to any disciplinary action being taken, the reasons for the disciplinary action shall be explained to the youth. The youth shall have an opportunity to explain the behavior leading to the violation.

10. If the youth is found not guilty of the alleged violation, the disciplinary report shall be removed from all files, except the director may retain his/her copy for administrative review purposes.

11. There shall be a written record of the findings of the hearing. A copy of the record shall be given to the youth, one placed in his/her file, and one provided to the facility director or designee. The facility director or designee shall retain copies of all proceedings findings for a minimum of six months.

12. The facility director or designee shall review all disciplinary hearings and dispositions to ensure conformity with policy and procedures.

13. The youth shall be informed of his/her right to appeal the decision of the disciplinary hearing officer/committee to the facility director or his/her designee at the time he/she is provided with the decision. The appeal shall be made in writing stating the basis of the appeal and shall be made within five calendar days of the receipt of the decision. The appeal shall be decided within 10 calendar days and the youth promptly notified in writing of the results of the appeal.

14. If a youth has allegedly violated multiple major rules at the same time, one disciplinary hearing shall be scheduled to hear all the charges. If the youth is found guilty of one or more of those violations, a disciplinary sanction shall be determined according to the facility/program's behavior management program. The hearing officer/committee cannot issue more than one disciplinary sanction for each hearing. Completion of program assignments can reduce the time of a disciplinary sanction. If the youth fails to complete a program assignment within 14 calendar days, an administrative staffing may be held to review the disciplinary sanction H. When a youth is alleged to have committed a criminal act covered by criminal law, the center should refer the matter to an appropriate law enforcement agency or court-officials.

I. Youth placed in a secure residential center shall not punish other youth except as

part of an organized therapeutic self-government program that is conducted in accordance with written policy and is supervised directly by staff. All restrictions of cruel and unusual punishment as found at Section 7.713.24, C, shall apply.

J. Disregard of any of the foregoing disciplinary rules or any disciplinary measure resulting in physical injury or abuse of any child may be grounds for the denial, revocation or making probationary of the license. 7.713.25 Security, Control, and Supervision [Rev. eff. 6/1/12]

A. Youth shall be under the supervision of qualified and trained staff members or volunteers at all times.

B. The door of the bedroom may be locked during sleeping hours for the safety of youth and/or staff and the security of the center.

C. Staff shall conduct visual checks of youth at least every five minutes when youth are in their bedrooms and the door is locked.

D. The center's perimeter shall be controlled by an appropriate means to ensure that youth remain within the facility and to prevent access by the general public without authorization.

E. Residents of the secure residential treatment center shall be physically counted according to a system established by the facility. Any changes in the number of residents shall be reported to the appropriate staff member on a shift by shift F. Staff shall inspect the center's security system and devices on a weekly basis and shall take appropriate corrective actions.

G. Except in emergency situations, firearms are not permitted in the secure residential treatment center.

H. The use of physical management and restraint shall comply with Section 7.714.53, et seq.

I. The use of mechanical restraints made of metal, soft leather, rubber, plastic or cloth is limited to cases of emergency and prevention of escape and after the failure of less restrictive alternatives. Only the facility director or designee may authorize the use of mechanical restraints. Any mechanical restraint will comply with Section 7.714.53, et seq. The facility shall establish written policy and shall train all staff in the established written policy. The written policy shall include the following elements, at the minimum:

1. Handcuffs shall be applied wrist to wrist in the front or back, or may be attached to a waist belt in the front only. Soft elbow restraints may also be utilized when necessary and shall be applied in the rear only. Thin, hard, portable plastic wrist restraints shall not be used on youth, except under emergency conditions identified in the facility’s written policy.

2. Shackles shall be applied on one person's ankles only and shall not be used to connect two persons' ankles together.

3. Handcuffs and shackles shall never be intertwined directly together in such a manner as to interfere with a person's ability to maintain his or her spinal column in an erect or straight position.

4. Youth shall never be handcuffed or otherwise attached to a vehicle.

5. Youth placed in restraints shall not be undressed or intentionally made uncomfortable.

6. Youth shall be immediately removed from restraints and evacuated into a safer area or separate smoke compartment whenever a fire alarm, set off because of concern of a fire, results in the evacuation of other youth from the building or smoke compartment where the restrained youth is located.

In the event that a fire alarm sounds which does not result in evacuation, the restrained youth shall not be left unattended during the alarm/emergency/drill.

7. Appropriate allowances shall be made to assure the safety, comfort, and dignity of the youth. Normal bodily functions shall be attended to, including elimination and respiration. The room shall be maintained at a normal room temperature and shall meet all state and local safety, sanitation, and health standards.

8. Because of the vulnerability of the youth during a physical management, precautions shall be taken to assure that the youth is protected from mistreatment, antagonism, and harm from another person.

9. Hard metal restraint may be used for transporting youth from one location to another.

10. When the only equipment immediately available to a staff member is hard restraint equipment and the equipment must be used to restrain a youth who poses a serious, probable, imminent threat of bodily harm to self or others, the equipment shall be exchanged for soft restraint equipment as soon as it is safely possible.

11. Following application, all restraint equipment shall be checked by the supervisor on duty to assure that the equipment has been property applied, is of the proper type to assure the youth's safety, and is not likely to cause injury or undue discomfort.

J. All special incidents and emergency situations shall be reported to the director of the center.

K. The secure residential treatment center shall maintain a control center to provide order and security. A manual of all the written procedures for the center's security and control with detailed instructions for the implementation of the procedures shall be maintained at the control center. At least the following procedures shall be written and maintained:

1. A procedure for dealing with escapes.

2. A procedure to govern the supervision of all youth outside the facility and movement of youth within the facility.

3. A procedure regarding searches for control of contraband. The procedure shall be explained to both youth and staff.

4. A procedure to govern the control and use of keys, tools, culinary, and medical equipment.

5. A procedure for the use of physical management, and necessary reporting of their use pursuant to Section 7.714.53, et seq. and Section 7.713.25, et seq. 7.713.26 Educational Programming A. A comprehensive educational program shall be developed and provided for all youth who are residents of the secure residential treatment center.

1. Such programs shall be developed cooperatively by the facility and Local Education Agency (LEA) or State Education Agency based on applicable auricular requirements.

2. The center shall develop assurances that the educational program is an integral part of the total treatment plan. Such assurances shall include procedures for information sharing, joint planning and follow through.

3. The educational program allows for flexible scheduling that permits the youth to enter at any time and to proceed at his/her own learning pace.

The youth shall attend classes appropriate to his/her educational level.

4. There shall be a written policy and procedure which provides that each youth is assessed in terms of academic, vocational, and personal needs.

5. Educational and vocational supervisors and instructors shall be licensed or certified by the state or as required by law.

6. Formal educational and vocational programs have a minimum of one teacher for every 15 students.

7. Educational and vocational training opportunities are available to each youth except when there is substantial evidence to justify otherwise.

8. Provision is made to meet the educational and vocational needs of youth who require special placement because of physical, mental, or emotional handicaps or learning disabilities.

9. Educational and vocational counseling are provided so that youth are placed in that phase of an educational or vocational program most suited to his/her needs and abilities.

10. Pre-vocational training programs are integrated with academic programs and are relevant to the vocational needs of the youth and to employment opportunities in the community.

11. There is an annual evaluation to measure the effectiveness of the educational and vocational training programs against stated performance objectives.

12. There is a system whereby the educational and vocational training programs are assessed against stated objectives by qualified individuals, professional groups and trade associations; this assessment is done at least every three years.

B. The center shall provide space, staff, equipment, and educational materials for the educational program, which is approved by the Colorado Department of Education. 7.713.27 Library Services A. Library services shall be provided and shall be available to all youth.

B. There shall be a qualified person who coordinates and supervises library C. Library services which are provided shall include but not be limited to the 1. Planned and continuous acquisition of materials to meet the needs of users.

2. Logical organization of materials for convenient use.

3. Circulation of materials to satisfy the needs of users.

4. Information services to locate facts as needed.

5. A reader's advisory service that helps provide users suitable materials.

6. Promotion of the uses of library materials.

7. A congenial library atmosphere. 7.713.28 Religious Services A. There shall be a written policy and procedure which provides for youth to participate in religious services and counseling on a voluntary basis.

B. A staff member shall coordinate the center's religious programs.

C. The facility shall provide space and equipment for the conduct of religious programs for residents. 7.713.29 Recreation Program A. There shall be a written policy and procedure which assures the provision of a recreation program with schedules and a plan for constructive leisure time activities, which includes both indoor and outdoor activities.

B. A variety of fixed and movable equipment shall be provided for each outdoor play area.

C. A center licensed for 50 or more youth shall have a full-time, qualified recreation director who plans and supervises all recreation programs. Facilities licensed for less than 50 youth shall have a staff member, who is trained in recreation or a related field and assigned to the responsibilities of the recreation director.

7.713.3 PERSONAL CARE OF THE CHILD 7.713.31 Medical and Health Services [Rev. eff. 6/1/12]

A. A secure residential treatment center shall ensure the availability of a comprehensive policy and procedures for the provision of preventive, routine, and emergency medical, mental health, and dental care for each youth in care. A primary physician, licensed to practice medicine in Colorado, shall advise the facility about establishment and implementation of the medical policy and procedures which shall include, but not be limited to:

1. Ongoing appraisal of the general health of each youth, including immunizations in accordance with state law and regulations.

2. Diagnostic services, emergency care, corrective care, recuperative care, and immunization updates.

3. Provision of medical examination of any youth suspected of having a communicable disease.

4. Provision of health education and sex education as appropriate including information about Acquired Immune Deficiency (AIDS).

5. Provision that any medical treatment administered will be explained to the youth in a language understandable to him/her.

6. Provision of dental care by a dentist, licensed in Colorado, who is available to the center.

7. Provision of mental health treatment by a mental health practitioner who is licensed or certified according to state law.

8. Availability of a physician and an emergency medical facility on a 24-hour, seven-day-a-week basis for treatment of the youth.

9. Procedures for dispensing medication, storage of medication, documentation of administration of all medication, disposition of medications, and notification of primary physician in cases of medication 10. Provision of medical and dental prosthesis when the health of the youth would otherwise be adversely affected, as determined by the responsible physician.

11. Assurance that youth are informed both orally and in writing of procedures required for gaining access to medical services.

12. Assurance that program staff are informed appropriately of a youth's special medical problems. At the time of admission, staff are informed of any physical problems which might require medical attention.

13. Provision for the management of serious and infectious diseases which are updated as new information becomes available.

B. The center shall prepare and maintain a quarterly report on the health delivery system and health environment. An annual statistical summary of health care provided to residents shall be maintained.

C. A medical screening shall be performed by health-trained or qualified health care personnel on each youth upon arrival at the facility; all findings shall be recorded on a printed screening form approved by the primary physician.

D. A general medical examination for each child shall be completed by a physician or a qualified nurse practitioner within thirty days after admission unless one was completed within sixty (60) calendar days before admission. A statement form signed by the examiner shall be retained in the child's file. This exam shall include the following:

1. An examination for physical injury and disease.

2. Vision and hearing screening.

3. A current assessment of the child's health, including immunizations.

E. Sick call for non-emergency medical service, conducted by a physician and/or other qualified medical personnel, shall be available to each youth weekly.

F. Whenever indicated, a youth shall be referred to an appropriate specialist for either future assessment or treatment.

G. Subsequent physical and other examinations shall be done annually or as directed by the physician.

H. The facility shall ensure that the youth receive annual dental examinations.

I. There shall be first aid supplies readily available.

J. Youth care staff and other personnel shall be trained to respond to emergency health-related situations within a four minute response time. A training program shall be established which includes the following:

1. Recognition of signs and symptoms, and knowledge of action required in potential emergency situations.

2. Administration of first aid and cardiopulmonary resuscitation (DPR).

3. Methods of obtaining assistance.

4. Signs and symptoms of mental illness, retardation, and chemical dependency.

5. Procedures for patient transfers to appropriate medical facilities or health care providers.

K. The facility shall make every effort to ensure that a child needing corrective devices such as glasses, hearing aids, etc., is provided with the necessary equipment.

L. If a youth wishes an exemption from a medical examination or medical treatment due to religious beliefs, the youth shall submit a written statement signed by his/her parents or guardian which states the reasons for such an exemption. A secure residential treatment center has the right to request a statement regarding general health from a medical examiner. In a potential life-threatening situation, the center shall refer the youth's care to the appropriate medical and legal

authority. A center does have the right to refuse admission to a youth whose parent or guardian refuses medical treatment or examination.

M. Medications shall be administered and stored in the following manner:

1. Any prescriptive or non-prescriptive medication shall be administered by staff members of the Secure Residential Treatment Center only on the written prescription of a physician for each youth.

2. Medication shall be administered only by a staff member of the secure residential treatment center who is a licensed physician, licensed registered nurse, or a staff member who has passed a competency evaluation, which is authorized by the Colorado Department of Public Health and Environment.

3. The secure residential treatment center shall obtain written authorization from the prescribing physician to administer any prescriptive or nonprescriptive medication.

4. Medication shall be stored in a safe, locked, clean container or cabinet.

5. The center shall have a written medication schedule for each youth for whom medication is prescribed, a copy of which shall be available to appropriate staff.

6. The center shall maintain for each youth a cumulative record of all medication, both prescriptive and non-prescriptive, dispensed to that youth a. The name of the youth, b. The name and dosage of medication, c. The reason for prescribing the medication, d. The time and date the medication is dispensed, e. The name and position of the dispensing person, f. The name of the prescribing physician.

N. Under no circumstances is a stimulant, tranquilizer or psychotropic drug administered for purposes of behavior management and control, or for purposes of experimentation and research.

O. When a youth first comes into care, the center shall ascertain all medication the youth is currently taking. At this time the center's physician shall carefully review all medication the youth is using and make plans to either continue the medication or to reconsider the medication needs of the youth.

P. All informed consent standards in the Colorado shall be observed and documented for medical care. The informed consent of parent, guardian, or legal custodian applies when required by law. When health care is rendered against the patient's will, it shall be in accord with State and Federal laws and 7.713.32 Food and Nutrition A. Meals shall be served under conditions that minimize regimentation. The dining area shall provide normal group eating facilities and conversation shall be permitted during dining room hours.

B. The center shall provide nutritious foods in the variety and amounts to meet the recommended “National Research Council's Recommended Daily Dietary Allowances” as adjusted for age, sex and activity of each youth in care.

C. At least three meals, of which two are hot meals, shall be provided at regular meal times during each 24-hour period, with no more than 14 hours between the evening meal and breakfast. If basic nutritional goals are met, variations may be allowed during weekend and holidays.

D. Menus shall be planned at least one week at a time, shall be dated, posted and filed for at last 12 months.

E. If menus are not prepared by a qualified nutritionist or dietitian, there shall be review and approval by a qualified nutritionist or dietitian at least quarterly.

F. Youth shall be encouraged to eat a variety of food served but shall not be subjected to undue coercion, including forced feeding or other punishment for refusal to eat.

G. All food shall be from sources approved or considered satisfactory by the health

authority. All foods shall be stored, prepared, and served in such a manner as to be clean, wholesome, free from spoilage, and safe for human consumption.

Home-canned vegetables and meats shall not be served. Only pasteurized milk shall be served.

H. Special diets as prescribed by appropriate medical, dental or religious personnel shall be prepared for the youth. A record of the diet shall be maintained with the youth's record of medication.

I. Water from an approved source shall be readily accessible to youth by means of an approved water fountain or single service cups.

J. There shall be a weekly inspection of all food service areas, including but not limited to the following:

1. Dining and food preparation areas and equipment.

2. Sanitary, temperature-controlled storage facilities for all foods K. There shall be daily checks of refrigerator and water temperatures by administrative, medical, or dietary personnel. 7.713.33 Personal Hygiene and Daily Routine A. The center shall establish procedures to ensure that youth receive training in good habits of personal care, hygiene and grooming appropriate to their age, sex, race and culture.

1. There shall be personal supervision by staff to provide for proper grooming and physical cleanliness of the youth.

2. Hair care services shall be available to youth.

3. The center shall insure that youth are provided with all necessary toiletry items, including clean, individual towels and washcloths, toothbrush, toothpaste, comb and shampoo.

B. A secure residential treatment center shall have a written plan of basic daily routines which shall be available to all personnel. This plan shall be revised as necessary.

1. Youth shall be provided activities outside his/her bedroom at least 14 hours per day.

2. Daily routines shall not be allowed to conflict with the implementation of a youth's treatment plan.

3. Daily routines shall be established for mealtimes, waking, and bedtimes.

4. Opportunity for physical exercise shall be planned for each youth to include at least one hour daily of large muscle activity. 7.713.34 Clothing and Personal Belongings A. A residential facility shall ensure that each child in care has adequate clean, wellfitting, attractive and seasonable clothing as required for health, comfort and physical well-being and as appropriate to age, sex, and individual needs.

1. Each youth shall have clean socks, underwear and towels on a daily basis and other clean clothing at least twice a week.

2. At time of admission the center shall provide for the thorough cleaning and, when necessary, disinfecting of the personal clothing of a new youth before storage or before allowing the youth to keep and wear personal clothing.

3. Each youth's personal clothing shall be identified.

4. A youth's clothing shall be kept clean and in good repair. The youth shall be involved, as appropriate, in the care and maintenance of his/her clothing. As appropriate, laundering, ironing, and sewing facilities shall be accessible the youth.

B. A secure residential treatment center shall ensure that discharge plans make provisions for clothing needs at time of discharge. The wardrobe for each youth shall go with him/her at time of discharge.

C. The center shall allow a youth in care to bring his/her personal belongings to the center as defined by the center's policy, and to acquire belongings of his/her own in accordance with the youth's treatment plan. However, the center shall, as necessary, limit or supervise the use of these items while the youth is in care.

Where limitations are imposed, the youth shall be informed of the reasons by staff; and the decision and reasons shall be recorded in the youth's case record.

Provisions shall be made for the protection of the youth's property.

D. Youth assigned to food service, hospital, farm, garage, institution physical plant maintenance shops, and other special work shall be issued special and, when appropriate, protective clothing and equipment.

7.713.4 HUMAN RESOURCES 7.713.41 Personnel Policy, Orientation and Training [Rev. eff. 6/1/12]

A. The center shall have a written statement of personnel policies which include but are not limited to:

1. Job descriptions for all positions required. The descriptions shall describe duties of the job, qualifications for performance, and supervision to be provided.

2. Salary range and provision for increments.

3. Hours of work, holidays, vacations, sick leave, and other leaves.

4. Conditions of employment, tenure, and promotion.

5. Employment benefits, including retirement plan, social security, hospitalization, and other insurances.

6. Employee evaluation procedure.

7. Termination and sanction procedures including but not limited to child abuse and the use and/or sale of an illegal substance.

8. Grievance procedures which may be used by staff.

B. A copy of the personnel policy shall be given to each staff member at the time of his/her employment.

C. The center shall have a comprehensive written plan for the orientation ongoing training and development of staff members.

1. All new full-time employees shall receive 40 hours of orientation/training prior to being independently assigned to a particular job. This orientation/training is to include, at a minimum, orientation to the purpose, goals, policies and procedures of the center; working conditions and regulations; responsibilities and rights of employees; and an overview of the juvenile justice and correctional field. Depending upon the employee(s) and the requirements of the particular job, the orientation/training may include some preparatory instruction related to the particular job. Provisions may be made for acknowledging and giving credit for prior training received.

2. All clerical/support employees who have minimal contact with youth shall receive an additional 16 hours of training during the first year of employment and 16 hours of training each year thereafter.

3. Professional specialists employees who have contact with youth and all support employees who have regular or daily contact with youth shall receive an additional 40 hours of training during the first year of employment and 40 hours of training each subsequent year of 4. Training for clerical, support and professional specialists employees shall include such topics as security procedures, rights and responsibility of youth, fire and emergency procedures, interpersonal relations, social/cultural lifestyles of the youth population, communication skills, First Aid and CPR.

5. All new youth care/supervisory staff shall receive an additional 120 hours of training during the first year of employment and 40 hours of training each subsequent year of employment. At a minimum this training covers the following areas:

a. Security Procedures, b. Supervision of Youth, c. The use of physical management, restraint and seclusion pursuant to the requirements of Section 7.714.53, et seq.

d. Report Writing, e. Youth Rules and Regulations, f. Rights and Responsibilities of Youth, g. Fire and Emergency Procedures, h. Key Control, i. Interpersonal Relations, j. Social/Cultural Lifestyles of the Youth Population, k. Child Growth and Development.

I. Communication Skills, m. First Aid and CPR.

6. All part-time staff and volunteers working less than 40 hours per week shall receive training appropriate to their assignments; volunteers working the same schedule as full-time, paid staff shall receive the same training as full-time staff.

7. Personnel who work with youth confined separately from the total population shall receive specialized training.

8. All administrative and managerial staff shall receive 80 hours of training during their first year of employment, and 40 hours of training each subsequent year of employment. This training shall cover the following areas, at a minimum: General Management and Related Subjects, Labor Law, Employee-Management Relations, The Interaction of Elements of the Criminal and Juvenile Justice Systems, and Relationships with Other Service Agencies.

9. The center shall maintain written documentation of training held, the participation of individual staff members, the hours involved, and/or other in-service training activities in which each staff member was involved.

Activities related to supervision of the staff members' routine tasks shall not be considered training activities for the purpose of this requirement.

D. All training programs shall be presented by persons who are qualified in the areas in which they are conducting training.

E. A staff member shall be designated as Training Director and shall plan and implement staff training programs. 7.713.42 General Requirements for All Personnel A. The Secure Residential Treatment Center shall provide professional staff and service personnel necessary to assure the health, safety, proper care, and treatment of the youth under care.

B. All personnel in the center shall evidence an interest in and a knowledge of youth and a concern for their proper care and well-being.

C. The center shall have written screening and hiring procedures and make reasonable efforts to evaluate the overall emotional health and stability of each applicant. Procedures shall include exploring for history of child battering, child abuse, child molestation, child neglect, previous criminal convictions, and drug or alcohol abuse. (See Section 7.701.36).

D. The center shall not hire or continue to employ any person whose health, educational achievement, emotional, or psychological makeup impairs his/her ability to properly protect the health and safety of the youth, or is such that it would endanger the physical or psychological well-being of the youth.

E. Each member of the staff, including part-time and substitutes, students, and volunteers whose assignment is required to meet staff qualifications or staff ratio shall have a medical examination within six months prior to employment and thereafter as required, in writing, by a physician, nurse practitioner, or physician's assistant (see Section 7.713.48 for volunteers). The written reports of the medical examinations, which shall be on file at the facility, shall be dated and signed by the examining medical personnel. Reports shall include:

1. Statement of evaluation of the person's physical condition and his/her suitability for employment in a secure facility caring for youth.

2. A list of known immunizations he/she has had and the most recent dates when immunized.

3. Tuberculin status. If the staff member has a certificate of previous negative tuberculin testing, the testing need not be repeated. If there is no certificate, the testing needs to be completed prior to employment.

F. In addition to a physical examination, food handlers, or those who prepare food for youth, shall have special tests as may be required by local ordinances or by the physician's recommendation.

G. An employee who, upon examination or as a result of tests, shows indication of a physical condition which could be hazardous to a youth, other staff, or self, or which would prevent performance of duties, shall not be assigned or returned to his/her position until the condition is corrected to the satisfaction of the examining physician.

H. Any employee suspected of a communicable disease shall have a medical examination. 7.713.43 Administrative Staff A. Administrator The administrator of a secure residential treatment center shall be qualified as 1. The administrator shall have received a bachelor's degree from an accredited college or university and have five years of verified experience in the human services field with youth; three years of experience shall be in a supervisory and/or administrative position.

2. The administrator shall assume the following duties:

a. Overall direction and responsibility for the youth program, facility and fiscal management.

b. Overall direction and responsibility for supervision of adequate c. The selection and training of a capable staff member who can assume responsibility for management of the center in the administrator's absence.

d. The establishment and maintenance of relationships with allied agencies, services and resources within the community.

B. Assistant or Acting Administrator 1. In each Secure Residential Treatment Center, there shall be a specifically designated staff member, age 21 or over, capable of acting as a substitute for the administrator during his/her absence. The duties and responsibilities of the substitute administrator shall be clearly defined in order to avoid confusion and conflict among other staff and youth.

2. If the administrator is regularly absent from the facility more than 50 percent of his/her working hours, an assistant administrator shall be appointed who meets the same qualifications as the administrator found at

Section 7.713.43, A.

C. Administrative Coverage 1. When there is a change in administrator, or when he/she has left the center permanently without a replacement, the State Department of Human Services shall be notified within 30 calendar days; or when a possible change in administrator is anticipated, it is preferable to notify the state department prior to the change.

2. The administrator or the staff member to whom the administrator has 7.713.44 Medical and Health Staff A. A secure residential treatment center shall have a primary physician, licensed to practice medicine in Colorado, available to establish and maintain the health and medical policy and procedures of the facility as found at Section 7.713.31.

1. If the physician is not a full-time employee, the description of the physician's consultative services or other duties to be performed shall be set forth clearly in a written, signed agreement with the facility.

2. Any medical personnel, who is an employee, a volunteer, or whose services are purchased by the center, shall hold appropriate state and federal license, certification or registration and be responsible to the primary physician for the medical aspects of his/her job. A copy of the credentials shall be maintained at the center. 7.713.45 Youth Care Staff A. Each youth care staff member shall be at least 21 years of age and have completed two years of college education. A high school diploma or equivalent and one year's experience in the human services field may be substituted for the required college.

B. Youth care staff aides shall be at least 18 years old, shall work under the direct supervision of a youth care staff member in activities specified by the youth care staff member, or with the approval of the director.

C. Relief staff shall have the same qualifications as the regularly assigned youth 7.713.46 Youth Care Staff-to-Youth Ratios A. The center shall know the intended whereabouts of each youth in care at all times. Youth shall be supervised at all times (Section 7.713.25).

B. There shall be a minimum of one (1) adult qualified as a youth care staff member on duty and one (1) adult on call who can be summoned at all times when there is one or more youth at the center.

C. At night there shall be at least one awake youth care staff member within each physically separate building and within hearing of youth, and a second person who can be summoned in case of emergency.

D. The ratio of youth care staff members to youth in care shall not be less than the following schedule except when transporting youth in vehicles (see Section 7.713.57):

Waking Hours Sleeping Hours 1 youth care staff member to 10 1 awake youth care staff member to 20 7.713.47 Case Management Staff and Other Professional Staff A. Case management shall be provided by:

1. A qualified professional having a master's degree in social work, psychology, or related fields from an accredited college or university. This professional shall have two years of treatment-oriented experience; or, 2. A designated member of the staff, who shall have a bachelor's degree from an accredited college or university with a major in behavioral science, human services or related fields, and three years experience in working with youth, and for whom there is an effective arrangement for consultation from a qualified professional as described above at Section 7.713.47, A, 1.

3. The ratio of case management staff to youth shall be at least one full-time case management staff member for every twenty (20) youth, or a part-time staff member assigned for a fraction thereof.

B. The case management staff shall be responsible for implementing the individual treatment plan as stated at Section 7.713.23.

C. Psychiatrists used by the center shall be qualified and licensed to practice, and shall provide, as needed, diagnosis, treatment and consultation services.

D. Psychologists who perform testing and diagnostic services shall have a master's degree in psychology, or shall have a bachelor's degree in a human services field and receive supervision from a psychologist who has a master's degree or a Ph.D. in psychology.

E. Other professionals providing specific therapy shall be licensed professionals as designated by Colorado state law. 7.713.48 Volunteers and Students A. If volunteers or students are used by a center, the administration shall define specifically the services to be given by that individual.

B. A volunteer shall perform professional services only when certified or licensed to do so.

C. Volunteers and students who are assigned to work directly with the youth shall:

1. Be subject to reference and criminal record checks similar to those performed for applicants for employment.

2. Be in good general health. The center has the right to contact the individual's physician.

D. Volunteers and students shall be:

1. Directly supervised by a paid staff member.

2. Oriented and trained as required at Section 7.713.4, C. 7.713.49 Food Services and Maintenance Staff Members A. All staff members shall comply with the requirements for all personnel as specified in Sections 7.713.41 and 7.713.42.

B. Food service staff of the center shall meet requirements of the state or local health requirements for food handlers.

C. There shall be one food service staff member who has basic knowledge and understanding of nutrition, food purchasing, menu planning, and food preparation. If the staff member is not qualified as a dietitian or nutritionist, there shall be regular consultation from a specialist in the field.

D. Maintenance staff shall be in sufficient numbers to maintain an adequate physical plant.

7.713.5 BUILDING AND FACILITIES 7.713.51 Building Site A. A secure residential treatment center shall be located in an area that is readily accessible to health resources, public and private utilities, adequate and safe water supplies, sewage disposal, fire and police protection.

B. The site shall be approved by the local zoning department.

C. If the secure residential treatment center is located in the same building as, or immediately adjacent to, other residential facilities, such as a residential child care facility or an adult treatment center, it shall be so arranged that the care and activities of the youth residing in the secure residential treatment center are completely separate and independent from the other residential facility. A secure residential treatment center may not be operated on the premises of a business of a nature which might be hazardous to the health, safety, morals, welfare of youth, and the operation of the secure residential treatment center. The center shall only care for youth of the age stated on the license. The center shall not be used for the care of persons over the age of 21 years old. 7.713.52 Building Approvals A. Each licensed center shall meet the requirements of the State Department of Public Health and Environment or its local unit, and the local fire department, and shall be inspected at least annually for compliance with current sanitation and life safety code regulations. All health and life safety hazards shall be corrected as required by the appropriate regulatory agency.

B. A center staff member, who is trained in and is familiar with the safety and sanitation requirements, shall conduct weekly inspections of the center and assure that any items of non-compliance with safety and sanitation regulations are corrected immediately. A record of each inspection shall be maintained for 12 months.

C. Licensed centers shall comply with applicable state or local building code D. Prior to construction, architectural plans for new buildings, or for extensive remodeling of existing buildings, shall be submitted for review and approval by the State Department of Public Health and Environment or its local unit, the local fire department, and local building department. Plans shall be submitted and reviewed by the State Department of Human Services as to appropriateness, general adequacy, and suitability for youth care. 7.713.53 Living Spaces and Equipment Necessary in a Residential Treatment Care Facility A. There shall be separate sleeping rooms for boys and girls. In sleeping rooms that accommodate two or more youth, 60 square feet of floor space per youth shall be provided. There shall be no more than six youth in any bedroom. Each bedroom for single occupancy shall have a minimum of 70 square feet of floor space.

Closet and/or drawer space for storage of personal items sufficient for the occupants in each sleeping room shall be provided.

Sleeping rooms above or below the floor of exit travel shall not be used for sleeping purposes for youth who are non-ambulatory.

B. Each youth shall be provided suitable sleeping facilities consisting of individual beds or bunks complete with mattresses in good repair and constructed so as to facilitate cleaning while in use by residents and upon each change of occupancy.

Triple-deck bunks are prohibited. Beds being used by youth shall have a mattress, clean linens, pillows, pillowcases, and blankets.

C. Each room of occupancy shall have natural light, be well-lighted and adequately ventilated by exterior windows or by an approved air-conditioning system. If a mechanical ventilation system is provided, it shall meet requirements of local building codes and fire regulations and a backup system to assure that ventilation is available in the event of power failure.

D. Each sleeping room has, at a minimum, the following facilities and conditions:

1. Toilet facilities available for use 24 hours a day.

2. A hand washing sink with hot and cold running water.

3. A desk, chair or stool.

4. Temperatures which are appropriate to the summer and winner comfort zones.

E. Staff rooms shall be located on the same floor or in the general area of youth's sleeping rooms so that the youth care worker can supervise youth and be readily accessible when needed.

F. There shall be a minimum of 35 square feet of space for each youth for informal individual or group activities. The area shall be adequately and appropriately furnished to accommodate social and recreational activities associated with such living areas.

G. There shall be a designated space distinct from youth's living areas 1o serve as an administrative office for such activity as secretarial work and bookkeeping.

H. There shall be a designated space to allow private discussions and counseling sessions.

I. Each center shall have a telephone. Each separate living unit within a center shall have 24-hour telephone service or an intercom system connected with an outside telephone service. Emergency telephone numbers, including fire, police, physician, poison control, health agency and ambulance, shall be conspicuously posted adjacent to the telephone. 7.713.54 Outdoor Space and Equipment A. All structures on the grounds of the center shall be maintained in good repair and free from any danger to health or safety.

B. The grounds of the center shall be maintained in an acceptable manner and shall be free from any hazard to health or safety.

1. Garbage and rubbish which is stored outside shall be stored securely in noncombustible, covered containers and shall be removed at least once every week, or more frequently if necessary.

2. Garbage and rubbish containers and incinerators shall be located separate from play areas.

3. Fences shall be in good repair.

4. Areas determined to be unsafe, including steep grades, cliffs, open pits, swimming pools, high-voltage boosters, or high-speed roads, shall be fenced off or have natural barriers to protect youth.

5. Playground equipment shall be so located, installed and maintained as to ensure the safety of youth.

C. A secure residential center shall have access to outdoor recreational space and suitable recreational equipment.

D. When a swimming pool is provided, it shall meet the requirements of the Colorado Department of Public Health and Environment. Safety precautions shall include protective fencing, winter coverage, which shall exclude plastic or inflatable-type domes, and a non-skid surface area of at least four (4) feet adjoining poolsides. 7.713.55 Dining, Kitchen, Laundry, Bathroom Facilities A. The dining area, whether located in the living unit or in a separate, central dining facility, shall meet the following requirements:

1. It shall be clean, well-lighted, properly heated, and ventilated.

2. Fifteen (15) square feet per person be provided to accommodate the youth and staff.

3. Floors shall be constructed and maintained with a non-skid surface.

4. Tables and chairs shall be of sturdy construction, scaled or adjusted to the proper height and size so that youth can be comfortably served.

5. Table service and settings shall be of the type, size, and design appropriate to the security of the facility.

6. All dishes, cups, and glasses used by youth in care shall be free from chips, cracks, or other defects.

7. Walls and floors shall be of materials that are easy to keep clean.

8. Dining and recreation areas may be combined if regulations for dining areas are consistently met.

B. The kitchen shall be designed and equipped to meet the requirements of sanitation, fire safety, and comfortable working conditions for the staff. There shall be:

1. Adequate space for receiving, storage, refrigeration, and preparation of food. Storage space shall be clean and well-ventilated; and containers of food shall be covered and stored above the floor on shelves or other clean surfaces.

2. Provision for daily disposal of garbage and other refuse. Food waste grinders shall be installed in compliance with applicable laws and 3. Separate storage of poisonous and toxic materials from food. Such materials shall be labeled and used only in ways that will neither contaminate food nor be hazardous to employees.

4. Mechanical dish washing equipment or other approved methods of dish washing in accordance with requirements of the State Department of Public Health and Environment.

5. Provision for a CO2 or dry powder fire extinguisher(s) in kitchen. If a commercial-type range is used, a hood with a filter must be installed.

6. Hand washing and toilet facilities for use of kitchen staff shall be readily accessible.

C. When a center has a central laundry facility, it shall be located in an area separate from areas occupied by youth. Laundry facilities with ample space for sorting, drying, and ironing shall be made available to youth old enough and capable of handling their personal laundry. These facilities shall be in an area supervised by a responsible adult.

D. Laundry trays or slop sinks shall be available and located conveniently for purposes of cleanliness and sanitation.

E. There shall be a ratio of at least one toilet, lavatory, and bathtub or shower for every six (6) youth, readily accessible and kept in sanitary condition. Separate toilet and bath facilities shall be available for boys, girls, and staff. Toilets and bath facilities shall have doors and partitions. Urinals may be substituted for up to one-third of the required number of toilets for boys in facilities which accept boys.

Toilets and bath facilities shall be accessible from a common hallway and be on the same floor with sleeping rooms.

F. Bath and toilet rooms shall be constructed of easily cleanable, nonabsorbent materials. Floors shall have an impermeable, nonskid surface. Walls shall have a finished surface extending to a height of four (4) feet in toilet rooms and six (6) feet in shower rooms. All surfaces shall be maintained in good repair.

G. Hot and cold water under pressure shall be supplied to all required plumbing fixtures except toilets. Water temperature control valves shall be inaccessible to youth, and water temperature shall be controlled by employees. Hot water in lavatories and bathing facilities shall not be above 110 degrees Fahrenheit.

H. If drinking fountains are provided, they shall be approved, angle-jet type with adequate water pressure at all times. 7.713.56 Building Safety [Rev. eff. 6/1/12]

A. Maintenance 1. Buildings shall be kept in good repair and maintained in a safe, clean, and sanitary condition. Good housekeeping shall be observed in all areas at all times. A housekeeping plan shall be written and implemented.

2. All areas available for youth's activities shall be maintained in safe condition, including elimination of debris and hazardous items of all kinds, and removal of broken play and recreational equipment and any other devices which are in poor repair.

3. There shall be a written procedure, which shall be implemented, to provide for the control of vermin and pests.

4. Closets, attics, basements, cellars, furnace rooms, and exit routes shall be kept free from accumulation of extraneous materials such as discarded furniture, furnishings, newspapers, or magazines. Combustibles such as cleaning rags, mops, and cleaning compounds shall be stored in wellventilated areas. Solutions, cleaning compounds, and other hazardous substances will be properly labeled and stored in areas inaccessible to 5. Storage of gasoline, kerosene, fuel oil, and other flammable material shall meet requirements of safety and fire codes.

6. There shall be a written policy to govern the control and use of all flammable, toxic, and caustic materials. The policy shall be implemented.

7. Provision shall be made for collection, storage, and disposal of refuse in an approved manner to prevent nuisance conditions.

8. Storage shall not be permitted around or near water heaters and furnaces.

9. There shall be ample closets for cleaning supplies and equipment. Closets shall have good ventilation and be located in each principal area.

B. Exits 1. Every building or structure, new or old, shall be provided with exits sufficient to permit the prompt escape of occupants in case of fire or other emergency. Additional safeguards shall be provided for life safety in case any single safeguard is ineffective due to some human or mechanical failure.

2. There shall be at least two approved, alternate, remotely-located means of egress from each floor of the building to safe and open space at ground level.

3. Egress from each dwelling unit or sleeping room shall be directly available without passage through another dwelling or room unit to the outside or to a common hallway leading to the outside.

4. Exits from bedrooms and other interior rooms, and exits to the outside of the building shall have the capability to be locked to limit the freedom of the youth in residence. Because of this capability the local fire department has the right to require safeguards not commonly found in less restrictive settings.

5. Every exit shall be clearly visible, or the route to reach it shall be conspicuously indicated in such a manner that every occupant of every building or structure who is physically and mentally capable will readily know the direction of escape from any point. Each path of escape shall be so arranged or marked that the way to a place of safety outside is unmistakable.

6. Pathways or hallways which lead to an exit shall not be cluttered or hazardous thus resulting in the obstruction of access to the exit.

7. In every building or structure, adequate and reliable illumination shall be provided for all exit facilities. Every building or structure shall be so constructed, arranged, equipped, maintained, and operated as to avoid undue danger to the lives and safety of its occupants from fire, smoke, fumes, or resulting panic during the period of time reasonably necessary for escape from the building or structure in case of fire or other 8. Compliance with this rule shall not be construed as eliminating or reducing the necessity for other provisions for safety of persons using a structure under normal occupancy conditions, nor shall any provision of this rule be construed as requiring or permitting any condition that may be hazardous under normal occupancy conditions.

9. The local fire department shall determine the adequacy of exits and other Uniform Building Code and the National Fire Protection Codes. In cases of practical difficulty or unnecessary hardship, the local fire department may grant exceptions from the Uniform Building Code or the National Fire Protection Codes, but only when it is clearly evident that reasonable safety is thereby secured.

C. Heating and Electrical Equipment 1. All heating units, gas or electric, shall be installed and maintained with safety devices to prevent fire, explosions, and other hazards. No openflame gas or oil stoves, hot plates or unvented heaters shall be used for heating purposes.

2. Electrical wiring systems in all buildings shall conform to the requirements of the state electrical board. Electrical appliances shall be examined frequently for worn or otherwise defective wiring.

3. Heating devices such as radiators, registers, fireplaces, and steam and hot water pipes within the reach of youth shall be screened or otherwise protected as deemed necessary for the youth in residence at the center.

D. General Safety Practices 1. A secure residential treatment center shall immediately notify the responsible agency or department of fire or other disaster which might endanger residents or require their removal for reasons of health and safety. The Licensing Section of the Colorado Department of Human Services shall be notified of a fire or other disaster.

2. A secure residential treatment center shall not maintain any firearm on the grounds or within the structures of the facility.

a. A facility shall not permit any staff member or youth to be in possession of any firearm on the grounds or within the structures of the center. If chemical weapons are carried by a staff member for personal protection, the weapons shall be locked when the staff member is in the center.

b. Security guards patrolling the grounds and structures of a center, whether employed by the center or by a security service under contract to the center, shall not be permitted to be in possession of any firearm or chemical weapon on the grounds or within the structures of the facility except in emergency situations which are detailed in written policy.

3. Porches, elevated walkways and elevated play areas within the center shall have barriers to prevent falls.

4. Power-driven equipment used by the center shall be kept in safe and good repair. Such equipment shall be used by youth only under the direct supervision of a staff member and according to state law.

5. All stairways containing more than four steps shall be equipped with a handrail.

6. Staff and youth shall be trained to report fires and other emergencies appropriately and shall be trained in fire prevention.

7. Power generators shall be tested at least every two weeks, and other emergency equipment and systems tested at least quarterly for effectiveness and shall be repaired or replaced if necessary.

8. The center shall have access to an alternate power source to maintain essential services in an emergency.

9. There shall be a procedure which provides for a communications system in emergency situations within the center and between the center and the community.

E. Evacuation and Fire Drills 1. There shall be a written evacuation plan prepared in the event of fire or major emergency which is approved by the local fire protection authorities pursuant to national fire safety codes. The plan shall be reviewed annually, updated if necessary, and reissued to the local fire jurisdiction.

The plan shall include but not limited to the following:

a. Location of building/room floor plans.

b. Use of exit signs and directional arrows for traffic flow.

c. Location of publicly posted plan.

d. At least quarterly drills or simulated drills on all shifts throughout the center.

e. Simulation of drills for evacuating extremely dangerous youth.

f. The means for the release of youth from locked areas and provision for a back-up system of security and control of youth.

2. All center personnel shall be trained in the implementation of the written emergency plans including fire, riot, hostage, medical, evacuation, and natural disasters. These plans are made available to all personnel. The plan and amendments shall be reviewed by staff at least annually.

3. In every building or structure, fire alarms shall be provided to warn occupants of the existence of fire so that they may escape, or to facilitate the orderly conduct of fire exit drills.

4. Responsibility for the planning and conduct of fire drills shall be assigned to competent persons qualified to exercise leadership.

5. Drills shall be held at unexpected times and under varying conditions to simulate the unusual conditions prevailing in case of fire or other disasters.

6. In the conduct of drills, emphasis shall be placed upon orderly evacuation under proper discipline rather than upon speed. No running or horseplay shall be permitted.

7. Drills shall include suitable procedures to make sure that all persons in the building, or all persons subject to the drill, actually participate.

8. Fire alarms shall be regularly used in the conduct of fire exit drills.

9. The center shall make special provisions for the evacuation of any physically handicapped youth.

10. The center shall take special care to help emotionally disturbed or perceptually handicapped youth understand the nature of such drills.

F. A secure residential treatment center shall maintain an active safety program, including investigation of all accidents and recommendations for prevention. 7.713.57 Transportation A. A secure residential treatment center shall ensure that each youth is provided with the transportation necessary for implementing the youth's treatment plan.

B. A Secure Residential Treatment Center shall have means of transporting youth in cases of emergency.

C. There shall be a written procedure to govern safety and security precautions pertaining to center and staff vehicles.

D. Any vehicle used in transporting youth in care of a Secure Residential Treatment Center, whether such vehicle is operated by the center, a staff member or any other person acting on behalf of the center, shall be properly licensed, and shall be maintained in conformity with all applicable motor vehicle laws. The vehicle shall be enclosed, provided with door locks, and shall be equipped with a first aid kit and fire extinguisher.

E. Any staff member of a secure residential treatment center or other person acting on behalf of the center operating a vehicle for the purpose of transporting youth shall be properly licensed to operate that class of vehicle in accordance with applicable laws of the Department of Revenue.

F. A secure residential treatment center shall not allow the number of persons in any vehicle used to transport youth to exceed the capacity established by the manufacturer for the vehicle.

G. In addition to the driver, there shall be sufficient number of supervisors traveling in any vehicle to meet the required staff-youth ratio as stated at Section 7.713.46 when transporting youth.

H. A secure residential treatment center shall ascertain the nature of any need or problem of a youth which might cause difficulties during transportation, such as seizures, a tendency toward motion sickness or a disability. The center shall communicate such information to the operator of any vehicle transporting youth in care.

7.713.6 RECORDS 7.713.61 Confidentiality A. There shall be a written procedure to govern record management which includes but is not limited to the following: Establishment and utilization, content, privacy, security, preservation, and a schedule for retiring or destroying inactive records.

These policies and procedures shall be reviewed annually.

1. Records shall be the property of the secure residential treatment center; and the center, as custodian, shall secure records against loss, tampering, or unauthorized use. The center shall designate who is to supervise the maintenance of records and to whom records may be released.

2. Employees of the center shall not disclose or knowingly permit the disclosure of any information concerning a youth or his/her family, directly or indirectly, to any unauthorized person except in case of medical 3. Information concerning a youth in care shall not be released without the voluntary, written consent of the parent(s) or guardian except to the youth, his/her parents(s) or guardian, their respective legal counsel, the court having jurisdiction over a youth's case, or an authorized public official in the performance of his/her mandated duties.

4. A secure residential treatment center may make available information in the case record to the youth, his parent(s) or guardian and their respective legal counsel if the information being released does not contain material which violates the right of privacy of another individual and/or material that must be withheld from release according to other laws or by order of the court. If, in the professional judgment of the administration of the center, it is believed that information contained in the record would be damaging to a youth, that information may be withheld except under court order.

Educational records shall be governed by federal and state laws.

5. It is acceptable to use material from case records for teaching or research purposes, development of the governing body's understanding and knowledge of the center's services or similar educational purposes, when names are deleted and other identifying information is disguised or deleted.

6. It is necessary to obtain an employee's permission or court order for the release of information from a personnel file.

7. The contents of records shall be identified and separated according to an established format.

8. All entries in the master file are dated and identified.

9. Personnel and records of youth shall be available, upon request, to authorized personnel of the Colorado Department of Human Services. All records regarding youth and all facts learned about youth and their relatives shall be kept confidential by the staff of the Colorado Department of Human Services pursuant to the state law.

B. There shall be a procedure which upholds the principle of confidentiality of the health record and includes the following requirements:

1. The active health record is maintained separately from the confinement record.

2. Access to the health record is controlled by the center's primary physician and the medical policy and procedure.

3. The center's primary physician or his/her designee shares with the center administrator information regarding a youth's medical management, security, and ability to participate in programs. 7.713.62 Necessary Records and Their Retention A. The secure residential treatment center shall maintain complete records as required for licensing the center in accordance with the Minimum Rules and Regulations for a Secure Residential Treatment Center.

B. A permanent register shall be maintained which contains:

1. Identifying information, such as name, sex, birth date, race, on each youth who has been in care at the center including a youth admitted in an 2. Name and address of referring agency. Name of referring personnel.

3. Date of admission.

4. Discharge date and name and address of person or agency to whom the youth is discharged.

C. Records for youth shall be retained for at least seven years. Retention of records for a longer period may be desirable when they reflect an accident, injury, or other unusual circumstance.

D. Records for personnel shall be retained for at least three years.

E. The following records shall be on file at the center or its administrative office:

1. Documents regarding the governing body including the charter, articles of incorporation, by-laws or other legal basis for existence, and names and addresses of current board of directors and officers of primary workers of the governing body.

2. Current health department inspection report.

3. Current fire department inspection report.

4. Weekly safety and sanitation inspection reports.

5. A list of current staff members, substitutes, and staffing pattern 6. Insurance coverage.

7. Annual audit. 7.713.63 Case Record for Youth A. A record for each youth in care shall be maintained in a master file at the center where the youth resides which shall contain the following:

1. Name, age, sex, place of birth.

2. Initial intake information form and study;

3. Documented legal authority to accept juvenile;

4. Information on referral source;

5. Social history;

6. Medical consent forms;

7. Name, relationship, address, and phone number of parent(s) and/or guardian(s) and person(s) juvenile resides with at the time of admission;

8. Driver's license number, social security number, and Medicaid number, when applicable;

9. Court and disposition;

10. Signed release of information forms, when required;

11. Progress reports on program involvement;

12. Program rules and disciplinary policy signed by juvenile;

13. Grievance and disciplinary record, if applicable;

14. Referrals to other agencies; and 15. Written agreements signed by parents or legal guardians pertaining to permission to care for youth, financial responsibility, medical services, and other permits. This may include the placement agreement signed by the center and the placement agency or individual placing youth.

16. The treatment plan, a summary of the periodic evaluations of the child's progress, and resultant changes in treatment plan.

17. Educational records and reports;

18. Incident reports;

19. Summary recording of significant contacts with parents or guardians and other agencies involved.

20. A summary of the discharge of the youth from the center which includes, but is not limited to the following:

a. The date of the discharge of the youth from the center, b. To whom the youth was released, c. The physical condition of the youth at time of discharge d. A summary of services provided during residence at the center.

e. A summary of the youth's response to treatment, accomplishments during residence and psychosocial status at the time of discharge.

f. The assessed needs which remain to be met and alternate service possibilities which might meet those needs.

g. A statement of an aftercare plan and identification of agency responsible for follow-up services and after care.

h. Circumstances which led to an unplanned discharge.

B. There shall be a health record maintained for each youth. The form and format of the health record, and the procedures for its maintenance and safekeeping shall be approved by the center's primary physician. The health record shall include but not be limited to the following:

1. The completed receiving screen form.

2. Health appraisal data forms.

3. All findings, diagnoses, treatments, dispositions.

4. Prescribed medications and their administration.

5. Laboratory, x-ray, and diagnostic studies.

6. Signature and title of documenter.

7. Consent and refusal forms.

8. Release of information forms.

9. Place, date, and time of health encounters.

10. Health service reports, e.g., dental, mental health and consultations.

11. Treatment plan, including nursing care plan.

12. Progress reports.

13. Discharge summary of hospitalization and other termination summaries. 7.713.64 Personnel Records A personnel record for each employee shall include: name, address, birth date, names and telephone numbers of persons to be notified in event of an emergency; date of employment, and date and reason for separation; documents verifying education, training, and work experience pre-employment references; physical examination at the time of employment and subsequent health examinations; and the indication of awareness of agency policies 7.713.65 Incident Reports and Logs [Rev. eff. 6/1/12]

A. There shall be maintained a permanent log in which is reported a summary of situations involving individual or groups of youth for use by supervisory and treatment staff. Each shift of staff members shall prepare shift reports that record routine and emergency situations.

B. All special incidents such as emergency situations, injuries, physical management or major rule violations shall be recorded and reported as required in these rules, Section 7.714.53, et seq., and reported to the director of the facility or his/her designee. A copy of the record shall be maintained in the youth's case record. 7.713.66 Reports A. A residential center shall notify immediately the youth's parent(s), guardian, and/or the placing agency of any illness, injury, or severe psychiatric episode resulting in medical treatment, hospitalization, or death.

B. Critical incidents shall be reported as outlined in Section 7.701.52.

7.714 QUALITY STANDARDS FOR TWENTY–FOUR (24)-HOUR CARE FOR

CHILDREN AND YOUTH

All rules in Section 7.714 will be known and hereinafter referred to as the Quality Standards for Twenty-Four (24)-Hour Care for Children and Youth and will apply to all applicants and licensees subject to licensing as a specialized group facility, a child placement agency (CPA) or county that certifies specialized group facilities, or a residential child care facility (RCCF), including facilities operating under a RCCF license. Facilities operating under a RCCF license include: qualified residential treatment programs (QRTP), psychiatric residential treatment facilities (PRTF), shelter care service programs, and runaway and homeless youth shelter care facilities. Secure residential treatment centers (SRTC) must comply with rules for physical restraint found in Section 7.713.24.B and Sections 7.714.53 through 7.714.536. Day treatment centers must comply with applicable rules for physical restraint found in Sections 7.706.17 and 7.714.53 through 7.714.536. 7.714.1 Program Description A. The facility must have a written overall program description for the facility. The written description must include the following:

1. The population served, including, but not limited to, the following: ages of children/youth accepted, special populations served, and exclusionary criteria that conforms to the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. §§ 12101-12213 (2009), as incorporated by reference in

Section 7.701.14;

2. Treatment modalities and programming utilized by the facility;

3. The title of the person who has overall responsibility for the development, implementation, and coordination of the treatment program;

4. Staff responsibility for planning, changes, and implementation of the treatment procedures and therapeutic interventions;

5. The range of procedures and interventions to be used and the anticipated range or types of behavior or conditions for which such procedures and interventions are to be used, including philosophy of treatment, modes of therapy, trauma-informed practices, positive behavior intervention, skillbuilding strategies, physical restraint, and seclusion where allowed and approved by the department; and 6. The facility’s responsibility for monitoring the safety of children/youth during routine care and treatment, including when the program may utilize emergency interventions.

7.714.2 GENERAL REQUIREMENTS FOR ADMISSION

A. Admission of a child/youth shall be in keeping with the stated purpose of the facility. Admission must be limited to those children/youth for whom the facility is qualified and licensed to care for. Care must be provided in a manner consistent with the child/youth rights outlined in Sections 7.714.31 through 7.714.32 and in the least-restrictive, most appropriate setting in order to meet the individualized child's/youth’s needs. Additionally, for children/youth in foster care or participating in the foster youth in transition program, care must be provided in a manner consistent with the child/youth rights outlined in Section 19-7-101(2), C.R.S. and Sections 7.714.33 through 7.714.34 and in the least-restrictive, most appropriate setting in order to meet the individualized child’s/youth’s needs. A facility that accepts youth in foster care or participating in a foster care transition program who are eighteen (18) years of age and older but under twenty-one (21) years of age must have a written policy to address how the facility will ensure the youth’s adult rights and duties will be accommodated, including, but not limited to, registering to vote and registering for selective service, in addition to their rights as identified in Section 7.714.33. 7.714.21 Admission Procedures Each facility must develop and adhere to written admission procedures. such procedures must be provided to the referring agencies and parent(s) and/or guardian(s) of the child/youth referred for placement. Procedures must include:

A. The written description of the program, as stated in Section 7.714.A.

B. The facility may only accept a child/youth into care after receiving all necessary information from the referral source, to include:

1. The name, date of birth, sex assigned at birth, gender identity, and physical description of the child/youth;

2. Reason for referral and identified risk and safety triggers;

3. Any known medical needs, including any allergies, injuries, prescribed medications, or necessary treatments;

4. Current presenting problems and areas of concern;

5. Anticipated length of stay;

6. Current functioning;

7. Required accommodations, including sleeping/roommate accommodations;

8. The name and contact information of the placing authority, which must include an emergency contact phone number for access to the placing

authority twenty-four (24) hours a day. Verification of the authority of the individual placing the child/youth at the facility must be provided and such information documented in the child’s/youth’s admission record; and 9. A placement agreement, including provisions for discharge pending necessary information on child/youth.

C. The facility must observe and document the physical condition of the child/youth at the time of admission, as outlined in the facility’s procedures, to include marks or tattoos, signs of abuse or neglect, or signs of illness. This process must not violate the child’s/youth’s right to privacy. Any signs of potential abuse or neglect must be reported to the child abuse and neglect hotline immediately. If there is reasonable cause to believe or suspect that the child/youth has physical signs of abuse or neglect in bodily areas not readily visible, then the facility must have the child/youth immediately seen by the facility nurse or outside medical staff.

D. For any child/youth admitted to the program, the facility must request and make every diligent effort, no less than three (3) documented requests within the first month of admission, to obtain, utilize, and keep in the child’s/youth’s file current, relevant information on the child/youth, to include:

1. Expected goals to be achieved by the child/youth while in care;

2. Required level of supervision for the child/youth, including during times of transportation and when off facility grounds;

3. Social, emotional, and developmental history;

4. History of trauma, abuse/neglect;

5. A mental health assessment and source of the assessment information, if obtained from an outside source such as a prior placement or mental health provider;

6. current family structure, relationship dynamics, and family functioning;

7. Behavioral health history or observable behaviors and/or actions that impact overall physical and psychological health, including, but not limited to, lifestyle choices like diet or exercise;

8. Physical conditions and health, to include allergies, chronic conditions, and current medications;

9. Mental and psychological health, to include emotional regulation, coping strategies, and current psychotropic medications;

10. Immediate supports available, to include cultural, relational, religious, spiritual, or emotional;

11. Substance use;

12. Previously successful and unsuccessful interventions;

13. Skills, assets, and strengths;

14. Previous placements;

15. The family services plan, if applicable and available; and 16. Educational records for the current and past year in accordance with

Section 7.701.63.B.8. Such records must be evaluated by the child’s/youth’s educational team or administrative unit to determine the child’s/youth’s educational needs for purposes of enrollment in school and ensuring a child/youth has access to required services listed in school plans, such as an individualized education plan (IEP) or 504 plan.

E. Authorizations must be obtained from the parent(s), legal guardian(s), and/or custodian(s) within one (1) week of admission, unless otherwise noted below, authorizations must include the following:

1. Consent for routine and emergency medical, dental, and vision care, obtained prior to or on day of admission in accordance with Section 13-22- 103(1), C.R.S. youth eighteen (18) years or older may give consent for medical care, dental care, and related care;

2. Consent for physical restraint and/or seclusion, obtained prior to utilizing and when applicable, as described in Section 7.714.531;

3. Consent to treatment for mental health services in accordance with Sections 27-65-103, C.R.S and 27-65-104, C.R.S. Children fifteen (15) years or older may give consent to receive mental health services;

4. Consent to release confidential information as required by law or court order;

5. Consent to treat for other behavioral health services and all treatment modalities the facility may utilize in the child’s/youth’s course of treatment;

6. Specific to QRTPs, consent for the BHA to release the state-approved assessment in accordance with Section 7.705.208; and 7. Consent for search practices conducted by the facility;

F. For an emergency admission of a child/youth to the facility, facilities may request additional information as needed, but at least the following must be obtained prior to or on the day of admission:

1. The name, date of birth, sex assigned at birth, gender identity, and physical description of the child/youth;

2. Any known medical needs, including any allergies, injuries, prescribed medications, or necessary treatments;

3. The name and contact information of the placing authority, which must include an emergency contact phone number for access to the placing

authority twenty-four (24) hours a day. Verification of the authority of the individual placing the child/youth at the facility must be provided and such information documented in the child’s/youth’s admission record;

4. Written authorization allowing routine and emergency medical, dental, vision, and mental health care to be provided to the child/youth; and 5. A placement agreement, including provisions for discharge pending necessary information on child/youth.

G. The facility must request and make every diligent effort, no less than three (3) documented requests within the first month of admission, to obtain, utilize, and document the following for each child/youth admitted to the program:

1. All persons allowed to have contact with the child/youth, including the manner and frequency of contact.

2. All documentation from referral sources of persons not allowed to have contact with the child/youth, including court orders, protection orders, and reasons for such restrictions if applicable and made available.

3. The name(s) and title(s) of the individual(s) to whom the child/youth may be released at the time of discharge from the facility, if made available;

4. The legal status, including probation or criminal adjudications, and custody of the child/youth.

H. When a child/youth is placed by a sending agency out-of-state, the interstate compact on the placement of children (ICPC) procedures must be followed as detailed in Part 18 of Article 60 of Title 24, C.R.S., including:

1. In accordance with Section 24-60-1802, C.R.S., the sending agency includes a party state, officer, or employee thereof; a subdivision of a party state, or officer, or employee thereof; a court of a party state; a person, corporation, association, charitable agency, or other entity which sends, brings, or causes to be sent or brought any child/youth to another party state ultimately responsible for the planning, financing, and placement of 2. Requests must be sent by the sending state directly to the Colorado Deputy Compact Administrator on federal form ICPC-100A (2021) prior to the placement of the child/youth in the Colorado facility herein incorporated by reference. No later editions or amendments are incorporated. The federal form ICPC-100A can be found at https://drive.google.com/drive/folders/1ZIRMFGQCETXSWY1KGXWBOS 6ROK61J-PM. Copies are also available for public inspection and copying at the Colorado Department of Human Services, 1575 Sherman Street, Denver, CO 80203, during regular business hours; and 3. No child/youth residing out of state may be admitted to a Colorado facility until an ICPC approval is granted by the Colorado Compact or Deputy Compact Administrator. 7.714.22 Child/Youth Orientation A. Within twenty-four (24) hours of arrival at the facility, the child/youth must be given an orientation to the facility. If the orientation cannot happen within the twenty-four (24) hour timeframe for child/youth-specific reasons or due to the need to acquire language or interpretation services, this must be documented in the child’s/youth’s file. The orientation must be conducted in the child’s/youth’s preferred language. The orientation must be consistent with the child’s/youth’s age, reported developmental and/or cognitive level, and ability to participate. If the child/youth is not able to participate in the orientation, the individual placing the child/youth in the facility must be given the orientation on behalf of the child/youth. The child/youth who received the orientation or their placing authority must sign and date the orientation form upon completion of the orientation. The orientation must include:

1. A tour of the facility to include where the child/youth will sleep, instructions on fire alarm and fire evacuation procedures, escape routes, and exits;

2. An overview of the rules/regulations and policies of the facility;

3. If applicable, a discussion as to when physical restraint may be used and the necessary permissions and an explanation of the debriefing process, as required by Sections 7.714.53 through 7.714.536;

4. For children/youth residing in foster care or participating in the foster youth in transition program, the location of the posted written notice of child/youth rights required by Section 19-7-101(5), C.R.S. The written notice must be posted in a place where children/youth have access.

For other children/youth, an explanation of child/youth rights, as identified in Section 7.714.31.B, and where the rights are posted in the facility;

5. For children/youth residing in foster care or participating in the foster youth in transition program, a notice must be provided containing contact information for the child’s/youth’s appointed attorney; the Office of the Child Protection Ombudsman; the appropriate county department of human/social services; and the Department of Human Services.

a. The notice must include an explanation that such children/youth may speak with the parties listed in Section 7.714.22.A.5 if they have any questions, concerns, or grievances related to the child/youth rights.

6. For children/youth who are not residing in foster care or not participating in the foster youth in transition program: an explanation of the facility’s grievance policies and procedures, the name and contact information for the designated client representative, and where the grievance forms and grievance box are located. The child/youth must be advised that they can request staff assistance with submission of a grievance.

a. Such children/youth must also be provided notice that they may contact the Office of the Child Protection Ombudsman, the appropriate county department of human/social services, and the Department about any questions, concerns, or grievances related to child/youth rights;

7. An introduction to staff and peers; and 8. An overview of the anticipated daily schedule for the child/youth.

B. A form listing the orientation requirements must be signed by the staff member and the child/youth, or the individual placing the child/youth, verifying the date the orientation occurred. A copy of such form must be provided to the child/youth and the placing authority of the child/youth, and a copy must be maintained in the child’s/youth’s file.

C. A copy of the rules/regulations and policies of the facility, a copy of the written notice form of child/youth rights, an explanation of the facility’s grievance policies and procedures, a name and number of a staff member to be contacted with questions and/or concerns, the contact information for filing a complaint with the Department, the Child Protection Ombudsman, and if applicable, information about when physical restraint may be used, must be sent to the child’s/youth’s parent(s) and/or guardian(s) and custodian(s) within one (1) week of admission and documentation that this information was provided to the parent(s) and/or legal guardian(s) and custodian(s) must be maintained in the child’s/youth’s file.

7.714.3 RELIGION, RIGHTS, AND GRIEVANCE PROCEDURES 7.714.31 Children’s/Youth's Rights A. The facility shall have written policies and procedures that address and ensure the availability of each of the following rights for children/youth in residence. A list of children’s/youth’s rights and the grievance procedure described in Section 7.714.31 and 7.714.32 may be posted in all facilities in areas frequented by children/youth, parent(s), and legal guardian(s) and custodian(s).

B. The following rights apply to all children/youth who are placed in facilities. These rights may not be limited or denied by the facility unless limited or denied in accordance with Section 7.714.31.C through 7.713.31.E. These rights include:

1. Every child/youth has the right to enjoy freedom of thought, conscience, cultural and ethnic practice, and religion;

2. Every child/youth has the right to a reasonable degree of privacy;

3. Every child/youth has the right to have their opinions heard and considered, to the greatest extent possible, when any decisions are being made affecting their life;

4. Every child/youth has the right to receive appropriate and reasonable adult guidance, support, and supervision;

5. Every child/youth has the right to be free from physical abuse or neglect and inhumane treatment. Every child/youth has the right to be protected from all forms of exploitation;

6. Every child/youth has the right to receive adequate and appropriate medical, mental health, and behavioral health care in the least restrictive setting possible, suited to meet their individual needs;

7. Every child/youth has the right to receive adequate and appropriate food, clothing, and housing;

8. Every child/youth has the right to live in clean, safe surroundings;

9. Every child/youth has the right to participate in an educational program that will maximize their potential in accordance with existing law;

10. Every child/youth has the right to communicate with a parent or legal guardian or custodian, caseworker, attorney, guardian ad litem, counsel for youth, therapist, physician, religious advisor, probation officer, other significant members of the child’s/youth’s team outside of the facility, and/or other significant approved connections;

11. No child/youth may be fingerprinted for the purpose of a criminal background check unless required by law enforcement;

12. A child/youth may be photographed upon admission for identification and administrative purposes of the facility. Such photographs must be confidential and must not be released by the facility except pursuant to court order. No other non-medical photographs or videotaping may be taken except in the case of a child abuse or police investigation or for use by a medical professional;

13. Every child/youth has the right to the same consideration for care and treatment as anyone regardless of race, color, national origin, religion, age, sex, gender identity, gender expression, political affiliation, sexual orientation, financial status, or disability;

14. Every child/youth has the right to be given the names and professional status of the staff members responsible for their care;

15. Every child/youth has the right to receive assistance from the child’s/youth’s client representative in filing a grievance or making complaints and to receive copies of the grievance or complaint procedure;

16. Every child/youth fifteen (15) years of age and older has the right to request their own medical records, to see the records at reasonable times, and to be given written reasons if the request is denied;

17. Notwithstanding any other provision of law, a child who is fifteen (15) years of age or older, whether with or without the consent of a parent or legal guardian or custodian, may consent to receive mental health services rendered by a facility, a professional person, or mental health professional licensed pursuant to Part 3, 4, 5, 6, or 8 of Article 245 of Title 12 in any practice setting. A licensed mental health professional may provide psychotherapy services, as defined in Section 12-245-202(14)(A), C.R.S., to a child who is twelve (12) years of age or older, without the consent of a parent or legal guardian or custodian, if the mental health professional determines that the minor is knowingly and voluntarily seeking such services and the provision of psychotherapy services is clinically indicated and necessary to the child’s/youth’s well being;

18. Every child/youth has the right to receive culturally responsive care, treatment, and services;

19. Every child/youth has the right to receive trauma-responsive care, treatment, and services; and 20. Every child/youth has the right to have contact and correspondence with their siblings, unless restricted by a court order.

21. Every child has the right to consent to substance use treatment in accordance with Section 13-22-102, C.R.S. All youth over the age of eighteen (18) years old have the right to consent to substance use treatment pursuant to Section 13-22-101, C.R.S.

C. The following children’s/youth's rights may be limited to reasonable periods during the day or restricted according to written policies of the facility to ensure the protection of the children/youth, staff, and program from unreasonable and unnecessary intrusions and disruptions and from health and safety hazards. All facilities are responsible to adhere to the rights of the children/youth and must also take reasonable steps to ensure safety of all involved, as identified in written policies of the facility.

1. Every child/youth has the right to have access to letter-writing materials, including postage, and to have staff members of the facility assist them if unable to write, prepare, and mail correspondence. Every child/youth has the right to receive and send sealed correspondence, including email if made available. No incoming or outgoing correspondence shall be opened, delayed, held, or censored by the personnel of the facility.

2. Every child/youth has the right to have access to telephones to both make and receive calls in privacy.

3. Every child/youth has the right to have convenient opportunities to meet with visitors.

4. Every child/youth has the right to wear their own clothes, including shoes, keep and use their own personal possessions, and keep and be allowed to spend a reasonable sum of their own money.

D. If the facility enforces any restrictions upon the child’s/youth’s rights as listed at

Section 7.714.31.C, the facility must, in compliance with the written policy and procedure of the facility:

1. Inform the child/youth, the child’s/youth’s parent(s), custodian(s), or legal guardian(s), in a language or mode of communication the child/youth, parent(s), legal guardian(s), and their custodian(s) can understand, of the conditions of and reasons for limitations or denials of their rights and document the notification in the child’s/youth’s file.

2. Place a written report summarizing the conditions of and reasons for the limitations or denials of the child’s/youth’s rights in that child’s/youth’s file.

Information pertaining to limitations or denials contained in the child’s/youth’s file must be made available, upon request, to the child/youth or the child’s/youth’s guardian ad litem (GAL) or counsel for youth (CFY).

3. When a limitation or denial of a child’s/youth’s rights affects another individual, the individual must be informed, in a language or mode of communication the individual can understand, of the conditions of and reasons for the action. All limitations or denials must be documented in the child/youth file and made available to the department upon request.

4. Ensure an administrator, case manager or licensed mental health professional conducts a documented review of the restriction at least every seven (7) days. written documentation of the reason for continuing the restriction must be maintained in the child’s/youth’s case file. If a review can not be obtained within the stated time frame, then the restriction must be discontinued. 7.714.32 Children’s/Youth’s Grievance Procedure A. The facility must designate a client representative and establish a written grievance procedure that provides adequate due process safeguards, spells out the appeal process, and assures that children/youth, their parent(s), custodian(s), legal guardian(s) are entitled to report any grievance and shall not be subject to any adverse action as a result of filing a grievance. If requested, a child/youth shall have a support person to help them write and file a grievance.

1. The facility must follow grievance procedures without alteration or interference and must respond in writing to any grievance filed within seventy-two (72) hours. The facility’s documented written response must include whether the grievance was approved or denied and the specific reasons for the decision. The response must also be reviewed and communicated with the child/youth in their preferred language or mode of communication.

2. This grievance procedure shall be made available to all children/youth.

3. If a grievance is filed with the facility, the grievance shall be recorded in the child’s/youth's file along with the investigation findings and resulting action taken by the facility. Information regarding the grievance must be sent to the individual or agency holding legal custody of the child/youth within seven (7) business days. A copy of the child’s/youth's grievance must be sent to the parent or legal guardian(s) or custodian(s) and the placing authority. Upon request, a copy must be provided to the child’s/youth’s guardian ad litem or counsel for youth.

4. A list of the children’s/youth’s rights may be prominently posted in all facilities in areas frequented by children/youth and legal guardians or custodian(s). The child/youth must also receive the grievance procedure; the name, address, and telephone number of their designated client representative; as well as a list of agencies where complaints may be filed. Grievance forms must be available to children/youth without requiring assistance from a staff member to access and submit the form.

B. A list of the children’s rights and the grievance procedures must be provided and explained to the child and the parent or guardian in a language or manner of C. The child/youth has the right to file a complaint with the Child Protection Ombudsman’s (CPO’s) office, the Department, the placing authority, and, if applicable, the appointed legal counsel. 7.714.33 Children’s/Youth’s Rights Pursuant to Section 19-7-101, C.R.S.

A. In addition to the rights described in Section 7.714.31, children/youth in foster care or participating in the foster youth in transition program must receive the following rights described in Section 19-7-101,(2), C.R.S.:

1. Fair and equal access, including:

a. Freedom from discrimination or harassment on the basis of actual or perceived race or ancestry, ethnic group, national origin, religion, sex, sexual orientation, gender identity, gender expression, disability, marital status, familial status, source of income, military status, or hiv status;

b. Freedom of thought, conscience, cultural and ethnic practice, and religion, including the right to attend or refuse to attend cultural, ethnic, and religious services and activities;

c. Expression of the child’s or youth’s gender identity and to be referred to by the child’s or youth’s preferred name or gender pronouns;

d. Freedom from threats, punishment, or retaliation for asking questions, stating concerns, or making complaints about a violation of the rights and protections established in Article 7 of Title 19, C.R.S.;

e. Access to services, placement, and state and federal programs and services for which the child or youth is eligible;

f. Developmentally appropriate notification of any benefits for which the child or youth is eligible or receiving, including written notification of who is serving as a representative payee, when applicable, and;

g. If there is a representative payee who accepts payments for a child or youth, an accounting of the use of those payments when requested by the child or youth and on an annual basis.

2. Appropriate placement and care, including:

a. Appropriate adult guidance, support, and supervision in a safe, healthy, and comfortable environment in which the child or youth is treated with fairness, respect, and dignity;

b. Consideration of the child’s or youth’s preference regarding the child’s or youth’s placement;

c. Freedom from physical, sexual, emotional, or other abuse; corporal punishment; neglect; or any other form of inhumane treatment, such as exploitation or trafficking;

d. Placement in the least restrictive setting that is appropriate to the child’s or youth’s needs, and receipt of the services and supports necessary to maintain that placement;

e. Freedom from abandonment or being locked in a room, building, or premises, or being subjected to isolation or other physical or medical restraint, unless otherwise authorized by statute;

f. Placement with a foster care provider who is aware of and understands the child’s or youth’s unique history as it relates to the child’s or youth’s care and who possesses the appropriate knowledge and skills to provide for the child’s or youth’s needs;

g. Application of the reasonable and prudent parent standard as required by federal law;

h. Return to the custody of a parent or legal guardian, consistent with applicable legal standards and considering the preferences of the child or youth;

i. Timely court proceedings and determinations about the child’s or youth’s placement;

j. Effective case management and planning that prioritizes the safe return of the child or youth to the child’s or youth’s parents, legal guardians, relatives, or kin, or moving the child or youth to other forms of permanent placement, if necessary;

k. A requirement that the representative payee for the child or youth, including the department of human services if it is acting as the representative payee, use any benefits the child or youth receives to meet the child’s or youth’s individual needs after the representative payee meets with the child or youth to ascertain the child’s or youth’s current and foreseeable needs; and l. Timely notification to the social security administration to initiate the transfer of benefits from a representative payee when a child or youth who is receiving benefits leaves the custody of the department of human services.

3. Access and communication, in a setting that provides privacy for in-person or other methods of contact, with professionals and other supports, a. Persons working on the child’s or youth’s behalf, including, but not limited to, caseworkers, the child’s or youth’s guardian ad litem or counsel for youth and their legal teams, mental health professionals, tribe, foster youth advocates and supporters, courtappointed special advocates, education rights holders, and probation officers. The child’s or youth’s contact with the child’s or youth’s guardian ad litem, counsel for youth, other attorneys, and members of the child’s or youth’s legal team must protect the applicable legal privileges and confidentiality;

b. The child’s or youth’s guardian ad litem or counsel for youth, the Child Protection Ombudsman, county departments of human/social services, or the Department of Human Services regarding any questions, concerns, or violations of the rights and protections established in Article 7 of Title 19, C.R.S.; and c. Connections to the child’s or youth’s community and supports, including communication and contact with people outside the foster care system who are important to the child or youth, unless otherwise limited by law or court order.

4. Confidentiality and privacy, including:

a. Confidentiality of all juvenile court records, consistent with existing b. Freedom from unreasonable searches, limitation of use, or taking of personal belongings or other unreasonable invasions of privacy;

c. Reasonable expectations of privacy to make and receive telephone calls and send and receive text messages, e-mail, and postal mail.

5. Education, including:

A. Receipt of a free and appropriate education, access to transportation to educational institutions, and an opportunity to participate in sports and extracurricular, cultural, personal enrichment, and social activities consistent with the child’s or youth’s age and developmental level, including access to computer technology and the internet as necessary for the child’s or youth’s education; and B. School stability that presumes the child or youth will remain in the school of origin, as defined in Section 22-32-138, C.R.S., in which the child or youth is enrolled at the time of placement, unless remaining in that school is not in the child’s or youth’s best interests.

6. Basic essentials, including:

a. Adequate and gender and culturally affirming food, clothing, hygiene products, and necessary hygiene services;

b. Personal allowance or employment opportunities appropriate to the child’s or youth’s age and developmental level, including appropriate opportunities to experience the use and value of money by making purchases for items according to the child’s or youth’s choice; and c. Personal belongings, including wearing the child’s or youth’s own clothing, having a safe place to store personal belongings, and having personal belongings transported in appropriate luggage with the child or youth during or shortly after a change of placement.

Personal belongings stored and transported after a change of placement must be maintained in the same or better condition.

7. Health care, including:

a. Adequate and appropriate medical, dental, vision, mental health, and substance use disorder services;

b. Reproductive and sexual health care consistent with Colorado state c. Freedom from the administration of prescription medication or other chemical substances, unless authorized by a physician or, when necessary, court order, after an individualized assessment of the child or youth, including a consultation with the child or youth, and with the child’s or youth’s consent, consistent with Colorado state d. Access to prescribed medications during a placement change or similar transition so the child or youth does not experience a disruption in the availability of necessary prescription medication;

e. Notification of the medications that were prescribed to the child or youth and the purpose for each medication for the child or youth.

8. Participation in legal and case planning, including:

a. Appointment of a guardian ad litem or counsel for youth pursuant to Sections 19-3-203 and 19-7-308, C.R.S.

b. Attending and fully participating in all hearings related to the child’s or youth’s case, including access to appropriate transportation for the child’s or youth’s court proceedings, and the opportunity to be heard separately when deemed necessary by the court pursuant to

Section 19-1-106(5), C.R.S.;

c. At the child’s or youth’s request, allowing certain people to be present for the child’s or youth’s court proceedings that take place pursuant to Section 19-1-106, C.R.S.;

d. Consulting with the court regarding the child’s or youth’s permanency goals pursuant to Section 19-3-702(1)(a), C.R.S.;

e. As appropriate to a child’s or youth’s age and developmental level, being informed of and participating in the development of the child’s or youth’s case plan, consistent with state and federal law; and f. As appropriate to a child’s or youth’s age and developmental level, participation in and accompaniment of support to meetings about the child’s or youth’s court proceedings.

9. The necessities to be self-sufficient during the transition to adulthood, a. Consistent with the child’s or youth’s developmental level, assistance with establishing a bank account, including identifying institutions where a child or youth may open a bank account, obtaining documents necessary to open an account, learning how to spend a reasonable amount of money, and managing personal income. This does not create an obligation to fund the child’s or youth’s bank account if one is created;

b. Having access to information regarding the work and educational options available to the child or youth, including, but not limited to, information regarding available financial aid and postsecondary education support consistent with state law;

c. Being allowed to work and develop job skills, consistent with state law and the child’s or youth’s age and developmental level;

d. Obtaining or receiving a free annual credit report from the Department of Human Services or a county department of human/social services and the additional credit-related and identity theft protections provided in Section 19-7-102, C.R.S. if the child or youth is in the legal custody of a county department of human/social services and is fourteen (14) years of age or older;

e. When the youth is eighteen (18) years of age or older and leaving foster care, being provided with the youth’s birth certificate, social security card, immigration documents, health insurance information, medical records, education records, either a driver’s license or a state-issued identification card, written information concerning the youth’s family history and contact information for siblings, if appropriate, and proof of foster care pursuant to Section 19-3- 702(4)(d), C.R.S.;

f. Notifying a youth who is turning sixteen (16) years of age of the youth’s eligibility for the foster youth in transition program;

g. Assisting a youth in applying for benefits the youth is eligible for or currently receiving, to ensure that benefits continue once the youth turns eighteen (18) years of age or transitions out of foster care, including redetermination for the purposes of social security benefits; and h. Driving instruction for youth fifteen (15) years of age and older pursuant to Section 26-5-115, C.R.S.

B. A juvenile court shall not limit or deny the rights enumerated in Section 19-7- 101(2), C.R.S. unless the court finds by clear and convincing evidence that there are extraordinary circumstances and the limitation or denial is necessary for the safety of the child/youth in foster care.

1. This is applicable to only the rights enumerated in Section 19-7-101(2), C.R.S. and does not alter the hearing requirements or standards otherwise established in Title 19, C.R.S. 7.714.34 Children’s/Youth’s Grievance Procedure Pursuant to Section 19-7- 101, C.R.S.

A. According to 19-7-101(5), C.R.S., the county department of human/social services shall provide each child or youth who is five (5) years of age or older with the written notice developed pursuant to Subsection 3 of Title 19 Part 7 at the time of the child’s or youth’s initial placement in foster care, at each placement change, and at least annually. The notice must be in the child’s or youth’s primary language.

B. The notice form required by 19-7-101(3), C.R.S., must be provided to children/youth residing in foster care or participating in the foster youth in transition program. 7.714.35 Religious and Spiritual Practices The facility shall demonstrate consideration for, and sensitivity to, the religious and/or spiritual backgrounds of children/youth in care. The facility shall assist a child’s/youth's involvement in religious and/or spiritual activities appropriate to the child’s/youth's religious and/or spiritual background, based upon the needs and interests of the A. A child/youth in care at the facility shall be allowed and encouraged to celebrate their religious and/or spiritual holidays.

B. Opportunity and assistance shall be provided for each child/youth to practice their chosen/preferred religious and/or spiritual beliefs. This includes, but is not limited to, making necessary arrangements for attendance of children/youth at the appropriate religious institution, spiritual ceremony, or at a study group for C. A child/youth may be invited to participate in the religious or spiritual activities of the facility/agency. Participation in any religious and/or spiritual activities of a facility are optional and not required.

D. A child/youth shall not be coerced or forced to participate in the religious and/or spiritual activities of the facility or to attend religious and/or spiritual services.

E. Prior to placement of the child/youth at the facility, the child/youth, their parent(s), legal guardian(s), custodian(s), and placing agency shall be notified of the practices, philosophy, and religious or spiritual affiliation of the facility.

Documentation of such notification must be maintained in the child’s/youth’s file.

F. Religious or spiritual intervention shall not be used by the facility in any form to control or change a child’s/youth's behavior, or treat or heal a medical condition.

G. A facility cannot deny medical, dental, behavioral, or mental health care to a child/youth because of the religious and/or spiritual affiliations of the facility. 7.714.4 Comprehensive Assessment and Individual Child’s/Youth's Plan The following section applies to the following license types: certifying child placement agencies or counties for specialized group facilities, residential child care facilities (RCCFs), psychiatric residential treatment facilities (PRTFs), and qualified residential treatment programs (QRTPs). QRTPs must also complete an assessment as required in Sections 7.705.208, 7.705.210, 7.705.211, and 7.705.212.

A. Comprehensive Assessment 1. Within seven (7) calendar days of admitting a child/youth into a facility, the facility or provider shall begin a comprehensive assessment/evaluation of 2. The comprehensive assessment shall be conducted by a multidisciplinary team. This team shall include persons responsible for implementing the plan on a daily basis, which includes persons who supervise the child/youth, persons who document the outcomes of the assessment or evaluation and provide treatment interventions, and persons who have had direct interaction with and observation of the child/youth. For those facilities that provide clinical services, the multidisciplinary team shall include licensed or provisionally licensed clinical professionals and/or medical professionals where required and as outlined in Sections 7.705.204 through 7.705.206.

3. The comprehensive assessment should assess for the need of a specialist to include, but not limited to, the following: psychiatric services, speech therapy services, and/or physical therapy services.

4. The comprehensive assessment must be completed by the fourteenth (14th) calendar day after admission.

5. The multidisciplinary team shall gather historical and current information to assess and evaluate the child/youth in at least the following areas:

a. Name, birthdate, and demographic data;

b. Reason for referral;

c. Immediate safety concerns;

d. Legal guardianship and custody;

e. Cultural factors that may impact placement or treatment, including age, ethnicity, linguistic/communication needs, gender identity, sexual orientation, relational roles, spiritual beliefs, socio-economic status, personal values, level of acculturation and/or assimilation, and coping skills;

f. Medical, health, and dental care, including allergies and a health

history of the child/youth and family, and if applicable, health information regarding speech therapy, occupational therapy, and physical therapy needs of the child/youth;

g. Mental health and treatment history, including all current and past medications, historical and current information on diagnoses, where applicable; and previous placements in treatment facilities;

h. Trauma history;

i. Education/vocation;

j. Personal/social development;

k. Family structure and community relationships;

l. Vocational training, if applicable;

m. Recreation;

n. Capacity for self-care and activities of daily living, including life skills development;

o. Independent living skills, if applicable;

p. Legal issues and history to include all adjudications and criminal charges and convictions;

q. Out-of-home placement history;

r. Substance use history;

s. Strengths, abilities, skills, and interests; and t. The needs of the child/youth that must be resolved for the child/youth to move to a less restrictive setting and/or successfully discharge from the facility.

6. All direct assessments of the child/youth shall be conducted in the child's/youth’s dominant language or mode of communication, including augmented or facilitated communication, if necessary. The child's/youth’s age, developmental stage and ability to understand, and cultural and religious or spiritual background must be taken into consideration.

B. Individual Child’s/Youth’s Plan 1. On the basis of the comprehensive assessment, and within fourteen (14) calendar days of admission, the facility shall develop an individual plan that is written, time-limited, strength-focused, outcome-based, and goaloriented. The plan must support the family services plan, if applicable.

2. The facility must provide an opportunity for the following persons to participate in the planning/evaluation process:

a. The primary caregiver for the child/youth;

b. The child/youth, consistent with state and federal laws and as appropriate to the child’s/youth’s age and developmental level;

c. Parent(s), legal guardian(s), or custodian(s) unless contraindicated or prohibited by law or court order;

d. Representatives of the placing agency;

e. School personnel;

f. Other persons significant in the child’s/youth’s life, such as a guardian ad litem, counsel for youth, respondent attorney, religious advisor, court appointed special advocate (CASA), therapist, or others identified by the child/youth and/or family, unless contraindicated;

g. When any of the above persons do not participate, the facility must have documentation of its efforts to involve the person(s). When the involvement of the child/youth, parent(s) legal guardian(s), or custodian(s) of the child/youth is deemed contraindicated or inappropriate by the agency or individual holding legal custody of the child/youth, the reasons must be documented. Any decision to not involve the child/youth, parent(s), legal guardian(s), or custodian(s) must be approved by the referral/placing agency.

3. The individual child’s/youth’s plan must include the following components:

a. The findings of the comprehensive assessment, including the strengths and needs of the child/youth.

b. Discharge criteria for the child/youth to successfully move to a less restrictive setting.

c. Documentation supporting the need for the current level of care.

d. Goals for the child/youth and family that address the identified areas of concern related to the current diagnosis, where applicable; and address the current areas of focus identified in the comprehensive assessment.

e. Objectives that are specific, measurable, achievable, relevant, and time-limited. The objectives must support and measure the child’s/youth’s progress toward meeting the goals.

f. Prior to placement and incorporated into the child’s/youth’s plan, a statement of the plan for supervision of the child/youth during their placement at the facility when the individual supervision plan deviates from the overall supervision policies as stated in Sections 7.705.47 and 7.709.25.

g. A plan for fostering, maintaining, and enhancing positive family relationships with the child/youth and their family, including siblings, other individuals considered like family, or guardian(s) and custodian(s), and including goals for the development of a permanent home for the child/youth.

h. A plan for fostering, maintaining, and enhancing active community involvement for the child/youth.

i. Specification of therapeutic services, specialized services, and strategies for positive behavior intervention that will be provided directly or arranged for, frequency of services, and method for ensuring their proper integration with the child’s/youth’s ongoing program activities.

j. A plan for behavior support of the child/youth. Staff members who are responsible for the care of the child/youth must be familiar with the behavior support and/or intervention plan for each child/youth.

k. A plan for discharge, aftercare, medication management, referrals to community resources, and moving to a less restrictive setting.

l. Identification of all persons responsible for implementing or coordinating implementation of the plan.

m. Signature, or written documentation of participation and review, by a representative of the facility, a representative of the placing agency, the child/youth, and the child’s/youth’s parent(s), legal guardian(s) and custodian(s). If an individual child’s/youth’s plan is not reviewed and/or signed by a member of the multidisciplinary team, an explanation as to why the member did not review and/or sign the plan must be documented in the child’s/youth’s file.

n. Written documentation by the facility that the plan and any subsequent revisions are developed in consultation with the child/youth when that child/youth has attained fourteen (14) years of age, explained to the child/youth in care and their parent(s), legal guardian(s), and custodian(s) in a language or manner of communication the child/youth, parent(s), legal guardian(s), and custodian(s) can understand.

o. Review of each plan must be completed every thirty (30) days to evaluate the progress toward achieving the goals and objectives.

The parties listed in Section 7.714.4.B.2 must have a documented opportunity to participate in the reviews. The plan must support the family services plan, when available.

p. The individual child’s/youth’s plan must include a family support goal addressing services and/or interventions to be provided by the program, as informed by the state-approved assessment. The individual child’s/youth’s plan must incorporate the findings of the comprehensive assessment, to include any goals as determined in the assessment, if available or appropriate.

4. If the individual child’s/youth’s plan requires the services of a specialist, such as a psychiatrist, psychologist, speech therapist, occupational therapist, or physical therapist, the specialist must be currently certified or licensed according to state law.

7.714.5 CONTRABAND, PHYSICAL RESTRAINT, AND SECLUSION 7.714.51 Searches and Control of Contraband A. The facility must have a written policy and procedures for conducting searches and control of contraband regarding children/youth, staff members, or visitors.

Searches involving children/youth must be completed upon admission to the facility or when it is suspected that a child/youth has contraband in their possession. Searches must be conducted in the least intrusive manner possible for the reason the search was being conducted. All contraband must be disposed of in accordance with the facility’s written policy and procedures. All searches must be documented, including the reason for the search, the person(s) conducting the search, and the results. The policies and procedures at a minimum must include:

1. Person searches of children/youth may only be conducted when the facility deems it necessary to discourage introduction of contraband or to promote the safety and security of other children/youth, staff members, and the facility. Person searches shall be conducted as follows:

a. The child/youth must be told they are about to be searched in a language or mode of communication the child/youth understands and prefers.

b. The child/youth must remove outerwear (e.g. sweater, jacket, coat, gloves, hat, and shoes) and empty all pockets.

c. Person searches must be performed in an area and in a manner that maintains the dignity and privacy of the child/youth.

d. Staff members must be trained in proper search techniques prior to conducting searches.

e. When conducting a search of a child/youth, staff may only physically touch children/youth when it is reasonable to suspect the child/youth possesses an item(s) that poses a safety risk to the child/youth, other children/youth, or staff. When a safety risk is not suspected, staff conducting searches of children/youth must not physically touch the child/youth, but may search the child’s/youth’s property and clothing. All searches, whether it involves physical touch or not, must be conducted in a manner that protects and respects the child’s/youth’s privacy.

f. Whenever possible, person searches should be performed by two (2) staff members with at least one (1) staff member conducting the person search of the same gender identity the child/youth being searched identifies with. g Staff members must search the child/youth’s removed outer layer of clothing and return it to the child/youth or notify the legal guardian(s), custodian(s), and guardian ad litem and/or counsel for youth (if any), if contraband is found and confiscated.

h. If a staff member detects anything that appears to be drug paraphernalia, contraband, or a weapon, the staff member must contact law enforcement’s non-emergency line to confiscate the item(s). The child’s/youth’s name and other identifying information must not be disclosed during the call to law enforcement. However, if a weapon is detected or suspected, the child’s/youth’s name and other identifying information may be disclosed during the call to law enforcement in accordance with HIPAA, as incorporated by reference in Section 7.701.14.

i. Searches of a person that include the removal of clothing to inspect a child/youth’s private areas of their body, strip searches, body cavity searches, or frisk/pat searches are prohibited. If a facility has reasonable cause to suspect a child/youth may have hidden an object on their body or in their body cavity, facilities must contact medical personnel.

j. The use of metal detection wands may be used unless contraindicated.

k. If the child/youth refuses to comply, the administrator or designee must be notified immediately and be responsible for resolving the matter.

l. The parent(s), legal guardian(s), custodian(s), the child/youth, and placement agency must be notified in writing and provide authorization for search practices conducted by the facility.

m. Any additional steps regarding searches must be added to the child/youth’s individual plan. The child/youth, parent(s), legal guardian(s), custodian(s), and placement agency must be notified of such steps during quarterly updates to the individual child/youth plan or as needed.

2. If the presence of contraband poses an imminent risk to the children/youth in care, the use of law enforcement and/or drug sniffing animals may be used after safety has been assessed.

3. If drugs, drug paraphernalia, or other illegal substances are found on the child/youth at the time of the search, the facility must confiscate and turn the contraband into law enforcement and document if law enforcement was not able to pick them up. A notification must then be made to the child’s/youth’s team, including the child’s/youth’s guardian and litem and/or counsel for youth (if any), and the Department. If the situation rises to the need of a critical incident report, one must be filed in accordance with Section 7.701.52. 7.714.53 Physical Restraint and Seclusion A. In accordance with the following rules, only facilities authorized by the Department may use physical restraint or seclusion as outlined by specific facility/license type. The facility shall use physical restraint only in accordance with the following rules.

B. All facilities must comply with all applicable statutes referenced in and including

Section 26-20-103, C.R.S. regarding Protection of Persons From Restraint.

C. Foster care providers may not utilize physical restraint unless approved by appeal waiver in accordance with Section 7.701.13. 7.714.531 Authorization of Physical Restraint A. At the time of admission to the facility, the parent(s), legal guardian(s) or custodian(s) of the child/youth must be notified that physical restraint may be performed in accordance with Section 26-20-103(1), C.R.S. For a facility to perform physical restraint, the legal guardian(s) or custodian(s) must give written consent for physical restraint to be performed on the child/youth. No physical restraint may be performed on an individual without the specific written permission of the child’s/youth’s legal guardian(s) or custodian(s). Youth eighteen (18) years of age or older may consent for themselves.

B. Upon a child’s/youth’s admission to a facility and at least annually thereafter, the facility or provider must obtain information and documents relevant to the use of reactive strategies from a variety of sources for the child’s/youth’s records.

Appropriate sources include the child/youth, their family members, treating medical professionals, and others familiar with the child/youth.

1. The child’s/youth’s records must include the following documentation:

a. A physician’s report of medical conditions or physical limitations that would place them at risk of physical injury during restraint or seclusion or otherwise preclude the use of one (1) or more emergency strategies;

b. Documentation of any history of trauma, such as a history of sexual or physical abuse that the child/youth, facility, or providers believe to be relevant to the use of emergency strategies;

c. Medical conditions or physical limitations that might create a risk to the individual, including, but not limited to:

1. Obesity;

2. Cardiac conditions;

3. Pregnancy;

4. Asthma or other respiratory conditions;

5. Back conditions or spinal problems;

6. Seizure disorders;

7. Deafness;

8. Blindness;

9. Limitations on range of motion;

10. Osteoporosis;

11. Osteopenia; and 12. Hemophilia.

2. In addition to the annual review:

a. The child’s/youth’s file information must be updated whenever there is a change in the child’s/youth’s physical or psychological condition that might affect their tolerance of physical restraint techniques.

b. The child’s/youth’s file must also be updated in compliance with any state-approved assessments. 7.714.532 Use of Physical Restraint A. Pursuant to Section 26-20-103, C.R.S., facility staff may only use restraint in cases of emergency, as defined in Section 26-20-102(3), C.R.S., and after a determination that such alternatives would be inappropriate or ineffective.

B. Prior to the use of restraint, the facility must have tried all positive and constructive methods of managing the child’s/youth’s behavior, based on policies and procedures of the facility and components of the individual child’s/youth’s plan, including but not limited to, the implementation of a structured and consistent behavior management program, physical structuring of the environment, talking with the child/youth, praise for appropriate behavior, skill training and development, assisting the child/youth with the expression of feelings, and de-escalation of the situation.

C. Only facility staff that have been appropriately trained or certified in accordance with a restraint model that includes nationally-recognized criteria that is evidence, performance, and competency based may use restraint.

D. Restraint must only be used for the period of time necessary to accomplish its

purpose. The child/youth must be released from a restraint within fifteen (15) minutes after the initiation of the restraint, except when precluded for safety reasons pursuant to Section 26-20-104(4), C.R.S., which must be documented in the individual file. Repeated application and release of the restraint in order to circumvent the fifteen (15) minutes is prohibited.

E. The following reactive strategies are prohibited:

1. Physical restraint or restrictive procedures involving noxious or painful stimuli;

2. Untested or experimental procedures;

3. Any physical crisis management technique that might restrict or obstruct a child’s/youth’s airway or impair breathing, including techniques whereby staff persons use their hands or body to place pressure on the child’s/youth’s head, neck, back, chest, abdomen, or joints;

4. Restraint of a child’s/youth’s hands with or without a mechanical device, behind their back must only be used in accordance with the approved restraint model used by the facility;

5. Physical holds relying on the inducement of pain for behavioral control;

6. Movement that results in hyperextension or twisting of body parts;

7. Any maneuver that causes a loss of balance without physical support (such as tripping or pushing) for the purpose of containment;

8. Any physical restraint procedure in which a pillow, blanket, or other item is used to cover the child’s/youth’s face as a part of the restraint process;

9. Any physical restraint procedure that may exacerbate a known medical or physical condition or endanger the child’s/youth’s life;

10. Use of any restraint technique medically contraindicated for a child/youth;

11. Restraint without continuous monitoring and documentation of vital signs and status with respect to release criteria;

12. Restraint should never place any weight on the chest, abdomen, head, neck, back, or on any joints of a child/youth;

13. If there are any circumstances that may pose a threat to the health and safety of a child/youth on the grounds of the licensed facility, including, but not limited to, soft, pliable surfaces, concrete, asphalt, foreign objects, or areas including broken glass, or outside in inclement weather, staff must refrain from restraining the child/youth. Staff may only utilize restraint if the child/youth is able to be positioned away from the circumstances that pose a health/safety hazard and only in cases of emergency, as defined in

Section 26-20-102(3), C.R.S.

14. Staff must make every effort to not use physical restraint in any setting outside of the licensed facility. If there is no other alternative and the situation cannot be controlled by the staff member(s) present through the use of restraint techniques that are described within the facility’s approved restraint model, staff must call law enforcement. Physical restraint shall be used only in accordance with an emergency situation, as defined in

Section 26-20-102(3), C.R.S.

15. Restraint must never be used as punishment or disciplinary sanction, as

part of a treatment plan or behavior modification plan, for the purpose of retaliation by staff or for the purpose of protection unless ordered by the court or in an emergency. 7.714.533 Implementation of Physical Restraint Facility procedures shall, at a minimum, include and comply with the following:

A. The use of prone restraint is prohibited. Momentary (as quickly as possible, but not to exceed five (5) minutes) utilization of a prone position is permissible only during the transitional measure portion of a physical restraint. Repeated application and release of the prone position in order to circumvent the five (5) minute criteria is prohibited.

B. In the course of a physical restraint, trained or and certified staff must be positioned within arm’s length of the child/youth and continuously monitor to assure that the child/youth is properly positioned, that the child/youth’s blood circulation is not restricted, that the child/youth's breathing and/or airway is not hindered or obstructed, and that the child/youth's other physical needs are met.

Staff must not place weight or pressure on the chest, abdomen or back of a child/youth or inhibit or impede the child/youth’s ability to breathe. Staff must continuously monitor to ensure that the breathing of the child/youth in such restraint is not compromised. If the child/youth is exceedingly agitated, staff may move farther from the child/youth, but must still be able to effectively observe, assess, and respond as necessary, to the child/youth’s physical condition. If breathing is restricted or compromised in any way, the restraint must be discontinued immediately and a physical assessment must occur to determine if medical attention is needed.

1. A transitional measure may be used during an episode of physical restraint to effectively gain initial physical control of an individual in order to prevent harm to self or others. A transitional measure may result in a restraint to maintain prolonged physical control or containment of an individual.

2. The facility shall provide adequate numbers of staff to assure the health and safety and the proper care and treatment of the children/youth in care as outlined in Section 7.705.46 and Section 7.714.91.A.1.

C. The restraint must be used only for the purpose of preventing the continuation or renewal of an emergency; only for the period of time necessary to accomplish its

purpose; and in the case of physical restraint, only if no more force than is necessary to limit the individual’s freedom of movement is used.

D. Restraint may be utilized only if certified staff persons are available in sufficient numbers to ensure its safe implementation and that there are enough staff to meet the individual needs of each child/youth in care. The staff must use no more force than is necessary to limit the child’s/youth’s freedom of movement.

E. The physical restraint requires continuous staff monitoring to include, but need not be limited to, ensuring breathing is not restricted or compromised and the need to terminate the restraint if there is a medical emergency for the safety of the child/youth and staff involved. 7.714.534 Staff Training A. Staff utilizing any physical restraint in facilities or programs shall be trained in the appropriate use and implementation of a model that includes nationallyrecognized criteria and a culturally-sensitive, trauma-informed care component that is evidence, performance, and competency based, prior to any staff being approved to use physical restraint. The model must include, at a minimum, the 1. Staff training and/or certification, to include training upon hire, and ongoing (at least every six (6) months) refresher training or practice exercises for each staff member trained or certified in restraint, to review and refresh skills related to early warning signs, prevention strategies, positive behavior intervention, de-escalation, and physical restraint, in accordance with the model. Verification of competency (e.g. passing post test score, certificate, etc.) must be kept in the staff file and made available to the department upon request;

a. Staff will be observed quarterly when performing physical restraint by a supervisor, trained professional, or medical staff of the facility who has been trained in physical restraint and will be involved in a debriefing process to identify what changes in practice can occur to reduce the use of physical restraint. If a supervisor of the facility determines a staff member did not correctly perform a physical restraint, the staff member must be immediately retrained or be restricted from performing further physical restraint until retraining can occur.

2. The health and behavioral effects of restraint on children/youth, including those with behavioral or mental health disorders or intellectual and developmental disabilities;

3. How to assess the signs of physical distress in a person in restraint;

4. A restraint prevention and de-escalation component, to include identifying antecedents including environmental factors that may cause an individual to escalate, non-physical crisis intervention techniques, and/or development of behavior management plans that are in alignment with individual treatment plans if necessary, to include the value of positive reinforcement over punishment in working with children/youth and methods for implementing positive behavior incentives prior to restraint being utilized;

5. A physical restraint process that prohibits or provides alternatives to a prone position, and includes identifying primary control techniques that emphasize utilizing only the minimum amount of force necessary to gain control and keep the child/youth safe; and 6. A debriefing process which includes a review of physical restraint, to determine the appropriateness and effectiveness of preventive/deescalation interventions used, the appropriateness of physical restraint, awareness of intentional and unintentional staff provocation, situational or environmental factors, and how, or if, physical restraints are preventable.

The debriefing process must also include the neutral reviewer who was not involved in the physical restraint. 7.714.535 Documentation Following Utilization of Physical Restraint If a physical restraint occurs, the following must be documented:

A. A description of the incident, including the name of the child/youth, date and time of the incident, the name of all witnesses to the incident, staff members involved, their position at the facility and their involvement in the physical restraint, the location of the restraint, and the date and exact time the restraint was implemented and the exact time the restraint was terminated.

B. A description of the observed precipitating incident(s) and/or the reported antecedent by the child/youth and the child's/youth’s behavior before the physical restraint occurred.

C. A description of what specific prevention strategies and trauma-informed interventions were attempted and/or taken to prevent or de-escalate the situation and the effect of any such intervention on the child/youth. Documentation of the individualized preventive and de-escalation interventions, trauma-informed practices, or interventions considered or utilized and positive behavioral intervention that must be attempted by staff prior to the use of physical restraint.

D. A detailed description of the physical restraint must include:

1. A clear rationale for the decision to initiate the physical restraint.

2. The specific emergency, unsafe situation, or imminent threat that led to the staff’s utilization of physical restraint.

3. A description of the physical restraint including the child’s/youth’s physical, emotional and behavioral condition prior to, during, and after the physical restraint, including, but not limited to, breathing, pulse, change in skin coloring, and signs of choking or respiratory distress. If the restraint lasts more than fifteen (15) minutes due to safety reasons, the justification must be documented within the report.

4. Staff must also document any negative outcomes of the physical restraint and any observations of behaviors or procedures that were not conducted in accordance with proper use of physical restraint training.

E. A description of the debriefing and evaluation with the child/youth and staff following the physical restraint and/or to address other options that may have been successful in de-escalating the child/youth.

1. The debrief must be informed by the child’s/youth’s safety plan to determine appropriate staff, location, and manner of debrief.

2. Staff involved in the physical restraint must be involved in the debrief with the child/youth, except when the presence of a particular staff may jeopardize the wellbeing of the child/youth.

3. A reasonable amount of time must be permitted to allow the child/youth to self-regulate after the physical restraint and the beginning of the debrief.

Efforts to debrief with the child/youth must be documented and kept in the child’s/youth’s file.

4. The debrief must take into consideration the needs of the child/youth, prioritize clear, simple language, allow ample time for responses, focus on positive reinforcement, with questions tailored to the child’s/youth’s individual understanding, and must ensure a supportive and nonjudgmental environment that respects the child’s/youth’s agency and ability to contribute to the discussion. The debrief must also be in alignment with Section 7.714.531.B.

F. Documentation of review by the neutral reviewer, as defined in Section 7.701.2, of whether the physical restraint was in accordance with the facility or model training, rules and regulations, agency policy, and in the best interests of safety of the child/youth and others.

G. Verification that notification of the use of physical restraint was made to the legal guardian(s), custodian(s), parent(s), and guardian ad litem or counsel for youth (if any) of the child/youth as soon as possible. 7.714.536 Review A. Each facility shall include physical restraint in its critical incident review process and/or quality management program.

1. Review the use of physical restraint a. Records of each physical restraint shall be reviewed by a supervisor of the facility within forty-eight (48) hours of each b. Every month, the facility must review in detail all restraints that occurred at the facility the month prior to identify trends that will be used by the facility to determine how to reduce the use of restraints, based on empirically-validated variables, such as, but not limited to, staff involved in the restraint, whether the restraint was justified in accordance with applicable regulations, and location. The reviews must incorporate quality assurance recommendations and safety measures to be implemented within policies and staff training.

Reviews of the restraints must be documented and made available to the department upon request.

c. According to the policies and procedures of the facility, the entire child’s/youth’s behavior management or the individual child’s/youth’s plan must be reviewed if it appears that the child/youth is being physically managed more than two (2) times in seventy-two (72) hours, more than three (3) times in seven (7) days, or more than three (3) times by the same staff member in fourteen (14) days. The child’s/youth’s individual plan must be evaluated to reconsider new behaviors, triggers, rewards, and deescalation techniques to reduce acting out behaviors.

d. If any particular de-escalation technique appears to be causing an escalation in the behavior of a child/youth or a group of children/youth, the use of the technique must be evaluated for its effectiveness. de-escalation techniques that are not effective or are counter-productive must be terminated at the earliest opportunity.

e. If either the child/youth or a staff member was seriously injured or died during a physical restraint, a thorough review of the physical re straint and injuries must be instituted immediately. Additionally, reports must be made to the state child abuse and neglect hotline, and notification must be sent to the Department in accordance with

Section 7.701.52. Based on the findings of the review, the staff members involved in the physical restraint must be retrained, be restricted from performing further physical restraint, and/or corrective personnel action must be taken.

f. If a staff member appears to be involved in a larger number of physical restraints due to intentional or unintentional provocation than other staff members or is unsuccessful at using de-escalation effectively, the facility must conduct a thorough review of the staff member's interactions with children/youth in care, prior physical restraint training, and need for further training or corrective personnel action as required by the facility’s policies.

B. Pursuant to Section 26-6-914(2)(k), C.R.S., a license can be suspended or revoked for a willful or deliberate failure to comply with the rules governing 7.714.54 Seclusion These rules are specific to psychiatric residential treatment facilities (PRTFs) and any other facilities authorized to utilize seclusion through the appeal/waiver process in accordance with Section 7.701.13. The purpose of seclusion is to temporarily isolate a child/youth in a designated room, during an emergency, to manage potentially dangerous or aggressive behavior with the goal of preventing harm to self or others and to de-escalate a crisis situation when less-restrictive measures have failed. 7.714.541 Authorization for Seclusion A. At the time of admission, the child/youth’s legal guardian(s) and custodian(s) must be notified of the facility’s use of seclusion and must give written consent for the child/youth to be secluded in conjunction with facility policy. No child/youth may be secluded without the specific written permission of their legal guardian(s) and custodian(s). if the legal guardian(s) and custodian(s) do not give authorization for seclusion, then seclusion cannot be utilized in any form. Youth eighteen (18) years of age or older may consent for themselves.

B. All facilities must ensure that staff are trained to explain, at time of admission, the use of seclusion to the child/youth, legal guardian(s), custodian(s), and if appropriate, to the child’s/youth’s parent(s). The explanation provided to the legal guardian(s), custodian(s), and child/youth must occur in a language or communication understandable to them and will include the purpose of seclusion and the emergency circumstances when a seclusion may occur. 7.714.542 Use of Seclusion A. Facility staff must only use seclusion in cases of emergency, as defined in

Section 26-20-102(3), C.R.S.; and after the failure of less restrictive alternatives or after a determination that such alternatives would be inappropriate or ineffective under the circumstances.

B. A child/youth who is placed in seclusion must be experiencing an emergency, meaning a serious, probable, imminent threat of bodily harm to self or others where there is the present ability to effect such bodily harm.

C. The child/youth may be physically guided during a transport to the seclusion room for up to two (2) minutes. If it requires more than two (2) minutes, this is considered a physical restraint and must be documented in accordance with

Section 7.714.535.

D. Prior to the use of seclusion, the facility must have tried all positive and constructive methods of de-escalating a child/youth, including but not limited to, implementation of a structured and consistent behavior management program, physical structuring of the environment, talking with the child/youth, praise for appropriate behavior, skill training and development, assisting the child/youth with the expression of feelings, and de-escalation of the situation.

E. Facility staff may only use seclusion if, prior to the use of placing the child/youth in seclusion, the staff has been appropriately trained in accordance with Section 7.714.544 and 42 CFR Section 483.376 of the Conditions of Participation for the Use of Restraint or Seclusion, as incorporated by reference in Section 7.705.101.D.

F. Seclusion must never be used as punishment or disciplinary sanction, as part of a treatment plan or behavior modification plan, for the purpose of retaliation by staff, for the purpose of protection unless ordered by the court or in an G. Seclusion shall only be used only for the purpose of preventing the continuation or renewal of an emergency and only for the period of time necessary to accomplish its purpose. 7.714.543 Facility Procedures When Utilizing Seclusion A. When seclusion is utilized, relief periods must be provided for reasonable access to toilet facilities. While in seclusion, staff must be physically present outside of the room for continuous observation purposes, and staff must document those observations of children/youth no less than every fifteen (15) minutes. A staff member must be physically present within hearing and sight distance of the seclusion room at all times when a child/youth is locked inside the room.

B. Seclusion must only occur for the period of time necessary to accomplish its

purpose. The child/youth must be released from seclusion when the state of emergency has ceased. Seclusion must not exceed two (2) hours per incident for children/youth ages nine (9) and older and must not exceed one (1) hour for children/youth under age nine (9).

C. Orders for seclusion must be by a physician or other licensed practitioner in the facility permitted to order seclusion and trained in the use of safety interventions, according to 42 CFR 483.358, as incorporated by reference in Section 7.705.101.D. If the physician is available, only they can order the seclusion. If the physician is unavailable, a verbal order must be received by a registered nurse or other licensed practitioner while the emergency safety intervention is being initiated by staff or immediately after the emergency safety intervention ends.

The physician must verify the verbal order in a signed written form in the child’s/youth’s file. The physician must be available to staff for consultation, at least by telephone, throughout the period of the emergency safety intervention.

D. There must be notification to another staff member on duty, that a child/youth has been placed in seclusion. If the seclusion room supervisor is not immediately available, the staff must continue to maintain safety and make all attempts to get a hold of the supervisor as soon as the situation is safely managed. 7.714.544 Required Seclusion Training for Staff A. Staff utilizing seclusion must have ongoing training and supervision to include at least the following:

1. The health and behavioral effects of restraint and seclusion on children/youth, including those with behavioral of mental health disorders or intellectual and developmental disabilities;

2. Emergency procedures including First Aid and fire protection;

3. The facility’s purpose, policies, and procedures for seclusion;

4. Any legal or clinical ramifications of placing the child/youth in seclusion;

5. The role of the neutral reviewer;

6. The dynamics of the behavior of children/youth when in seclusion;

7. Safe methods of moving the child/youth to the seclusion room in alignment with Sections 7.714.532, 7.714.533, and 7.714.542;

8. Methods of searching a child/youth when placing the child/youth in the seclusion room, only if in alignment with Section 7.714.51;

9. The protection of keys for the seclusion room, if applicable;

10. Trauma-informed care;

11. Effective de-escalation techniques for children/youth in crisis;

12. The value of positive over negative reinforcement in working with children/youth;

13. Methods for implementing positive behavior incentives prior to seclusion being utilized in an attempt to reduce the emergency;

14. Consideration of and how to minimize traumatization or retraumatization. 7.714.545 Facility Staff Requirements for Seclusion A. There must be a seclusion room supervisor who is a full-time facility staff member and holds one of the following license types in Colorado: licensed clinical social worker (LCSW), licensed professional counselor (LPC), licensed marriage and family therapist (LMFT), licensed psychologist, or a board-eligible psychiatrist licensed to practice medicine in Colorado. This staff member must be designated and trained to be responsible for the use of the seclusion room. If the seclusion room supervisor is not a psychiatrist or a licensed psychologist, there must be such a person contracted to provide consultation with the seclusion room supervisor and staff. Seclusion room supervisors must be present and able to be available at the facility at all times.

B. The residential child care facility which operates a seclusion room must appoint a neutral reviewer. This neutral reviewer must not be the seclusion room supervisor or the person who placed the child/youth in the seclusion room. The reviewer must determine if the situation resulting in the confinement of a child/youth in a seclusion room merits such a decision. The neutral reviewer must be a staff member of the facility or a professional contracted by the facility in one (1) of the following positions: administrator, assistant administrator, social worker, psychologist, psychiatrist, nurse, or lawyer.

C. There must be sufficient staff on the milieu in compliance with Section 7.705.46 when a child/youth is placed in seclusion. At the time of placement of the child/youth in the seclusion room, the neutral reviewer must be notified in person or by telephone. Leaving a message is not notification, and if the neutral reviewer cannot be contacted in person or by telephone and present for observation purposes, the child/youth must not be placed in a seclusion room.

D. The facility must designate in its statement of purpose and policy for the operation of the seclusion room, as identified in Section 7.705.68.A, which staff members may be able to place a child/youth within the seclusion room. Identified staff members must be employed or contracted as one (1) or more of the following positions: administrator, assistant administrator, child care staff, social worker, teacher, psychologist, psychiatrist, or nurse. Designated staff members must be trained and supervised in the use of the seclusion room. 7.714.546 Documentation Following Utilization of Seclusion The following information must be documented:

A. A written report which states the child's/youth’s name, the time the child/youth was placed in the seclusion room, the staff member who placed the child/youth in the seclusion room, the staff member who was notified, and describes the following: the precipitating incident and the child's/youth’s behavior before placement in the seclusion room, and actions taken by staff members of a less restrictive nature to try to control, calm, or contain the child/youth and a clear rationale for the decision to initiate the seclusion.

B. During seclusion, the following must be documented, if applicable:

1. An indication that the child/youth was checked continuously for observation purposes and documentation of those observations of children/youth no less than every fifteen (15) minutes, with the following notations: time, one-line description of what the child/youth was doing, and initials of the person supervising;

2. When the child/youth was last given access to restroom facilities;

3. When the child/youth had opportunity for exercise, if applicable;

4. When and what type of medications were given and by whom; and 5. When the child's/youth’s last staff contact occurred.

C. Description of the resolution between the staff member and the child/youth at the termination of the use of the seclusion room and the behavior of the child/youth as a result of being in the seclusion room.

D. The observable physical condition of the child/youth when entering the seclusion room and any change in the observable physical condition of the child/youth when leaving the seclusion room.

E. An indication of review by the neutral reviewer as to the appropriateness of confinement of the child/youth in the seclusion room.

F. Verification that notification was made to the placing authority by the next day of the seclusion and the appropriateness of the seclusion.

G. Notification to the parent(s), legal guardian(s), and custodian(s) of each use of the seclusion, no later than the end of the day that the seclusion occurred, with a written report completed and given to the legal guardian(s), custodian(s), and guardian ad litem or counsel for youth by the next day. 7.714.547 Review of the Use of Seclusion A. The record of use of the seclusion room must be reviewed daily by the seclusion room supervisor and weekly by the facility administrator. If one (1) child/youth is placed in the seclusion room more than three (3) times in seventy-two (72) hours, the entire plan for the child/youth must be reviewed. A physician must evaluate and authorize any further use of the seclusion room or other treatment for the B. If the same staff member places a child/youth in the seclusion room three (3) times in a thirty (30) day period, this must be investigated by the seclusion room supervisor and evaluated in the child’s/youth’s plan.

C. All agencies must have an administrative oversight component, to include, at a minimum, tracking and reviewing episodes of seclusion and physical restraint data such as through a quality assurance or performance improvement process.

D. Pursuant to Section 26-6-914(2)(k), C.R.S., a license can be suspended or revoked for a willful or deliberate failure to comply with the rules governing seclusion. 7.714.548 Physical Requirements for Seclusion A. The seclusion room must be located in reasonable proximity to the living unit or other areas of activity. An adult staff member must stay directly outside the seclusion room at all times when a child/youth is locked inside the room.

B. The seclusion room must be a minimum of eighty (80) square feet in size.

C. The seclusion room must be kept in a clean and sanitary condition.

D. All switches for light, heat, and ventilation, as well as other electrical outlets, must be outside the room. All switches must be available only to the staff.

E. There must be no features by which a child/youth might injure themselves within the seclusion room such as utility pipes, cleaning equipment and materials, or mirrors.

F. Exterior windows are not recommended, but if there are window panes they must be of shatter-resistant material.

G. There must be an observation window on the door from which all parts of the room are visible for purposes of supervision. The window must be made of shatter-resistant materials.

H. There must be an approved ventilating system.

I. There must be an approved system which detects products of combustion and is wired into a no switch electrical outlet and is out of the reach of children/youth.

J. The seclusion room must be constructed of one (1) hour fire-resistant material.

The door must be of one (1) hour fire-resistant material.

K. The seclusion room must have a lighted, soothing environment. The child/youth must not be subjected to glaring lights. All lights must be recessed into the ceiling and must be covered with a shatter-resistant guard which is flush with the ceiling.

L. There must be no more than one (1) locked door between the child/youth and the staff member.

M. If the seclusion room is soundproof, there must be an intercom system which is activated when a child/youth is in the room.

N. There must be a light over the entrance of the seclusion room which is lighted any time a child/youth is locked in the room.

O. Seclusion rooms must be examined after each use to determine any damage to the room or identified safety issues needing to be corrected. 7.714.549 Approvals Necessary to Operate a Seclusion Room A. The written approval of the local fire department and the department must be received prior to the initial use of the seclusion room.

B. The licensee must request an inspection by the fire department at least annually.

The licensee must retain a copy of the inspection report in the facility file.

C. The records of the use of the seclusion room, the policy for operation of the room, the children/youth’s records, staff records, and the room must be open to staff members of the department of human services for inspection at any time. 7.714.6 Educational/Vocational Programs A. Educational/vocational programs shall be developed and provided for all schoolage children/youth who are residents of the facility in accordance with the individual child’s/youth’s plan, the Public School Finance Act outlined in Article 54.5 of Title 22, C.R.S., and as required by the Exceptional Children's Educational Act outlined in Article 20 of Title 22, C.R.S. and Rules and Regulations for the Administration of the Exceptional Children’s Educational Act (1 CCR 301-8) (June 30, 2024), herein incorporated by reference. No later editions or amendments are incorporated. The rules and regulations for the Administration of the Exceptional Children’s Act can be found at https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=6624.

Copies are also available for public inspection and copying at the Colorado Department of Human Services, 1575 Sherman Street, Denver, CO 80203, during regular business hours.

1. Children/youth shall attend educational/vocational programs in the most appropriate and least restrictive educational setting for the child/youth and following the rules of a best interest determination (BID) meeting as outlined in Section 7.301.241. Facility schools must not require students to attend their educational facility unless and until the county has determined that it is in the child’s/youth’s best interest to change schools and has specifically requested a change in enrollment in accordance with Section 22-32-138(1)(g), C.R.S. and Section 7.301.241.D. Any school attended within the community must be accredited by the state of colorado. online education or home-based learning programs must:

a. Be accredited or approved by the state of Colorado.

b. be taught by a teacher licensed in the state of Colorado.

c. Be included in the individual child’s/youth’s plan and approved by the placing agency.

d. Include a written plan for recreation, socialization, and community involvement for the child/youth.

e. Include a written plan for supervision while the child/youth is in the online education program.

2. Homeschooling is prohibited.

3. Children/youth attending school must be permitted to participate in school extracurricular activities to the extent of their interests and abilities and in accordance with each individual child’s/youth's plan.

4. The facility must develop assurances that the educational/vocational program is an integral part of the child’s/youth’s plan.

B. In order to ensure that all students who may have disabilities are provided an appropriate education, the facility must ensure that adequate "child find" procedures are utilized. Such procedures must be developed cooperatively with local education agencies (LEA) in accordance with Exceptional Children's Educational Act rules and regulations and LEA procedures and in accordance with the Individuals with Disabilities Education Act (IDEA) (October 2010), 20 U.S.C. Sections 1400 through1482, and Section 504 of the Rehabilitation Act of 1973 (October 2016), 29 U.S.C. Section 794, as incorporated by reference in

Section 7.701.14. Child find includes a process for screening, referring, assessing, and staffing students suspected of having a disabling condition.

C. The facility that operates its own educational program must provide adequate space, staff, equipment, and educational materials as required in the Exceptional Children's Educational Act Rules and Regulations outlined in 1 CCR 301-8, as incorporated by reference in Section 7.714.6.A.

D. School records must be transmitted according to state law, pursuant to Section 24-72-204, C.R.S., Section 504 of the Rehabilitation Act of 1973, (October 2016), 29 U.S.C. Section 794, and the Individuals with Disabilities Education Act (IDEA)

(October 2010), 20 U.S.C. Sections 1400 through 1482, as incorporated by reference in Section 7.701.14.

7.714.65 REQUIREMENTS OF A SPECIALIZED PROGRAM FOR

CHILDREN/YOUTH AT RISK AND SURVIVORS OF SEX AND LABOR

TRAFFICKING

A. The facility must have written policies and procedures that describe the admission requirements of the facility, an overview of the facility and its programming, the transitional planning services provided, and how to support the long-term impact of trauma on survivors of human trafficking.

B. The written policies and procedures of the facility must address child/youth unapproved leave from the campus, peer recruitment for trafficking, external safety threats, and any other known safety risk to children/youth or staff.

C. All staff members must complete training in the following areas within ninety (90) days of beginning employment at the facility and renew the training on an annual 1. Indicators of human trafficking;

2. The different types of trafficking;

3. The impact of trauma on survivors of human trafficking;

4. The service needs of human trafficking survivors;

5. Identifying secondary trauma;

6. Survivor-informed active listening;

7. Individualized needs assessment; and 8. Gender identity, spiritual, cultural, intellectual, physical, and emotional dynamics resulting from their trafficking experience.

D. In addition to the requirements in Section 7.714.65.C, all staff members must complete eight (8) additional hours of annual training in human trafficking subject areas.

E. The facility must complete an assessment of service needs with every child/youth in the facility. The needs assessment must be conducted at the time of intake and on a minimum of a quarterly basis, in order to develop and maintain a comprehensive individual plan. The comprehensive individual plan must include, but is not limited to:

1. Safety planning including online safety, harm reduction, and safe/approved contacts;

2. Long-term housing;

3. Identifying and building a natural support network;

4. Identifying and building healthy relationships;

5. Spiritual/religious support;

6. Cultural support;

7. Identifying and accessing legal services;

8. Medical and mental health services;

9. Accessing transportation;

10. Educational, vocational, and job skill training services;

11. Job search, employment, and budgeting services;

12. The impact of trauma on survivors of human trafficking; and 13. Discharge planning to include safe community re-entry, identified supports outside of the program, and ongoing case management services. 7.714.7 Community Participation Participation in community activities must be encouraged, supported, and a vital part of each child’s/youth's life and choice, and must be in accordance with each individual child’s/youth's plan.

A. The facility must reflect consideration for, and sensitivity to, the racial, cultural, ethnic, and religious backgrounds of children/youth in care. The facility must involve a child/youth in cultural and/or ethnic activities appropriate to their cultural and/or ethnic background and involve the child/youth in determining appropriate B. The facility must utilize available services, facilities, and activity programs of the community, and children/youth must be given opportunities to participate as individuals or as a group in agency-sponsored recreational and cultural programs such as provided by YMCA, YWCA, scouting organizations, schools, and churches or other religious institutions.

C. Children/youth in foster care or participating in a foster care transition program must be provided access to information regarding available work options consistent with applicable laws and Section 7.714.33.

D. Facilities must establish written policies regarding monies earned and spent.

Such policies must include:

1. Money earned, received as a gift, or received as allowance by a child/youth in care must be deemed to be that child’s/youth's personal property.

2. Facilities must document all monies earned and received by children/youth, the procedure for requesting money, the time frame in which requests will be completed, and accounting for monies received from and distributed to or on behalf of the child/youth. Documentation of such transactions must be made available to the child/youth and their legal guardian(s) and custodian(s) upon request and at time of discharge.

Any monies remaining in a child’s/youth’s account must be given to the child’s/youth’s legal guardian(s) and custodian(s) at time of discharge, unless the child/youth is eighteen (18) years or older, at which time the money must be transferred to them directly.

3. For other children/youth not residing in foster care or not participating in the foster youth in transition program, limitations may be placed on the amount of money a child/youth may possess or have access to at one time when such limitations are in the child’s/youth's best interests as documented in the child’s/youth’s file.

4. Restitution, or court-ordered payment made by a criminal offender to a victim to compensate for losses caused by a crime, cannot be used as a means of discipline unless it is ordered by a court based on a criminal offense that was issued prior to placement in the facility. Monies received as gifts must not be used toward restitution. A written record of any restitution paid by a child/youth must be maintained in the case file. An accounting of all payments made must be made available to child/youth or their legal guardian(s) and custodian(s) upon request and at time of E. Chores at the facility are considered part of the participatory responsibility of living together. All chores must provide constructive experiences in accordance with the age and ability of the child/youth and must not substitute for the work of F. All chores must be scheduled so as not to conflict with other essential scheduled G. The facility shall comply with all child labor laws and regulations in making work assignments.

H. A child/youth must not be exploited in any manner. Facilities may not permit a child/youth to participate in a solicitation on behalf of the facility for a fundraising activity without the written permission of the parent(s) legal guardian(s), and custodian(s) for each specific activity, and the child/youth must be willing to participate in the activity.

7.714.8 PERSONAL CARE OF THE CHILD/YOUTH 7.714.81 Preventative, Supportive, and Corrective Feedback and Discipline A. Preventative and supportive discipline is designed to be constructive and educational and may include diversion, counseling, predetermined consequences such as temporary loss of privileges, and/or interventions from the trauma behavior support plan developed by the child/youth and their therapist.

B. Rights must not be denied as a disciplinary measure.

C. Separation when used as discipline must be properly assessed if appropriate to the child’s/youth’s age, developmental level, history of trauma, and circumstances. The child/youth must always be within hearing of an adult in a safe, clean, well-lit, well-ventilated room in the facility that contains at least eighty (80) square feet of floor space. Exit routes from any room which a child/youth is being separated must be kept free of barriers to escape. No lock or other mechanism preventing egress from the room may be installed. No child/youth may be isolated in a bathroom, closet, attic, pantry, or garage as a means of discipline.

D. Children/youth in care at the facility must not discipline other children/youth. This does not prohibit a facility from operating an organized, therapeutic, selfgovernment program or positive peer culture that is conducted in accordance with the written policies of the facility and these rules and is directly supervised by a staff member.

E. A facility shall prohibit all corporal, inhumane, cruel, and unusual discipline including, but not limited to, the following:

1. Any type of physical punishment inflicted in any manner upon the body of the child/youth such as spanking, striking, swatting, punching, shaking, biting, hair pulling, rough handling, striking with an inanimate object, or discipline that is designed to, or likely to, cause physical pain.

2. Any shaming, humiliating, or frightening method of discipline to control the actions of any child/youth or group of children/youth.

3. Physical exercise such as running or walking laps, push-ups, or carrying or stacking heavy rocks, bricks, or lumber when used solely as a means of 4. Assignment of physically strenuous or hard work that could result in harm to the child/youth.

5. Requiring or forcing a child/youth to take an uncomfortable position such as squatting or bending or requiring a child/youth to stay in a position for an extended length of time such as standing with nose to the wall, holding requiring or forcing a child/youth to repeat physical movements when used 6. Group discipline except in accordance with the facility’s written policy and these rules.

7. Verbal abuse, derogatory remarks about the child/youth, their family, their race, ancestry, ethnic group, national origin, religion, sex, sexual orientation, gender identity, gender expression, disability, marital status, familial status, source of income, military status, hiv status, cultural background, or any other component of the child’s/youth’s identity, or any intervention or type of treatment that subjects a child/youth to verbal abuse, ridicule, humiliation, or that can be expected to cause excessive emotional trauma.

8. Denial of any essential, basic program service solely for disciplinary 9. Deprivation of meals or snacks, although scheduled meals or snacks may be provided individually.

10. Denial of visits or communication privileges with family, clergy, attorney, guardian ad litem (GAL), counsel for youth (CFY), mental health professionals, court-appointment special advocates, education rights holders, probation officers, and/or caseworker solely as a means of 11. Releasing noxious, toxic, or otherwise unpleasant sprays, mists, or aerosol substances in proximity to the child’s/youth’s face.

12. Any intervention that denies a child/youth sleep, food, water, shelter, access to bathroom facilities, adequate bedding, or appropriate physical comfort.

13. Requiring the child/youth to remain silent for a period of time as a form of 14. Denial of shelter, clothing, or bedding.

15. Withholding of emotional response or stimulation.

16. Discipline associated with toileting, toileting accidents, or lapses in toilet 17. Sending a child/youth to bed as punishment. This does not prohibit a facility from setting individual bedtimes for children/youth.

18. Force feeding a child/youth.

19. Use of emergency interventions (e.g. physical restraint or seclusion) as discipline for a child/youth, as a part of therapy, or as a threat to control or gain compliance of a child’s/youth’s behavior.

20. Interventions that use a device, material, or object that is designed to immobilize the child/youth.

21. Any intervention that deprives a child/youth of the use of their senses, including sight, hearing, touch, taste, or smell.

22. Use of “rebirthing therapy” or any therapy technique that may be considered similar to rebirthing therapy as a therapeutic treatment, as defined in Section 12-245-224(1)(t)(iv), C.R.S.

23. Use of “conversion therapy” or any therapy technique aimed at changing a person’s gender identity, sexual orientation, or gender expression in opposition to the child’s/youth’s documented requests. Conversion therapy does not include practices or treatments that provide acceptance, support, and understanding for the facilitation of an individual’s coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, as long as the counseling does not seek to change sexual orientation or gender identity in accordance with Section 12-245-224(1)(t)(v), C.R.S. 7.714.82 Medical and Health Services A. The facility shall ensure the availability and make every reasonable effort to obtain a comprehensive program of preventive, routine, and emergency medical, mental health, vision, and dental care for each child/youth in care. The facility shall have a written plan for providing such care. This plan shall include at a minimum:

1. Assignment of one (1) person to be responsible for the coordination of medical care for the children/youth residing in the facility.

2. Ongoing appraisal of the general health of each child/youth, including documentation of immunization status or exemption as required by the Colorado Department of Public Health and Environment (CDPHE). Proof of immunization must be provided prior to or on the first day of admission.

3. Procedures for obtaining diagnostic services; emergency care, including the availability of a physician or emergency medical facility on a twentyfour (24)-hour, seven (7)-day-a-week basis; corrective care; recuperative care; and immunization updates.

4. Provision of age and developmentally appropriate health education, which includes: sexual health, including the risk of sexually transmitted disease, and birth control information.

5. Provision that any medical treatment administered will be explained to the child/youth in a language or manner of communication understandable to them.

6. The provision of dental care by a Colorado-licensed dentist, who is available to the facility.

7. Procedure for obtaining the verbal consent by a physician, if in an emergency situation, and written consent from the child’s/youth’s legal guardian(s) or custodian(s) prior to any new psychotropic medication being administered.

a. Verbal consent by a physician shall only be utilized in an emergency situation. Verbal consent must be communicated only through the physician and the nurse on duty and documented in the child/youth individual file.

b. Written consent shall be obtained after the emergency has subsided and within forty-eight (48) hours of administration of any new psychotropic medication.

c. The child’s/youth’s parent(s), legal guardian(s), and custodian(s) shall be notified of any change of dosage in psychotropic medications prior to the new dosage being administered, including the reason for the change and the new dosage ordered by the prescribing provider.

8. Procedures for notifying children/youth about prescribed medication and their purposes; administration of medication; storage of medication; documentation of administration of all medication; disposing of medications when not needed or no longer in use; documenting current or unused medications at time of discharge; ensuring children’s/youth’s access to prescribed medications during placement changes and similar transitions; and notification to a primary physician in cases of medication B. A general medical examination for each child/youth must be completed or scheduled with a physician, physician's assistant, or a nurse practitioner prior to or within fourteen (14) calendar days following admission. A statement from the examiner shall be retained in the child’s/youth's file. This exam shall include the 1. A review of the child’s/youth’s medical history, when available, at time of examination.

2. A review of current medications the child/youth is taking and medications the child/youth has been taking within thirty (30) days prior to placement.

3. An examination for physical injury and ongoing medical conditions.

4. Vision and hearing screening.

5. A current assessment of the child’s/youth's health, including immunizations.

C. Whenever indicated, a child/youth must be referred to an appropriate specialist for either further assessment or treatment.

D. Subsequent physical and other examinations shall be done annually or as directed, in writing, by the physician or other licensed health care provider.

Ongoing medical conditions must be considered before implementation of a treatment strategy.

E. Dental examinations for all children/youth three (3) years of age or older, or at a younger age if recommended by a physician or dentist, must have been completed within four (4) months prior to placement or within eight (8) weeks following placement. The facility must ensure that each child/youth receives a dental examination every six (6) months or as required in writing by a dentist.

F. At all times there shall be First Aid supplies readily available at the facility. For every twenty (20) children/youth, at least one (1) person supervising the children/youth must be certified in First Aid or the equivalent, CPR, and AED for all ages of children/youth in care. When children/youth are with a staff member away from the facility, the staff member must have a current certification(s) in First Aid, CPR, and AED. The First Aid, CPR, and AED course must be from a nationally recognized organization and include a face-to-face demonstration of competency with a certified instructor in both child/youth and adult competencies.

G. The facility, in conjunction with the parent(s), legal guardian(s), and custodian(s) must make every effort to ensure that a child/youth needing corrective devices such as glasses, hearing aids, etc., is provided with the necessary equipment.

H. The facility has the right to request a statement regarding the child’s/youth's general health from a licensed health care provider. In a potentially lifethreatening situation, the facility must refer the child’s/youth's care to the appropriate medical and legal authority. If a child/youth wishes an exemption from a medical examination or medical treatment due to religious beliefs, the child/youth must submit a written statement signed by their parent(s), legal guardian(s), and custodian(s) at the time of admission which states the reasons for such an exemption. The facility has the right to refuse admission to a child/youth whose parent(s), legal guardian(s), and custodian(s) refuses medical treatment or examination based upon religious convictions.

I. The facility must regularly maintain and update a summary of the medical care received by the child/youth while at the facility, including the dates of service; the name and contact information of the medical professional who examined the child/youth; the results of the exam; and any medication that was prescribed or had a change of frequency or dosage. A copy of the document must be given to the caseworker upon the child’s/youth's discharge so that it can be given to the facility where the child/youth is being admitted or to the child’s/youth's parent(s), legal guardian(s), custodian(s), or family member(s) with whom the child/youth is placed. When the facility has received a summary of medical care from a previous placement, this information must be included in the discharge summary, as outlined in Section 7.714.86, to provide a cumulative health history to subsequent caregivers.

J. Medications shall be administered and stored in accordance with the manner described within this Subsection J and CDPHE Regulations Regarding Medication Administration, Storage, and Disposal (July 1, 2017) which are herein incorporated by reference. No later editions or amendments are incorporated.

The regulations can be found at 6 CCR 1011-1, Chapter 24 or https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=7567&fileN ame=6%20CCR%201011-1. These regulations are also available for public inspection at the Colorado Department of Human Services, 1575 Sherman Street, Denver, CO 80203, during regular business hours:

1. When a child/youth first comes into care, the facility must ascertain all medication the child/youth is currently taking and the medications that arrived with the child/youth. Medications arriving with the child/youth must only be accepted if stored in the original pharmacy-labeled container with the child’s/youth’s name and prescriber. Multiple medications combined in one (1) container must not be accepted. Medications currently prescribed for the child/youth that did not arrive with the child/youth must be obtained within twenty-four (24) hours after admission. When a medication is required to sustain life, the medication must be obtained by the next scheduled dose, even if the next dose is due in less than twenty-four (24)

2. All medication must be kept in a clean, locked storage area inaccessible to children/youth and stored according to pharmacy instructions.

a. Medications must be stored in their original container with a pharmacy label at all times. The use of “pill boxes” or “reminder boxes” or pre-pouring of medications is prohibited unless prepared and administered by an approved pharmacy.

b. Medications that require refrigeration must be stored separate from food. If medications that require refrigeration are stored in the same refrigerator as food, they must be in a sealed container, away from food, and not on a shelf over any other food in the refrigerator.

c. Containers of over-the-counter medications used occasionally as a “pro re nata” (PRN) and not prescribed as an ongoing treatment program for an individual child/youth, do not have to be labeled with the name of an individual child/youth for use.

d. Medication must not be stored with disinfectant, insecticides, bleaches, household cleaning solutions, or poisons.

e. Controlled medications must be double locked, and the keys to the locks must be under the control of the staff member responsible for administering medications at all times.

3. All prescriptive medications shall be administered only upon the written prescription of a licensed health care provider. The facility must also obtain written authorization from the prescribing provider to administer any non-prescription, pro re nata (PRN), or over-the-counter medication, including dietary supplements and vitamins used to treat an identified symptom.

a. All medications and supplements authorized for use by the child/youth must be labeled with the child’s/youth’s name.

b. The facility may maintain on site and use epinephrine injectors in accordance with Section 25-47-103, C.R.S.

c. Staff authorized to administer epinephrine must be trained as required in Section 25-47-104, C.R.S. Any staff member who administers epinephrine must immediately ensure the injected individual is transported to an emergency room.

4. The facility must obtain consent from the child’s/youth’s physician, parent(s), and legal guardian(s) or custodian(s) for any changes in the type or dose of medication the child/youth is taking in accordance with

Section 7.714.82.A.7. Verbal consent by a physician is only allowed in an emergency situation. In non-emergency situations, written consent from the child’s/youth’s legal guardian(s) and custodian(s) must be obtained prior to any new psychotropic medication being administered. The facility must identify a procedure for obtaining verbal consent from a physician in an emergency situation prior to any new psychotropic medication being administered consistent with Section 7.714.82.A.7.

5. The facility must obtain a minimum of verbal authorization from the child’s/youth’s physician, parent(s), and legal guardian(s) or custodian(s) for any medication prescribed for each acute illness or injury. This must be documented in the child/youth file.

6. The facility must have a written medication schedule for each child/youth to whom medication is prescribed, including non-prescriptive medications or procedures ordered by a prescribing provider, a copy of which must be available to staff. The information on the medication schedule and the medication administration record must include the reason the medication is being prescribed and must be consistent with the written prescribing provider order and the pharmacy label for each medication and/or procedure ordered.

7. In an emergency situation, non-prescriptive medication may be administered on the verbal authorization of a prescribing provider. Written confirmation must then be obtained for the verbal authorization within forty-eight (48) hours excluding weekends and federal holidays.

8. The facility must maintain for each child/youth a cumulative record of all medication, both prescriptive and non-prescriptive, administered to that child/youth and any procedures ordered by the prescribing provider a. The name of the child/youth;

b. The name of the prescribing provider;

c. The reason the medication or procedure was ordered;

d. The name and dosage of medication;

e. A description of the procedure administered and the results, along with any medical follow up required;

f. The time and date the medication was administered or procedure was conducted; and g. The name of the person administering the medication or conducting the procedure.

9. The facility must maintain a record of all controlled substances on site, a. The name of the licensed health care provider prescribing the medication provider;

b. The reason the medication was prescribed;

c. The name of the medication;

d. The dosage of the medication;

e. The number of pills brought into the facility;

f. The name of the child/youth for which the medication is prescribed;

g. A starting count and ending count for each shift conducted by two (2) different staff, one (1) on each shift;

h. The initials of the individual(s) who conducted the count; and i. A printed name/identifier for the initials.

10. All controlled substances shall be stored under double lock at all times.

Keys that open the locks to the controlled substances must be under the control of the person(s) responsible for administering the medication or secured in an additional locked area at all times.

11. The facility shall document the following information as it relates to handling administration of, return of, and disposal of medication:

a. Documentation of:

1. All medication errors, including follow-up with the staff member who was responsible for the error and/or the prescribing provider, if necessary; and 2. Adverse reactions caused by the medication error or after the administration of the medication.

b. Documentation of all discontinued medication, medications that are refused or wasted, and disposing of medications. Medications must be disposed of in accordance with CDPHE Regulations Regarding Medication Administration, Storage, and Disposal, as incorporated by reference in Section 7.714.82.J.

12. Only staff members who are qualified managers, as defined in Section 25- 1.5-301(4), C.R.S. or authorized by passing the Qualified Medication Administration Personnel (QMAP) training and assessment through the Colorado Department of Public Health and Environment within the last five (5) years are approved to administer medications. The approved training entity (ate) must also include in its course content the expectations regarding medication administration set forth in Section 7.714.82.J.

Verification of current QMAP training must confirm the date the training was given. The staff member must also receive additional training specific to the program as found at Section 7.714.82.J. Verification of passing the QMAP evaluation and any other additional program-specific medication administration training must be maintained in the staff member’s personnel file.

a. A facility must require each QMAP or qualified manager, as a condition of employment or promotion to a position for which the individual has access to medications, to sign a disclosure statement, under penalty of perjury, stating that they have never had a professional license to practice nursing, medicine, or pharmacy revoked in Colorado or any other state for reasons directly related to the administration of medications.

b. A minimum of one (1) staff currently authorized to administer medications must be on site and available during all operational c. Staff currently trained as a QMAP must follow all requirements covered in the QMAP certification except where these practices are prohibited or do not apply to children or youth in care. Practices must take into consideration the cognitive and developmental level of the child/youth and not invade a child’s/youth’s privacy.

d. Any medications that require the QMAP to use an administration route other than topical or oral, including but not limited to, gastrostomy tube or administration of insulin by syringe, must be specifically authorized for administration per Section 12-255-131, C.R.S. of the Nurse and Nurse Aide Practice Act.

e. In addition to the CDPHE QMAP training, each facility must provide on-the-job, evidence-based training that focuses on the unique medication needs of the population of the facility.

f. All direct care staff must be trained in the recognition of common side effects of medication.

13. Staff currently trained as a QMAP must follow the seven (7) rights of the administration of medications as follows:

a. Right person;

b. Right medication;

c. Right dose;

d. Right time;

e. Right route;

f. Right documentation; and g. Right to refuse.

14. Medications prepared for children/youth that will be away from the facility during the time of scheduled administration, must be prepared in compliance with the Pharmaceutical Practice Act, Sections 12-280-101 through 12-280-604, C.R.S. (2024); the Uniform Controlled Substances Act of 2013, Sections 18-18-101 through 18-18-607, C.R.S. (2024); and the State Board of Pharmacy Rules and Regulations at 3 CCR 719-1 (November 30, 2024), herein incorporated by reference. No later editions or amendments are incorporated. These regulations are available at no cost from the Colorado State Pharmacy Board at 1560 Broadway, Denver, CO 80202 or at https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=111 89&fileName=3%20CCR%20719-1. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Provider Services Unit, 1575 Sherman St., Denver, CO 80203, during regular business hours.

15. When a child’s/youth’s individual plan includes a provision for the child/youth to learn about and/or manage an ongoing health condition, per prescribing provider’s orders, for the purpose of continued life skills, and self care, a QMAP staff may monitor the youth self-administering the medication. Monitoring means:

a. Reminding the child/youth to take medication(s) at the time ordered by the prescribing provider.

b. Handing the child/youth a container or package of medication that was lawfully labeled previously by a pharmacist for the individual c. Visual observation of the child/youth self-administering the medication to ensure compliance.

d. Making a written record of the child’s/youth’s compliance with regard to each medication, including the time taken.

e. Notifying the prescribing provider if the child/youth refuses or is unable to comply with the prescribing provider’s instructions regarding the medication.

K. In all instances where a new prescription medication is to be ordered as a part of an ongoing treatment program or due to an acute illness or injury, the following information must be provided to the child/youth, their parent(s), custodian(s), and legal guardian(s):

1. The name of the prescribing provider that ordered the medication;

2. The name of the medication being prescribed;

3. The proper use of the medication;

4. The reasons for ordering the medication for this child/youth;

5. A description of the benefits expected;

6. The common side effects, if any;

7. The major risks, if any;

8. The probable consequences of not taking the medication explained in a language or mode of communication that is easily understood by the child/youth, their parent(s), and/or legal guardian(s) or custodian(s).

L. No involuntary medications may be administered unless the facility is licensed as a PRTF and approved through facility policies and procedures to administer chemical restraints.

M. The child/youth may refuse to take their medication at any time. The facility must document the refusal in the medication log. The facility must hold a staffing with the child’s/youth’s multidisciplinary team for a child/youth who has refused medication for more than five (5) days to determine possible solutions and evaluate continued placement. The staffing must occur within twenty-four (24) hours if the child/youth is refusing any life-saving medications.

N. No child/youth shall be threatened with or experience any behavioral consequences or disciplinary action by staff due to refusal to take medication.

O. The facility must have naloxone available onsite and in facility vehicles at all times. All staff must be trained on how to use naloxone. Certificates for naloxone training must be kept in each staff member’s file. 7.714.83 Personal Hygiene and Daily Routine A. The facility shall establish procedures to ensure that children/youth receive training in good habits of personal care, hygiene, and grooming appropriate to their age, gender identity, race, and culture.

1. Facility staff must supervise children/youth to provide for proper grooming and physical cleanliness of the children/youth.

2. The facility must ensure that children/youth have access to necessary and appropriately maintained toiletry items, individual towels and washcloths, toothbrush, toothpaste, comb, shampoo, and other gender and culturally affirming hygiene products during daily hygiene routine times and other times hygiene is necessary for the child/youth.

B. The facility must have a plan of basic daily routines for children/youth in care.

1. Daily routines must not be allowed to conflict with the implementation of a child’s/youth's plan.

2. Daily routines must be established for mealtimes, waking, and bedtimes.

3. Opportunity for physical activity must be planned for each child/youth. 7.714.84 Clothing and Personal Belongings A. The facility shall make provisions for the storage and protection of children’s/youth’s property when admitted into the facility. The facility/agency is responsible for creating a written policy or acknowledgement, as identified in

Section 7.705.63.C, that identifies the length of time children’s/youth’s property will be stored at the facility/agency.

B. The facility shall allow a child/youth in care to bring their personal belongings to the program and to acquire belongings of their own as appropriate to their age and developmental level. However, the facility shall, as necessary, supervise the use of these items while the child/youth is in care. Children/youth residing in foster care or participating in the foster youth in transition program have a right to basic essentials including personal belongings as outlined in Section 19-7- 101(2)(f)(iii), C.R.S. (2024) that shall only be limited or denied by court order. For other children who are not residing in foster care or not participating in the foster youth in transition program, the facility shall, as necessary for the safety of the child/youth, limit the use of these items while the child/youth is in care.Where extraordinary limitations are imposed, the child/youth shall be informed of the reasons, in a language or manner of communication the child/youth can understand. The decision and reasons shall be recorded in the child’s/youth's file.

Provisions shall be made for the protection of the child’s/youth's property.

C. The facility shall ensure that each child/youth in care has adequate clean, properfitting, suitable, and seasonable clothing as required for health, comfort, and physical well-being and as appropriate to age, gender identity, individual needs, culture, and ethnicity.

1. Each child’s/youth's clothing shall be distinguished as their own in accordance with the facility's policies.

2. A child’s/youth's clothing shall be kept clean and in good repair. The child/youth shall be involved, as appropriate, in the care and maintenance of their clothing. As appropriate, laundering, ironing, and sewing facilities must be accessible to the child/youth and supervised by staff while in use.

D. The facility shall ensure that discharge plans make provisions for clothing needs at time of discharge. The wardrobe for each child/youth must go with them at time of discharge in appropriate luggage.

E. Should there be belongings left at the time of the child’s/youth’s discharge, the facility is responsible for following their policy for storage and disposal of belongings, as identified in Section 7.705.63.E. 7.714.85 Discharge and Aftercare Plan A. Within forty-five (45) calendar days of admitting a child/youth into care, the facility must develop a discharge and aftercare plan in collaboration with the county department of human/social services or placing entity, the child/youth, and the family engagement and permanency team.

B. The aftercare plan must describe the services and resources needed by the subsequent care provider to meet the needs of the child/youth and how those services and resources will be provided.

C. If a child/youth is discharged during the first seventy-two (72) hours of admission, the facility must assure that available mental health information is included in the discharge summary pursuant to Section 7.714.85.H.

D. The plan must be reviewed and/or modified by the licensed clinician or provisionally licensed clinician with review and signature by the supervising licensed clinician no less than monthly during the child’s/youth’s placement and during aftercare services. Changes to the plan must be documented in the child’s/youth’s individual file.

E. The facility must incorporate the plan into the discharge summary as outlined at

Section 7.714.85.H.

F. The facility may revise the terms of aftercare support and services with the placing entity of any child/youth not placed by a county department of human/social services or the Division of Youth Services (DYS) and must provide aftercare support in accordance with the contract established with the placing entity.

G. Facilities may refer to other entities to provide aftercare services and must clearly document in the aftercare plan whom they referred to, contact information, and the specific services to be provided.

H. Within five (5) business days of when a child/youth is removed from placement, the facility must complete and send to the placing agency, a summary of the child’s/youth’s discharge from the facility which includes, at a minimum:

1. The date of the discharge of the child/youth from the facility;

2. Where the child/youth was placed following discharge;

3. A summary of the services provided to the child/youth during care;

4. Goals met/not met during treatment at the discharging facility;

5. The treatment goals and assessed needs which remain to be met and alternate service recommendations which might meet those goals and needs;

6. A statement of an aftercare plan and identification of who is responsible for follow-up services and aftercare;

7. If the discharge was planned or unplanned; and 8. The circumstances which led to an unplanned discharge;

I. Copies of a youth’s file, including discharge information but excluding all medical and/or educational information covered by HIPAA and FERPA, must be provided to parent(s), legal guardian(s), or custodian(s) upon request or to others by written consent pursuant to Section 7.701.61. Copies of a youth’s file, including discharge information but excluding all medical and/or educational information covered by HIPAA and FERPA, may be provided upon request with written consent of the youth pursuant to Section 7.701.61. Releases of information shall be consistent with applicable federal and state law. 7.714.86 Required Notification A. The facility shall immediately notify the child’s/youth’s parent(s), legal guardian(s), custodian(s), guardian and litem and/or counsel for youth (if any), and/or the responsible placing authority of any serious illness or serious injury resulting in medical treatment away from the facility, hospitalization, or death involving a child/youth in care.

B. The facility must notify the parent(s), legal guardian(s), custodian(s), guardian ad litem and or/counsel for youth (if any), and/or placing authority as soon as possible or at least within twenty-four (24) hours excluding weekends and stateobserved holidays upon discovery that a child/youth has run away.

C. Critical incidents must be reported as outlined in Section 7.701.52.

D. A report about death must immediately be provided to the department licensing and monitoring specialists and include:

1. The child’s/youth’s name, birthdate, address, and telephone number;

2. The names of the child’s/youth’s parent(s), legal guardian(s), custodian(s), and their address and telephone number if different from that of the child/youth;

3. Date of the fatality;

4. Brief description of the incident or illness leading to the death;

5. Names and addresses of witnesses or persons who were with the child/youth at the time of death; and 6. Name and address of the police department or authority to whom the report was made.

E. Any change in the status of the facility, which includes, but is not limited to, moving locations, structural damage to the facility due to flooding or fire, or any instance that could potentially affect the safety and care of the children/youth in care, must be immediately reported to the Department.

F. The facility must immediately notify the department of any court order or physician's order that violates these regulations.

G. The facility must regularly notify the parent(s), legal guardian(s), custodian(s), and/or placing authority of the issues related to the care of the child/youth including changes in medication; discipline; treatment; behavior management; physical restraint and seclusion; and restriction of rights as outlined in Section 7.714.31.D.1.

7.714.9 PERSONNEL/POLICY REQUIREMENTS 7.714.91 General Requirements for All Staff A. The facility shall provide adequate numbers of staff to assure the health and safety and the proper care and treatment of the children/youth in care as outlined in Section 7.705.46.

B. All staff in the facility shall demonstrate:

1. An interest in, and a knowledge of, children/youth and a concern for their proper care and well- being; and 2. An ability to maintain appropriate physical boundaries and maintain a level of professionalism with children/youth in care.

C. The facility shall have written screening procedures and make reasonable efforts to evaluate the overall emotional health and stability of each applicant and/or staff member.

D. A facility shall not hire or continue to employ any person whose health, educational achievement, or emotional or psychological makeup impairs their ability to properly protect the health and safety of the children/youth in care, or who could endanger the physical or psychological well-being of the E. A staff member who, upon examination or as a result of tests, shows indication of a physical condition which could be hazardous to a child/youth, other staff, or self, or which would prevent performance of duties, shall not be assigned or returned to their position until the condition has cleared to the satisfaction of the examining physician, physician’s assistant, or nurse practitioner. 7.714.92 Personnel Policy, Orientation, and Training A. The facility must have a comprehensive written policy for the hiring, retention, orientation, initial and ongoing training, and professional development of staff.

1. The facility must provide an introductory training and orientation program for all facility staff. This program must include orientation to emergency and safety procedures, professional boundaries, and the general and specific duties and responsibilities of the job. The introductory training and orientation training must be completed within thirty (30) days of hire and before working alone with children and youth in care.

a. The orientation training must include the facility’s policy on required boundaries between staff members and the children/youth cared for or discharged from the facility.

b. The professional boundaries training must include:

1. Physical and emotional boundaries;

2. Staff social media, artificial intelligence (AI), and cell phone boundaries;

3. Staff use of video or other electronic contact boundaries;

4. The legal ramifications for inappropriate boundaries with children/youth in care; and 5. The facility’s employment and termination policy for employees having or suspected of having inappropriate boundaries with children/youth in care.

c. Each employee must review the facility’s policy on boundaries and be trained in professional boundaries within thirty (30) days of hire and annually thereafter and sign a facility-created form stating that they have reviewed and agreed to the policy. Documentation must be maintained in the staff file and made available to the department B. The facility must document that all staff who in the course of their job duties engage in unsupervised programming or activities with children/youth receive appropriate training in the following areas as applicable to their position:

1. Within ninety (90) days of hire, the following training must be completed and annually thereafter.

a. Developmentally appropriate behavior management practices including positive behavior supports and appropriate discipline strategies for the population served in the facility and according to the facility’s trauma-informed care model.

b. The facility's administrative procedures and overall program goals.

When the facility has a certifying agency, the administrative procedures of the certifying agency must also be included in the c. De-escalation strategies to be used with children/youth, in alignment with the facility’s trauma-informed care plan and/or the facility’s physical management and de-escalation model. Training to the definition of emergency and imminent danger to self and others, and the responsibility of all staff to report suspicion of abuse and neglect if a child/youth is physically restrained without emergency criteria being met every six (6) months in accordance with Section 7.714.534.A.1.

d. Procedures for child/youth supervision based on the individual needs of children/youth, including the need for informed supervision of children/youth with inappropriate sexualized behaviors and/or suicidal ideation.

e. The development and implementation of the individual child’s/youth’s plan of care.

f. Training on the facility’s approved trauma-informed care model.

g. Confidentiality as it relates to 42 C.F.R. parts 160, 162, and 164 of the Health Insurance Portability and Accountability Act (HIPAA)

(2024); which are hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman St., Denver, Colorado 80203, during regular business hours. These statutes and regulations are also available for public inspection at no cost at the U.S. Department of Health and Human Services website https://www.hhs.gov/hipaa and to 20 U.S.C. 123G and 34 C.F.R. part 99 of the Family Educational Rights and Privacy Act (FERPA) (2024) which is hereby incorporated by reference. No later editions or amendments are incorporated. These statutes and regulations are available for public inspection and copying at the Colorado Department of Human Services 1575 Sherman St., Denver, Colorado 80203 during regular business hours. These statutes and regulations are also available for public inspection at no cost at the U.S. Department of Education website https://studentprivacy.ed.gov/FERPA.

h. All facility staff must complete the state-approved mandatory reporting training.

i. All staff must complete the state-approved Volume 7 rules and regulations training according to the license type of the facility.

j. Training on how to recognize when children/youth have potentially been victims of labor or sex trafficking and reporting such to the Colorado child abuse and neglect hotline.

2. Every six (6) months and/or two (2) times per training year:

a. The facility's emergency and safety procedures, including but not limited to fire evacuation drills and disaster drills, a minimum of two (2) times per year, at least four (4) months apart.

b. Physical restraint of children/youth in accordance with facility policies and

Section 7.714.534.A.1, including recognition of early warning signs, prevention strategies, positive behavior interventions, the ability to recognize and respond to signs of physical distress in children/youth who are subject to a physical restraint as required in Sections 7.714.53 through 7.714.536 for those staff authorized to perform physical restraint.

3. Additional training requirements:

a. QMAP training in accordance with 7.714.82.J.

b. CPR/First Aid training in accordance with 7.714.82.F.

c. In addition to the training requirements identified in Section 7.714.92.B, all staff must have a minimum of ten (10) hours annually of specialized training specific to the facility’s stated purpose and population of children and youth being served at the facility.

d. Staff at facilities serving children/youth funded by the Children’s Habilitation Residential Program (CHRP) must complete thirty-two (32) hours of annual training, with sixteen (16) hours dedicated to specialized training that specifically address the needs of the children/youth being served at the facility.

4. The facility must maintain written documentation of specific in-service training a. The name of the training;

b. The date, time, and length of the training;

c. A description or summary of the topics covered in the training;

d. The name and the title of the trainer;

e. Names, titles, and signatures of staff who completed the training.

f. The individual staff members’ job duties do not meet the requirement of initial and annual training. 7.714.93 Colorado Provider Training Academy This applies to residential child care facilities, qualified residential treatment programs, psychiatric residential treatment facilities, secure residential treatment centers, and homeless youth shelters. The Department will provide a ninety (90) day notice to specialized group facilities and day treatment facilities prior to the implementation of staff being required to participate in the training.

A. Facility direct child care staff, supervisors, clinical staff, case management staff, management, administrative staff, and directors must complete the certification process through the Colorado Provider Training Academy.

1. The facility must ensure that each newly hired staff member is enrolled in the Colorado Provider Training Academy within ten (10) days of hire and successfully completes the forty (40) hour, initial, foundational certification within ninety (90) days of employment.

2. The facility must ensure that all staff have access to the necessary technology to complete the required training.

3. Staff hired before the implementation of the Colorado Provider Training Academy must complete the forty (40) hour foundational certification within six (6) months of the implementation of these rules.

4. The facility must ensure supervisors complete the additional six (6) hours of the supervisor certification program provided by the Colorado Provider Training Academy.

5. Staff enrolled in the Colorado Provider Training Academy must complete all required transfer of learning exercises with the assistance of a supervisor or supervisor designee.

6. All staff must demonstrate an emerging level of competence through reflection, pre- and post-tests, trainer review, observation, and verification by the Colorado Provider Training Academy as outlined in the trainee certification requirements.

7. Certification is considered current as long as the staff member maintains successful completion of all ongoing training requirements. If staff do not meet their training requirements by the designated timeframe, client contact must not be permitted until the training requirements are met.

8. The forty (40) hour foundational training through the Colorado Provider Training Academy, mandatory reporting training, and Volume 7 rules and regulations training may be transferred if a person becomes employed through another facility. QMAP and CPR/First Aid may also transfer if they are not expired.

7.715 STANDARDS FOR HOMELESS YOUTH SHELTERS 7.715.1 INTRODUCTION [Rev. eff. 9/15/12]

All rules in Section 7.715 will be known and hereinafter referred to as the Standards for Homeless Youth Shelters. All homeless youth shelters shall comply with the General Rules for Child Care Facilities located at Section 7.701. 7.715.11 Definitions [Rev. eff. 9/15/12]

“Homeless youth” is defined in the general rules at Section 7.701.21.

“Homeless youth shelter” is defined in the general rules at Section 7.701.21.

“Religion” when used in these rules includes traditional religious beliefs and spiritual beliefs such as those of Native Americans.

“Staff member” of the shelter, as used in these rules, includes staff that work timelimited work shifts and do not live at the shelter on a permanent basis.

7.715.2 MANAGEMENT REQUIREMENTS 7.715.21 Governing Body A. The governing body is the individual, partnership, corporation or association in whom the ultimate authority and legal responsibility is vested for the conduct of the shelter.

B. When the governing body does not include a board of directors, there shall be an advisory committee of at least two other individuals who act in an advisory capacity to the governing body. The names of the advisory committee members shall be disclosed to the Department. The advisory committee shall meet at regularly- stated intervals.

C. Minutes of the advisory committee or the board of directors shall be maintained.

The minutes shall be available to the Department upon request, except that the minutes containing confidential personnel information need not be shared with D. The functions of the governing body shall include:

1. The appointment of an administrator who shall be responsible, according to established performance criteria, to the governing body, and shall delegate to him/her the executive authority and responsibility for the administration of the shelter according to its defined purpose.

2. The formulation and regularly-planned review of policies and procedures to be followed by the shelter.

3. The provision of necessary facilities, adequate financing, qualified youth in accordance with these standards. 7.715.22 Fiscal Management A. A shelter shall demonstrate that it is financially sound and manages its financial affairs prudently. All funds disbursed by the shelter shall be expended in accordance with the program objectives as specified by the governing body.

B. A shelter shall demonstrate fiscal accountability through regular recording of its finances. 7.715.23 Insurance A. Every shelter shall carry public liability insurance. The applicant or licensee shall submit the amount of the insurance and the name and the address of the insurance agency providing the insurance for the shelter. Information about the insurance should be maintained at the shelter.

B. Facilities operating their own transportation vehicles shall carry insurance in compliance with the minimum limits as required by the Colorado Revised Statutes.

C. The shelter shall carry workman's compensation and unemployment insurance as required by law.

7.715.3 HUMAN RESOURCES 7.715.31 Administrative Staff A. Administrator The on-site administrator of a shelter shall be qualified as follows:

1. The administrator shall have received a bachelor's degree from an accredited college or university and have three years of verified experience in the human services field, two of which were in a supervisory or administrative position; or The administrator shall have received a master's degree and have two years of verified experience in the human services field, one of which was in a supervisory or administrative position.

2. The administrator shall assume the following duties:

a. Overall direction and responsibility for the youth, program, shelter, and fiscal management.

b. Overall direction and responsibility for supervision of adequate c. The selection and training of a capable staff member who can assume responsibility for management of the shelter in the administrator's absence.

d. The establishment of relationships and contact maintenance with allied agencies, services, and resources within the community.

B. Assistant or Acting Administrator 1. In each youth care shelter, there shall be a specifically designated staff member, age 21 or over, capable of acting as a substitute for the administrator during his/her absence. The duties and responsibilities of the substitute administrator shall be clearly defined in order to avoid confusion and conflict among other staff and youth.

2. If the administrator is regularly absent from the shelter more than 50 percent of his/her working hours, an assistant administrator shall be appointed who meets the same qualifications as the administrator found at

Section 7.715.31, A.

C. Administrative Coverage 1. The Department shall be notified in writing when a possible change in administrator is anticipated or at the time there is a change in administrator. Documents verifying the qualifications of the acting/interim or new administrator, including official transcripts and documents verifying work experience, shall be submitted to the Department.

2. The administrator or the staff member to whom the administrator has 7.715.32 Youth Care Staff A. Each youth care staff shall be at least 21 years of age and have completed two years of college education. A high school diploma or equivalent and one year's experience in the human services field may be substituted for the required college.

B. Each peer counselor shall be at least 17 years old and shall work directly under the supervision of a youth care staff in activities specified by the youth care staff or with the approval of the shelter director.

C. Relief staff shall have the same qualifications as regularly assigned youth care D. There shall be one staff member that has basic knowledge and understanding of nutrition, food purchasing, menu planning, food handling, preparation, and storage. 7.715.33 Youth Care Staff-to-Youth Ratios [Rev. eff. 9/15/12]

A. There shall be a minimum of one (1) adult qualified as a youth care staff on duty and one (1) adult on call who can be summoned at all times when there is one youth or more at the shelter.

B. At night there shall be at least one awake staff person within each physically separate building, and within hearing of youth, and a second person who can be immediately summoned in case of emergency.

C. The ratio of youth care staff to youth in care shall be dependent on the needs of the youth. The ratio of on duty staff shall not be less than the following schedule except when transporting youth in vehicles (see Section 7.715.87):

Age of Youth Waking Hours Sleeping Hours 18 years and over 1 staff member: 20 youth 1 staff member: 20 11 to 18 1 staff member: 20 youth 1 staff member: 20 For facilities that serve youth under the age of eighteen, and youth over the age of eighteen, a separate staff member is required to serve each population.

The ratio of youth care staff to youth in care does not apply to the adult on call identified in provision A, above. A single individual can serve as the adult on call when a facility size or age range requires more than one on duty adult staff member. 7.715.34 Volunteers and Students A. If volunteers or students are used by a shelter, the administration shall define specifically the services to be given by that individual.

B. Volunteers and students who are assigned to work directly with the youth shall:

1. Be subject to reference checks similar to those performed for employment applicants.

2. Be in good general health. The shelter has the right to contact the individual's physician.

C. Volunteers and students shall be:

1. Directly supervised by a paid staff member.

2. Oriented and trained in the philosophy of the shelter, confidential nature of their work, and the specific job which they are to do, prior to assignment. 7.715.35 Medical and Health Staff A shelter shall have a primary physician or Family Nurse Practitioner (FNP) licensed in Colorado, available to establish and maintain the health and medical plan and procedures of the shelter. This person must be present on-site at least weekly. All medical staff, whether employed by the shelter, or whether their services are purchased or volunteered, shall be licensed and responsible to the primary physician or FNP for the medical aspects of their job. 7.715.36 Case Management Staff and Other Professional Staff A. Case management shall be provided by:

1. A qualified professional having a master's degree in social work, psychology, or child development from an accredited college or university.

This professional shall have two years of treatment-oriented experience, 2. A designated member of the staff, who shall have a bachelor's degree from an accredited college or university with a major in behavioral science, human services or related fields, and three years experience in working with youth, or a designated member of the staff, who shall have at least five years verified full-time experience working with homeless or runaway youth; and for whom there is an effective arrangement for consultation from a qualified professional as described above.

3. The qualified professional, as specified in Section 7.715.36, A, 1, may be a full-time or part-time employee of the shelter, a staff member of a recognized agency, or an individual with which the shelter has a contract to provide the necessary services and/or consultation.

4. The ratio of case management staff to youth shall be dependent on the type of shelter and the needs of the youth therein, but there shall be at least one full-time case management staff member for every twenty (20) youth, or a part-time staff member assigned for a fraction thereof.

B. The case management staff shall be responsible for providing case management services as stated at Section 7.715.42, B.

C. Youth in need of specific individual therapy shall be referred to an appropriate treatment provider. 7.715.37 General Requirements for All Staff A. The shelter shall provide adequate numbers of staff to assure the health and safety and the proper care and treatment of the youth in care.

B. All staff in the shelter shall demonstrate an interest in, and a knowledge of, youth and a concern for their proper care and well-being.

C. The shelter shall have written screening procedures and make reasonable efforts to evaluate the overall emotional health and stability of each applicant and/or staff member. Procedures should include exploring for any history of youth battering, youth abuse, youth molestation, youth neglect, or previous criminal convictions.

D. Each staff member, including part-time staff and substitute staff, shall have on file at the shelter verification of tuberculin status. If the staff member has a certificate of previous negative testing, the testing does not need to be repeated. If there is no certificate, the testing needs to be completed prior to employment or E. A staff member who, upon examination or as a result of tests, shows indication of a physical condition which could be hazardous to a youth, other staff, or self, or which would prevent performance of duties, shall not be assigned or returned to his/her position until the condition has cleared to the satisfaction of the examining physician or nurse practitioner. 7.715.38 Personnel Policy, Orientation, and Training A. The shelter shall have a comprehensive written plan for the recruitment, hiring or certification, orientation, ongoing training, and professional development of staff.

1. The shelter shall have an introductory training and orientation program for all staff. This program shall include orientation to emergency and safety procedures and the general and specific duties and responsibilities of the job.

2. The shelter shall maintain written documentation of specific in-service training held, staff participating, the hours involved, and/or other on-going training activities in which staff were involved. Activities related to supervision of the staff members' routine tasks shall not be considered training activities for the purpose of this requirement.

B. The shelter shall document that all staff receive appropriate training in the following areas:

1. The shelter's emergency and safety procedures, including but not limited to fire evacuation drills, tornado drills, where appropriate, and flood evacuation drills, where appropriate, on at least a semiannual basis.

2. Universal precautions regarding safe work practices to prevent exposure to blood and bodily fluids.

3. The principles and practices of working with youth.

4. The shelter's administrative procedures and overall program goals.

5. Acceptable behavior management techniques, including appropriate discipline in accordance with shelter policies and these rules.

6. Appropriate professional boundaries (both physical and emotional) between staff and youth while in placement at the shelter and after 7. Positive and constructive methods of dealing with the youth including but not limited to physical structuring of the environment and de-escalation of crisis situations.

8. Annual review of these regulations by all appropriate staff members of the 9. All staff must have twenty-clock hours of on-going job specific training a year. Training may include areas listed above.

7.715.4 PROGRAM 7.715.41 Program Description A. The shelter shall have a written overall program description for the shelter.

B. The written description shall address at least the following areas:

1. Case Management Provided 2. Family counseling 3. Education 4. Shelter provided (housing, food, clothing) 7.715.42 Case Management Services A. A staff member qualified as stated at Section 7.715.36, A, shall be assigned the responsibility for case management for each youth.

B. Each individual assigned the responsibility of providing case management services for a youth shall:

1. Participate actively in the treatment planning, discharge and after care planning.

2. Assure that appropriate information concerning the youth and her/his background is shared with other staff members who deal with the youth regularly and to maintain communication with parents, guardians, if available, and with the individual or agency responsible for discharge planning and follow-up care of the youth, if applicable.

3. Assure that the plan developed for each youth is implemented, and documented in the youth's file. 7.715.43 Admission Policy and Procedures [Rev. eff. 9/15/12]

A. Admission of a youth shall be in keeping with the stated purpose of the homeless youth shelter and shall be limited to those youth for whom the shelter is qualified by staff, program, equipment, and needs of youth already in residence to provide care deemed necessary. Care must be provided in the least restrictive, most appropriate setting in order to meet the youth's needs.

B. Each shelter shall have a written admission policy which at a minimum must 1. The policies and procedures related to intake.

2. The age range and sex of youth accepted for care.

3. The needs, problems, situations or patterns best addressed by the shelter's program.

4. The anticipated criteria, problems, situations, and patterns that would result in the shelter requesting removal of a youth.

5. A statement regarding the religious orientation or affiliation of the shelter, and of the religious activities at the shelter, if any.

6. A statement regarding any charges or costs for services that may be expected from the youth, the youth's family or others who may be responsible for the youth.

C. The shelter shall accept a youth into care only after a preliminary assessment and screening of presenting problems in areas such as social, physical health, mental health.

D. Upon admission of a youth to a shelter:

1. The shelter shall provide all necessary services pursuant to section 26- 5.7-106(2), C.R.S.

2. A youth who has reached the age of 15 or older may consent to shelter and services for a period not to exceed 21 days when the following criteria are met:

A. The youth shall voluntarily and knowingly sign a consent form that includes:

1. All services the youth may receive during their stay at the shelter and the total number of days the youth may consent.

2. Legal limits to confidentiality.

3. How and when parent(s), legal guardian(s), and/or child welfare agencies will be notified of the youth’s stay.

4. An explanation that services provided by the shelter are provided free of charge to the youth without exchange of any goods, services, or sexual acts.

B. The consent form shall be explained in the child's dominant language or mode of communication, including augmented or facilitated communication, if necessary, and shall take into consideration the child's age, disability, and cultural and religious background.

C. The consent form shall be signed within 12 hours of admission.

E. Within 24 hours of arrival at the shelter, a youth shall be given an orientation to the shelter, consistent with the youth's age and ability to participate, which includes at least the following:

1. Tour of the shelter and instruction on fire alarm and fire evacuation procedures, escape routes and exits.

2. The rules/regulations of the shelter.

3. Procedures affecting the youth's behavior, including limiting or restricting a youth's rights where allowed, the type of discipline used in the shelter, and consequences for certain behaviors.

4. The complete youth's rights and youth's grievance procedures as developed by the shelter or by the certifying authority.

F. For youth under the age of eighteen (18), if reconciliation with the youth’s family has not occurred within seventy-two (72) hours following admission to the shelter, and the director of the shelter or other person in charge does not anticipate that reconciliation will be achieved within twenty-one (21) consecutive days, the director or other person in charge shall provide the youth and the youth's parent(s) or legal guardian(s) with a written statement identifying:

1. The availability of counseling services;

2. The availability of longer term residential arrangements; and 3. The possibility of referral to the county department.

G. Youth may reside at a shelter for a period not to exceed twenty-one (21) consecutive days unless the youth is paced in a voluntary alternative residential placement pursuant to Section 26-5.7-107 or 26-5.7-108, C.R.S.

For youth under the age of eighteen (18), a voluntary residential agreement shall be developed with the involvement of the youth and, if possible, the youth's parent or the legal guardian(s). Where the involvement of any of these is not feasible or desirable, the reasons for the exclusion shall be recorded by the shelter. If the youth and the youth’s parent cannot agree on an initial voluntary alternative residence within twenty-one (21) days, the shelter may make a referral to the county department. If an agreement can be reached, the placement agreement shall include at least the following information:

1. Discussion of the youth's and the parent's or guardian's expectations regarding: family contact, reconciliation and involvement; how family contact and involvement are to occur, the nature and goals of care, the anticipated planned discharge date and the plan for the youth following 2. A delineation of the respective roles and responsibilities of all agencies and persons involved with the youth and his/her family.

3. Legal status or custody of the youth.

4. If a youth is placed by a Colorado county department of social services, the appropriate state form or contract shall be completed. This form or contract may provide some of the required authorizations.

For youth between the age of eighteen (18) and twenty-one (21), the voluntary residential agreement shall be developed with the involvement of the youth.

Other individuals may participate in the development of the agreement at the youth and shelter’s discretion The agreement shall include at least the following information: the nature and goals of care, the anticipated planned discharge date, and the plan for the youth following discharge.

H. Pursuant to Section 26-5.7-105(5), C.R.S., if the facility determines that a referral for additional services needs to be made, it shall make the referral to the appropriate county department of human/social services, notify the county department of the facility's relationship to the youth pursuant to section 19-1-307 (2)(e.5)(I), and notify the county department of the date when the twenty-one-day shelter time period will expire.

For youth under the age of eighteen (18), the shelter will contact the county department of residence of the parents(S) of the youth for the limited purpose of determining whether a county department is serving the youth.

I. Pursuant to Section 26-5.7-105(4), C.R.S., when a youth under fifteen years of age is admitted to a licensed homeless youth shelter, the director of the shelter or other person in charge shall notify the county department of residence of the parents of the youth within seventy-two (72) hours of the youth’s admission.

J. Pursuant to Section 26-5.7-105(7), C.R.S., if a youth who is at least eleven (11) years of age but less than fifteen (15) years of age has been served up to twentyone (21) consecutive days and returns again to the licensed homeless youth shelter after leaving the shelter, the director of the shelter or other person in charge shall notify the county department of residence of the parents of the youth within seventy-two (72) hours of the youth’s admission.

K. If the shelter staff know the youth is away from home without permission, the shelter shall notify the youth’s parent or law enforcement pursuant to Section 26- 5.7-106, C.R.S. 7.715.44 Youths Rights A. The shelter shall have written policies and procedures that address and ensure the availability of each of the following core rights for youth in residence. These rights may not be restricted or denied by the shelter.

1. Every youth has the right to enjoy freedom of thought, conscience, cultural and ethnic practice, and religion.

2. Every youth has the right to a reasonable degree of privacy.

3. Every youth has the right to have his or her opinions heard and considered, to the greatest extent possible, when any decisions are being made affecting his/her life.

4. Every youth has the right to receive appropriate and reasonable adult guidance, support and supervision.

5. Every youth has the right to be free from physical abuse or neglect and inhumane treatment. Every youth has the right to be protected from all forms of sexual exploitation.

6. Every youth has the right to receive adequate, appropriate, and timely emergency medical care.

7. Every youth has the right to receive adequate and appropriate food, clothing, and housing.

8. Every youth has the right to live in clean, safe surroundings.

9. Every youth has the right to participate in an educational program that will maximize his/her potential in accordance with existing law.

10. Every youth has the right to communicate with others outside the shelter, such as a parent or guardian, caseworker, attorney or guardian ad litem and/ or counsel for youth, current therapist, physician, religious advisor, and, if appropriate, probation officer.

B. The following youth's rights may be limited to reasonable periods during the day or restricted according to written policies of the shelter to ensure the protection of the youth, staff, and program from unreasonable and unnecessary intrusions and disruptions and from health and safety hazards.

1. Every youth has the right to have access to letter-writing materials, including postage, and to have staff members of the shelter assist him/her if unable to write, prepare, and mail correspondence.

2. Every youth has the right to have access to telephones to both make and receive local emergency telephone calls.

C. Written policies that restrict or limit a youth's rights as listed at Section 7.715.44, B, must include at a minimum the requirement that the shelter notify the youth at the time of admission of any policy that would limit or restrict a youth's rights. The notification must be communicated in a language or mode of communication the youth can understand and, if possible, be signed by the youth.

D. If the shelter enforces any restrictions upon the youth's rights as listed at Section 7.715.44, B, the shelter must, in compliance with the written policy and procedure of the shelter 1. Inform the youth in a language or mode of communication the youth can understand, of the conditions of and reasons for restriction or termination of his/her rights.

2. Place a written report summarizing the conditions of and reasons for restriction, denial, or termination of the youth's rights in that youth's case record along with information about if or when the youth's right(s) can be restored. This Information must be made available to the youth upon 3. When a restriction of a youth's rights affects another youth at the shelter, the youth shall be informed, in a language or mode of communication the individual can understand, of the conditions of and reasons for the action. 7.715.45 Youth's Grievance Procedure A. The shelter must establish a written grievance procedure that provides adequate due process safeguards, spells out the appeal process, and assures that youth and parent(s) or guardian(s) are entitled to report any grievance and shall not be subject to any adverse action as a result of filing the grievance.

1. The shelter must follow grievance procedures without alteration, interference, or unreasonable delay.

2. If a grievance is filed with the shelter, the grievance shall be recorded in the youth's record along with the investigation findings and resulting action taken by the shelter.

B. A list of the youth's rights and the grievance procedures must be provided and explained to the youth and the parent or guardian in a language or manner of 7.715.46 Discipline [Rev. eff. 6/1/12]

A. The shelter shall have written policies and procedures regarding discipline that must be explained to all youth, parent(s), guardian(s), staff, and placing agencies. These policies must include positive responses to a youth's appropriate behavior.

B. Discipline shall be constructive or educational in nature and may include talking with the youth about the situation, praise for appropriate behavior, diversion, separation from the problem situation, and withholding privileges.

C. Basic rights shall not be denied as a disciplinary measure.

D. Youth in care at the shelter shall not discipline other residents.

E. A shelter shall prohibit all cruel and unusual discipline including, but not limited to, the following:

1. Any type of physical hitting or any type of physical punishment inflicted in any manner upon the body of the youth such as spanking, striking, swatting, punching, shaking, biting, hair pulling, roughly handling a youth, striking with an inanimate object, or any humiliating or frightening method of discipline to control the actions of any youth or group of youth.

2. Discipline that is designed to, or likely to, cause physical pain.

3. Physical exercises such as running laps, push-ups, or carrying heavy rocks, bricks, lumber or other heavy items when used solely as a means of punishment.

4. Assignment of physically strenuous or harsh work that could result in harm to the youth.

5. Requiring or forcing a youth to take an uncomfortable position such as squatting or bending, or requiring a youth to stay in a position for an extended length of time such as standing with nose to the wall, holding requiring or forcing a youth to repeat physical movements when used 6. Group discipline except in accordance with the shelter's written policy and these rules.

7. Verbal abuse or derogatory remarks about the youth, his/her family, his/her race, religion, or cultural background.

8. Denial of any essential/basic program service solely for disciplinary purposes. This does not prohibit the shelter from requesting the youth to leave the shelter because of inappropriate behavior.

9. Deprivation of meals or snacks to a youth that has not been requested to leave the shelter.

10. Releasing noxious, toxic, or otherwise unpleasant sprays, mists, or aerosol substances in proximity to the youth's face.

11. Denial of sleep.

12. Requiring the youth to remain silent for a period of time inconsistent with the youth's age, developmental level, or medical condition.

13. Denial of shelter, clothing or bedding to a youth that has not been requested to leave the shelter.

14. Withholding of emotional response or stimulation.

15. Use of physical management, seclusion or restraint as discipline for a 7.715.47 Non-Discrimination In compliance with Section 7.701.14, the shelter shall not discriminate against a youth based upon race, religion, age, gender or disability.

7.715.48 RELIGION AND CULTURE

A. The shelter shall demonstrate consideration for, and sensitivity to, the cultural and religious backgrounds of youth in care.

B. Youth in care at the shelter shall be allowed and encouraged to celebrate their cultural and religious holidays.

C. A youth may be invited to participate in religious and cultural activities of the D. A youth shall not be coerced or forced to participate in the religious activities of a shelter or to attend religious services.

E. Any form of religious or cultural intervention used by the shelter to control or change a youth's behavior, or treat or heal a medical condition, must be approved, in writing, by the legal guardian(s) of the youth prior to the use of the intervention.

F. A shelter cannot deny medical care to a youth because of religious beliefs.

7.715.5 PERSONAL CARE OF THE YOUTH 7.715.51 Medical and Health Services A. The shelter shall ensure the availability of emergency medical care for each youth in care.

B. Whenever indicated, a youth shall be referred to an appropriate specialist for either further assessment or treatment.

C. At all times there shall be first aid supplies readily available at the shelter and at least one (1) person present at the shelter or with the youth who is certified in first aid, or the equivalent, and CPR for all ages of youth in care.

D. The shelter, in conjunction with the parent(s) or guardian(s), shall make every effort to ensure that a youth needing corrective devices such as glasses, hearing aids, etc., is provided with the necessary equipment.

E. In a potentially life.-threatening situation, the shelter shall refer the youth's care to the appropriate medical and legal authority.

F. Administration of any medication at the shelter shall be done only by a person licensed and authorized by law and administered according to the written policies of the shelter.

G. All medication to be administered must be kept in a clean storage area inaccessible to the youth and stored according to pharmacy instructions.

H. All prescribed medications shall be administered only upon the written prescription of a physician.

7.715.6 FOOD, NUTRITION, PERSONAL HYGIENE, DAILY ROUTINE

CLOTHING AND PERSONAL BELONGINGS 7.715.61 Food and Nutrition A. The shelter shall provide nutritious foods in the variety and amounts as appropriate for the age, appetite, and activity of each youth in care.

B. At least three nourishing, wholesome, well-balanced meals a day shall be offered at regular intervals.

C. Menus shall be planned at least one week at a time, shall be dated, posted and filed for at least one month.

D. Youth shall be encouraged to eat a variety of the food served but shall not be subjected to undue coercion, including forced feeding, or punished for refusal to eat.

E. All food shall be from sources considered satisfactory by the health authority. All foods shall be stored, prepared, and served in such a manner as to be clean, and wholesome.

F. Youth must not be given foods that are contrary to their religious beliefs, or of their family, or are known to cause an allergic reaction or a health hazard.

G. Water shall be readily accessible to youth by means of an approved water fountain or single-service cups.

H. Common drinking cups shall not be permitted. 7.715.62 Personal Hygiene and Daily Routine A. The shelter shall establish procedures to ensure that youth receive training in good habits of personal care, hygiene, and grooming appropriate to their age, gender, race and culture.

B. There shall be supervision by staff to provide for proper grooming and physical cleanliness of the youth.

C. The shelter shall ensure that youth are provided with necessary and appropriate toiletry items, including clean, individual towels and washcloths, toothbrush, toothpaste, comb, and shampoo. 7.715.63 Clothing and Personal Belongings A. The shelter shall allow a youth in care to bring his/her personal belongings to the program, as defined by the shelter policy, and to acquire belongings of his/her own in accordance with the youth's plan. However, the shelter shall, as necessary, limit or supervise the use of these items while the youth is in care.

Where extraordinary limitations are imposed, the youth shall be informed of the reasons, in a language or manner of communication the youth can understand.

The decision and reasons shall be recorded in the youth's case record.

B. Provisions shall be made for the protection of the youth's property while the youth is residing at the shelter. If the shelter safeguards any money, valuable: or personal property for a youth, the shelter shall maintain and inventory as such possessions. A full return or accounting of such possessions shall be made upon discharge of the youth from the shelter.

C. The shelter shall ensure that each youth in care has adequate clean, properfilling, and seasonable clothing as required for health, comfort, and physical wellbeing and as appropriate to age, gender, individual needs, culture, and ethnicity.

D. The wardrobe for each youth shall go with him/her at time of discharge.

7.715.7 LIVING SPACES, EQUIPMENT, AND NECESSARY FACILITIES 7.715.71 Living Spaces and Equipment Necessary in a Shelter [Rev. eff. 9/15/12]

A. Youth eleven to eighteen years of age may be housed in the same area in a shelter. Youth eighteen (18) to twenty-one may be housed in the same area in a shelter. Youth under the age of eighteen may not be housed in the same area as youth over the age of eighteen.

B. There shall be separate sleeping rooms for boys and girls. Sleeping rooms above or below the floor of exit travel shall not be used for sleeping purposes for youth who are non-ambulatory.

C. Each youth shall be provided suitable sleeping equipment consisting of individual beds, or bunks, complete with mattresses in good repair, or individual cots. All sleeping equipment shall be constructed so as to facilitate cleaning while in us 3 by youth and upon each change of occupancy. Triple-deck bunks are prohibited.

Sleeping equipment being used by youth shall have, clean sheets, pillows, pillowcases and blankets.

D. Each room of occupancy shall be well-lighted and adequately ventilated.

E. Staff rooms shall be located on the same floor or in the general area of youth's sleeping rooms so that the youth care staff can supervise youth and be readily accessible when needed.

F. There shall be a designated space distinct from youth's living areas to serve as an administrative office.

G. There shall be a designated space distinct from youth's living areas to allow for private discussions and/or counseling sessions.

H. Each shelter shall have a telephone. Each separate living unit within a shelter shall have 24-hour telephone service or an intercom system connected with an outside telephone service. Emergency telephone numbers, including fire, police, physician, poison control, health agency, and ambulance shall be conspicuously posted adjacent to each telephone. 7.715.72 Dining, Kitchen, Laundry, Bathroom Facilities A. The dining area, whether located in the living unit or in a separate central dining room in the shelter, shall meet the following requirements:

1. It shall be clean, well-lighted, properly heated, and ventilated.

2. Walls and floors shall be of materials that are easy to keep dean.

B. The kitchen shall be designed and equipped to meet the requirements of efficiency, sanitation, fire safety, and comfortable working conditions. There shall be:

1. Adequate space for receiving, storage, refrigeration, and preparation of food. Storage space shall be dean and well-ventilated, and containers of food shall be covered and stored above the floor on shelves or other clean surfaces.

2. Provision for daily disposal of garbage and other refuse.

3. Separate storage of poisonous and toxic materials from food. Such materials shall be labeled and used only in ways that will neither contaminate food nor be hazardous to staff or youth.

4. Mechanical dish washing equipment or other approved methods of dish washing in accordance with requirements of the State Department of Public Health and Environment.

5. Hand washing and toilet facilities for use of kitchen staff shall be readily accessible.

C. Bath and toilet rooms shall be constructed of easily cleanable material. All surfaces shall be maintained in good repair. Toilet and bathing facilities shall have doors or partitions.

7.715.8 BUILDING, FIRE SAFETY AND TRANSPORTATION 7.715.81 Building Site A. The shelter must be located in an area that is readily accessible to health resources, public and private utilities, adequate and safe water supplies, sewage B. The shelter site shall be located in accordance with local zoning department requirements.

C. The entire premises of the shelter are subject to inspection for licensing purposes, including but not limited to the residence where care is to be provided, the grounds surrounding the shelter, the basement, the attic (if accessible), any storage buildings, and a garage or carport, if applicable.

D. If the shelter is located in the same building as, or immediately adjacent to, other facilities, or an adult treatment center, or a nursing home, it shall be so arranged that the care and activities of the youth residing in the shelter are completely separate and independent from the other facility. The shelter may not be operated on the premises of a business that might be hazardous to the health, safety, morals, or welfare of youth and the operation of the shelter.

E. The shelter, including indoor and outdoor space, shall be maintained in a dean and safe condition free from hazards to health and safety.

F. There shall be outdoor space available to provide some recreation area for south. 7.715.82 Building Maintenance A. Buildings shall be Kept in good repair and maintained in a safe, dean, and sanitary condition. Good housekeeping must be observed in all areas at all times.

B. All areas of the shelter available to youth's activities including equipment, materials and furnishings shall be of sturdy, safe construction, easy to dean, and free of hazards, such as sharp points or comers, splinters, protruding nails, broken play and recreational equipment or paint that contains lead or other poisonous materials and might be dangerous to the life or health of youth.

C. Closets, attics, basements, cellars, and furnace rooms shall be kept free from accumulation of significant amounts of extraneous materials such as furnishings, newspapers, or magazines that could pose a fire or health hazard.

D. Provision shall be made for collection, storage, and disposal of refuse in an approved manner to prevent nuisance conditions. 7.715.83 Building Safety A. Egress from each dwelling unit sleeping room, and dormitory shall be available directly to the outside or to a common hallway leading directly to the outside.

B. In every building or structure, exits shall be so arranged and maintained as to provide free and unobstructed egress from all parts of the building or structure at all times when it is occupied. No lock or fastening to prevent free escape from the inside of any building shall be installed.

C. Every exit shall be clearly visible or the route to reach it shall be conspicuously indicated in such a manner that every occupant of every building or structure who is physically and mentally capable will readily know the direction of escape from any point Each path of escape shall be so arranged or marked that the way to a place of safety outside is unmistakable.

D. In every building or structure adequate and reliable illumination shall be provided for all exit facilities.

E. Every building or structure shall be so constructed, arranged, equipped, maintained, and operated as to avoid undue danger to the lives and safety of its occupants from fire, smoke, fumes, or resulting panic during the period of time reasonably necessary for escape from the building or structure in case of fire or other emergency.

F. The local fire department shall determine the adequacy of exits and other measures for life safety. 7.715.84 Fire Safety [Rev. eff. 6/1/12]

A. Fire hazards, such as defective electrical appliances and electric cords, B. The shelter shall contain at least one U.L.-approved fire extinguisher, highly visible, easily accessible, and in working condition, weighing not less than five pounds, that has a rating of 2A, 10BC. This requirement may be waived where more extensive fire-control measures are required by a local fire department C. A smoke detector, in working condition, must be installed on each level of the shelter where care occurs and near sleeping areas.

D. No gas or electric space heaters, open-flame gas or 09 stoves, hot plates, or unvented heaters shall be used in the shelter for heating purposes.

E. Flammables, aerosol paints, insecticides, chemicals, and other dangerous materials shall be locked or stored so they are inaccessible to youth and must be stored in areas separate from sleeping or living areas. Flammables shall be stored in an approved container.

F. Heating devices such as radiators, registers, fireplaces, and steam and hot water pipes that pose a fire or bum hazard to youth shall be screened or otherwise protected.

G. Flammable material must not be stored near a furnace, hot water heater, or other heating device.

H. There shall be no candles or other burnable objects permitted in sleeping areas.

I. Exit doors shall be obvious. No lock or fastening to prevent free escape from the inside of any room used by the youth shall be permitted.

J. Exit routes shall be kept free of discarded furniture, furnishings, laundry, and evacuation of the shelter. 7.715.85 Emergency Drills A. There shall be written procedures for staff and youth to follow in case of emergency or disaster. These procedures shall be developed by the shelter with the assistance of qualified fire and safety personnel and shall include provisions for staff roles and responsibilities during an emergency, evacuation of the shelter, and the assignment of a central meeting place where each individual may be accounted for.

B. Fire exit drills must be held regularly.

C. Drills must be held at unexpected times and under varying conditions to simulate the conditions of an actual fire.

D. Drills must emphasize orderly evacuation under proper discipline rather than speed. Running or horseplay shall not be permitted.

E. Drills must include suitable procedures for ensuring that all persons in the shelter actually participate.

F. A record of fire drills held over the past 12 months must be maintained by the G. Fire alarm facilities shall be regularly used in the conduct of drills.

H. The shelter shall make special provisions for the evacuation of any physically handicapped youth in the shelter.

I. The shelter shad take special care to help emotionally disturbed or perceptually handicapped youth understand the nature of such drills.

J. If appropriate to the location of the shelter, tornado drills must be held often enough so that all occupants are familiar with the drill procedure and conduct during a drill is a matter of established routine. A record of tornado drills held over the last 12 months must be maintained by the shelter. 7.715.86 General Comfort and Safety A. AH hazardous chemicals, tools, and other equipment, including matches, plastic bags, paints, gasoline, medicines, insecticides, and cleaning and laundry materials, shall be stored in a safe manner. Products which could cause poisoning or contamination shall not be stored in rooms or areas where food is stored or prepared.

B. A shelter shall not maintain any firearms or air rifles on the grounds or within the structure of the shelter. A shelter shall not permit any staff member or youth to be in possession of any firearm on the grounds or within the structures of the shelter. Any other weapons such as bows, hunting knives and hunting sling shots must be unstrung at all times and must be locked and inaccessible to youth.

Chemical weapons, even when carried by staff members to and from work for protection, shall be locked when present at the shelter. Weapons must not be transported in any vehicle in which youth are riding.

C. Water from any source other than a regular municipal water supply shall be tested annually for compliance with water quality requirements. (Sterilized containers for free laboratory tests of drinking water may be secured from the county health department or by writing to the Colorado Department of Public Health and Environment, 4210 East 11th Avenue, Denver. Colorado 80220.)

D. The shelter shall be equipped with adequate light, heat, ventilation, and plumbing for safe and comfortable occupancy.

E. The shelter must be equipped with hot and cold running water.

F. All garbage, refuse and other wastes shall be kept in a suitable receptacle and disposed of in such a manner as not to constitute a health hazard or nuisance.

G. All stairways containing more than four steps shall be equipped with a handrail.

H. The shelter shall nave a telephone, and emergency numbers shall be posted near the telephone, including those related to medical care, fire, law enforcement and poison control where available. 7.715.87 Transportation A. A shelter shall ensure that each youth is provided with the transportation necessary for implementing the youth's individual plan.

B. A shelter shall have means of transporting youth in cases of emergency.

C. Any vehicle used by the shelter in transporting youth in care, whether such vehicle is operated by a staff member or any other person acting on behalf of the shelter, shall be properly licensed, and the vehicle shall be maintained in accordance with Colorado law.

D. Any staff member or other person acting on behalf of the shelter operating a vehicle for purpose of transporting youth shall be property licensed to operate the class of vehicle in accordance with Colorado law.

E. Youth under 16 years of age must be property fastened into a restraint system that conforms to Section 42-4-236, C.R.S.

F. A shelter shall not allow the number of persons in any vehicle used to transport youth to exceed the number of available seats and seatbelts in the vehicle.

G. The vehicle shall be enclosed.

H. A shelter shall ascertain the nature of any need or problem of a youth which might cause difficulty during transportation, such as seizures or a tendency toward motion sickness. The shelter shall communicate this information to the driver of any vehicle transporting youth in care.

7.715.9 RECORDS, REPORTS AND CONFIDENTIALITY 7.715.91 Confidentiality A. The shelter shall have a policy as to the maintenance, storage and confidentiality of records.

B. Records shall be the property of the shelter and shall be protected against loss, tampering, or unauthorized use.

C. Facts learned about youth and their families shall be kept confidential, with the following exceptions:

1. In medical emergencies, and then only when the assistance and/or expertise is required of that unauthorized person; or 2. To the youth, his/her parent(s) or guardian(s) and their respective legal counsel(s), a court having jurisdiction over the youth, or an authorized public official, or licensing representative in performance of his/her mandated duties; or 3. If the parent(s) or guardian(s) has given voluntary, written consent.

4. Mandatory reporting of child abuse as required by law; and;

5. Reporting to the appropriate authority a youth's attempt to harm his/herself or others.

6. A youth's records may only be released upon the written consent of the 7.715.92 Records A. The shelter shall maintain complete records as required for the licensing of the shelter in accordance with the rules regulating the shelter.

B. Records for youth shall be retained for at least three years. Retention of records for a longer period may be desirable when they reflect an accident, injury or other unusual circumstance.

C. A record of admission shall be completed for each youth in care at the time of admission. The admission record shall be maintained at the shelter where the youth resides and shall contain:

1. Youth's name, date and place of birth (verified by a birth certificate when possible), gender, race, religious preferences, and date of admission.

2. Psychiatric and psychological reports, when available.

3. Summary recording of significant contacts with parent(s), guardian [s) and D. When a youth is removed or discharged from placement, the shelter shall complete a summary of the youth's discharge from the shelter which includes at a minimum:

1. The date of the discharge of the-youth from the shelter.

2. The plan for the youth.

3. Circumstances which led to an unplanned discharge.

E. Copies of a youth's file, including discharge information, shall be provided to parent(s) or guardian(s) upon request or to others by written consent pursuant to

Section 7.715.91.

F. A copy of all policies developed by the shelter shall be maintained for at least three years. 7.715.93 Reports A. The shelter shall immediately attempt to notify the youth's parent(s), guardian(s), and/or the responsible agency of any serious illness or serious injury resulting in medical treatment away from the shelter, hospitalization or death involving a youth in care.

B. The shelter must immediately report in writing to the licensing authority any accidents, injuries, serious illnesses, or fatalities that occurred at the shelter and that resulted in emergency medical treatment away from the shelter, hospitalization or death. The report must be made within 48 hours after the accident, illness, or death occurred.

C. A report about a death must include:

1. The youth's name, birth date, address, and telephone number.

2. If known, the names of the youth's parent(s) or guardian(s) and their address and telephone number if different from that of the youth.

3. Date of the fatality.

4. Brief description of the incident or illness leading to the death.

5. Names and addresses of witnesses or persons who were with the youth at the time of death.

6. Name and address of police department or authority to whom the report D. The shelter must immediately report in writing to the department any change in the status of the shelter that would affect care of youth.

E. The facility must immediately report in writing to the department any legal action brought against a shelter regarding any youth, staff, or conduct of the shelter at the time of initiation of such legal action 7.716 COLORADO SCHOOL READINESS QUALITY IMPROVEMENT PROGRAM [Repealed eff. 03/05/2026] 7.717 EARLY CHILDHOOD COUNCILS [Repealed eff. 03/05/2026] 7.718 (None) [Repealed eff. 03/05/2026] 7.719 RULES REGULATING SPECIAL ACTIVITIES [Rev. eff. 6/1/07]

These rules for Special Activities shall apply to School-Age Child Care Centers, Residential Child Care Facilities, and Children's Resident Camps. 7.719.1 GENERAL PROVISIONS [Rev. eff. 6/1/07]

A. There shall be a written program that reflects the purpose of the child care facility, including a list of activities at the child care facility. The written program must be provided to parents.

B. Parents shall be given the opportunity to indicate to child care facility staff whether they do not wish their child to participate in a special activity (see

Section 7.711.61, A. 10).

C. Each phase of the child care facility program shall be under the supervision of a resident qualified staff member who shall be responsible for health and safety precautions. Verification of experience and/or certification shall be in the staff members personnel files at the child care facility.

D. If the child care facility participates in special activities other than those for which rules are found in this section, such as ballooning or winter camping, the child care facility shall develop and follow a written plan which includes at least the 1. The qualifications of the supervisor of the activity.

2. The qualifications of any other staff members necessary for proper supervision of the activity.

3. The number of necessary staff members needed to supervise the activity.

4. Conditions under which a child may participate in the activity, such as age or skill level of the child.

5. Any special equipment necessary, its supply and condition.

6. Access to medical treatment.

7. Development of an emergency plan.

E. Paint ball activities where children shoot paint balls at other children are prohibited at a child care facility.

F. The staff member supervising special activities shall possess evidence of appropriate experience, training, and/or certification in the program specialty Said staff member shall be present at the site of the activity whenever the activity is being earned out unless other wise indicated in these rules.

G. The qualified supervising staff member of special activities shall have the following duties:

1. Direct training of other staff members working in the activity.

2. Assign duties to staff members.

3. Assure that all necessary equipment is complete, in good repair, and safe to use.

4. Assure that environmental hazards are not sever enough to cause danger to children.

H. Rules shall be reviewed with children at the beginning of each activity.

I. First Aid supplies shall be available at each special activity site.

J. The staff to child ratio for each type of facility must be followed according to rules for that facility regardless of activity unless the ratio is different for the specified activity, in which case the activity staff to child ratio should apply.

7.719.2 WATER ACTIVITIES 7.719.21 Swimming [Rev. eff. 6/1/07]

A. There shall be a swimming supervisor who, as a minimum, holds a current Red Cross life guard training certificate or equivalent, such as a YMCA or Boy Scout aquatics instructor's certificate. If the child care facility is offering swimming instruction, the swimming supervisor must also hold a Red Cross water safety instructor certificate or equivalent.

B. At any time the swimming area is open, there shall be at the swimming area a staff member who holds at least a current life guard training certificate or equivalent for each thirty campers in the water. There shall be present as least one staff member for each ten children in the water. The lifeguard does not count in the staff to child ratio for supervision of children.

C. The swimming area shall be off limits when appropriate numbers of qualified staff members are not present.

D. If the child care facility uses a pool for which the child care facility is not responsible, the child care facility need not provide a lifeguard if there is a qualified lifeguard provided by the pool. If the pool does not provide a qualified lifeguard, staff members meeting qualifications stated at Section 7.719.2, B. must be provided by the child care facility. There shall be at least one staff lookout counselor at the pool for each ten children in the water.

E. Swimming area rules and emergency procedures shall be posted in a visible location at the swimming area.

F. The swimming pool or swimming area shall meet the standards of the Colorado Department of Public Health and Environment.

G. If children are permitted to swim in a lake or pond, swimming areas shall be clearly designated H. Before children are permitted to swim in deep water, swimming skills must be tested by property trained staff members.

I. There shall be a system known to child and lookout staff for checking the children when children are in the water.

J. The following equipment must be available for use at the pool side or the take shore in which swimming is permitted:

1. A rescue tube;

2. Reach pole; and, 3. Backboard.

K. Where the size of the body of water makes it impossible to reach victims by reach pole, rescue tube or other rescue device, a rescue boat must be available at all times.

L. If a child care facility has shoreline activities such as wading, fishing, ecology or nature studies, the child care facility shall have a written policy which defines qualifications of persons accompanying the group and safety, factors to be followed. Staff members shall be acquainted with the policy.

M. In the case of a travel-trip camp, there shall be a minimum of one staff member who holds at least current Red Cross life guard training certificate or equivalent who is responsible for all swimming activities. 7.719.22 Boating, Canoeing, Sailing, and Kayaking on Flatwater [Rev. eff. 6/1/07]

A. The boating supervisor shall hold, at a minimum:

1. A current Red Cross life guard training certificate or equivalent; or, 2. Boy Scout certificate; or, 3. Basic small craft instructor, small craft safety, or paddle safety certificate for the type of craft which is to be supervised; or, 4. Documentation of experience indicating knowledge and skill in teaching and supervision specific to the watercraft activities to be conducted.

B. The boating supervisor, or staff member equally qualified who has been trained by the boating supervisor, must be on site during the activity.

C. Other staff members shall have appropriate experience and training for the type of craft to be utilized.

D. Whenever children are on the water they shall be wearing a United States Coast Guard approved personal notation device appropriate to the weight of the child.

E. There shall be a minimum of two lookout staff members at the shoreline and/or on the water at any time when children are on the water in boating, canoeing, kayaking or sailing activities. Hazards such as the size of the lake, the skill of the children, the conditions of the water, and the temperature of the water, shall be taken into account by the supervisor of the activity when determining the number and location of lookout staff necessary with the children, but there shall never be fewer staff with the children than those required at Section 7.711.23, D.

F. Except for kayaking, there shall be a staff member m any boat which holds one or more children under seven years old.

G. At no time shall the occupancy of the craft exceed the capacity established for the craft by the United States Coast Guard standards.

H. There shall be a warning device, such as a loud whistle, air horn, or other audible signal device, which can readily be heard by persons on the water that indicates the need for children and staff to return to the facility.

I. Where the size and depth of the Body of water indicates, there shall be a rescue boat in close proximity to where the activity takes place. This rescue boat shall be in good repair and shall contain appropriate equipment, such as a rescue tube, reach pole, extra oar, or paddle.

J. Water craft shall not enter a swimming area when swimmers are in the water. 7.719.23 Boating, Canoeing, Tubing, and Kayaking on Class I or II Moving Water [Rev. eff. 6/1/07]

A. The boating supervisor shall hold, at a minimum:

1. Current Red Cross life guard training certificate or equivalent; or, 2. Boy Scout certificate; or, 3. Basic small craft instructor certificate for the type of craft which is to be supervised; or, 4. Documentation of experience indicating knowledge and skill in teaching and supervision specific to the watercraft activities to be conducted.

B. The boating supervisor must be on site during the activity.

C. Children shall only canoe, tube, or kayak on Class II or less water.

D. Supervising staff must be experienced and knowledgeable about the river being used, including the height and speed of the river.

E. The child care facility must have a written policy on evaluating the safety of the river. Supervising staff must be trained on the policy.

F. Each child shall wear a Unites States Coast Guard approved personal flotation device whenever they are on the moving water.

G. The supervisor of this activity shall be trained in Red Cross standard First Aid and safety, and CPR.

H. The supervisor shall be familiar with rescue techniques with canoes, kayaks, and tubes on moving water and shall train children in these techniques.

I. Rescue equipment appropriate to the activity shall be available, such as rope throw bag and rescue tubes. 7.719.24 White Water Rafting on Class III and IV Rivers (Classes of rivers are those as defined by the International Scale of River Difficulty) [Rev. eff. 6/1/07]

A. If the child care facility operates white water rafting, the child care facility must be licensed by the Division of Parks and Outdoor Recreation as a river outfitter.

B. If a child care facility provides a white water rafting experience by purchase from a river outfitter, the license of the outfitter must be valid.

7.719.3 ARCHERY AND RIFLERY 7.719.31 Archery [Rev. eff. 6/1/07]

A. The archery supervisor shall have certification, documented training or experience from a recognized organization or certifying body for the type of activities offered.

B. The archery range shall be free from hazards and well-marked. There shall be a clear path to the target which is not obstructed by such things as rocks, trees or branches. Traffic, trail, or other camp activities shall not be placed in the direction of the flight of the arrows.

C. Equipment shall be maintained in safe condition. Bows and arrows shall be inspected for fractures, splinters or cracks before each use. Damaged bows and arrows shall not be utilized.

D. Equipment shall be stored under lock and key when not in use. Bows and arrows shall be used only in the specified archery area.

E. If the child care facility has field archery, a procedure shall be established and posted to provide for the safety of the archers, including issuance of arrows at check-in point of the archery trail, check in of archer at the beginning of the archery trail, and check out when archer has completed the trail.

F. The archery supervisor or a staff person trained and authorized by the archery supervisor must be present at all times when children are present at the archery range or field.

G. All archers shall use the same firing line. Arrows shall be issued only at the firing line.

H. Arrows shall be nocked to bow string after shooters are on the firing line and after the signal to shoot has been given.

I. Before arrows are released, shooters shall have a definite target.

J. Movement must be controlled by a supervising staff member. All persons must stay behind the firing line until the signal to retrieve arrows is given. All arrows shall be retrieved at the same time. 7.719.32 Riflery [Rev. eff. 6/1/07]

A. The riflery supervisor shall hold a National Rifle Association instructor's or assistance instructor's certification in rifle shooting or equivalent certification from a national organization or shall have verified experience equivalent to that necessary to obtain the National Rifle Association Fire Arm certification.

B. If the riflery supervisor is not present at the rifle range whenever children are firing guns, the staff person(s) trained by the riflery supervisor must be present at all times when children are present.

C. The rifle range shall be free from all hazards, away from other activities and traffic of any type; shall be well marked with danger signs or flags; all blind approaches shall be fenced or blocked off.

D. The range shall be constructed with an appropriately designed bullet-stop so that all bullets will be stopped behind the targets. The bullet-stop shall be free of trees, rocks, boulders, or other objects which may cause a bullet to ricochet away from the bullet-stop.

E. There shall be a well-defined firing line which shall be level with the targets and elevated off the ground. A minimum space of five feet between firing points shall be established or firing points separated by a permanent divider. Targets must be designed to minimize potential for ricochet. Targets cannot depict human form.

F. Only the following types of guns shall be permitted:

1. .22 caliber rimfire, single-shot, bolt-action rifles having no trigger modification other than the factory setting.

2. Pneumatic spring-type and CO air guns may be either .22 caliber or .177 (BB size).

G. Proper condition of the firearms shall be maintained by inspection before and after usage, cleaning as necessary. Firearms that do not function properly shall be repaired and tested before usage.

H. Instruction on the use of firearms shall be presented to the children prior to the use of the rifle range.

I. No more than five cartridges at a time shall be distributed to a child by the responsible supervising staff member and issued only at the firing line.

J. Firing shall be permitted at the firing line only. Observers shall remain behind firing line.

K. Actions of uncased firearms shall be kept open except when on firing line ready to fire.

L. All firearms shall be unloaded immediately upon the command “cease firing” regardless of when this command is given. Actions shall remain open until further commands are given.

M. On ranges where shooters must go down range to change targets and score: movement must be controlled by the supervising staff member.

N. All spent or unspent cartridges must be returned to the supervising staff member. 7.719.4 HORSEBACK RIDING [Rev. eff. 6/1/07]

A. The horseback riding supervisor shall have completed at least one of the 1. Certificate from nationally recognized organization or riding school.

2. Written verification of successful experience in formal horseback riding instruction.

B. The horseback riding supervisor shall train a sufficient number of child care facility riding staff members in the supervision of children in the horseback riding program for the anticipated size of the riding program.

C. Child care facility riding staff shall be trained by the horseback riding supervisor in emergency procedures appropriate to the horseback riding activity.

D. At least two trained riding child care facility staff members, one of whom holds a current American Red Cross standard First Aid and safety certificate or equivalent, shall accompany each trail excursion. If the horseback ride is more than one hour from emergency medical services, at least one staff member shall be trained in wilderness first aid training. If the horseback ride is for seven or more nights and is more than one hour away from emergency medical services, there must be at least one staff member with each group of children with wilderness first responder training, CPR, and medication administration training.

If more than twenty children participate in the trail excursion, there shall be a trained riding child care facility staff member assigned for each additional ten or fewer riders.

E. First Aid supplies shall be carried on each trail excursion and available at each horseback riding ring/arena.

F. No person is allowed in the riding area unless the horseback riding supervisor or a trained riding child care facility staff member is present.

G. The riding supervisor shall determine the child's riding experience and level of skill and must take these into account in assigning which horse each child should ride and determining the type of riding activity in which each child should engage.

Children shall be given instruction in basic safety, which shall include at least the following: riding rules in the ring and on the trail, how to approach, mount and dismount.

H. Children shall be appropriately dressed for riding, which shall include shoes or boots and long pants. The riding supervisor must evaluate the footgear of each child and make the stirrups safe for each child's shoe or boot.

I. Protective head gear/helmets are mandatory for children ring riding and on trail rides.

J. Parents must be notified in advance of what type of protective gear is used by the child care facility. If children bring helmets from home, they must be specifically designed for equestrian use, worn correctly, and in good condition.

K. The horseback riding equipment shall be in good condition, properly sized and adjusted for each rider.

L. The horse bam or stable, ring, and commonly used trail(s) shall be in good repair and free of dangerous obstructions.

M. Horses shall be cared for with evidence of an adequate feeding schedule and a means to care for sick horses.

N. Horses shall not be permitted in the other designated activity areas. 7.719.5 TRAMPOLINE [Rev. eff. 6/1/07]

A. The trampoline supervisor shall have documented formal training and experience in use of trampoline and knowledge of safety and spotting techniques.

B. Trampolines shall be equipped with pads along the sides and shall be kept in good repair.

C. No person shall be on the trampoline unless a trampoline supervisor is present and spotters are present on all four sides of the trampoline.

D. Trampolines shall be secured from unauthorized use by any person.

E. The child shall dismount the trampoline by sitting on the edge and sliding off. No child shall jump off the trampoline.

F. Spotters shall be posted on four sides of each trampoline at all times. Spotters shall not stand, sit, or lie on trampoline, but shall stand in a position of readiness, watching the jumper at all times.

7.719.6 CLIMBING ACTIVITIES 7.719.61 Rock Climbing and Ropes Courses [Rev. eff. 6/1/07]

A. When a child care facility offers basic/single-pitch rock climbing or advanced/multi-pitched climbing, which includes such topics as the care and use of basic equipment, knots, anchors and belays, verbal signals, safely measures, basic climbing holds and moves, and techniques of rappelling, the following rules must be complied with:

1. The climbing supervisor shall:

a. Be at least 18 years old;

b. Have certification or documented experience in knots, anchors, safety zones, verbal signals, belaying, rappelling, and safe tie-ins, or training or experience from a recognized organization, such as the Association for Challenge Course Technology or certifying body for the type of activities offered; and, c. Have at least six weeks' experience in a management or supervisory capacity in similar types of programs.

2. A climbing instructor shall have verified knowledge of technical climbing by completion of a course or climbing school, or a minimum of ten hours of instruction.

3. At least two climbing instructors must be present at the climbing site at all times.

4. There shall be one climbing instructor for each six (6) climbers or two climbing instructors for thirteen (13) children.

5. There shall be a staff member who holds at least a current Red Cross standard First Aid and safety certificate or equivalent at the rock climbing site.

6. First Aid supplies, put together by a person knowledgeable in First Aid supplies needed for climbing activities and possible injuries, shall be present at the climbing site.

7. No child shall be forced to participate in this activity.

8. The climbing supervisor shall be responsible for the proper maintenance of all equipment used. Equipment shall be checked by the supervisor immediately prior to use.

9. All rock climbing equipment shall meet industry standards and shall be maintained, visually and physically inspected, and replaced on a timely 10. Climbers must wear helmets at all times when in designated helmet zones.

11. The child care facility shall not permit an unsupervised climb.

12. The climbing supervisor must have knowledge of where the climb is to occur and must give approval on the day of the climb for the climb to occur.

13. Each rock climber must be visually supervised.

14. Children waiting to climb must be supervised by a staff member.

15. All climbers and rappellers shall be belayed in a top rope manner by a belayer that has been instructed in proper procedures, and directly supervised until competency has been demonstrated.

B. If the child care facility offers advanced/multi-pitched climbing, the following rules shall also be complied with:

1. The climbing supervisor accompanying participants shall:

a. Hold a current Red Cross standard First Aid and safety certificate or equivalent, and a current certificate for cardiopulmonary resuscitation;

b. Have been an instructor, under supervision, for two seasons with verifiable experience and a review of any serious accidents;

c. Have completed a technical climbing school or training in technical climbing with evidence by letter of such completion;

d. Have led ten additional multi-pitched Class V climbs (the classification of the climbs as defined by the American Alpine Club) within the last two years; and, e. Have knowledge of mountain rescue techniques. If the climb is more than sixty (60) minutes from emergency medical services, the climbing supervisor must hold a current wilderness First Aid training certificate or equivalent.

2. The climbing instructor or the rope leader shall have:

a. The same training as the climbing supervisor;

b. Have been an instructor, under supervision, for one season with verifiable experience and a review of any serious accidents;

c. Completed a technical climbing school or training in technical climbing;

d. Led five additional multi- pitched climbs; and, e. Knowledge of mountain rescue techniques. No instructor shall take campers on a climb he/she has not completed previously.

3. No child will be the rope leader.

4. A child who is permitted to participate in the climb must be at least thirteen (13) years old. The climbing supervisor shall assess the ability of the child as to the difficulty of the climb.

5. The climbing instructor and climbing site must be approved by the climbing supervisor for each climb.

6. The climbing supervisor, an equally qualified person, or two (2) equally qualified rope leaders shall be present at the climb site.

7. There shall be one rope leader that is at least eighteen (18) years of age to each three climbers in an extended climb.

8. First Aid equipment must be carried with the staff on each climb.

C. If the child care facility offers high and/or low ropes courses or a climbing wall, the following rules must be complied with at all times:

1. The rope supervisor must have training and experience on the type of rope course or climbing wall being used and must hold a current standard First Aid and safety certificate or, if the ropes course or climbing wall is more than sixty (60) minutes from definitive care, must hold a wilderness First Aid card.

2. The rope instructor must have training and experience on the type of rope course or climbing wall being used and must be supervised by the rope supervisor and must hold a current standard First Aid and safety certificate or, if the ropes course or climbing wall is more than sixty (60) minutes from definitive care, must hold a wilderness First Aid card.

3. Ropes courses must have written evidence of annual inspection by qualified Association of Challenge Course Technology (ACCT) personnel of course elements for integrity of all hardware, materials, and equipment.

4. Ropes courses must be inspected regularly before use by the rope supervisor or the rope instructor.

5. All equipment and elements of a rope course or climbing wall must be safety checked prior to each use and have written records of regular inspection and maintenance of all equipment and elements utilized.

6. Children must wear safety equipment appropriate to the size of the child and appropriate helmets when using the high ropes course or climbing wall.

7. At all times, there must be a rope supervisor or rope instructor on the ropes course with children.

8. Ropes courses and climbing walls must be off limits to children when a rope supervisor or rope instructor is not present.

9. Access to ropes courses and climbing walls must be controlled by education, signs, and whatever other means are necessary to control unsupervised access.

10. The child care facility must have written safety procedures for use of the ropes course(s) and climbing wall. Staff must be trained on the safety procedures.

7.719.7 HIKING, BACKPACKING, AND CAMPING 7.719.71 Hiking [Rev. eff. 6/1/07]

If the child care facility offers hiking activities, the following rules shall be complied with:

A. The hiking supervisor must hold a current Red Cross standard First Aid and safety certificate or equivalent; shall have knowledge of outdoor experience and the symptoms and correct treatment procedures for hypothermia and dehydration; and, shall have verifiable experience in hiking and backpacking at the elevation where the hike is to take place.

B. The staff members involved in hiking shall be trained by the supervisor and shall continually observe and monitor campers on the trail for early diagnosis and treatment of injury or illness.

C. When a group takes a hike within 60 minutes of definitive medical care, there must be at least one staff member currently qualified with Red Cross standard First Aid and safety training certificate or equivalent, current CPR certificate, and current training in the Department required and approved medication administration training.

D. When a group takes a hiking or backpacking trip where children are either more than 60 minutes away from definitive medical care, there must be at least one staff member with each group of children with current wilderness First Aid training, or equivalent, current CPR training, and current medication administration training.

E. At least two (2) staff members must accompany a group in hikes. From time to time, hiking groups may divide up as long as hikers are always with one staff member and staff members are in visual, verbal or electronic (radio or wireless communication) contact with each other.

F. In selecting the area for hiking, the hiking supervisor shall consider the hiker's age, physical condition and experience, as well as the season, weather trends, methods of evacuation, and communication.

G. Before participation, children must be instructed on:

1. The fundamental safety procedures to follow on the trail;

2. Procedures to follow if lost;

3. Proper health and sanitation procedures on the trail;

4. Rules governing land to be hiked;

5. Potential high-risk areas; and, 6. Fire precautions.

H. Each hiker shall be equipped with protective clothing against natural elements such as ram, snow, wind, cold, sun, and insects.

I. First Aid supplies, put together by a person knowledgeable in First Aid supplies needed for possible accidents and/or injuries, shall be present on each hike. The contents of each kit shall be adequate for the number of children, the terrain, and the length of the hike.

J. An itinerary of the hiking trip and a list of all people on the hike must be kept at the child care facility.

K. The child care facility must have written safety procedures for hiking, including the written protocol for evacuating a child that becomes sick or injured on a hike.

Staff and children must be trained on the safety procedures and protocol. 7.719.72 Backpacking and Camping [Rev. eff. 6/1/07]

A. The backpacking and camping supervisor shall have knowledge and verifiable experience in camping and/or backpacking at the elevation where the backpacking or camping will take place.

B. When a group is backpacking or camping within sixty (60) minutes of definitive medical care, there must be at least one staff member currently qualified with Red Cross standard First Aid training certificate or equivalent, current CPR training, and current training in the Department required and approved medication administration training.

C. When a group is backpacking or camping where children are more than sixty (60) minutes away from definitive medical care, there must be at least one staff member with each group of children with current wilderness First Aid training or equivalent, current CPR training, and current medication administration training.

D. If a child will require medication administration while away from the child care facility while backpacking or camping, there must be at least one staff member present with current medication administration training who has been delegated by a registered nurse to administer medication.

E. The staff members involved in backpacking or camping shall be trained by the supervisor and shall continually observe and monitor children on the trail for early diagnosis and treatment of injuries or illness.

F. The backpacking or camping supervisor shall consider the hiker's age, physical condition, and experience, as well as the season, weather trends, methods of evacuation and communication, and water quality and quantity in selecting the area for backpacking or camping.

G. Children shall have a safety orientation and be instructed on the applicable precautions, such as:

1. The fundamental safety procedures to follow on the trail;

2. Procedures for a hiker if he/she becomes lost;

3. Proper health procedures, including the need for drinking fluids and eating appropriate foods;

4. Sanitation procedures;

5. Relevant rules and regulations;

6. Potential high-risk areas which may be found on the trail;

7. Fire danger precautions; flash floods; lightening dangers; and, 8. Procedures when encountering wild animals.

H. Children shall be oriented to minimum impact guidelines and techniques.

I. Each child shall be equipped with protective clothing and equipment against anticipated natural elements such as rain, snow, wind, cold, sun, and insects.

J. Appropriate first aid supplies shall be present on each trip. The contents of each kit shall be adequate for the number of children, the terrain, and the length of the trip.

K. An itinerary of the trip with a list of participants must be available to parents, staff, local police jurisdictions and staff or contractors of the Colorado Department of Human Services.

L. The child care facility must have written safety procedures for backpacking or camping, including the written protocol for evacuating a child that becomes sick or injured. 7.719.8 BIKING [Rev. eff. 6/1/07]

If a child care facility has bicycling trips either on a public road or on mountain trails, the following rules shall be complied with:

A. The bicycling supervisor must be familiar with state laws about bicycling; be knowledgeable about the type of bicycling terrain where the bicycle trips will occur be knowledgeable about bicycling in the mountains, if applicable: shall know how to make simple bicycle repairs; and, shall hold at lest a current Red Cross standard First Aid and safety certificate or equivalent.

B. At least two (2) staff members must accompany a group while biking. From time to time, biking groups may divide up as long as bikers are always with one staff member and staff members are in visual, verbal or electronic (radio or wireless communication) contact with each other. A bicycling supervisor or staff member equally qualified and another qualified staff member must accompany each bicycle trip. Correct staff to child ratios must be complied with at all times. There must be one staff member at the beginning and end of each bicycle group.

C. Each bicycler shall wear head protection and the bicycle shall be equipped with brakes in good condition. Bicycles shall be in good condition, properly maintained, inspected prior to each bicycling trip, and adjusted to the size of the child riding the bicycle. Children using their own bicycles will be informed in advance, in writing, that their bicycles must be in good condition, properly maintained, inspected prior to each bicycling trip, and adjusted to the size of the child riding the bicycle.

D. An appropriate bicycle repair kit and First Aid equipment must be taken on each trip. The First Aid supplies must be put together by a person knowledgeable in First Aid supplies needed for bike trips and possible accidents and/or injuries.

E. The bicycling supervisor must instruct children as to emergency procedures, safe riding practices, and road and trail etiquette.

F. The bicycling supervisor shall evaluate each child as to his/her physical capability to participate in the planned bicycling trip, keeping in mind the trip length, terrain, altitude of the trip, and weather conditions.

G. Water/fluids must be taken on each bicycle trip.

H. An itinerary of the biking trip and a list of all people on the biking trip must be kept at the child care facility.

I. The child care facility must have written safety procedures of bike trips, including the written protocol for evacuating a child that becomes sick or injured on a bike trip. Staff and children must be trained on the safety procedures and protocol.

7.720 RULES REGULATING NEIGHBORHOOD YOUTH ORGANIZATIONS [Repealed eff. 03/05/2026] 7.721 RULES REGULATING HOST FAMILY HOMES [Eff. 9/15/12]

Child Placement Agencies and county departments are authorized to certify Host Family Homes. These rules apply to those child placement agencies and county departments that choose to certify Host Family Homes. 7.721.1 DEFINITIONS [Eff. 9/15/12]

“Homeless youth” is defined in the General Rules at Section 7.701.21.

“Licensed Host Family Home” is defined in the General Rules at Section 7.701.21.

“Host home parent” is the responsible adult in the host family home that is participating in the host family home. 7.721.2 GENERAL REQUIREMENTS [Eff. 9/15/12]

A. The certifying child placement agency or county shall be able to assure the health and safety and the proper care and treatment of the youth in the host B. The host family home must be located in an area that is accessible to health resources, public and private utilities, adequate and safe water supplies, sewage C. The child placement agency or county shall have written screening procedures and make reasonable efforts to evaluate the overall emotional health and stability of each host family home applicant and/or staff member. Procedures shall include exploring for any history of youth battering, youth abuse, youth molestation, youth neglect, or previous criminal convictions.

D. The child placement agency or county shall determine policies, procedures and case management structure that clearly defines duties and responsibilities for host home parents.

E. The child placement agency or county shall develop an adequate emergency preparedness and management plan for host home parents.

F. The child placement agency or county shall have on file the verification of tuberculin status of host home parents and other residents of the home. If the host family home residents have certificates of previous negative testing, the testing does not need to be repeated. If there is no certificate, the testing needs to be completed prior to host family home certification and annually thereafter.

G. The child placement agency or county shall ensure that all staff, certified host family homes and program partners demonstrate an interest, receive training and have knowledge of positive youth development, homelessness and a concern for the proper care and well being of youth. 7.721.21 Management Requirements 7.721.211 Certifying Child Placement Agency or County [Eff. 9/15/12]

A. The child placement agency or county is the individual, partnership, corporation or association in whom the ultimate authority and legal responsibility is vested for the conduct of the host family home.

B. When the child placement agency or county does not include a board of directors, there shall be an advisory committee of at least two other individuals who act in an advisory capacity to the governing body. The names of the advisory committee members shall be disclosed to the Department. The advisory committee shall meet at regularly stated intervals.

C. Minutes of the advisory committee or the board of directors shall be maintained.

The minutes shall be available to the Department upon request, except that the minutes containing confidential personnel information need not be shared with D. The functions of the child placement agency or county shall include:

1. The appointment of an administrator who shall be responsible to establish and implement, according to performance criteria, to the governing body, and shall delegate to him/her the executive authority and responsibility for the administration of Host family home certification according to its defined

purpose.

2. The certification of all host family homes.

3. The formulation and regularly planned review of policies and procedures to be followed by the host family homes.

4. As necessary, establish formal agreements with local agencies participating in the host family home. If a local agency delegates responsibility for any responsibility established by the host family home, the child placement agency or county must certify and document that the local agency meets requirements established in rule.

5. Sixty-day notice must be given to State Department of any changes to formal agreements established by child placement agency or county.

6. The provision of necessary emergency services and temporary shelter using host family homes; adequate financing; qualified personnel and host family home provider; and services and program functions for the welfare and safety of youth in accordance with these standards. 7.721.212 Fiscal Management [Eff. 9/15/12]

The child placement agency or county shall demonstrate that it is financially sound and manages its financial affairs prudently. All funds disbursed by the child placement agency or county shall be expended in accordance with the program objectives as specified by the governing body. 7.721.213 Insurance [Eff. 9/15/12]

A. The child placement agency or county certifying the host family home shall determine policy and procedures on liability insurance that includes the host family home supervised by the agency.

B. The host family home shall maintain adequate insurance and submit annually the amount of the insurance and the name and the address of the insurance agency providing the insurance for the host family home.

C. Information about the insurance should be maintained at the child placement agency or county.

D. Agencies and host family homes participating in the host family home operating their own transportation vehicles shall carry insurance in compliance with the minimum limits as required by the Colorado Revised Statutes.

E. The child placement agency or county shall establish procedures to review and establish annually that all agencies and host family homes participating in the host family home meet program insurance requirements.

7.721.22 HUMAN RESOURCES 7.721.221 ADMINISTRATIVE STAFF [Eff. 9/15/12]

A. Administrator of the child placement agency or county shall be qualified as 1. The administrator shall have received a Bachelor's degree from an accredited college or university and have two years of verified experience in the human services field, two of which were in a supervisory or administrative position; or the administrator shall have received a Master's degree and have two years of verified experience in the human services field, one of which was in a supervisory or administrative position.

2. The administrator shall assume the following duties:

a. Overall direction and responsibility for the youth, program, host family home, and fiscal management.

b. Overall direction and responsibility of supervision of adequate staff.

c. The selection, roles, responsibilities and training of a capable staff member who can assume responsibility for management of host family homes in the administrator's absence.

d. The establishment of relationships, protocols, agreements and contact maintenance with allied agencies, services, and resources within the community.

B. Case Manager The child placement agency or county shall specifically designate a staff member, age twenty-one (21) or over, capable of acting as a substitute for the administrator during his/her absence. The duties and responsibilities of the substitute administrator shall be clearly defined in order to avoid confusion and conflict among other staff, provider within host family home and youth.

C. Administrative Coverage 1. The Department shall be notified in writing when a possible change in administrator is anticipated or at the time there is a change in administrator. Documents verifying the qualifications of the acting/interim or new administrator, including official transcripts and documents verifying work experience, shall be submitted to the Department.

2. The administrator or the staff member to whom the administrator has 7.721.222 Case Management Staff and Other Professional Staff [Eff. 9/15/12]

A. Case management shall be provided by the child placement agency or county.

1. A qualified professional having a Bachelor’s degree in social work, psychology, or child development from an accredited college or university shall supervise the host family home. This professional shall have two years of treatment-oriented experience; or, 2. A case manager who meets the requirements of the child placement agency or county.

B. The case management staff shall be responsible for providing case management services as stated at Section 7.715.42, B. 7.721.23 Capacity [Eff. 9/15/12]

A. When a certified home participating in the host family home only provides temporary emergency shelter for youth, the home may be certified for up to four (4) youth including siblings groups.

B. Child placement agency or county shall instruct homes participating in the host family home in requirements in accommodations and required supervision placement of both male and female youth.

7.721.3 HOST FAMILY HOME CHARACTER, SUITABILITY, AND

QUALIFICATIONS [Eff. 7/1/14]

A. A certificate shall be denied in accordance with Section 7.710.34, D and E.

B. A certificate may be denied or revoked if the host family home’s own children have been placed in foster care or a residential treatment facility under circumstances which demonstrated that the provider(s) in host family home or another resident of the home was abusive, neglectful, or a danger to the health, safety, or well-being of children within the home.

C. The providers in host family home shall be able to provide for a homeless youth’s physical, mental and character development.

D. Applicants shall demonstrate stability in family relationships within the host family E. The licensing or certifying authority must receive at least three written statements which describe the applicant's character, interpersonal relations, and ability to provide care for youth from references provided by the applicant, at least two from a source/person who are not related to the applicant and who have known the applicant one year or longer (references need not be residents of Colorado).

Licensing or certifying representatives may contact others who may have knowledge or information regarding the applicant's character or suitability.

F. The host family home provider shall possess basic knowledge of childcare, positive youth development, runaway and homeless youth issues, and good nutrition, and shall cooperate with the licensing or certifying agency in programs designed to increase such knowledge.

G. Providers in a host family home shall protect youth receiving shelter in the home from exposure to second hand smoke.

1. Smoking is prohibited inside the host family home at all times when homeless youth are present.

2. Smoking is prohibited in motor vehicles used by providers in host family homes or case managers when a youth is present.

H. The financial resources of a host family home shall be adequate to assure that the home where the shelter is provided is maintained in safe repair and in conformity with standards and that the requirements of these regulations can be fulfilled.

I. Each host family home provider shall have a health assessment within one year prior to certification or within thirty (30) calendar days after certification and thereafter as required, in writing, by a licensed health care professional. The reports of the medical examinations shall be dated and signed by the examining physician or nurse practitioner and shall be provided to the certifying authority.

Reports shall include a statement of the evaluation of the person's physical ability to care for youth.

J. If, in the opinion of the licensed health care professional or the assessment worker, an emotional or psychological condition exists which would have a negative impact on the care of youth, the certification of a host family home shall be conditioned upon the satisfactory report of a licensed mental health practitioner.

K. Other children of the providers of the host family home and any other persons not placed by the agency and living in the host family home shall obtain a medical statement from a licensed health care professional verifying that each such person suffers from no illness or communicable disease which would adversely affect youth receiving shelter in the host family home. This statement shall be obtained annually or as required in writing by an approved health care professional. A licensed health care professional is defined as a physician, nurse practitioner, or a physician's assistant. This statement shall have been signed within the twelve-month period preceding the certificate granted to the home. 7.721.31 Medical and Health [Eff. 9/15/12]

A. The child placement agency or county shall provide referrals to local health care providers for any youth requiring medical attention while participating in a host B. Child placement agency or county of the host family home will determine policies for storage and distribution of medications. 7.721.32 Personnel Policy, Orientation, and Training [Eff. 9/15/12]

A. The child placement agency or county shall have a comprehensive written plan for the recruitment, hiring or certification, orientation, ongoing training, and professional development of providers in a host family home.

B. The child placement agency or county shall have an introductory training and orientation program for all providers in a host family home. This program shall include orientation to emergency and safety procedures and the general and specific duties and responsibilities of staff/case managers and host family home providers.

C. The child placement agency or county shall maintain written documentation of specific in-service training held, staff/providers participating, the hours involved, and/or other on-going training activities in which staff /providers were involved.

D. The child placement agency or county shall document that all staff and providers in the host family home receive appropriate training in the following areas:

1. The child placement agency or county’s administrative procedures and overall program goals.

2. The emergency and safety procedures, including but not limited to fire evacuation drills, tornado drills, where appropriate, and flood evacuation drills, where appropriate, on at least a semiannual basis.

3. Universal precautions regarding safe work practices to prevent exposure to blood and bodily fluids.

4. CPR and basic First Aid.

5. The principles of positive youth development and practices of working with 6. Acceptable behavior management techniques, including appropriate discipline in accordance with host family home policies and these rules.

7. Appropriate boundaries (both physical and emotional) between case workers, the host home parent, and/or the youth while the youth is in the host family home and after the youth leaves the host family home.

8. Positive and constructive methods of dealing with the youth including, but not limited to, physical structuring of the environment and de-escalation of crisis situations.

9. Hazardous materials.

10. Storage and distribution of medications.

11. Mandated reporting.

7.721.4 PROGRAM 7.721.41 Program Description [Eff. 9/15/12]

A. The child placement agency or county shall have a written overall program description for the host family home.

B. The written description shall address at least the following areas:

1. Provision of case management;

2. Referral to emergency medical and/or dental services;

3. Referral to education/vocational services;

4. Housing, food, and clothing resources;

5. Referral to medical, dental and substance abuse services;

6. Recreation opportunities;

7. Youth rights;

8. Requirements of the host family home provider.

C. Child placement agency or county will develop and provide services using a positive youth development approach that ensures a young person a sense of:

1. Safety and structure;

2. Belonging and membership;

3. Self-worth and social contribution;

4. Independence and control over one’s life; and closeness in interpersonal relationships. 7.721.42 Case Management Services [Eff. 9/15/12]

A. The child placement agency or county shall be assigned the responsibility for case management for each youth.

B. Each individual assigned the responsibility of providing case management services for a youth shall:

1. Participate actively with the youth, family, host family home provider, and other supports to create a service and transition plan and to address the provision of resources and/or identified services.

2. Assure that appropriate information concerning the youth and her/his background is shared with other staff members and providers in host family home who deal with the youth regularly and to maintain communication with youth’s parents, guardians, if available, and with the individual or agency responsible for discharge planning and follow-up care of the youth, if applicable.

3. Assure that the plan developed for each youth is implemented, and documented in the youth's file. 7.721.43 Admission Policy and Procedures A. Admission of a runaway/homeless youth to a host family home shall be in keeping with the stated purpose of the program.

B. Notification and contacts:

1. Pursuant to Section 26-5.7-105(4), C.R.S., when a youth under fifteen years of age is admitted to a licensed host family home, the director of the facility, shelter, or other person in charge shall notify the county department of the county of residence of the parents of the youth within seventy-two (72) hours of the youth's admission.

2. Pursuant to Section 26-5.7-105(5), C.R.S., if the facility determines that a referral for additional services needs to be made, it shall make the referral to THE APPROPRIATE county department of human/social services, notify the county department of the facility's relationship to the youth pursuant to section 19-1-307 (2)(e.5)(I), and notify the county department of the date when the twenty-one-day shelter time period will expire.

3. Pursuant to Section 26-5.7-105(7), C.R.S., if a youth who is at least eleven (11) years of age but less than fifteen (15) years of age has been served up to twenty-one (21) days and returns again to the licensed host family home after leaving the host family home, the child placement agency or county certifying the host family home shall make a referral for services to the county of residence of the parents of the youth.

C. Child placement agency or county shall place youth in host family homes where the provider of the host family home is qualified and taking into account the needs of children already in residence to provide the care necessary. Care must be provided in the least restrictive, most appropriate setting in order to meet the youth’s needs.

D. Each host family home and its certifying authority shall have a written admission policy that at a minimum must include:

1. The policies and procedures related to intake.

2. The age range and sex of youth accepted/admitted for care.

3. The needs, problems, situations or patterns best addressed by the host E. Any pre-placement requirements for the youth, the parent(s) or guardian, and/or the placing agency.

F. The anticipated problems or situations that would result in the host family home or certifying authority requesting removal of a youth from the host family home.

G. The written description of admission policies and criteria shall be provided to referring agencies.

H. The child placement agency or county shall accept a youth into temporary/emergency shelter only after a preliminary intake assessment and screening of immediate needs. Further assessments of areas such as social, physical health, mental health shall be conducted within three days of admission.

I. Pursuant to Section 26-5.7-106(2), C.R.S., upon admission of a youth to a host family home, the child placement agency or county shall:

1. Notify the youth's parent(s) or county department of human/social services of the youth's whereabouts, physical and emotional condition, and the circumstances surrounding the youth's placement within 24 hours;

2. Notify the youth's parent that it is the paramount concern of the facility or shelter to achieve reconciliation between the parent and the youth, to reunify the family, and to inform the parent about the alternatives that are available;

3. Arrange transportation for the youth to the residence of the youth's parent when the youth and the parent agree that the youth shall return to the home of the youth's parent. The parent shall reimburse the party who paid for the transportation costs to the extent of the parent's ability.

4. Arrange transportation for the youth to an alternative residential placement facility when the youth and the youth's parent agree to such placement.

The parent shall reimburse the appropriate person for transportation costs to the extent of the parent's ability.

J. Within 24 hours of admission the child placement agency or county is responsible to contact parent(s)/legal guardians(S) of youth under the age of eighteen and document their permission to serve or attempts made to contact parents/legal guardians. If notifying the parent(s) or legal guardian(s) would not be in the youth's best interest due to an imminent risk of abuse or neglect by the parent(s) or legal guardian(s), the shelter shall notify the appropriate county department of human/social services instead of the parent(s)/legal guardian(s).

K. Within 24 hours of arrival at the host family home, a youth shall be given an orientation to the host family home, consistent with the youth’s age and ability to participate, which includes at least the following:

1. Tour of the host family home and instruction on fire alarm and fire evacuation procedures, escape routes and exits.

2. The rules of the host family home.

3. Procedures affecting the youth's behavior, including limiting or restricting a youth's rights where allowed, the type of discipline used in the host family home, and consequences for certain behaviors.

4. The complete youth’s rights and youth’s grievance procedures as developed by the host family home or by the certifying authority.

L. If reconciliation with the family and voluntary return of the youth has not been achieved within 48 hours following admission to the host family home, excluding Saturdays, Sundays and legal holidays, and the child placement agency or county department does not anticipate reconciliation occurring within twenty-one (21) consecutive days, the child placement agency or county shall provide the youth and the youth’s parent with a written statement identifying:

1. The availability of counseling services;

2. The availability of longer term residential arrangements; and, 3. The possibility of referral to the county department.

M. The case plan shall be developed with the involvement of the youth, the parent(s) or guardian(s) of the youth, the representative of the child placement agency or county, and when possible, the host family home provider. Where the involvement of any of these is not feasible or desirable, the certifying authority shall record the reasons for the exclusion. The case plan shall include by reference or attachment at a minimum the following:

1. Discussion of the youth’s and the parent's or guardian's expectations regarding: family contact and involvement; how family contact and involvement are to occur; the nature and goals of care, including any specialized services or specialized treatment to be provided; the religious orientation and practices of the host family home; and, the anticipated planned discharge date and plan for the youth following discharge.

2. Written authorization for care and treatment of the youth.

N. A youth who has reached the age of 15 or older may consent to shelter and services for a period not to exceed 21 days when the following criteria are met:

1. The youth shall voluntarily, knowingly, and willingly sign a consent form that includes:

A. All services the youth may receive during their stay at the shelter and the total number of days the youth may consent to stay in the host home.

B. Legal limits to confidentiality.

C. How and when parent(s), legal guardian(s), and/or child welfare agencies will be notified of the youth’s stay.

D. An explanation that services provided by the shelter are provided free of charge to the youth without exchange of any goods, services, or sexual acts.

2. The consent form shall be explained in the child's dominant language or mode of communication, including augmented or facilitated communication, if necessary, and shall take into consideration the child's age, disability, and cultural and religious background.

3. The consent form shall be signed within 12 hours of admission.

O. Documentation of all required notifications and consents shall be kept in the youth’s file.

7.721.5 YOUTH RIGHTS 7.721.51 Youth Rights A. The child placement agency or county shall have written policies and procedures that address and ensure the availability of each of the following core rights for youth in host family home. These rights may not be restricted or denied by the host family home.

1. Every youth has the right to enjoy freedom of thought, conscience, cultural and ethnic practice, and religion.

2. Every youth has the right to receive adequate and appropriate food, clothing, and housing.

3. Every youth has the right to live in clean, safe surroundings.

4. Every youth has the right to participate in an educational program that will maximize his/her potential in accordance with existing law.

B. Every youth has the right to communicate with others outside the host family home, such as a parent or guardian, caseworker, attorney or guardian ad litem and/ or counsel for youth, current therapist, physician, religious advisor, and, if appropriate, probation officer.

C. Written policies that restrict or limit a youth's rights as listed at Section 7.721.5 must include at a minimum the requirement that the host family home notify the youth at the time of admission of any policy that would limit or restrict a youth’s rights. The notification must be communicated in a language or mode of communication the youth can understand and, if possible, be signed by the D. If the host family home enforces any restrictions upon the youth's rights as listed at Section 7.721.5, the host family home must, in compliance with the written policy and procedure of the host family home:

1. Inform the youth in a language or mode of communication the youth can understand, of the conditions of and reasons for restriction or termination of his/her rights.

2. Place a written report summarizing the conditions of and reasons for restriction, denial, or termination of the youth's rights in that youth's case record along with information about if or when the youth’s right(s) can be restored. This Information must be made available to the youth upon 3. When a restriction of a youth's rights affects another youth in the host family home, the youth shall be informed, in a language or mode of communication the individual can understand, of the conditions of and reasons for the action. 7.721.51 Youth’s Grievance Procedure [Eff. 9/15/12]

A. The child placement agency or county of the host family home must establish a written grievance procedure that provides adequate due process safeguards, spells out the appeal process, and assures that youth and parent(s) or guardian(s) are entitled to report any grievance and shall not be subject to any adverse action as a result of filing the grievance.

1. The host family home must follow grievance procedures without alteration, interference, or unreasonable delay.

2. If a grievance is filed with the host family home, the grievance shall be recorded in the youth's record along with the investigation findings and resulting action taken by the child placement agency or county.

B. A list of the youth’s rights and the grievance procedures must be provided and explained to the youth and the parent or guardian in a language or manner of 7.721.6 DISCIPLINE [Eff. 9/15/12]

A. The child placement agency or county shall have written policies and procedures regarding discipline that include:

1. Discipline shall be constructive or educational in nature.

2. Procedures for diversion or separation from the problem situation.

3. Procedures for withholding privileges.

4. Positive responses to youth’s appropriate behavior.

B. Policies and procedures must be explained to all youth, parent(s), guardian(s), staff, host family home provider and placing agencies. Basic rights shall not be denied as a disciplinary measure.

C. Youth in care at the host family home shall not discipline other residents.

D. Separation when used as discipline must be brief and appropriate to the youth’s age and circumstances. The youth shall always be within hearing of an adult in a safe, clean, well-lighted, well-ventilated room in the host family home that contains at least 50 square feet of floor space.

E. The child placement agency or county shall prohibit all cruel and unusual discipline and ensure providers of host family home and case managers are trained on established guidelines and appropriate discipline. 7.721.7 NON-DISCRIMINATION [Eff. 9/15/12]

In compliance with Section 7.701.14, the host family home shall not discriminate against a youth based upon race, religion, age, gender or disability. 7.721.71 Religion and Culture [Eff. 9/15/12]

A. The host family home shall demonstrate consideration for, and sensitivity to, the cultural and religious backgrounds of youth in care.

B. Youth in care of the host family home shall be allowed and encouraged to celebrate his/her cultural and religious holidays.

C. A youth may be invited to participate in religious and cultural activities of the host family home but shall not be required to participate.

D. Any form of religious or cultural intervention used by the host family home to control or change a youth's behavior, or treat or heal a medical condition, must be approved, in writing, by the legal guardian(s) of the youth prior to the use of the intervention.

E. The host family home cannot deny medical care to a youth because of host family home’s religious beliefs.

F. Opportunity and assistance shall be provided for each youth to practice the chosen/preferred religious beliefs and faith of his/her family. If the family has no preference, the individual preference of the youth shall be respected. The child placement agency or county will attempt to make necessary arrangements for attendance of youth at the appropriate religious institution or at a study group for 7.721.8 EDUCATION AND COMMUNITY INVOLVEMENT 7.721.81 Education [Eff. 9/15/12]

Youth shall attend educational/vocational programs in the most appropriate and least restrictive educational setting for the youth, including, but not limited to, attending regular classes conducted in accredited secondary schools within the community and workforce programs to achieve outcomes such as decreasing secondary school dropout rates, increasing rates of attaining a secondary school diploma or its recognized equivalent, or increasing placement and retention in postsecondary education or advanced workforce training programs. 7.721.82 Community Participation [Eff. 9/15/12]

A. Participation in community activities shall be encouraged, supported, and a vital

part of each youth’s life and choice.

B. The child placement agency or county shall reflect consideration for, and sensitivity to, the racial, cultural, ethnic and/or religious backgrounds of youth in care. The host family home shall involve a youth in cultural and/or ethnic activities appropriate to his/her cultural and/or ethnic background. Other factors should include, but are not limited to, consideration of the child's family, community, neighborhood, faith or religious beliefs, school activities, friends, and child's and family's primary language.

C. The host family home shall utilize available services, facilities, and activity programs of the community, and youth shall be given opportunities to participate as individuals or as a group in agency-sponsored recreational and cultural programs.

D. Chores at the host family home are considered part of the participatory responsibility of living together. They shall provide constructive experiences in accordance with the age and ability of the youth. All chores shall be scheduled so as not to conflict with other essential scheduled activities. Youth participating in the host family home cannot provide independent care/supervision of other residents in the host family home.

E. The child placement agency or county shall comply with all child labor laws and regulations in making work assignments, with consideration for agricultural work assignments in those communities.

F. Case manager shall approve paid or voluntary work assignments outside of the host family home. Approval shall include knowledge of the employer, the specific type of work, and the conditions of employment/voluntary work.

G. A youth shall not be exploited. A youth may not participate in solicitation on behalf of the child placement agency or county or certifying authority for a fundraising activity without the written permission of the parent(s) or guardian(s) for each specific activity, and the youth must be willing to participate in the activity.

7.721.9 PERSONAL CARE OF THE YOUTH 7.721.91 Medical and Health Services [Eff. 9/15/12]

A. The child placement agency or county of the host family home shall ensure the availability of emergency medical care for each youth in care.

B. Whenever indicated, a youth shall be referred to an appropriate specialist for either further assessment or treatment.

C. At all times there shall be first aid supplies readily available at each host family home and at least one (1) person present at the home or with the youth who is certified in First Aid, or the equivalent, and CPR for all ages of youth in care.

D. The child placement agency or county, in conjunction with the parent(s) or guardian(s), shall make every effort to ensure that a youth needing corrective devices such as glasses, hearing aids, etc., is provided with the necessary equipment.

E. In a potentially life-threatening situation, the child placement agency or county shall refer the youth's care to the appropriate medical and legal authority.

F. Child placement agency or county of the host family home will determine policies for Medications which include the following:

1. Required storage procedures in homes participating in the host family home including locked containment of all medication.

2. During admission process case manager shall ascertain all medication the youth is currently taking.

3. All medication must be kept in a clean storage area inaccessible to youth and stored according to pharmacy instructions.

4. All prescriptive medications shall be administered only upon the written prescription of a physician. The child placement agency or county shall also obtain written authorization from the prescribing physician to administer any non-prescriptive medication.

5. Child placement agency or county will provide providers of host family homes complete instructions to ensure proper administration of medication for each youth.

6. For youth under 18 years old, in an emergency situation, non-prescriptive medication may be administered on the verbal authorization of a physician. Written confirmation must then be obtained for the verbal authorization.

7. The child placement agency or county maintains for each youth a cumulative record of all medication, both prescriptive and non-prescriptive, dispensed to that youth, including:

a. The name of the youth.

b. The name and dosage of medication.

c. The time and date the medication was dispensed.

d. The name or initials of the person administering the medication.

8. The child placement agency or county will establish guidelines for documenting an error of any sort with medication including:

a. Notification to poison control if medication is administered incorrectly.

b. Documentation of missing medication. 7.721.92 Food, Nutrition, Personal Hygiene, Daily Routine, Clothing, and Personal Belongings 7.721.921 Food and Nutrition A. The host family home shall provide nutritious foods in the variety and amounts as appropriate for the age, appetite, and activity of each youth.

B. At least three nourishing, wholesome, well-balanced meals a day shall be offered at regular intervals. The host family home provider will document meals in a log to be audited by the child placement agency or county.

C. Family meals including all children and adults present in the home shall be provided whenever possible.

D. Youth shall be encouraged to eat a variety of the food served but shall not be subjected to undue coercion, including forced feeding, or punished for refusal to eat.

E. All food shall be from sources approved or considered satisfactory by the health

authority. All foods shall be stored, prepared, and served in such a manner as to be clean, wholesome, free from spoilage, and safe for human consumption. Only pasteurized milk shall be served. Fruits, vegetables and meats may be frozen.

F. The child placement agency or county of the host family home shall inform providers of host family home of the special diets prescribed for youth including those that are contrary to their religious beliefs, or of their family, or are known to cause an allergic reaction or a health hazard.

G. Water shall be readily accessible to youth by means of an approved water source. Youth will be provided clean single-service cup for administering medication and rinsing mouth in bathroom. 7.721.922 Personal Hygiene and Daily Routine [Eff. 9/15/12]

A. The child placement agency or county of host family home shall establish procedures to ensure that youth receive training in good habits of personal care, hygiene, and grooming appropriate to their age, gender, race and culture.

B. The host family home shall ensure that youth are provided with necessary and appropriate toiletry items, including clean, individual towels and washcloths, toothbrush, toothpaste, comb, shampoo and clean cups and dishes. 7.721.923 Clothing and Personal Belongings [Eff. 9/15/12]

A. The host family home shall allow a youth in care to bring his/her personal belongings to the program, as defined by the child placement agency or county policy, and to acquire belongings of his/her own in accordance with the youth's plan. However, the host family home shall, as necessary, limit or supervise the use of these items while the youth is in the program. Where extraordinary limitations are imposed, the youth shall be informed of the reasons, in a language or manner of communication the youth can understand. The decision and reasons shall be recorded in the youth's case record.

B. The child placement agency or county shall establish provisions for the protection of the youth's property while the youth is participating in the host family home. If the host family home safeguards any money, valuables or personal property for a youth, the child placement agency or county shall maintain and inventory all such possessions. A full return or accounting of such possessions shall be made upon discharge of the youth from the host family home. 7.721.93 Living Spaces, Equipment, and Necessary Facilities for a Host Family Home 7.721.931 Physical Requirements for a Safe and Adequate Host Family Home [Eff. 9/15/12]

A. The entire premises of homes participating in the host family home are subject to inspection for licensing or certification purposes, including, but not limited to, the interior of the home, the grounds surrounding the home, the basement, the attic (if accessible), any storage buildings, and a garage or carport, if applicable.

B. Homes participating in the host family home, including indoor and outdoor space, shall be maintained in a clean and safe condition free from hazards to health and C. The following shall be required for all host family homes:

1. Although the presence of firearms and ammunition is strongly discouraged in host family homes, if child placement agency or county policies allow the presence of any weapons such as firearms, air rifles, bows, hunting knives or hunting sling shots, they shall be unstrung and unloaded at all times when youth are in the home and shall be stored in locked containers out of the reach youth. Ammunition and arrows shall be stored in separate locked containers. Firearms that are solely ornamental can be excepted from the storage requirement. Weapons shall not be transported in any vehicle in which youth are riding. Law enforcement professionals are exempted from the requirements of this section if conditions of their employment require them to carry weapons.

2. At least thirty-five (35) square feet of usable indoor space exclusive of halls, baths and sleeping area shall be available for each child. All floor space shall have carpets, tile or smooth finish that may be easily cleaned.

Interior walls shall be constructed of solid material and be free from holes.

Unfinished basements must be inaccessible to youth when safety hazards are present.

3. Exterior doors shall be maintained in such a manner that would permit easy exit. Interior doors shall be designed to prevent youth from being trapped.

4. A basement that will be used regularly in the care of youth in any manner shall be equipped with more than one exit; such exit may be an accessible window.

5. The home shall be equipped with refrigeration, and provisions shall be made for the washing, rinsing and storing of dishes in a safe and sanitary manner.

6. A comfortable bed in a well-ventilated room, which is not customarily used for other purposes, shall be available for each youth in the host family home. There shall be a minimum of forty (40) square feet of floor space for each youth’s bed, and the beds should be placed at least two feet apart when arranged in parallel. Youth under the age of eighteen (18) may not be housed in the same living areas, including bedrooms, as youth over the age of eighteen.

7. No home participating in the host family home shall be used for a rental income business or an adult foster care facility. A business of a nature that might be hazardous to the health, safety, morals or welfare of youth shall not be operated on the premises of the home.

8. Mobile homes participating in the host family home shall have at least two exits, be skirted and properly installed and stabilized.

9. The child placement agency or county shall establish procedures for safety issues related to swimming pools; trampoline or other outdoor equipment shall be assessed by the child placement agency or county, addressed by the county or state health department as necessary, and documented in the case file.

D. A certificate shall be denied, suspended, revoked or made probationary for failure to repair or otherwise comply with any of the preceding requirements when a defect or noncompliance with such requirement has been noted by the licensing or certifying representative of the child placement agency or county and brought to the attention of the licensee or applicant in writing. 7.721.932 Host Family Home Maintenance [Eff. 9/15/12]

Child placement agency or county shall ensure that homes participating in the host family home:

A. Are kept in good repair and maintained in a safe, clean, and sanitary condition.

B. All areas available to youth’s activities including equipment, materials and furnishings shall be of sturdy, safe construction, easy to clean, and free of hazards, such as sharp points or corners, splinters, protruding nails, broken play and recreational equipment, or paint that contains lead or other poisonous materials and might be dangerous to the life or health of youth.

C. Are kept free from accumulation of significant amounts of non-essential materials such as furnishings, newspapers, or magazines that could pose a fire or health hazard.

D. Have provisions for collection, storage, and disposal of trash to prevent infestation by rodents. 7.721.933 Fire Safety [Eff. 9/15/12]

Child placement agency or county shall establish procedure for homes participating in the host family home that ensure:

A. All homes participating in the host family home shall contain at least one Underwriters Laboratories (U.L.) approved fire extinguisher, highly visible, easily accessible, and in working condition, weighing not less than five pounds, that has a rating of 2A, 10BC. This requirement may be waived if more extensive firecontrol measures are required by a local fire department.

B. A smoke detector and carbon monoxide detector, in working condition, must be installed on each level of the home and near sleeping areas.

C. Fire hazards, such as defective electrical appliances and electric cords, D. No gas space heaters, open-flame gas or oil stoves, hot plates, or un-vented heaters are used in the home for heating purposes. No electric space heaters shall be used in the home for permanent heating purposes.

E. Flammables, aerosol paints, insecticides, chemicals, and other dangerous materials shall be locked or stored so they are inaccessible to youth and must be stored in areas separate from sleeping or living areas. Flammables shall be stored in an approved container and not be stored near a furnace, hot water heater, or other heating device.

F. Heating devices such as radiators, registers, fireplaces, wood-burning stoves, and steam and hot water pipes that pose a fire or burn hazard to youth shall be screened or otherwise protected.

G. There shall be no candles or other burnable objects permitted in youth’s sleeping areas. Youth shall not be permitted to smoke inside host family home or in any vehicle used to transport.

H. Exit doors shall be clearly identified to all youth. No lock or fastening to prevent free escape from the inside of any room used by the youth shall be permitted.

I. Exit routes shall be kept free of discarded furniture, furnishings, laundry, and evacuation of the homes participating in the host family home. 7.721.94 Transportation [Eff.9/15/12]

A. The child placement agency or county of the host family home shall ensure that youth are provided with the transportation necessary for implementing the youth’s service plan.

B. Homes participating in the host family home shall have means of transporting youth in cases of emergency.

C. Any vehicle used by the host family home in transporting youth in care shall be properly licensed and the vehicle shall be maintained in accordance with D. Any host home parent or other person acting on behalf of the host family home operating a vehicle for purpose of transporting youth shall be properly licensed to operate the class of vehicle in accordance with Colorado law.

E. Youth must be properly fastened into a restraint system that conforms to all applicable Federal Motor Vehicle Safety Standards and pursuant to Colorado F. The host family home shall not allow the number of persons in any vehicle used to transport youth to exceed the number of available seats in the vehicle.

G. The vehicle shall be enclosed and provided with door locks.

H. The child placement agency or county of the host family home shall ascertain the nature of any need or problem of youth in the program that might cause difficulty during transportation, such as seizures or a tendency toward motion sickness.

The host family home shall communicate this information to the driver of any vehicle transporting youth. 7.721.95 Records, Reports and Confidentiality 7.721.951 Confidentiality [Eff. 9/15/12]

A. The child placement agency or county shall have a policy as to the maintenance, storage and confidentiality of records.

B. Records shall be the property of the child placement agency or county and shall be protected against loss, tampering, or unauthorized use.

C. Facts learned about youth and their families shall be kept confidential, with the following exceptions:

1. In medical emergencies, and then only when the assistance and/or expertise is required of that unauthorized person; or, 2. To the youth, his/her parent(s) or guardian(s) and their respective legal counsel(s), a court having jurisdiction over the youth, or an authorized public official, or licensing representative in performance of his/her mandated duties; or, 3. If the parent(s) or guardian(s) has given voluntary, written consent facts maybe shared using confidential fax or encrypted email.

4. Mandatory reporting of child abuse as required by law; and, 5. Reporting to the appropriate authority a youth’s attempt to harm his/herself or others.

6. A youth’s records may only be released upon the written consent of the youth, and the legal guardian for youth under eighteen years old; facts may be shared using confidential fax or encrypted email. 7.721.952 Records [Eff. 9/15/12]

A. The child placement agency or county shall maintain complete records as required for the host family home.

B. Records for youth shall be retained for at least three years. Retention of records for a longer period may be desirable when they reflect an accident, injury or other unusual circumstance.

C. A record of admission shall be completed for each youth in the host family home at the time of admission. The admission record shall be maintained at the child placement agency or county. The host family home where the youth where the youth resides shall received an abbreviated admissions record that contains:

1. Youth's name, date and place of birth (verified by a birth certificate when possible), gender, race, religious preferences, and date of admission.

2. Psychiatric and psychological reports, when available.

3. Medical/medication summary and reports, when available.

4. Summary recording of significant contacts with parent(s), guardian(s) and D. When a youth is removed or discharged from the host family home, the child placement agency or county shall complete a summary of the youth's discharge from the home which includes at a minimum:

1. The date of the discharge of the youth from the home.

2. The plan for the youth.

3. Circumstances that led to an unplanned discharge.

E. Copies of a youth's file, including discharge information, shall be provided to parent(s) or guardian(s) upon request or to others by written consent.

F. A copy of all policies developed by the child placement agency or county for the host family home shall be maintained for at least three years. 7.721.953 Reports [Eff. 9/15/12]

A. The Child Placement Agency or County shall immediately attempt to notify the youth's parent(s), guardian(s), and/or the responsible agency of any serious illness or serious injury resulting in medical treatment away from the home, hospitalization or death involving a youth in the host family home.

B. The child placement agency or county must immediately report in writing to the Department any accidents, injuries, serious illnesses, or fatalities that occurred at the host family home and that resulted in emergency medical treatment away from the host family home, hospitalization or death. The report must be made within 48 hours after the accident, illness, or death occurred.

C. A report about a death must include:

1. The youth's name, birth date, address, and telephone number.

2. If known, the names of the youth's parent(s) or guardian(s) and their address and telephone number if different from that of the youth.

3. Date of the fatality.

4. Brief description of the incident or illness leading to the death.

5. Names and addresses of witnesses or persons who were with the youth at the time of death.

6. Name and address of police department or authority to which the report D. The child placement agency or county of the host family home must immediately report in writing to the Department any change in the status of the home that would affect care of youth.

E. The child placement agency or county must immediately report in writing to the Department any legal action brought against a home participating in the host family home regarding any youth, staff, or conduct of the home at the time of initiation of such legal action.

These rules will address the operation of a substitute placement agency that places a substitute child care teacher or director into a licensed child care facility for the purpose of providing substitute child care. 7.730 RULES REGULATING SUBSTITUTE PLACEMENT AGENCIES [Repealed eff. ______________________________________________________________________ Editor’s Notes

History Rules 7.702; 7.707; 7.712 eff. 05/01/2007.

Rules 7.705, 7.711, 7.712, 7.719 eff. 06/01/2007.

Rules 7.701.2; 7.701.3; 7.708; 7.709; 7.710 eff. 07/30/2007.

Rules 7.701.32-33, 7.710.56 A-J.5 emer. rules eff. 08/03/2007.

Rules 7.710.33 L-M, 7.710.36 A eff. 09/01/2007.

Rules 7.701.32-33; 7.710.56 eff. 10/30/2007.

Rules 7.710.52, 7.710.56 emer. rules eff. 12/07/2007.

Rules 7.710.52; 7.710.56 eff. 01/30/2008.

Rule 7.710.32 eff. 04/01/2008.

Rules B&P, 7.701.4, 7.707.42, 7.712.33, eff. 09/01/2008.

Rules 7.709, 7.710.34, 7.710.36 eff. 11/01/2008.

Rule 7.707 eff. 01/01/2010.

Rules 7.702.52-7.702.54, 7.702.55 D-7.702.56 A.5, 7.710.1-7.710.25, 7.710.33 A, J, L. 6, M, 7.710.34-7.710.42, 7.710.45-7.710.98, 7.716.4-7.716.6 B eff. 05/01/2010.

Rule 7.701.33 A emer. rule eff. 09/10/2010.

Rule 7.701.33 A eff. 12/01/2010.

Rules 7.716.1, 7.716.2.A.7, 7.716.3 eff. 01/01/2011.

Rule 7.710.12 eff. 03/02/2011.

Rules 7.700, 7.701.11, 7.701.2, 7.701.33 A, 7.701.4, 7.720 eff. 04/01/2011.

Rules 7.701.33 A-D.1, 7.701.33 H-I emer. rules eff. 08/10/2011.

Rules 7.701.33 A-D.1, 7.701.33 H-I eff. 11/01/2011.

Rules 7.705.9-7.705.96 repealed eff. 01/01/2012; Rules 7.701.2, 7.705.1, 7.705.33, 7.705.42, 7.705.43, 7.714, 7.714.4, 7.714.932 eff. 01/01/2012.

Rule 7.17 repealed eff. 02/01/2012.

Rule 7.708 eff. 04/01/2012.

Rules 7.701.2, 7.701.31, 7.701.33, 7.701.4, 7.701.9, 7.702.2, 7.702.43, 7.702.91, 7.705, 7.705.22, 7.705.33, 7.705.55, 7.705.6, 7.705.82, 7.705.84, 7.705.100, 7.706, 7.706.1, 7.706.15 - 17, 7.706.19, 7.707.1, 7.707.22, 7.707.31, 7.707.71, 7.707.923, 7.708.11, 7.708.31, 7.708.34-35, 7.708.36, 7.708.61, 7.708.65, 7.709.2, 7.709.21, 7.709.24, 7.710, 7.710.11, 7.710.2, 7.710.21-22, 7.710.24-25, 7.710.33-34, 7.710.36, 7.710.41-42, 7.710.44-45, 7.710.52-53, 7.710.55-56, 7.710.92-93, 7.711.1, 7.712.41-42, 7.712.74, 7.713, 7.713.1, 7.713.21, 7.713.23- 25, 7.713.31, 7.713.41, 7.713.56, 7.713.65, 7.714, 7.714.1-2, 7.714.4-5, 7.714.52-53, 7.714.92, 7.714.933, 7.715.11, 7.715.46, 7.715.82, 7.715.84.H, 7.720.41, 7.720.73 eff. 06/01/2012. Rules 7.702.1, 7.705.7, 7.707.32 B.7, 7.710.26, 7.711.75 W, 7.712.1, 7.712.33, 7.718 repealed eff. 06/01/2012.

Rules 7.702.44, 7.708.39 A, 7.709.29 E eff. 07/01/2012.

Rule 7.708.11 emer. rule eff. 09/07/2012.

Rules 7.701.21, 7.705.81-82, 7.708.1 B, 7.710.1, 7.710.33 A-J, 7.715.1, 7.715.33, 7.715.43 F-K, 7.715.71 A, 7.721 eff. 09/15/2012.

Rules 7.708.11, 7.708.7 eff. 12/01/2012.

Rules 7.701.2 D, 7.711.1 eff. 04/01/2013.

Rules 7.701.13, 7.701.33 eff. 02/01/2014.

Rules 7.708.21, 7.708.21.I, 7.721.3, 7.721.3 G eff. 07/01/2014.

Rule 7.701.35 eff. 08/01/2014.

Rules 7.701.100, 7.702.42, 7.702.64, 7.702.73, 7.706.19, 7.707.6, 7.707.75, 7.711.76, 7.712.32, 7.712.74 eff. 04/01/2015. Rule 7.702.93 repealed eff. 04/01/2015.

Rules 7.701.2, 7.701.4, 7.706.1 eff. 10/01/2015.

Rules 7.701.200, 7.705.22 A, 7.705.83, 7.708.39, 7.708.39, 7.708.61, 7.708.61 K, 7.708.65, 7.709.22, 7.709.22 I, 7.709.25, 7.709.25 E, 7.710.43, 7.710.43 H-I eff. 11/01/2015.

Rules 7.701.2, 7.701.32, 7.701.33, 7.701.34, 7.701.56, 7.708, 7.708.1, 7.708.11, 7.708.2-7.708.21-7.708.26, 7.708.3-7.708.31, 7.708.33, 7.708.34, 7.708.35, 7.708.36, 7.708.37, 7.708.38, 7.708.39, 7.708.41, 7.708.42, 7.708.43,-7.708.46, 7.708.51, 7.708.52, 7.708.61, 7.708.62, 7.708.63, 7.708.64, 7.708.65, 7.708.67, 7.708.7, 7.708.71, 7.708.72, 7.708.74, 7.710, 7.710.1, 7.710.3-7.710.31, 7.710.33, 7.710.34, 7.710.36, 7.710.52 eff. 01/01/2016.

Rules 7.702-7.702.94 eff. 02/01/2016.

Rules 7.701, 7.702, 7.707, 7.712 eff. 10/01/2016.

Rule 7.717 eff. 04/01/2017.

Rules 7.701.200, 7.708.42, 7.710-7.710.56, 7.710.91-7.710.98, 7.721.921 eff. 10/01/2017.

Rule 7.701 eff. 01/01/2018.

Rule 7.704 eff. 02/01/2018.

Rule 7.701.4 eff. 03/02/2018.

Rules 7.711-7.711.55, 7.712 eff. 04/01/2018.

Rules 7.701.2 J.7-13, 7.701.32, 7.701.33 C-D, 7.702.41 F-G, 7.702.44 E, 7.707.32 B, 7.707.34, 7.707.35, 7.707.36 B.3, eff. 09/30/2018.

Rules 7.708.1 A.1, 7.701 A.5 eff. 01/01/2019.

Rule 7.730 eff. 02/01/2019.

Rule 7.716 eff. 03/15/2019.

Rules 7.701.14, 7.701.2 J.11-14, 7.701.33 A.1, 7.701.33 D, 7.701.33 D.1- 2, 7.701.365 C, 7.701.4 eff. 06/01/2019.

Rule 7.701 eff. 01/30/2020.

Rules 7.708.21 L-M, 7.708.31 A-F, 7.708.41 A-G emer. rules eff. 06/12/2020.

Rules 7.708.21 L-M, 7.708.31 A-F, 7.708.41 A-G eff. 09/01/2020.

Rules 7.701.33 D.4, 7.701.33 J eff. 09/30/2020.

Rules 7.701.21, 7.705.81 B.1, 7.705.82 B, 7.705.82 C, 7.715.43 D, 7.715.43 F, 7.715.43 H, 7.721.43 B.2, 7.721.43 I.1, 7.721.43 J, 7.721.43 N, 7.721.43 O eff. 01/30/2021.

Rules 7.701.2, 7.701.33 A.1, 7.701.33 C-D, 7.701.65, 7.701.200 C, 7.701.300, 7.701.400, 7.701.500, 7.703 eff. 04/01/2021.

Rules 7.708.21 I, 7.708.21 N-Q, 7.708.21.1, 7.708.22 B-D, 7.708.25 C, 7.708.25 K, 7.708.26 F, 7.708.31, 7.708.31.1 eff. 06/30/2021.

Rule 7.705.200 eff. 10/01/2021.

Rule 7.702 eff. 12/01/2021.

Rules 7.701.2, 7.708.1 A.1-4 , 7.710.48 C emer. rules eff. 07/08/2022.

Rules 7.701.2, 7.708.1 A.1-4, 7.710.48 C eff. 09/30/2022.

Rules 7.704.11, 7.708.21 P, 7.708.31.1 A.1, 7.701.31.1 B, C, D.1, 7.708.33 A, 7.708.51 A- C.6, 7.714.31, 7.714.52, 7.714.932 A-C.11, 7.715.44, 7.721.51 eff. 03/02/2023.

Rules 7.701.31 A, 7.710.33 A.5 eff. 04/01/2023.

Rules 7.708.21 (L), R eff. 06/01/2023.

Rule 7.710.33 A.4 eff. 02/01/2024.

Rule 7.705.103 eff. 06/01/2024.

Rules 7.701.14, 7.701.2, 7.710.55 A.2, 7.710.55 B.8, 7.710.55 C.1.d, 7.710.58, 7.710.6 C.1, 7.710.6 F-H.2, 7.710.62, 7.710.650-7.710.653 eff. 05/30/2025.

Rules 7.701, 7.705, 7.714 eff. 07/01/2025.

Rules 7.701.2, 7.701.53 B, 7.701.53 E, 7.705.43 A, 7.705.64 A-E, 7.714.92 A-B, 7.714.93 eff. 09/15/2025.

Rules 7.702, 7.707, 7.711, 7.712, 7.716, 7.717, 7.718, 7.720, 7.730 repealed eff. 03/02/2026.

##### **12 CCR 2509-9** Early Childhood {#sec-12-ccr-2509-9 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-9}

DEPARTMENT OF HUMAN SERVICES

EARLY CHILDHOOD

12 CCR 2509-9 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Addition of Sections 7.800 through 7.823 were final adoption following publication at the 2/7/2014 State Board rule-making session, with an effective date of 4/1/2014 (Rule-making# 13-10-9-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

7.800 EARLY CHILDHOOD

7.810 NURSE HOME VISITOR PROGRAM 7.811 DEFINITIONS [Eff. 4/1/14]

"Alternative Nurse Home Visitation Program" means a program that provides home visits by nurses but is not the program described in Section 26-6.4-104(1), C.R.S., but does qualify for funding from the Nurse Home Visitor Fund because it meets the requirements of Section 26-6.4-104(4), C.R.S. and Section 7.820 of these rules.

"Board" means the State Board of Human Services.

"Conflict of interest" means a personal or financial interest that could reasonably be perceived as an interest that may influence an individual in his or her official duties.

"Department" means the Colorado Department of Human Services.

"Entity" means any nonprofit, not-for-profit, or for-profit corporation, religious or charitable organization, institution of higher education, visiting nurse association, existing visiting nurse program, local health department, county department of social services, political subdivision of the state, or other governmental agency or any combination thereof.

"Expansion site" means a program that is already serving at least fifty low-income, first-time mothers, through a grant received under these rules, in the previous fiscal year, and the implementing entity is applying for additional funding to enable it to serve additional low-income, first-time mothers.

"Financial interest" means a substantial interest held by an individual which is an ownership or vested interest in an entity, or employment or a prospective employment for which negotiations have begun, or a directorship or officership in an entity.

"Health sciences facility" means a facility located at the University of Colorado Health Sciences Center that is selected by the President of the University of Colorado.

"Low-income" means an annual income that does not exceed two hundred percent of the federal poverty level.

"New entity" means any entity that has not previously received funding for the program pursuant to these rules.

"Nurse" means a person licensed as a professional nurse pursuant to Section 12-38-102, C.R.S., et seq., or accredited by another state or voluntary agency that the State Board of Nursing has identified by rule (3 CCR 716-1) pursuant to Section 12-38-108(1)(a), C.R.S., as one whose accreditation may be accepted in lieu of board approval.

"Nurse Home Visitor Program" or "Program" means a program that is described in Section 26-6.4-104(1), C.R.S., and meets the requirements of these rules.

"Nurse supervisor" means a nurse with a Master's degree in nursing or public health, unless the implementing entity can demonstrate that such a person is either unavailable within the community or an appropriately qualified nurse without a Master's degree is available.

"Visit protocols" mean nurse home visit guidelines addressing, at a minimum, prenatal, infancy and toddler development; and cover topics such as positive birth outcomes, parental life course development and parenting skills.

7.812 PROCEDURES FOR GRANT APPLICATION

A. Grant Application Contents 1. All applications shall be submitted to the department by entities as defined in Section 7.811 in accordance with these rules and shall contain, at a minimum, the basic program elements specified in Section 26-6.4-106, C.R.S., and the following information. A budget which includes each of the following:

a. Salaries and benefits for the staff required in Section 7.817;

b. Costs of the training provided by the Health Sciences Facility, and costs to cover any other training required by the Health Sciences Facility.

Allowable costs include, but are not limited to, travel costs and training materials;

c. Costs to purchase and maintain the management information system and related technical assistance;

d. Operating costs, including, but not limited to, office and program supplies, postage, telephones, computer(s) with internet access, liability insurance, medical supplies, mileage reimbursement and other staff development for the required staff;

e. A description of how the applicant will fund any additional costs not funded by the grant;

f. Any in-kind contributions the applicant or other stakeholders in the community may donate.

2. Applications for New Entities In addition to the requirements of Section 7.812, A, 1, of these rules, applications for new entities shall contain, at a minimum, the following information:

a. A description of the experience the applicant has working with the target population and existing home visitation programs;

b. A description of the community support for the program and for the applicant as the lead organization in its implementation, including detailed information about the broad based support for the program's implementation. Breadth of community support shall be judged by the diversity of those involved in supporting the program's implementation, and can be evidenced through letters of support and more formal referral relationships among various community organizations and the applicant;

c. A description of the specific needs of the population to be served including, but not limited to, the socio-demographic and health characteristics that justify the need for the program and the number of first-time, low-income mothers eligible for the program;

d. A description of the relationship of the applicant with the schools, prenatal clinics and other referral sources for the first-time, low-income mothers who will be served by the program, with specific information about the duration of these relationships;

e. A description of the nature and duration of the referral linkages that exist between the applicant and other service providers throughout the community including, but not limited to, providers of social services, mental health services, workforce preparation services, job training services, legal services, health care services and child care services;

f. Except as provided in Section 7.819, a description of a plan for recruiting at least one hundred first-time, low-income mothers;

g. A description of the collaboration between the applicant and other entities providing similar services to the same population, including plans for coordination and a description of how the program will fit in with and complement the community's efforts to meet the needs of the target population, if applicable;

h. A plan for hiring and retaining qualified staff that represents the community's racial and cultural diversity;

i. A description of the applicant's capacity to comply with and monitor the implementation of the grant requirements;

j. Summary of the major strengths of the applicant and the community that will lead to successful implementation of the program; and, k. A statement as to whether the applicant plans to work collaboratively with other entities in either administering the program or through an oversight board, and whether the other entities are other counties, municipalities, agencies or organizations.

l. If an applicant currently provides services in compliance with Sections 7.816 through 7.819, using funding other than from the Nurse Home Visitor Program Fund, the applicant shall state if:

1) The applicant expects to continue to receive funding from such alternative funding source; and, 2) Funds received pursuant to these rules will be used to increase the number of clients served.

3. Applications for Multiple Community Collaboration If multiple communities with lower birth rates need to collaborate to meet the one hundred-family requirement, the applicant shall provide specific plans that address the mechanisms and history of the collaboration in addition to complying with the requirements of Sections 7.812, 1 and 2. The plan shall include, but not be limited to, examples of previous collaborations.

4. Applications for Expansion Sites In addition to complying with the requirements of Section 7.812, A, 1, each expansion site shall submit the following in its application:

a. Confirmation that the entity has implemented the program in compliance with these rules;

b. A description of additional community demand for the program that is not being met through the current funding;

c. A specific plan for building additional infrastructure to support the expansion of the program including, but not limited to, physical space, staff supervision and computer data entry personnel;

d. A description of how the implementing entity has addressed previous specific challenges relating to the program;

e. A plan describing the implementing entity's strategy to recruit and train sufficient qualified nurses to implement and expand the program; and, f. A description of community support for the planned expansion of the program.

B. Timelines for Grant Applications Grant applications may be solicited up to two times each fiscal year. 7.813 REVIEW OF APPLICATIONS [Eff. 4/1/14]

A. The Department shall conduct an initial technical review of submitted applications to ensure that all required components are included.

B. After the Department's technical review of the applications, the health sciences facility shall review the applications and shall select a list of entities that the health sciences facility recommends to administer the program in communities throughout the state.

C. The Department shall review the budget and budget justification in the application of each selected entity and provide technical assistance to ensure an accurate budget to support implementation in accordance with program requirements. 7.814 CRITERIA FOR SELECTION OF ENTITIES [Eff. 4/1/14]

A. At a minimum, the following criteria shall be used for selecting potential grantees:

1. The applicant meets the definition of an "entity" as defined in Section 7.811;

2. The entity submits a completed application in accordance with, the requirements of

Section 7.812;

3. The entity demonstrates the capacity and ability to adequately administer and implement the program;

4. The entity demonstrates that it will comply with the requirements of Sections 7.816 through 7.818;

5. The entity's geographic service area and/or the population it serves advances the implementation of the program in communities throughout the state; and, 6. The entity is selected on a competitive basis.

B. More than one entity may receive funding in a particular community if it can demonstrate in its application:

1. Broad community support for the implementing entity;

2. Existence of a sufficient number of eligible women to support multiple implementing entities;

3. Existence of close coordination and mutual support between the entities; and, 4. A specific plan for the coordination by the applying entity and other nurse home visitation programs in the community.

C. Special consideration shall be given to entities that are proposing to administer the program as a collaborative effort among multiple entities. 7.815 AWARDING OF PROGRAM GRANTS [Eff. 4/1/14]

A. The State Board of Human Services shall approve grants and award funding to the entities selected on a competitive basis by the health sciences facility.

B. The grant awards may, at a minimum, include monies to fund:

1. Reasonable and necessary salaries and benefits for nurses, nurse supervisors and data entry employees;

2. Reasonable and necessary operating costs, including but not limited to, medical, program and office supplies, telephones, computer equipment, mileage reimbursement, any required insurance, and staff development;

3. Reasonable and necessary training, training materials and travel costs associated with obtaining training required by Section 7.816, A;

4. Reasonable and necessary cost for purchasing the management information system, and any related technical assistance; and, 5. Reasonable and necessary costs for developing any infrastructure necessary for program administration and implementation. 7.816 PROGRAM REQUIREMENTS [Eff. 4/1/14]

A. Training Requirements Each nurse employed by an entity to provide home visiting nursing services through the Nurse Home Visitor Program shall be required, at a minimum, to attend and complete the following training:

1. Preparatory study educating nurse home visitors on their nurse home visitor role and competencies, including:

a. Applies theories and principles integral to implementation of the Nurse-Family Partnership Model.

b. Uses evidence from randomized trials and data collection software to guide and improve practice.

c. Delivers individualized client care across the six domains.

d. Establishes therapeutic relationships with clients.

e. Utilizes reflective process to improve practice.

2. Interactive training where nurse home visitors receive instruction and assistance to begin applying information. Prepares new nurses to implement the intervention with fidelity to the Nurse-Family Partnership Model.

3. Training to give nurses an opportunity to deepen their understanding of the Nurse-Family Partnership Model, specifically in regards to:

a. Infant temperament;

b. Motivational interviewing;

c. Fidelity to the model elements.

B. Visit Protocols The visit protocols followed by the entity in administering the program shall cover information specific to prenatal, infant and toddler phases. The visit protocols shall, at a minimum, address:

1. The physical and emotional health of the mother and the baby, including for the mother information on the importance of nutrition and avoiding alcohol and drugs, including nicotine;

2. The environmental health issues such as ensuring a safe environment for the child;

3. The life course development for the mother, including employment, educational achievement, budgeting and financial planning, transportation and housing;

4. The parental role and responsibilities; and, 5. The role of family and friends in supporting goal attainment.

C. Program Management Information Systems The management information system used by the entity in administering and implementing the program shall, at a minimum, include the following:

1. Documentation of the services received by clients enrolled in the program;

2. Information to assist the program staff in tracking the progress of families in attaining program goals;

3. Information to assist nurse supervisors in providing feedback to individual nurse home visitors on strengths and areas for improvement in implementing the program; and, 4. Information to assist program staff in planning quality improvements to enhance program implementation and outcomes.

D. Reporting and Evaluation System 1. At least once every month, each implementing entity shall submit the data generated by the management information system required by Section 7.816, C, to the health sciences facility; and, 2. The data will be analyzed and the health sciences facility shall make available, on no less than a quarterly basis, a report to the entity evaluating the program's implementation, and on a semi-annual basis shall also make available reports on benchmarks of program outcomes.

3. The implementing entity shall submit an annual report that complies with the requirements in Section 7.821 to both the health sciences facility and the community in which the entity implements the program that reports on the effectiveness of the program within the community.

4. The annual report shall be submitted on or before March 1, or not later than sixty (60) days after the end of the fiscal year for which funding was provided if the program has not submitted a request for continuation of funding. The annual report shall be written in a manner that is understandable for both the health sciences facility and members of the community that the program serves. 7.817 STAFFING REQUIREMENTS [Eff. 4/1/14]

A. For every one hundred (100) low-income, first-time mothers enrolled in the program the program shall, at a minimum, have the following staff:

1. Four full time equivalent (FTE) nurses;

2. One half FTE nurse supervisor, and, 3. One-half FTE data entry/clerical support person.

B. The data entry/clerical support person shall provide office support to the nursing staff and assure data are submitted as required by Section 7.816, C and D.

C. The caseload for any one nurse at one time shall not exceed twenty-five low-income, first-time mothers. 7.818 ELIGIBILITY OF CLIENTS [Eff. 4/1/14]

A. At a minimum, the following is required to be eligible to receive program services:

1. A woman with an annual income that does not exceed two hundred percent of the federal poverty level;

2. No previous live births; and, 3. Enrolled in the program during pregnancy or prior to the end of the first month of the baby's life.

B. Preference will be given to women who enroll in the program prior to the twenty-eighth (28th) week of pregnancy. 7.819 NUMBER OF CLIENTS SERVED WAIVER [Eff. 4/1/14]

A. Except as provided in Section 7.819, B, each entity shall provide services to a minimum of one hundred low-income, first-time mothers in the community in which the program is administered and implemented.

B. Small Community Size:

1. If the population base of a community does not have the capacity to enroll one hundred eligible families, an entity may apply to the Board for a waiver from this requirement.

2. Prior to granting any waivers, the Board shall consult with the health sciences facility to ensure that the entity can implement the program within a smaller community and comply with program requirements.

7.820 AVAILABILITY OF FUNDING FOR ALTERNATIVE NURSE HOME VISITATION PROGRAMS [Eff. 4/1/14]

A. An alternative nurse home visitation program may qualify for funding under the nurse home visitor program if the alternative nurse home visitation program:

1. Has been in operation in the state as of July 1, 1999 for a minimum of five (5) years;

2. Has achieved a significant reduction in each of the following:

a. Infant behavioral impairments due to use of alcohol and other drugs, including nicotine;

b. The number of reported incidents of child abuse and neglect among families receiving services;

c. The number of subsequent pregnancies by mothers receiving services;

d. The receipt of public assistance by mothers receiving services; and, e. Criminal activity engaged in by mothers receiving services and their children.

B. Any alternative nurse home visitation program qualifying for funding under this section shall be exempt from the requirements of Section 7.816 if it continues to demonstrate significant reductions in the occurrences specified in Section 7.820, A, 2.

C. Any alternative nurse home visitation program qualifying for funding under this section shall comply with the requirements of Section 7.821 of these rules.

7.821 REPORTING REQUIREMENTS FOR TOBACCO SETTLEMENT PROGRAMS

A. All programs shall annually submit to the department a report which, at a minimum, includes the following information:

1. The amount of tobacco settlement moneys received by the program for the preceding fiscal year;

2. A description of the program, including the program goals, population served by the program, the actual number of people served, and the services provided; and, 3. An evaluation of the operation of the program, which includes the effectiveness of the program in achieving its stated goals.

B. Annual program reports shall be submitted in accordance with statutory requirements for master tobacco settlement agreement funding. 7.822 CONFLICTS OF INTEREST [Eff. 4/1/14]

A. Applicability Except as provided for in Sections 26-6.4-105, C.R.S. through 26-6.4-108, C.R.S. regarding the health sciences facility, this section applies to any person involved in:

1. The review of completed applications; or, 2. Making recommendations to the Board regarding an entity that may receive a grant and the amount of said grant; or, 3. Members of the Board.

B. Prohibited Behavior No person who is involved in the activities specified in Section 7.822, A, shall have a conflict of interest. Such conflict of interest includes, but is not limited to, any conflict of interest involving the person and the grantee or the person and the tobacco industry.

C. Responsibilities of Persons with a Potential Conflict of Interest A person who believes that he or she may have a conflict of interest shall disclose such conflict of interest as soon as he or she becomes aware of the conflict of interest. If the person is a member of the Board and acting in the capacity as a Board member, the person shall publicly disclose the conflict of interest to the Board; other persons shall disclose the conflict of interest in writing to the Department. If the Board or the Department, whichever is appropriate, determines the existence of a conflict of interest, the person shall recuse himself or herself from any of the activities specified in Section 7.822, A, relating thereto. 7.823 CRITERIA FOR REDUCTION OR CESSATION OF FUNDING [Eff. 4/1/14]

A. Upon recommendation from the health sciences facility, the Board may reduce or eliminate the funding of a program if the entity is not operating the program in accordance with the program requirements established in Sections 7.816 through 7.818, except as provided in Section 7.820 of these rules, or is operating the program in such a manner that it does not demonstrate positive results.

B. An entity shall receive written notification from the Board if the entity's funding is subject to reduction or elimination. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 04/01/2014.

Sections 7.812 A.1, 7.821 eff. 12/01/2018.

##### **12 CCR 2509-10** EARLY INTERVENTION PROGRAM [Repealed eff. 07/30/2024] {#sec-12-ccr-2509-10 omnilex-key=us-co-regs-official--department-9--12 CCR 2509-10}

DEPARTMENT OF HUMAN SERVICES

Social Services Rules EARLY INTERVENTION PROGRAM - Repealed eff. 07/30/2024 12 CCR 2509-10 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ NOTE: EARLY INTERVENTION PROGRAM RULES AS PROMULGATED BY THE COLORADO DEPARTMENT OF EARLY CHILDHOOD MAY BE FOUND AT 8 CCR 1401-1. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 07/01/2013.

Sections 7.900, 7.913.A, 7.920.H-7.920.I, 7.980.D.1 eff. 03/02/2014.

Sections 7.900, 7.912-7.913, 7.920-7.940, 7.980-7.990 eff. 07/01/2014.

Sections 7.900-7.901, 7.914, 7.920-7.940 eff. 07/01/2015.

Sections 7.901, 7.911.A.3, 7.911.A.5, 7.912.D.1, 7.914, 7.915.C, 7.920.D.2.e, 7.920.E-J, 7.940.I, 7.940.I.2.d, 7.940.I.2.e, 7.951, 7.961 eff. 10/01/2016.

Entire rule eff. 01/01/2019.

Rules 7.900, 7.901, 7.940 emer. rules eff. 07/10/2020.

Rules 7.900, 7.901, 7.920, 7.940 eff. 10/30/2020.

Rules 7.900 A.4.b, 7.900 A.5, 7.970 eff. 04/30/2022.

Entire rule repealed eff. 07/30/2024.

## **2510** Services for the Aging (Volume 10; Older Americans Act (OAA) Programs)

##### **12 CCR 2510-1** Rule Manual Volume 10, Older Americans Act (oaa) Programs {#sec-12-ccr-2510-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2510-1}

DEPARTMENT OF HUMAN SERVICES

OLDER AMERICANS ACT (OAA) PROGRAMS (RULE MANUAL VOLUME 10)

12 CCR 2510-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] ________________________________________________________________________

Statement of Basis and Purpose and Specific Statutory Authority of Revisions Made to Rule Manual Volume 10 Volume 10 was rewritten and reissued when finally adopted following publication at the 8/2/85 State Board meeting, with an effective date of 10/1/85. Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Addition of sections 10.500 - 10.515, and revision of section 10.900 were finally adopted following publication at the 10/2/87 State Board meeting, with an effective date of 12/1/87 (Document 9). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions of sections 10.100 - 10.202, 10.207 - 10.280, 10.300 - 10.427, and 10.455 - 10.485 were finally adopted following publication at the 12/2/88 State Board meeting, with an effective date of 2/1/89 (CSPR# 88-8- 18-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions of sections 10.100 - 10.405, 10.411 - 10.415, 10.470 - 10.472, 10.478 - 10.485, and 10.802 - 10.815 were finally adopted following publication at the 12/6/90 State Board meeting, with an effective date of 2/1/91 (CSPR# 90-8-15-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions of sections 10.305, 10.310, and 10.335 - 10.345 were finally adopted following publication at the 5/3/91 State Board meeting, with an effective date of 7/1/91 (CSPR# 91-3-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions of sections 10.125 - 10.135, 10.300 - 10.305, 10.413 - 10.415 and 10.802 - 10.805 were adopted emergency at the 7/12/91 State Board meeting, with an effective date of 7/12/91 (CSPR# 91-5- 15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 10.125 - 10.135, 10.300 - 10.305, 10.413 - 10.415 and 10.802 - 10.805 were adopted emergency and final at the 8/2/91 State Board meeting, with effective dates of 7/12/91 and 8/2/91 (CSPR# 91-5-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to sections 10.100 - 10.220, 10.305, 10.400 through 10.402, 10.407 through 10.415 and 10.470 through 10.472 were adopted emergency at the 9/6/91 State Board meeting, with an effective date of 9/6/91 (CSPR# 91-3-11-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Revisions to sections 10.100 - 10.220, 10.305, 10.400 through 10.402, 10.407 through 10.415 and 10.470 through 10.472 were adopted emergency and final at the 10/4/91 State Board meeting, with effective dates of 9/6/91 and 10/4/91 (CSPR# 91-3-11-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to section 10.235 were adopted emergency and final at the 12/6/91 State Board meeting, with an effective date of 1/1/92 (CSPR# 91-7-19-2). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 10.305, 10.320, 10.400 through 10.412, and 10.470 were adopted emergency at the 3/5/93 State Board meeting, with an effective date of 3/5/93 (CSPR# 93-2-9-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 10.305, 10.320, 10.400 through 10.412, and 10.470 were final adoption of emergency at the 4/2/93 State Board meeting, with an effective date of 3/5/93 (CSPR# 93-2-9-2).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 10.110 - 10.120, 10.220 - 10.235, 10.300 - 10.305, 10.320 - 10.330, 10.400 - 10.405, 10.411 - 10.412, 10.416 - 10.427, and 10.470 - 10.472 were final adoption following publication at the 9/10/93 State Board meeting, with an effective date of 11/1/93 (CSPR# 93-6-22-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to sections 10.100 - 10.105, 10.400 - 10.402, and 10.410 were adopted emergency at the 9/10/93 State Board meeting, with an effective date of 9/30/93 (CSPR# 93-8-11-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of Revisions to sections 10.100 - 10.105, 10.400 - 10.402, and 10.410 were final adoption of emergency at the 10/1/93 State Board meeting, with an effective date of 9/30/93 (CSPR# 93-8-11-2). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions/additions to sections 10.100 - 10.120, 10.400 - 10.402, 10.410 and 10.700 were adopted emergency at the 1/7/94 State Board meeting, with an effective date of 1/1/94 (CSPR# 93-12-7-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions/additions to sections 10.100 - 10.120, 10.400 - 10.402, 10.410 and 10.700 were final adoption of emergency at the 2/4/94 State Board meeting, with an effective date of 1/1/94 (CSPR# 93-12-7-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours Revisions to sections 10.305 and 10.470 were final adoption following publication at the 4/1/94 State Board meeting, with an effective date of 6/1/94 (CSPR# 93-12-10-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions and additions to sections 10.100, 10.700 - 10.710, and 10.713 - 10.714 were adopted emergency at the 9/9/94 State Board meeting, with an effective date of 9/1/94 (CSPR# 94-8-2-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions and additions to sections 10.100, 10.700 - 10.710, and 10.713 - 10.714 were final adoption of emergency at the 10/7/94 State Board meeting, with an effective date of 9/1/94 (CSPR# 94-8-2-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 10.100 - 10.120 and 10.400 - 10.405 were adopted emergency at the 9/8/95 State Board meeting, with an effective date of 9/8/95 (CSPR# 95-7-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 10.100 - 10.120 and 10.400 - 10.405 were adopted emergency and final at the 10/6/95 State Board meeting, with an effective date of 9/8/95 (CSPR# 95-7-25-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to section 10.401 were adopted as emergency at the 7/9/99 State Board meeting, with an effective date of 7/9/99 (CSPR# 99-6-16-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to section 10.401 were final adoption of an emergency rule at the 8/6/99 State Board meeting, with an effective date of 7/9/99 (CSPR# 99-6-16-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Revisions to sections 10.140 and 10.401 were final adoption following publication at the 4/6/2001 State Board meeting, with an effective date of 6/1/2001 (CSPR# 00-12-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

This Rule Manual Volume 10 concerning Older Americans Act programs was rewritten in its entirety and adopted following publication at the 2/4/2005 State Board meeting, with an effective date of 4/1/2005 (Rule-making# 03-12-1-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to sections 10.620.1, 10.630.1, 10.640, and 10.640.5 were adopted following publication at the 4/7/2006 State Board meeting, with an effective date of 6/1/2006 (Rule-making# 06-1-3-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revision to section 10.820 was adopted as emergency at the 7/31/2006 special emergency State Board meeting, with an effective date of 8/1/2006 (Rule-making# 06-7-20-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revision to section 10.820 was final (permanent) adoption of emergency rules at the 10/6/2006 State Board meeting, with an effective date of 10/6/2006 (Rule-making# 06-7-20-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to Sections 10.150, 10.410.1, 10.710.2, 10.720.2, 10.730.2, 10.730.3, 10.730.4, 10.730.8, and 10.930 through 10.940.2 were final adoption following publication at the 4/4/2008 State Board meeting, with an effective date of 6/1/2008 (Rule-making# 07-12- 17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Sections 10.100 through 10.970 were deleted in entirety and rewritten, as final adoption following publication at the 10/1/2010 State Board meeting, with an effective date of 12/1/2010 (Rule-making# 10- 6- 10-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 10.205, 10.302.3, 10.305.1, 10.418.1, and 10.420.1 were final adoption following publication at the 11/4/2011 State Board meeting, with an effective date of 1/1/2012 (Rule-making# 11-8- 17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

As a result of a comprehensive review of 12 CCR 2510-1, revisions to Sections 10.120, 10.202, 10.203, 10.210, 10.213, 10.301, 10.302.3 – 10.302.5, 10.304.1 – 10.304.3, 10.305, 10.305.1, 10.309, 10.310, 10.316, 10.400, 10.401.11, 10.401.3, 10.401.41, 10.401.43, 10.402.1, 10.402.5, 10.404.2, 10.406.2, 10.407.2, 10.408.2, 10.411.2, 10.411.3, 10.411.41, 10.411.6, 10.411.71, 10.411.74, 10.411.8, 10.412.1 - 10.412.3, 10.412.41, 10.412.6, 10.412.74, 10.412.9, 10.417.4, 10.417.6, 10.417.8, 10.417.91, 10.418, 10.420, 10.420.2, 10.420.31, 10.420.91, 10.421, 10.422.1, 10.422.11, 10.422.22, 10.422.3, 10.422.4, 10.422.5 – 10.422.51, 10.422.6, 10.422.62, 10.422.82, and 10.422.9, were final adoption following publication at the 12/4/2015 State Board meeting, with an effective date of 2/1/2016 (Rule-making# 15-7- 23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

10.100 OLDER AMERICANS ACT PROGRAMS 10.110 INTRODUCTION [Rev. eff. 12/1/10]

The purpose of the Older Americans Act (OAA) is to encourage and assist state agencies and Area Agencies on Aging (AAA) to concentrate resources in order to develop greater capacity and foster the development and implementation of comprehensive and coordinated systems to serve older adults.

A. To accomplish this, the State Department may enter into new and cooperative arrangements with the following:

1. Area Agencies on Aging;

2. Other state agencies including agencies that administer home and community care programs;

3. Indian tribes and tribal organizations;

4. Providers, including voluntary organizations or other private sector organizations, of supportive services, nutrition services, and multipurpose senior centers; and, 5. Organizations representing older adults.

B. The Older Coloradans Act (OCA), Section 26-11-100.1 through 26-11-207, C.R.S., includes the provisions of the Older Americans Act programs. 10.120 DEFINITIONS [Rev. eff. 12/1/10]

“Activities of Daily Living” (ADLs) means activities that are regularly necessary for personal care. These activities include: transfers in and out of a bed or chair, toileting, walking, dressing, bathing, hygiene, and eating.

“Administration” means the Administration on Aging (AoA) of the United States Department of Health and Human Services.

“Adult Day Care” means personal care for dependent older adults in a supervised, protective, and congregate setting during some portion of a day.

“Applicant agency” means an entity that is applying for a contract or other funding, or for designation or consideration as an Area Agency on Aging.

“Area Agency on Aging” (AAA) means a private nonprofit or public agency designated by the State Unit on Aging (SUA) to administer the Older Americans Act and related programs within a Planning and Service Area (PSA) in the State of Colorado.

“Area Agency on Aging Advisory Council” means a representative body of laypersons and service providers, designated by the AAA to represent the interests of older adults within the boundaries of a Planning and Service Area.

“Area Plan” means a document submitted by the AAA to the SUA every four years in a format specified by the State Department, which includes goals and measurable objectives; and identifies planning, coordination, administration, supportive, and nutrition services, as well as evaluation activities to be undertaken.

“Assessment” means the process of determining eligibility for a program, and may be used to measure the changes in a client due to participation in a program.

“Assisted Transportation” means assistance and transportation, including escort, for a person who has physical or cognitive difficulties using regular vehicular transportation.

“Carry-Over” means the estimated or actual portion of the funds made available to a contractee for a budget year which are not expended during that budget year, and which may be available for use (carried over) during a subsequent budget year, or reallocated as necessary.

“Case management” means assistance, either in the form of access or care coordination, in circumstances where the eligible individual and/or their caregivers are experiencing diminished functioning capacities, personal conditions, or other characteristics which require the provision of services by formal service providers. Activities of case management shall include: assessing needs, developing care plans, authorizing services, arranging services, coordinating the provision of services among providers, follow-up, and reassessment, as required.

“Cash and Counseling” means the range of services provided or paid for through allowance, vouchers, or cash that are provided to the consumer so that the consumer can obtain the supportive services that are needed.

“Cash Match” means local cash received from non-Federal and non-State sources, passing to the control of the contractee or sub-contractee or contract agencies, which is used for the payment of allowable costs charged to the contract, and for the satisfaction of requirements for non-Federal/non-State share of program expenses.

“Child” means an individual who is not more than eighteen (18) years of age.

“Chore services” means those services designed to increase the safety of older adults living at home such as assistance with heavy housework, yard work or sidewalk maintenance. Chore service activities are one-time, seasonal or occasional in nature, and shall be planned with input from the older adult based on an evaluation of the older adult’s strengths and needs, and the degree of physical and/or cognitive impairment of the older adult.

“Colorado Commission on Aging” (CCOA) means an advisory board, appointed by the Governor and confirmed by the state Senate to advise the State Unit on Aging on matters concerning older adults and to monitor the implementation of the Older Americans Act. The Commission reviews existing programs for the aging and makes recommendations to the Governor, Colorado Department of Human Services, Colorado Department of Health Care Policy and Financing, and the General Assembly for improvements in such programs.

“Colorado Long-Term Care Ombudsman” (CLTCO) means an entity with expertise and experience in the fields of long-term care and advocacy, serving on a full-time basis to carry out the functions identified in the Older Americans Act.

“Community focal point” means a facility established to encourage the maximum collaboration and coordination of services for older adults.

“Comprehensive and coordinated service delivery system” means a system for providing all necessary supportive services, including nutrition services, in a manner designed to:

A. Facilitate the accessibility and use of interrelated social, supportive, and nutrition services provided to meet the needs of older adults in a Planning and Service Area;

B. Develop and make the most effective use of supportive services and nutrition services in meeting the needs of older adults within the planning and service area;

C. Use resources efficiently and with a minimum of duplication; and, D. Encourage and assist public and private entities that have unrealized potential for meeting the service needs of older adults to provide such assistance on a voluntary basis.

“Conflict of interest” means a direct official action on a matter in which the AAA, provider, council member, or other interested party has the opportunity for substantial financial, contractual, or employment gain.

“Congregate meal” means the provision of a meal that meets all requirements as specified at Section 10.411 of these rules to an eligible older adult at a nutrition site, senior center or some other congregate setting.

“Construction”, with respect to multipurpose senior centers, means building a new facility, including the costs of land acquisition and architectural and engineering fees, or making modifications to or in connection with an existing facility which are in excess of double the square footage of the original facility and/or all physical improvements.

“Contract” means an agreement, allowable and enforceable by law, between two or more competent parties, for a legal consideration. More specifically, in regard to these rules, it is a legal written agreement between agencies or other entities to provide, supply, or perform on the one part, and remunerate on the other part, a particular service, goods, or materials, in (a) particular time frame(s) and location(s).

“Contractor” means an organization or person that provides goods, materials, and/or services for remuneration under the stipulations of a contract.

“Coordination” means a formal or informal arrangement through which the SUA, AAA, or another entity or coalition brings together the planning and service resources of two (2) or more public and private agencies in Colorado for the purpose of expanding or strengthening services for older adults.

Coordination refers to cooperative efforts, in support of common objectives, directed toward joint planning and resource development, increased quality and quantity of services, and the improvement of services to achieve a more effective and efficient comprehensive system.

“Counseling” means the provision of advice or support to assist older adults in addressing issues and concerns, or in making decisions “Desk evaluation” means the process of a review of the direction, compliance with regulations and policy and procedures, efficiency, and effectiveness of a program or part of a program through use of written documentation requested of an AAA by the SUA.

“Dietary supplement” means a product intended to supplement the diet that bears or contains one or more of the following ingredients:

A. A vitamin;

B. A mineral;

C. An herb or other botanical;

D. An amino acid;

E. A dietary substance for use by an older adult to supplement the diet by increasing the total dietary intake; or, F. A concentrate, metabolic, constituent, extract, or any combination of the above ingredients.

“Dietetic Technician, Registered” means an individual who:

A. Has:

1. Completed a minimum of an Associate Degree granted by a U.S. accredited college/university;

2. Completed a Dietetic Technician Program as accredited/approved by the Commission on Accreditation/Approval for Dietetics Education of the American Dietetic Association;

3. Successfully completed the Registration Examination for Dietetic Technicians; and, 4. Accrued fifty (50) hours of approved continuing professional education every five years;

B. Or has:

1. Completed the minimum of a Bachelor’s degree granted by a U.S. regionally accredited college or university, or foreign equivalent;

2. Met current minimum academic requirements (Didactic Program in Dietetics) as approved by the Commission on Accreditation/Approval for Dietetics Education of the American Dietetic Association;

3. Completed a supervised practice program under the auspices of a Dietetic Technician Program as accredited/approved by the Commission on Accreditation/Approval for Dietetics Education of the American Dietetic Association;

4. Fully completed the Registration Examination for Dietetic Technicians; and, 5. Accrued fifty (50) hours of approved continuing professional education within a specific five-year reporting period.

“Education” means a supportive service designed to assist older adults to better cope with their economic, health, and personal needs through services such as consumer education, continuing education, health education, falls prevention education, medication management education, preretirement education, financial planning, and other education and training services which advances the objectives of the Older Americans Act.

“Elder abuse, neglect, and exploitation” means abuse, neglect, or exploitation, of an older adult.

“Employability plan” means a document developed with the enrollee's input that takes into consideration the individual's work history, work preference, skills, aptitudes, and barriers to employment resulting in planned service actions to achieve an agreed upon occupational goal.

“Enrollee” means an older adult who is eligible for the Title V as defined at Section 10.120 “Definitions”, Senior Community Services Employment Program, and receives services and paid wages as a result of participating in program activities and/or community service employment.

“Evaluation” means the process of a review of the direction, compliance with regulations and policy and procedures, efficiency and effectiveness of a program or part of a program through use of an evaluation tool developed by the SUA or AAA including completed written documentation of the findings.

“Evidence-based disease prevention and health promotion program” means a program that meets the current definition of evidence-based disease prevention and health promotion as defined by the Administration on Aging and has:

A. Demonstrated through evaluation to be effective for improving the health and well-being or reducing disease, disability and/or injury among older adults; and, B. Proven effective with older adult population, using experimental or quasi-experimental design;

C. Research results published in a peer-review journal; and, D. Been fully translated in one or more community site(s); and, E. Developed dissemination products that are available to the public.

“Family caregiver” means an adult family member, or another individual, who is an informal provider of inhome and community care to an older adult, or to an individual with Alzheimer’s disease or a related disorder with neurological and organic brain dysfunction.

“Frail” means an older adult who is determined to be functionally impaired due to:

A. Inability to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, B. A cognitive or other mental impairment, requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to self or others.

“Funding letter” means a unilateral contracting document that allows a State agency to increase or decrease the amount of funding for a specific sub-contractee based upon the funding available to the state agency.

“Funding request” means the documentation submitted annually by each AAA to the SUA, in a format prescribed that includes updated budgetary information.

“Greatest economic need” means the need resulting from an income level at or below the federal poverty guidelines.

“Greatest social need” means the need caused by non-economic factors, which include: physical and mental disabilities; language barriers; and cultural, social, or geographical isolation, including isolation caused by racial or ethnic status, that restricts the ability of a person to perform normal daily tasks; or threatens the capacity of a person to live independently.

“Hazard Analysis Critical Control Point” (HACCP) means a proactive, comprehensive, science-based, food safety system, approved by the Colorado Department of Public Health and Environment that allows nutrition project operators to continuously monitor their establishments and reduce the risk of food borne illness.

“Health oversight agency” means an agency or authority of the United States, a state, a territory, a political subdivision of a state or territory, or an Indian tribe, or a person or entity acting under a grant of

authority from or contract with such public agency, including the employees or agents of such public agency or its contractors or persons or entities to whom it has granted authority, that is government programs in which health information is necessary to determine eligibility or compliance, or to enforce civil rights laws for which health information is relevant.

“High nutrition risk” means a score of six (6) or more on the Determine Your Nutritional Risk checklist published by the Nutrition Screening Initiative. Requirements shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication “Homebound” means an older adult who is assessed as unable to leave his or her home without human assistance, due to a disabling physical or emotional condition or an environmental condition that may have a health related impact.

“Home delivered meal” means the provision of a meal that meets all requirements as described at Section 10.412, et seq., of these rules to an eligible individual at that person’s home.

“Home health aide” means a Certified Nursing Aid (CNA) who does not hold a license or other mandatory professional requirements for practice, other than certification, who performs services under the supervision of a RN.

“Homemaker services” means providing assistance to persons who meet the eligibility requirements for in-home services and who are unable to perform two or more of the following instrumental activities of daily living: preparing meals, laundry, shopping for personal items, managing money, using the telephone, or doing light housework.

“Home modification” means specific adaptations, repairs, maintenance, renovation, modifications, or improvements in a consumer’s existing home setting.

“Host agency” means a public or private nonprofit organization, other than a political party, exempt by law from taxation that provides a worksite and supervision for an enrollee under the Title V, as defined at

Section 10.120 “Definitions”, Senior Community Services Employment Program.

“Indian tribe,” except for the purposes of Title VI of the Older Americans Act, as defined at Section 10.120 “Definitions”, means any tribe, band, nation, or other organized group or community of Indians, which is:

A. Recognized as eligible for special programs and services provided by the United States to Indians because of their status as Indians; or, B. Located on, or in proximity to, a federal or state reservation or rancheria.

“Information and assistance” means a service that provides individuals with information on services available within the community and links individuals to the services and opportunities that are available within the community.

“In-kind match” means services, goods, or property donated by a contractee or third party, which are allowable costs of a contract, for which no cash reimbursement is required, and which are applied to a requirement for the non-federal/non-state share of program expenses.

“Instrumental Activities of Daily Living Skills” (IADLS) means activities necessary for independent living, including: meal preparation, shopping, medication management, housework, laundry, appointment management, money management, access resources, transportation, and telephone.

“Internal control” means processes designed to provide reasonable assurance regarding the achievement of objectives in the following categories:

A. Effectiveness and efficiency of operations;

B. Reliability of financial reporting; and, C. Compliance with applicable laws and regulations.

“Legal assistance” means legal advice, counseling, and representation provided by an attorney or other person acting under the supervision of an attorney.

“Local ombudsman” means an individual trained and designated as qualified by the state Long-Term Care Ombudsman to act as a representative of the office of the state Long-Term Care Ombudsman pursuant to Section 26-11.5-103(2), C.R.S.

“Long-Term Care (LTC) facility” means:

A. A nursing facility as defined at Section 25.5-4-103(14), C.R.S.;

B. An assisted living residence as defined at Section 25-27-102(1.3), C.R.S.; or, C. An extended care facility with any swing bed.

“Long-Term Care Ombudsman complaint” means an alleged problem or issue, verbal or written, in which the Colorado or Local Long-Term Care (LTC) Ombudsman takes direct action or suggests action at the request of residents, family, or other interested persons. Such action is taken in order to identify issues, resolve problems, or alter the outcome of situations. Complaints may be specific to individual residents or may involve general issues affecting many residents.

“Long-Term Care Ombudsman education” means provision of information and/or training to residents and staff of LTC facilities and communities, regarding resident’s rights, the ombudsman, and other related issues.

“Long-Term Care Ombudsman services” means actions taken to identify, investigate, or seek to resolve complaints made by or on behalf of an older adult who resides in a long-term care facility, relating to actions, inactions, or decisions of providers or public agencies that may adversely affect the health, safety, welfare, and rights of the residents.

“Low-income” means incomes below the federal poverty guidelines.

“Material aid” means aid in the form of goods or food such as direct distribution of commodities, surplus food, and distribution of clothing, smoke detectors, eyeglasses, hearing aids, oral health, or security devices.

“Means test” means the use of an older adult’s income or resources to determine eligibility pursuant to these rules.

“Medical food” means a food formulated to be consumed or administered entirely under supervision of a physician, and intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.

“Monitoring” means a review by the contractor agency of one or more contract activities, that may include on-site visits to the contractor agency; and/or data collection activities of contractors and subcontractors, for the purpose of assuring that the contract is being administered in accordance with the Older Americans Act programs, and that the purposes of the contract are being met.

“Multigenerational” means activities intended to promote interaction among generations, and may include opportunities for older adults to serve as mentors or advisors in childcare, youth day care, educational assistance, at-risk youth intervention, juvenile delinquency treatment, and family support programs.

“Multipurpose senior center” means a community facility for the organization and provision of a broad spectrum of services for older adults including: mental and physical health services; social, nutritional, and educational services; and the provision of facilities for recreational activities for older adults.

“Native American” means an American Indian or a Native Hawaiian.

“Native Hawaiian” means any individual whose ancestors were natives of the area that consists of the Hawaiian Islands prior to 1778.

“Needs assessment” means the process of evaluating an older adult’s status and needs; identifying the service or combination of services required to maintain the older adult’s ability to live independently.

“Nonprofit,” as applied to any agency, institution, or organization, means an agency, institution, or organization owned and/or operated by one or more corporations or associations whose profits must be used exclusively for the charitable, educational or scientific purpose for which it was formed.

“Nutrition counseling” means the provision of individualized advice and guidance, by a registered dietitian in accordance with federal or state law and/or policy, to individuals or their caregivers, for those individuals at nutritional risk because of their health or nutritional history, dietary intake, medication use, or chronic illnesses. Nutrition counseling addresses the options and methods for improving nutrition status.

“Nutrition education” means a program to promote better health by providing accurate and culturally sensitive nutrition, information and instruction to older adults and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise.

“Nutrition outreach” means an activity designed to seek out and identify the maximum number of older adults in greatest need of nutrition and supporting social services, such as those hard to reach, isolated, withdrawn, low-income, or a minority.

“Nutrition project area” means the geographic area for which a single nutrition project is designed.

“Nutrition screening” means the process of identifying older adults at nutritional risk or with malnutrition.

“Nutrition services” means services and activities intended to provide older adults with assistance in maintaining a well-balanced diet, including congregate and home delivered meals, nutrition counseling and nutrition education.

“Nutrition Services Incentive Program (NSIP)” means a program carried out by the United States Department of Health and Human Services to allot cash, commodities, or a combination of cash and commodities to states and contractees providing nutrition program to older adults.

“Nutrition site” means a location where congregate meals are provided, and may include senior centers, community buildings, older adult housing complexes, and public schools.

“Nutritionist” is defined as an individual who has:

A. Completed the minimum of a Bachelor’s degree granted by a United States accredited college or university in foods and nutrition or home economics; and, B. Professional, verifiable experience of a minimum of six months in nutrition education, menu design, and menu analysis.

“Older adult” means a person who is sixty (60) years of age or older.

“Older Americans Act funds” means Federal funds authorized under the Older Americans Act.

“On-site evaluation” means the process of reviewing of the direction, compliance with regulations and policies and procedures, efficiency and effectiveness of a program or part of a program through both discussion, and review of documentation with relevant persons by the SUA or AAA.

“Outreach” means an interaction with individuals initiated by an agency or organization for the purpose of identifying potential clients (or their caregivers) and encouraging their use of existing services and benefits.

“Personal care” means providing personal assistance, stand-by assistance, supervision or cues for persons who meet the requirements for in-home services.

“Personal representative” means an individual who, under applicable law has authority to act on behalf of an individual who is an adult or an emancipated minor in making decisions related to health care.

“Place of residence” means a permanent declared dwelling place.

“Planning and Service Area” (PSA) means a geographic area of the state, designated by the State Unit on Aging for purposes of planning, development, delivery, and overall administration of services under an Area Plan.

“Poverty level” is based on the federal poverty guidelines.

“Program” means a particular set of services and activities authorized and funded.

“Program development” means activities directly related to either the establishment of a new service or the improvement, expansion, or integration of existing services.

“Program income” means any income generated by a contractor or subcontractor from activities, part or all of the cost of which is borne by the contractor or subcontractor.

“Public information” means a service that provides the public and individuals with information on resources and services available to consumers within their communities.

“Public transportation vehicle” means a bus, car, train, light-rail vehicle, or any other mode of transportation used by a public transportation entity to provide transportation services to the general public.

“Reassurance” means the process of contacting an older adult on a regular basis in order to provide comfort and/or help.

“Registered Dietician” means an individual who has:

A. Completed the minimum of a Bachelor’s degree granted by a United States regionally accredited college or university;

B. Met current academic requirements (Didactic Program in Dietetics) as approved by the Commission on Accreditation/Approval for Dietetics Education of the American Dietetic Association;

C. Completed a minimum of nine hundred (900) supervised practice hours of pre- professional experience accredited/approved by the Commission on Accreditation/Approval for Dietetics Education of the American Dietetic Association. Requirements referenced in A, B, and C shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication D. Successfully completed the Registration Examination for Dietitians; and, E. Accrued seventy-five (75) hours of approved continuing professional education every five years.

“Registered service” means a service that requires the collection of consumer demographic or other information as defined by the State Unit on Aging.

“Representative payee” means a person who is appointed by a governmental entity to receive, on behalf of an older adult who is unable to manage funds by reason of a physical or mental incapacity, any funds owed to the individual by the entity.

“Resident” means any older adult who is sixty (60) years of age or older, who is a current, prospective, or former patient or consumer of any long-term care facility.

“Rural” means any area that is not defined as urban.

“Screening” means the process of administering a standard instrument or tool to determine an older adult’s needs.

“Single Entry Point” (SEP) means the availability of a single access or entry point within a local area where a current or potential long-term care consumer may obtain long-term care information, screening, assessment of need, and referral to appropriate long-term care programs and case management services.

“Supplemental Nutrition Assistance Program” (SNAP) formerly known as 'The Food Assistance Program' provides food benefits to low-income households. Electronic Benefit Transfer (EBT) cards are issued and are used like cash at most grocery stores to buy food, ensuring that recipients have access to a healthy diet.

“State Unit on Aging” (SUA) means the unit in the State agency designated by the Executive Director to administer the Colorado State Plan on Aging including Older American Act programs. In Colorado, this agency is the Colorado Department of Human Services, Division of Aging and Adult Services.

“Subcontract” shall be defined the same as “contract” , except that subcontracts are awarded by Area Agencies on Aging (AAA). An agency to which a contract is made by the AAA to provide services pursuant to the Older Americans Act requirements is a subcontractee.

“Sub-project sponsor” means a public or private nonprofit organization awarded funds and positions by the SUA to administer the Senior Community Services Employment Program within an agreed upon geographic area. It is used interchangeably with the terms sub-project and sub-contractee.

“Supportive services” means those services as described in these rules and as included in the State Plan on Aging.

“Swing bed” means hospital beds that can be used as either Skilled Nursing Facility (SNF) or hospital inpatient levels of care on an as needed basis. The facility must receive approval from Medicare to provide post-hospital SNF care.

“Therapeutic diet” means “Therapeutic diet” means a diet intervention ordered by a health care practitioner as part of the treatment for a disease or clinical condition manifesting an altered nutritional status, to eliminate, decrease, or increase certain substances in the diet (e.g., sodium, potassium).

“Title III” shall mean Title III of the Older Americans Act of 1965, codified at 42 U.S.C. Sections 3021 to 3030s-2. No further amendments or editions are incorporated. Copies of this code are available for inspection during normal business hours or by contacting: Division of Aging and Adult Services, Manager, State Unit on Aging, Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado “Title V” shall mean Title V of the Older Americans Act of 1965, codified at 42 U.S.C. Sections 3021 to 3030s-2. No further amendments or editions are incorporated. Copies of this code are available for inspection during normal business hours or by contacting: Division of Aging and Adult Services, Manager, State Unit on Aging, Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado “Title VI” shall mean Title VI of the Older Americans Act of 1965, codified at 42 U.S.C. Sections 3021 to 3030s-2. No further amendments or editions are incorporated. Copies of this code are available for inspection during normal business hours or by contacting: Division of Aging and Adult Services, Manager, State Unit on Aging, Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado “Title VII” shall mean Title VII of the Older Americans Act of 1965, codified at 42 U.S.C. Sections 3021 to 3030s-2. No further amendments or editions are incorporated. Copies of this code are available for inspection during normal business hours or by contacting: Division of Aging and Adult Services, Manager, State Unit on Aging, Colorado Department of Human Services, 1575 Sherman Street, Denver, Colorado “Transportation” (one-way trip) means going from one location to another in a vehicle. It does not include any other activity.

“Tribal organization”, except for purposes of Title VI of the Older Americans Act, as defined at Section 10.120 “Definitions”, means the recognized governing body of any Indian tribe, or any legally established organization of Indians, which is controlled, sanctioned, or chartered, by such governing body.

“Urban area” means a territory identified according to criteria that encompasses at least 2,500 people, of which at least 1,500 reside outside institutional group quarters. 10.200 AREA AGENCIES ON AGING (AAA) [Rev. eff. 12/1/10]

Area Agencies on Aging engage in community planning, coordination, and program development, and provide a broad array of services for eligible older adults.

10.201 AAA DESIGNATION 10.201.1 Designated Agency Requirements [Rev. eff. 12/1/10]

A designated Area Agency on Aging shall be:

A. An established AAA operating within a Planning and Service Area (PSA);

B. Any office or agency of a unit of general purpose local government which is designated to function only for the purpose of serving as an AAA by the chief elected official of the unit;

C. Any office or agency designated by the appropriate chief elected officials of any combination of units of general purpose local government to act only on behalf of the SUA, which can and will engage only in the planning or provision of a broad range of supportive services, or nutritional services within the PSA; or, D. Any public or private nonprofit agency in a PSA or any separate organizational unit within such an agency, which is under the supervision or direction of the SUA, which can and will engage only in the planning or provision of a broad range of supportive services and nutrition services within the PSA. 10.202 PLANNING AND SERVICE AREA DESIGNATION [Rev. eff. 12/1/16]

A. Planning and Service Areas shall be designated after considering the following:

1. Geographical distribution of older adults age sixty (60) and over in the state;

2. Incidence of need for supportive services, nutrition services, multipurpose senior centers, and legal assistance;

3. Distribution of older adults who have the greatest economic need (with particular attention to low-income minority older adults and older adults residing in rural areas);

4. Distribution of older adults who have the greatest social need (with particular attention to low-income minority older adults and older adults residing in rural areas);

5. Distribution of older adults who are Native Americans residing in the area;

6. Distribution of resources available to provide such services or centers;

7. Boundaries of existing areas within the state that were drawn for the planning or administration of supportive services programs;

8. Location of units of general-purpose local government within the state; and, 9. Consideration of older adults with limited English proficiency.

B. Application for Designation or Modification of a PSA An application for designation or modification of an existing PSA may be made by:

1. Any unit of general-purpose local government that has a population of 100,000 or more;

2. A region within the state that is recognized for area-wide planning;

3. A metropolitan area;

4. An Indian reservation;

5. An Area Agency on Aging; or, 6. The State Unit on Aging.

C. The designation process for a PSA shall be open to new applicants when:

1. More than fifty percent (50%) of the counties in the PSA request the SUA to open the designation for an AAA to new applicants; or, 2. The PSA served by the AAA has been modified; or, 3. The existing AAA withdraws its designation; or, 4. An AAA has been de-designated by the SUA.

D. The applicant shall include an assessment of the distribution of older adults and other factors as outlined in the proposed PSA, including the impact of the proposed change on these same factors in the existing PSAs that would remain if the application were approved.

E. The applicant, the SUA, or any other affected PSA may submit documentation concerning the effect of the proposed change on current delivery systems for consideration by the SUA.

F. An Area Agency on Aging shall be designated for each Planning and Service Area.

G. Right of First Refusal 1. When the State designates a new Area Agency on Aging, the right of first refusal shall be given to a unit of general-purpose local government if the designated agency meets the following criteria:

a. An established office of aging that is operating within a designated Planning and Service Area;

b. Any office or agency of a unit of general purpose local government, which is designated to function only for the purpose of serving as an Area Agency on Aging by the chief elected official of such unit; or, c. Any office or agency designated by the appropriate chief elected officials of any combination of units of general purpose local government to act only on behalf of such combination for such purpose.

2. If the unit of general-purpose local government chooses not to exercise the right of first refusal, preference shall be given to an established or applicant Area Agency on Aging. 10.203 AAA GENERAL RESPONSIBILITIES [Rev. eff. 2/1/16]

A. The responsibilities of the AAA shall include the following:

1. Developing and maintaining an organizational structure and capacity to effectively administer OAA programs and responsibilities;

2. Developing and implementing a plan to assist potential direct service providers to develop capacity to efficiently and effectively provide services under the Area Plan;

3. If applicable, an update of progress in developing potential direct service providers shall be included in the annual funding request;

4. Administering the plan in accordance with fiscal and programmatic requirements stated in the Older Americans Act, in these rules, and the AAA policies and procedures;

5. Identifying needs and targeting of services to older adults;

6. Selecting a local agency, program, or person(s) to be designated as the Local Long-Term Care Ombudsman and to serve as an official and identifiable link to the Colorado Long- Term Care Ombudsman, including designation of a “lead” Local LTC ombudsman;

7. Ensuring that criminal background checks are conducted for all employees, volunteers, and contractors;

8. Providing services or contracting with local providers to provide services under the caregiver support programs;

9. Ensuring that all for-profit contracts shall be submitted to the SUA for approval;

10. Ensuring that funds made available under the Older Americans Act shall not be used for lobbying activities including, but not limited to, any activities intended to influence any decision or activity by any non-judicial federal, state or local individual or body;

11. Ensuring that federal funds are not used to supplant non-federal funds, and those efforts to obtain support from private sources and other public organizations continue;

12. Providing leadership and advocacy for older adults within the PSA, including monitoring and evaluating factors and issues affecting older adults;

13. Establishing and maintaining a uniform data and reporting system compatible with state systems for collection and exchange of required data and information that accurately reflects the project and financial operations; and, 14. Completing reports in formats as required by the SUA.

B. Priority Services The AAA shall ensure that the adequate amounts, as developed by the SUA and with stakeholders’ input, of Title III, as defined at Section 10.120 “Definitions”, Part B funding are expended for the following priority services:

1. Access services as defined in Section 10.400;

2. In-home services as defined in Section 10.400; and, 3. Legal assistance as defined in Section 10.419. 10.204 DIRECT SERVICES AND SERVICE STANDARDS [Rev. eff. 12/1/10]

A. The Area Agency on Aging (AAA) shall not directly provide supportive services, nutrition services, in-home services, or disease prevention and health promotion services unless, in the judgment of the SUA:

1. Provision of the services by the AAA is necessary to assure an adequate supply of services;

2. The services are directly related to AAA administrative functions;

3. The AAA can provide services of comparable quality more economically; or, 4. There is no identified service provider in the PSA that provides the service.

B. Except for the services described above, or where a waiver is granted by the SUA, AAAs shall award funds by contract to community service provider agencies and organizations. 10.204.1 Waiver Application [Rev. eff. 12/1/10]

An AAA shall request a direct service waiver from the SUA in the Area Plan, annual funding request, or whenever the AAA is applying to directly provide a service not previously approved by the SUA. 10.205 OVERSIGHT OF SERVICE PROVIDERS [Rev. eff.1/1/12]

AAAs shall assure that services authorized under the Older Americans Act are delivered through a network of local service providers under contract with the SUA or the AAA. Failure to comply with the requirements of these rules by any service provider including contractors, or subcontractors, shall be grounds for termination of the contract or subcontract. As a condition for receipt of funds under the OAA, all service providers, including contractors and subcontractors, shall:

A. Provide the AAA, within required timeframes, statistical and other information that the AAA requires to meet its planning, coordination, evaluation, and reporting requirements established by the SUA;

B. Specify how the provider intends to satisfy the service needs of low-income minority older adults and older adults residing in rural areas of the area served, including attempting to provide services to low-income minority older adults at least in proportion to the number of low-income minority older adults in the population served by the provider;

C. Provide consumers with an opportunity to contribute to the cost of the service in accordance with Sections 10.310 and 10.401.4;

D. Bring to the attention of appropriate officials for follow-up, conditions or circumstances that place the older adult, or the household of the older adult, in imminent danger;

E. Where feasible and appropriate, make arrangements for the availability of services to older adults in weather related emergencies or other emergency situations;

F. Assist consumers in taking advantage of benefits under other programs;

G. Establish complaint and appeals procedures and inform consumers of their right to complain and receive a written response at the provider level and Inform consumers of their grievance rights and their right to request and receive an informal hearing at the provider level; and, H. Establish a waiting list for services. 10.206 CONSUMER CONFIDENTIALITY [Rev. eff. 12/1/10]

All AAAs and service providers shall maintain the confidentiality of protected health information, including the consumer’s personal identification information such as Social Security Number and individually identifiable health information, and ensure that no information about an eligible consumer is disclosed by the agency or provider without the informed written consent of the consumer or the consumer’s personal 10.207 TARGETING OF SERVICES [Rev. eff. 12/1/10]

A. Preference and priority in the delivery of services shall be given to older adults with limited English proficiency, the greatest social or economic need with particular attention to low income minority older adults and individuals who are frail, homebound by reason of illness or have an incapacitating disability or otherwise isolated as defined below:

1. The need caused by non-economic factors which include physical and mental disabilities, language barriers, and cultural, social, or geographical (rural) isolation such as those caused by racial or ethnic status which restricts an older adult’s ability to perform normal daily tasks or which threatens an older adult’s capacity to live independently; and, 2. The need resulting from an income level at or below the federal poverty guidelines.

B. No person applying for or receiving services under the OAA shall be discriminated against based on age, gender, religion, race, ethnicity, sexual orientation, political belief, or disability. 10.208 OUTREACH [Rev. eff. 12/1/10]

The outreach service shall include activities to assure that the maximum number of eligible older adults are informed of, and have an opportunity to participate in, services funded through the Older Americans Act, including low-income minority older adults and older adults living in rural areas and:

A. Establish communication with the local news media to inform the public of available services and opportunities to contribute to the planning and implementation of services; and, B. In a Planning Service Area where a majority of older adults speak a language other than English as their principal language, provide outreach in that language. 10.209 COORDINATION [Rev. eff. 12/1/10]

Coordination shall include planning, development, and use of community-based resources to create effective service delivery systems within the PSA that delay or prevent institutionalization of older adults, including:

A. Coordinating with the Single Entry Point agency(ies) in the PSA as well as other long-term care services and adult protection;

B. Developing relationships with other service organizations, including local public and nonprofit agencies providing services to older adults within the PSA;

C. Pooling of resources when appropriate;

D. Participating on the Single Entry Point Community Advisory Committee and the Single Entry Point Resource Development Committee, if feasible. 10.210 PROGRAM DEVELOPMENT [Rev. eff. 2/1/16]

A. Program development activities shall include establishment of a new service or improvement, expansion, or integration of existing services.

B. Program development services shall meet the following criteria to be funded with Title III, as defined at Section 10.120 “Definitions”, Part B, supportive services funds:

1. Activities intended to achieve a specific service(s) goal or objective; and, 2. Activities occurring during a specifically defined and limited period. 10.211 AREA PLAN [Rev. eff. 12/1/10]

A. Each AAA shall develop an Area Plan in the format prescribed by the SUA to provide a comprehensive and coordinated system of programs to meet the needs of the older adults in the PSA.

B. All Area Plans must be approved by the SUA.

C. AAAs are responsible for revising and updating Area Plans as required by the SUA.

D. The AAA shall conduct at least one public hearing on the Area Plan to provide an opportunity for the public, officials of county and other local governments, and other interested parties to comment on the Area Plan.

E. The AAA shall conduct public hearings when it plans to submit, amend, or seek a waiver for any

part of the Area Plan, to provide an opportunity for the general public, officials of local units of general-purpose government, service providers, and other interested parties to comment on the Area Plan.

F. A summary of the comments, including resulting changes to the proposal plan(s), shall be submitted to the SUA with the Area Plan and annual updates.

G. Records of the public meetings shall be on file at the AAA and shall be available for review upon request.

H. On an annual basis, using a format specified by the SUA, the AAA shall complete an annual funding request to make fiscal and programmatic adjustments to the Area Plan including the submission of an annual budget. 10.212 DATA COLLECTION, PERFORMANCE EVALUATION, AND MONITORING [Rev. eff. 12/1/10]

A. Data Collection and Reporting The AAA shall ensure that data and reports submitted to the SUA shall be in a format compatible with State systems and that data submitted to the SUA can be manipulated without manual reentry of data by SUA staff.

B. Evaluation Each AAA shall evaluate the costs and benefits, quality, accessibility, utilization, priority, targeting, and overall effectiveness of all programs, services, and activities for which it provides funding within each contracted fiscal year.

C. Monitoring 1. The AAA shall monitor the performance of all service providers awarded a contract at least every six (6) months.

2. On-Site Evaluations The AAA shall conduct a comprehensive on-site evaluation of each new service provider within ninety (90) calendar days of the date the contractor begins providing services to older adults or their caregivers under the OAA and annually thereafter unless otherwise approved by the SUA. 10.213 EMERGENCY PREPAREDNESS/DISASTER RELIEF [Rev. eff. 2/1/16]

A. The OAA provides for potential reimbursement to any state on behalf of AAAs in the state for delivery of supportive services and related supplies during any major disaster declared by the President.

B. Disaster relief funds provide expense reimbursement with no matching requirement for Title III, as defined in Section 10.120 “Definitions”, services provided above those normally expected by the AAA as a result of a declared disaster in their PSA.

C. Eligibility for services is based on OAA eligibility.

D. Disasters for which services may be provided include tornados, floods, earthquakes, drought, blizzards, pestilence, famine, fire, building collapse, transportation accidents, or other situations that the victims of such a disaster cannot alleviate without assistance.

E. Each AAA shall ensure home delivered meal providers deliver emergency meals to home delivered meal consumers.

F. Each AAA shall develop an emergency preparedness plan in the format prescribed by the SUA.

G. All emergency preparedness plans must be approved by the SUA.

H. AAAs are responsible for revising and updating emergency preparedness plans as required by the SUA. 10.214 CONFLICT OF INTEREST [Rev. eff. 12/1/10]

No officer, employee, or other representative of the SUA, Colorado Long Term Care Ombudsman (CLTCO) or an AAA shall give the appearance of a conflict of interest.

A. Staff members of the SUA shall not serve on a policy board or advisory council of an AAA or other organization, which receives OAA or the OCA funds, or has submitted an annual funding request or contract proposal for such funds.

B. Members of AAA Advisory Councils, who are also employees, board members, or serve on subcommittees of agencies that have submitted an annual funding request or contract proposals to the Area Agency on Aging shall not take part in the process of evaluating applications or proposals in the service category in which the proposal was submitted, and shall abstain from voting to approve or disapprove of the application or proposal, or any applications or proposals in the service category in which the proposal was submitted. 10.215 AREA AGENCY ON AGING ADVISORY COUNCIL [Rev. eff. 12/1/10]

A. Each AAA shall establish and support an Advisory Council.

B. In selecting the membership of the Advisory Council, the AAA shall ensure potential conflicts of interest are identified and corrected.

C. The AAA shall make efforts that underserved consumers have representation on the Advisory Council. 10.216 COMMUNITY FOCAL POINTS [Rev. eff. 12/1/10]

A. The AAA shall ensure services funded under the Older Americans Act are based at, linked to, or coordinated with the designated community focal point when applicable, and older adults within the PSA have information regarding access, including transportation, to designated community focal points and OAA programs.

B. The AAA shall work with other appropriate service agencies within the community to achieve maximum coordination and access to services and opportunities from community focal points. 10.217 SENIOR CENTER CONSTRUCTION AND RENOVATION [Rev. eff. 12/1/10]

In making awards for the construction or renovation of senior centers, the AAA shall ensure the facility complies with federal, state and local health, fire, safety, building, zoning, and sanitation laws, ordinances or codes.

10.300 FISCAL ADMINISTRATION AND MANAGEMENT 10.301 ALLOTMENT OF FUNDS FOR TITLE III AND TITLE VII SERVICES [Rev. eff. 2/1/16]

The allocation formula for all Title III and Title VII, as defined at Section 10.120 “Definitions”, services shall be developed in conjunction with the AAAs, SUA, and with input from stakeholders and approved by the Colorado Commission on Aging.

10.302 STATE AND LOCAL MATCH 10.302.1 General Match Requirements [Rev. eff. 12/1/10]

To be acceptable, all matching contributions, including cash and in-kind contributions, shall meet the following criteria:

A. Verifiable from contractor or sub-contractor records;

B. Not included as contributions (match) for any other federally assisted project or program;

C. Reasonable and necessary for proper and efficient accomplishment of project or program objectives;

D. Allowable under applicable cost principles;

E. Not paid by the federal government under another award, except where authorized by federal statute to be used for matching;

F. Provided for in the approved budget; and, G. Conforms to federal matching requirements. 10.302.2 Administrative Match [Rev. eff. 12/1/10]

A. The non-federal share of the cost of administering the Area Plan shall not be less than twenty-five percent (25%) of the total costs incurred for Area Plan administration during the contract period.

B. The non-federal share shall be from local (non-state) sources and may be cash or in-kind contributions. 10.302.3 Title III, Parts B and C [Rev. eff. 2/1/16]

Title III, as defined at Section 10.102 “Definitions”, Parts B and C require a fifteen percent (15%) match.

A. The State shall match at least five cents ($0.05) for every eight-five cents ($0.85) of federal funding.

B. The local match requirement shall be ten percent (10%) of the combined state and federal funds (in cash or in-kind).

C. The SUA shall not require that every sub-contractor or contractor meet the minimum ten percent (10%) local match requirement.

1. The net costs of supportive and nutrition services provided under the Area Plan during the contract period shall contain a local match component of not less than ten percent (10%).

2. The AAA shall have flexibility to determine individual match requirements for its contractors in meeting this ten percent (10%) requirement. 10.302.4 Title III, Part E [Rev. eff. 2/1/16]

A. Title III, as defined at Section 10.120 “Definitions”, Part E funds shall require a twenty-five percent (25%) match, including:

1. Appropriations from the Colorado General Assembly; and, 2. Local resources available to AAAs in the form of cash and in-kind.

B. Expenditures used to satisfy the non-federal share requirement shall be related to the purposes of Title III, Part E, and may not be used to meet the non-federal share requirements of other federal programs, including other sections of Title III, as defined at Section 10.120 “Definitions”. 10.302.5 Title VII [Rev. eff. 2/1/16]

AAAs shall meet the allocation of Title VII, as defined at Section 10.120 “Definitions”, funds with a twentyfive percent (25%) local match (in cash or in-kind contribution). 10.303 IN-KIND CONTRIBUTIONS [Rev. eff. 12/1/10]

A. In-kind contributions include, but are not limited to, the following:

1. Personal services provided by volunteers or other unpaid staff for which the contractor would otherwise have to pay, when the service is an integral and necessary part of the project. These services shall be valued at rates consistent with those ordinarily paid for similar work in the same labor market and may include fringe benefits.

2. Donated goods, including expendable property such as office supplies, laboratory supplies, or workshop and classroom supplies, shall be valued at fair market value at the time of donation.

3. If approved by the SUA, donated buildings, space, land, or equipment shall be valued at:

a. Fair rental value of the equipment or space if the donor retains ownership; or, b. Fair market value at the time ownership of the building, space, land, or equipment is transferred to the contractor, if the contracting agency approves the match.

4. Depreciation or use allowance may be counted as match.

B. In-kind contributions shall be documented to identify the in-kind contribution and the methodology for determining the value placed on the in-kind contribution.

C. The value of donated goods or services shall not be reimbursable as a direct or indirect cost of the contract.

D. Neither the cost nor the value of in-kind contributions shall be counted toward satisfying a costsharing (match) requirement of an OAA grant, if counted towards satisfying a cost-sharing or matching requirement for another federal grant, a federal procurement contract, or any other award of federal funds. 10.304 AREA PLAN FUNDING REQUESTS AND APPROVAL [Rev. eff. 12/1/10]

A. Contractors of the SUA shall apply for Older Americans Act funds at a time and in the format designated by the SUA.

B. Contractors shall be notified in writing by the SUA of approval, conditional approval, or disapproval of the application.

C. Issuance of the signed option letter or funding letter constitutes spending authority for the contractor, and approval of the Area Plan and/or annual funding request.

D. The project period shall be stipulated in the option letter or funding letter issued by the SUA and shall be the period from the start date of the contract to the end date of the contract.

E. The project period shall not extend beyond the end of the contract unless a later date is specifically authorized in writing by the SUA or specified in the funding request or contract approved by the SUA.

F. Submission of a request for reimbursement after the issuance of an option letter or funding letter, or revised option letter or funding letter is issued, constitutes acceptance of all contract conditions, unless a written appeal is filed by the AAA. 10.304.1 Awarding of Funds [Rev. eff. 2/1/16]

A. The federal government awards funds to the SUA for the purpose of distributing such funds throughout Colorado according to the guidelines established under the Older Americans Act and the approved State Plan on Aging.

B. The AAAs shall have a formal award agreement or contract with service providers to provide services under the Area Plan.

C. Preference in awarding funds or contracts for Title III, as defined at Section 10.120 “Definitions”, services shall be given to minority organizations which meet any one of the following criteria: not for profit organization with a controlling board comprised at least fifty-one percent (51%) of individuals who are American Indian or Alaskan Native Asian, Black or African American, Native Hawaiian or other Pacific Islander, or Hispanic or a private business concern that is at least fiftyone percent (51%) owned by individuals in the racial and ethnic categories listed above or a publicly owned business having at least fifty-one percent (51%) of its stock owned by one or more individuals and having its management and daily business controlled by one or more individuals in these racial and ethnic categories listed, if, in the judgment of the awarding agency and all other requirements being equal, the award or contract:

1. Facilitates meeting the requirement of giving preference to older adults with greatest social or economic need; and, 2. Results in particular attention to low-income minority older adults and older adults living in rural areas. 10.304.2 Conditions of Award or Contract [Rev. eff. 2/1/16]

Program activities conducted with a Title III, as defined at Section 10.120 “Definitions”, award or contract shall comply with the following:

A. The Older Americans Act;

B. Clarifications or guidance issued by the United States Department of Health and Human Services;

C. Colorado Department of Human Services’ Older Americans Act Program rules;

D. Any conditions attached to the contract, option letter or funding letter issued to Area Agencies, sub-contractors, or contractors; and, E. Requirements found at 45 CFR, Part 1321; 45 CFR, Part 74; 45 CFR, Part 92; and 45 CFR, Part 95. These shall not include any later amendments to or editions of the incorporated material.

Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication 10.304.3 Cash Advances on Awards [Rev. eff. 2/1/16]

A. The SUA may provide cash advances to an AAA for cash flow purposes during the reimbursement period.

B. Cash advances shall be distributed from the specific federal funding part that made up the money for the advance.

C. Cash advances shall be used to pay for services funded through the specific federal funding part related to the advance.

D. Cash advances that are made up of federal dollars shall not be used as an advance for other funding streams.

E. In the event a new agency becomes the AAA, the exiting AAA shall return the balance of the cash advance to the SUA within thirty calendar days of contract termination. 10.304.4 Interest on Cash Advances [Rev. eff. 12/1/10]

A. Contractors and sub-contractors shall maintain advances of federal funds in interest-bearing bank accounts. This shall include cash advances as described in this rule section.

B. Interest earned on these cash advances of federal funds shall not be considered “local” income.

C. Interest amounts up to $250.00 per year may be retained for administrative expenses.

D. Interest amounts in excess of $250.00 shall be remitted annually to the SUA. 10.304.5 Enforcement, Suspension, or Termination of a Contract [Rev. eff. 12/1/10]

A. The contracting agency (SUA or AAA) shall take one or more enforcement actions, if the contract recipient:

1. Fails to comply with these rules; or, 2. Has materially failed to comply with the terms of the annual funding request; or, 3. Fails to carry out required corrective action by the dates specified by the contracting agency.

B. Enforcement actions may include:

1. Temporarily withholding cash payments pending correction of the deficiency by the contractor or sub-contractor;

2. Disallowance (denial of use of funds and any applicable matching credit) for all or part of the cost of the activity or action not in compliance;

3. Total or partial suspension of the current award;

4. Termination of the current award; and, 5. Other remedies as may be legally available.

C. Non-compliance shall be documented by the contracting agency.

D. The contracting agency shall notify the contractor in writing of the required corrective actions and dates by which the corrective action shall be due.

E. Notification shall include the contractor’s or sub-contractor’s rights to a hearing, appeal or other administrative action.

F. The contractor or sub-contractor shall not incur new obligations against the contract during the period of suspension unless expressly authorized to do so by the contracting agency.

G. If the contractor remains in suspension until the end of the contract period recorded in the option letter or funding letter, the contract shall be automatically terminated.

H. If a contract to an AAA is suspended or terminated by the SUA, the agency acting on its behalf may administer the Area Plan described in Section 10.211.

I. Termination of a contract shall occur on other grounds if:

1. The contracting agency and the contractor agree upon the termination conditions; or, 2. The contractor notifies the agency in writing of the termination, the effective date and, in case of partial termination, the portion of the contract to be terminated.

J. In the case of partial termination, the contracting agency shall determine whether the remaining portion of the contract will accomplish the purposes for which it was awarded. If not, the contracting agency may terminate the contract in its entirety.

K. If a contract is terminated:

1. The contractor shall not incur new obligations after the effective date of the termination;

2. The contractor shall cancel outstanding obligations; and, 3. The contracting agency shall allow full credit to the contractor for obligations properly incurred prior to termination that cannot be cancelled. 10.304.6 Multipurpose Senior Center Federal Reversionary Interest [Rev. eff. 12/1/10]

The Administration on Aging (AOA) retains a federal reversionary interest to recover funds at a percentage of the current market value of the multipurpose senior center, equal to the percentage of AOA funds contributed to the cost of the facility. 10.305 TRANSFERS OF FUNDS [Rev. eff. 2/1/16]

A. The OAA provides authority for the state to transfer funds, within specific limits, among its allotments for supportive services and senior centers, congregate meals and home delivered meals.

B. The OAA does not provide authority for the State to transfer funds in or out of the allotments for Preventive Health Services/Disease Prevention, the Long-Term Care Ombudsman or the National Family Caregiver Support Program.

C. The AAA may transfer up to forty percent (40%) of funds between Title III, as defined at Section 10.120 “Definitions”, Part C-1 (Congregate meals) and Part C-2 (Home delivered meals).

D. The AAA may transfer up to thirty percent (30%) of its allotment between Title III, Part B, and the Nutrition Programs under Title III, as defined at Section 10.120 “Definitions”, Part C.

E. If the AAA requests a transfer that exceeds the maximum percentage, a waiver justifying the additional amount shall be submitted to the SUA. 10.305.1 Restrictions on Fund Use [Rev. eff.2/1/16]

A. Program development and coordination activities shall not be funded as a cost of supportive services for Area Plan administration until the AAA has spent 10 percent (10%) of its Title III, as defined at Section 10.120 “Definitions”, allotments on administration of Area Plans.

B. Title III Program Income Program income generated by Title III, as defined at Section 10.120 “Definitions”, shall not be used for AAA administration.

C. Title III, Part E – National Family Caregiver Support Program 1. Area Agencies on Aging providing caregiver services to consumers and/or their families prior to enactment of the Title III, as defined at Section 10.120 “Definitions”, Part E, shall:

a. Use these funds only to increase the level of services provided; and, b. Not supplant other federal, state or local funds used for this purpose with funds from Title III, as defined at Section 10.120 “Definitions”, Part E.

2. Area Agencies on Aging shall not expend more than ten percent (10%) of Title III, as defined at Section 10.120 “Definitions”, Part E, Federal funds to provide support services for grandparent caregivers. 10.306 CARRY-OVER FUNDS [Rev. eff. 12/1/10]

Area Agencies on Aging shall expend OAA funds during the budget year for which the funds are granted.

Carry-over funds are funds that are not expended during the budget year and may be available during the next budget year. The SUA may reallocate carry-over funds, or carry-over funds may revert to the SUA. 10.307 PAYMENT [Rev. eff. 12/1/10]

Contractors shall submit requests for reimbursement in the format and time period required by the SUA.

10.308 ACCOUNTING 10.308.1 General Requirements [Rev. eff. 12/1/10]

A. Agencies which are contractors of the SUA shall utilize double-entry accounting systems including, but not limited to: a general ledger, cash receipts journal, cash disbursements journal, in-kind receipts, disbursements journal, and general journal. Additionally, individual payroll records shall be maintained.

B. Contractors shall have qualified accounting personnel available to perform accounting functions. 10.308.2 Internal Control Procedures [Rev. eff. 12/1/10]

State contractors shall ensure that internal controls are established and maintained for itself and its subcontractors in accordance with state policies and procedures. At a minimum, agencies shall develop and maintain a fiscal policy and procedures manual that shall establish minimum fiscal requirements in accordance with federal, state, and local statutes, rules, and procedures. The local advisory council shall review the fiscal policy and procedures manual. If the agency is an AAA, the agency’s governing board shall approve the fiscal policy and procedures manual. The fiscal policy and procedures manual shall include, but not be limited to:

A. Cash control procedures including requirements for the collection of consumer contributions and guest fees, recording of cash receipts and expenditures, depositing of cash, separation of cash handling from record keeping responsibilities and periodic reconciliation of all cash funds including bank accounts;

B. A plan to equitably distribute on a timely basis the state's cash advance by the AAA to its subcontractors;

C. Bidding, purchasing, and contracting procedures in accordance with federal, state and local requirements;

D. Requirements for bid guarantees, performance bonds and payment bonds for bids and contracts for construction and facility improvement;

E. A procedure for distributing joint costs among projects or contracts in accordance with the section on cost distribution methods in these rules; and, F. In-state and out-of-state travel policies, including specification of required signatures and documentation. 10.309 TITLE III PROGRAM INCOME [Rev. eff. 2/1/16]

A. Program income shall include all income earned by a contractor, or subcontractor that is directly generated by supported activities, the cost of which is borne by the contractor or subcontractor, B. All program income shall be used in accordance with the additional costs alternative and shall be added to funds committed to the project or program, and used to further eligible project or C. All program income, including earnings, and expenditures of program income shall be reported D. Program income shall be fully expended before requesting reimbursement for Older Americans Act or state funding for senior services. 10.310 CONSUMER CONTRIBUTION [Rev. eff. 2/1/16]

A. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under Title III, as defined at Section 10.120 “Definitions”.

B. Methods of solicitation for voluntary contributions shall be non-coercive.

C. The AAA shall provide service providers with policy and guidelines for accepting voluntary 1. The AAA shall establish and maintain procedures to protect the privacy of the consumer’s 2. Eligible consumers shall not be denied service(s) provided under Title III, as defined at

Section 10.120 “Definitions”, because the consumer’s decision not to contribute.

3. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the D. The AAA and service providers shall not perform a means test for any service for which contributions are accepted, or deny services to any eligible consumer who does not contribute to E. Guest Fees Guest fees are required charges equal to the full cost of the service to persons who are not eligible consumers of the program but are receiving services. Fees shall be determined using guidelines and procedures established by the SUA.

F. Usage Fees Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-contract purposes. If nutrition project contractors or sub-contractors use equipment purchased with Title III, as defined at Section 10.120 “Definitions”, funds to produce meals sold to other organizations:

1. The compensation shall be directly credited to the cost of goods or services provided under the current contract, if the equipment was acquired under the current year’s contract; and, 2. If the equipment was acquired with a prior year’s contract, the compensation shall be recorded as program income.

G. Sales of Equipment and Supplies Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for as program income.

H. Program income earned after contract support has ended shall be subject to the terms of the contract or subcontract. If this category of income is not specifically detailed in the contract document, the agency may dispose of the income as it chooses. 10.311 THIRD PARTY PAYMENTS [Rev. eff. 12/1/10]

A. Payments from Medicare, insurance companies, or other third party sources shall be credited directly to the cost of goods or services provided.

B. If Medicaid funds are used to purchase services, no additional funds shall be used for those services.

C. Refunds for defective or unused merchandise or manufacturer rebates or discounts shall be credited directly to the cost of the goods or services provided.

D. Donations unrelated to the receipt of services are not program income and may be used to meet local matching requirements.

E. The use of goods and property, and the value of staff personnel time used in fund raising activities shall be fully compensated. 10.312 NUTRITION SERVICES INCENTIVE PROGRAM (NSIP) [Rev. eff. 12/1/10]

A. Funds received from the AoA shall be distributed by SUA.

B. The AAA allocation shall be based on the percentage of the number of eligible meals served each year by the AAA/nutrition service project to the total number of meals served under Colorado Nutrition projects.

C. All meals shall be reported to the SUA on a regular basis in the format required by the SUA.

D. NSIP cash funds shall only be used to purchase United States agricultural foods for the nutrition program, and shall be used to increase the number of meals served. 10.313 FIXED ASSETS, SUPPLIES, AND CAPITAL EXPENDITURES [Rev. eff. 12/1/10]

A. Fixed assets are:

1. Real property (land, buildings, and building improvements);

2. Leasehold improvements (remodeling or redecorating of rented or leased spaces); and, 3. Tangible personal property (office furniture, kitchen equipment and vehicles) with a useful life of more than one (1) year.

B. Fixed assets may be acquired by purchase or by donations.

1. Prior approval of the contracting agency shall be obtained prior to purchase of a fixed asset with a value in excess of $5,000.00. Issuance of an option letter or funding letter shall constitute approval if the proposed purchase and its justification have been included in the fiscal section of the funding request.

2. Donations of fixed assets shall be used as in-kind match if they further the purposes of the contract. The cost shall be recorded at fair market value and all requirements for fixed assets shall apply.

C. The AAA or sub-contractor shall maintain, at a minimum, insurance coverage adequate to cover the replacement value of all fixed assets.

D. Fixed assets funded in whole or in part by grant funds may be used on a part-time basis for nongrant purposes by:

1. Nonprofit agencies, provided that:

a. A minimum usage fee is charged in accordance with program income requirements at Section 10.401.16; and, b. The part-time usage does not conflict with the use of the equipment for the purposes of the contract.

2. Profit-making organizations, provided that:

a. A usage fee equal to or greater than the prescribed minimum is charged;

b. Usage does not conflict with the use of the equipment for purposes of the contract; and, c. Prior approval has been obtained from the contracting agency. 10.314 FISCAL AND PERFORMANCE REPORTING REQUIREMENTS [Rev. eff. 12/1/10]

A. At the end of each reporting period, performance and fiscal reports shall be submitted to the SUA in a format and time period specified by the SUA.

B. Area Agencies on Aging failing to meet SUA requirements to provide accurate and timely reports may be subject to further corrective action, including:

1. Suspension of reimbursement payments; and, 2. Withholding of funding request. 10.315 DATA AND REPORTING [Rev. eff. 12/1/10]

Each AAA shall ensure that record keeping and documentation requirements are met as required by the A. Documentation Documentation including, but not limited to, consumer files, accounting records, deposit slips, cancelled checks, bank statements, monthly bank reconciliation, invoices, receiving reports, shall be maintained and clearly documented with supporting information and references.

B. Retention of Records 1. Contractors and sub-contractors shall retain fiscal and programmatic records until formal written notice permitting disposal of the records is received from the contracting agency.

2. The SUA shall transmit written notice to its contractors within six (6) months of the date retention of the records is no longer required by federal regulations.

3. Within three (3) months after receiving the notice, the AAA shall notify its sub-contractors in writing that retention of the records is no longer required. 10.316 FISCAL AUDITS [Rev. eff. 2/1/16]

A. Frequency of Audits 1. An independent auditor shall audit all AAAs annually.

2. Each contractor of the SUA and each sub-contractor shall be audited in accordance with Federal Office of Management and Budget requirements for audits of states, local governments and nonprofit organizations. Requirements shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any state publication depository library.

3. Contractors, including AAAs, of the SUA shall be responsible for scheduling audits of their agency and shall budget for the use of an independent registered certified public accountant to carry out the audit.

4. The audit of an AAA shall include a representative sample of the transactions under contract that are less than lower limits established by the Federal Office of Management and Budget for such audits, if the aggregate of the contracts is material according to the auditor’s judgment.

a. Audits of contractors and sub-contractors shall be conducted in accordance with federal requirements for audits of states, local governments and nonprofit organizations and as directed by the SUA.

b. The contractor of this program is considered an independent contractor of Title III, as defined at Section 10.120 “Definitions”, federal financial assistance, subject to audit requirements regardless of the amount of federal funding the contractor receives.

B. Audit costs may be charged to the contract if the audit meets all requirements of Section 10.316.

If multiple funding sources are covered by the audit, an equitable portion of the audit costs may be charged to the contract. 10.400 SERVICES AND PROGRAMS [Rev. eff. 2/1/16]

A. Among the authorized Services under the Older Americans Act are Access Services, including, transportation, outreach, and information and assistance; In-Home Services including, chore services, home health aide services and homemaker services; and community services including, adult day care and legal assistance.

B. Title III, as defined at Section 10.120 “Definitions”, Part B, authorizes senior centers; access services, such as transportation, outreach, information and assistance, and case management;

In-home services; and community services, such as adult day care, long-term care ombudsman, and legal assistance.

C. Title III, as defined at Section 10.120 “Definitions”, Parts C-1 and C-2, authorizes nutrition services including nutrition outreach, nutrition screening, nutrition education, nutrition counseling, and congregate meal and home delivered meal services.

D. Title III, as defined at Section 10.120 “Definitions”, Part D authorizes disease prevention and health promotion services.

E. Title III, as defined at Section 10.120 “Definitions”, Part E authorizes the National Family Caregiver Support Program (NFCSP).

F. Title V, as defined at Section 10.120 “Definitions”, authorizes the Senior Community Services Employment Program (SCSEP).

G. Title VII, as defined at Section 10.120 “Definitions”, authorizes the Vulnerable Elder Rights programs, including legal assistance developer; long-term care ombudsman; and elder rights and prevention of elder abuse, neglect, and exploitation. 10.401 GENERAL PROGRAM AND SERVICE REQUIREMENTS [Rev. eff. 12/1/10]

The following applies to all Older Americans Act, Older Coloradans Act, and State Funding for Senior Services programs and services listed within Section 10.400, et seq. unless more stringent requirements are cited. 10.401.1 General Service Eligibility [Rev. eff. 12/1/10]

All adults age sixty (60) and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need. 10.401.11 General Registration [Rev. eff. 2/1/16]

All recipients of registered services shall have a registration completed as prescribed by the SUA. 10.401.12 General Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult within thirty days of the delivery of registered services using the assessment tool approved by the State Unit on Aging. 10.401.13 General Annual Funding Request Responsibilities [Rev. eff. 12/1/10]

A. Annual Funding Request 1. The AAA shall submit information about the proposed use of State Funding for Senior Services/Older Americans Act funds in the annual funding request.

2. The purpose of the annual funding request shall be to allow the AAA to articulate to the SUA and to the local community an Area Plan for what will be accomplished during the State fiscal year with available funding.

3. The AAA Advisory Council shall:

a. Review the Area Plan to ensure it is in accordance with the requirements of the annual funding request application; and, b. Make recommendations for the plan.

4. The governing board of the AAA shall review the Area Plan. Approval by this board requires the signature of the executive director or chairperson of the governing board.

5. Approval by the SUA shall follow the requirements for approval of the Area Plan and annual funding request as described in these rules.

B. The AAA shall award contracts to service providers using State Funding for Senior Services (SFSS) funds.

1. Contracts awarded by the AAA may cover a multi-year period, but shall not exceed four years.

2. Funds shall be awarded on the State fiscal year.

3. Award of funds for subsequent years shall be contingent on the availability of funds and acceptable performance of the contract as determined by the AAA.

4. AAAs may provide direct service only with approval of the SUA as part of the AAA’s Area Plan or through a direct service waiver. 10.401.14 General Data and Records [Rev. eff. 12/1/10]

The AAA shall collect data and maintain records in the format mandated by the SUA. Data and records shall be used to monitor program administration, compliance, and to evaluate the effectiveness of AAA programs. 10.401.15 General Background Checks AAAs shall ensure that criminal background checks are conducted for all employees, volunteers, and contractors pursuant to the policy and procedure manual. 10.401.2 General Targeting of Services [Rev. eff. 12/1/10]

Preference and priority in the delivery of services shall be given to older adults with the greatest social or economic need with particular attention to low-income minority older adults and individuals who are frail, homebound by reason of illness or incapacitating disability or otherwise isolated as defined below:

A. Need caused by non-economic factors which include physical and mental disabilities, language barriers, and cultural, social, or geographical (rural) isolation including that caused by racial or ethnic status which restricts an older adult’s ability to perform normal daily tasks or which threatens such older adult’s capacity to live independently.

B. Older adults with limited English proficiency.

C. No person applying for or receiving service under the OAA shall be discriminated against based on age, gender, religion, race, ethnicity, sexual orientation, political belief, or disability. 10.401.3 General Program Income [Rev. eff. 2/1/16]

A. Program income shall include all income earned by a contractor, or subcontractor that is directly generated by supported activities, the cost of which is borne by the contractor or subcontractor, B. All program income shall be used in accordance with the additional costs alternative and shall be added to funds committed to the project or program and used to further eligible project or C. All program income, including earnings and expenditures of program income shall be reported D. Program income earned after the contract has ended shall be subject to the terms of the contract or subcontract. If this category of income is not specifically detailed in the contract document, the agency may dispose of the income as it chooses. 10.401.4 General Consumer Contribution and Fees 10.401.41 General Contribution [Rev. eff. 2/1/16]

A. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under Title III, as defined at Section 10.120 “Definitions”.

B. Methods of solicitation for voluntary contributions shall be non-coercive.

C. The AAA shall provide service providers with policy and guidelines for accepting voluntary 1. The AAA shall establish and maintain procedures to protect the privacy of the consumer’s 2. Eligible consumers shall not be denied service(s) provided under Title III, as defined at

Section 10.120 “Definitions”, because of the consumer’s decision not to contribute.

3. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the 4. The AAA and service providers shall not perform a means test for any service for which contributions are accepted, or deny services to any eligible consumer who does not contribute to the cost of the service. 10.401.42 General Guest Fees [Rev. eff. 12/1/10]

Guest fees are required charges equal to the full cost of the service to persons who are not eligible consumers of the program but are receiving services. Fees shall be determined using guidelines and 10.401.43 General Usage Fees [Rev. eff. 2/1/16]

Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-grant purposes.

If nutrition project contractors or sub-contractors use equipment purchased with Title III, as defined at

Section 10.120 “Definitions”, funds to produce meals sold to other organizations:

A. The compensation shall be directly credited to the cost of goods or services provided under the current contract, if the equipment was acquired under the current year’s contract; or, B. If the equipment was acquired with a prior year’s contract, the compensation shall be recorded as 10.401.5 General Sale of Equipment and Supplies Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for 10.401.6 General Payor of Last Resort [Rev. eff. 12/1/10]

OAA funds shall not be used to pay for available services provided through other Federal or State programs for which the older adult is eligible or is receiving. 10.401.7 Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. General 1. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

2. All providers shall keep such records and information as necessary to document the services provided to consumers receiving care.

B. Coordination of Services The AAA or contracted service provider shall coordinate activities with the activities of the Single Entry Point agency(ies), as well as other community agencies and voluntary organizations providing the same types of services.

C. Language Assistance 1. In a PSA where a majority of older adults speak a language other than English as their principal language, the outreach service shall be provided in that language.

2. Information and assistance, and outreach activities shall be conducted in the principle language spoken in areas where Native American older adults comprise at least:

a. One percent (1%) of a PSA’s population age sixty (60) and over; or, b. Five percent (5%) or more of the state’s age sixty and older Native American population reside within a PSA.

10.402 CAREGIVING SERVICES 10.402.1 Caregiving Services Eligibility [Rev. eff. 2/1/16]

A. Area Agencies on Aging (AAAs) and/or the service providers with whom the AAAs contract shall provide support services to caregivers who are:

1. Family caregivers of other individuals, providing informal in-home, and community care to an older adult (sixty years of age or older) who is “frail” and determined to be functionally impaired because of:

a. An inability to perform at least two Activities of Daily Living (ADL) without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, b. Cognitive or other mental impairment that requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or others.

2. Grandparent(s), step-grandparent(s), or older adult(s) who are relative caregivers of a child by blood, marriage, or adoption and are fifty-five (55) years of age or older, and who:

a. Live with the child; and, is the primary caregiver of the child because the biological, step, or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; or, b. Have a legal relationship to the child, such as legal custody or guardianship, or are raising the child informally.

3. Family caregivers providing care for individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction.

B. Family caregiver(s) of a care recipient shall be provided respite care and supplemental services under the National Family Caregiver Support Program only if the care recipient is functionally impaired and meets either of the following conditions:

1. Unable to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or, 2. Due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to himself or herself or another individual.

C. Priority for caregiving services shall be given to:

1. Older adults in greatest economic need or greatest social need with preference given to low-income minority older adults and older adults residing in rural or geographically isolated areas;

2. Family caregivers who provide care for older individuals (as found in 10.402.1, A, 1) with Alzheimer’s disease and related disorders; and, 3. Caregivers who provide care for children with severe disabilities. 10.402.2 Caregiving Services Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services 10.402.21 Caregiving Services Provider Responsibilities and Requirements (Adult Day Care)

A. All providers of adult day care shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. Adult day care centers shall provide a safe environment for all older adults, including older adults exhibiting behavioral problems, wandering behavior, or limitations in mental/cognitive function.

C. Adult day care providers shall keep such records and information as necessary to document the services provided to older adults receiving adult day care.

D. All adult day care centers shall maintain a minimum staff to consumer ratio of 1 to 8 (1:8) to provide for the needs of the population served.

E. Adult day care centers providing medication administration as a service shall have qualified persons on staff trained in accordance with applicable state laws.

F. Adult day care providers shall accept only older adults whose needs can be met by the adult day care center within its certification category and according to its admission criteria. 10.402.22 Caregiver Services In-home Provider Responsibilities and Requirements (Recipient Older adults receiving in-home services under the OAA shall have the following rights:

A. To be fully informed in advance about each in-home service provided under the OAA, and about any change in services that may affect the well-being of the older adult;

B. To participate in planning and changing an in-home service provided under the OAA, unless the C. To voice a grievance with respect to a service that is provided or fails to be provided, without D. To have their property treated with respect; and, E. To be fully informed, orally and in writing, of these rights by the AAA or contractor before receiving an in-home service. 10.402.3 Caregiving Services Registration [Rev. eff. 12/1/10]

All care recipients and their family caregivers receiving registered services under the National Family Caregiver Support Program (NFCSP) shall have a registration completed as prescribed by the SUA. 10.402.4 Caregiving Services Assessment [Rev. eff. 12/1/10]

An assessment, prescribed by the SUA, shall be completed for the care recipient if the caregiver is provided respite services.

A. The assessment shall include, but not be limited to:

1. A caregiver profile, including demographic information on the caregiver and the care recipient;

2. An evaluation of the informal support systems available to, and used by, the caregiver;

3. A care receiver profile and evaluation of the strengths and needs of the older adult; and, 4. Determination of the formal support services and resources available to the caregiver within the community.

B. An assessment or reassessment shall be completed using the format and timeframes prescribed by the SUA. 10.402.5 (None) [Rev. eff. 2/1/16] 10.402.6 Respite Care Services [Rev. eff. 12/1/10]

A. Respite care services include the following activities:

1. In-home services, including services provided by volunteers or in-home service providers;

2. Adult day care services; and, 3. Institutional respite care.

B. Respite care services shall be provided in the most appropriate manner available to meet the needs of the care recipient and the family caregiver.

C. Older Americans Act (OAA) funds shall not be used to pay for respite care services if such services are available and provided through other federal or state programs for which the care recipient is eligible or is receiving. 10.402.61 In-Home Respite Services [Rev. eff. 12/1/10]

A. Volunteer In-home Respite Services If volunteer in-home respite services are provided by the AAA or a contracted agency, the AAA shall be responsible to ensure that the volunteer providing respite services receives the information, training, and ongoing supervision necessary to safely and effectively provide respite care.

B. Non-Volunteer In-Home Respite Services In-home service provider staff, including homemakers or personal care service providers, may be used to provide brief in-home respite services for caregivers if appropriate to the older individual’s needs. 10.402.62 Institutional Respite Care [Rev. eff. 12/1/10]

A. Institutional respite care includes services provided on a short-term basis (i.e., less than thirty (30) consecutive days) in an assisted living residence or nursing facility.

B. Only those portions of facilities that are licensed as nursing facilities or assisted living residences shall be used for respite consumers. 10.402.63 Assisted Living Residence (ALR) Respite Care [Rev. eff. 12/1/10]

An individual utilizing an Assisted Living Residence for short-term respite must be able to be provided adequate services in the ALR. 10.402.64 Nursing Facility Respite Care [Rev. eff. 12/1/10]

A. For each respite consumer, the facility shall provide an initial assessment as described in Section 10.401.25, which shall serve as the plan of care; obtain physicians’ treatment plan and diet orders; and have a chart for the consumer. The chart shall identify the individual as a respite consumer.

B. Admission to a nursing facility for respite care shall not require the same forms as required for a routine nursing facility admission.

C. The nursing facility shall have written policies and procedures available to staff regarding respite care consumers. 10.402.7 Title III, Part E Funding Allocations [Rev. eff. 12/1/10]

A. Funds for the National Family Caregiver Support Program shall be distributed according to the state allocation formula described in Section 10.301.

B. Funding for supplemental services and support services for grandparents and other family caregivers shall be according to the requirements of the Older Americans Act.

C. Services provided under the National Family Caregiver Support Program shall supplement, and not supplant, funding from other federal, state, or local funds for services. 10.402.8 Colorado Family Caregiver Support Program [Rev. eff. 12/1/10]

A. The Colorado General Assembly created the Colorado Family Caregiver Support Program as found in Section 26-11-207, C.R.S., administered by the SUA and the AAAs.

B. The Colorado Family Caregiver Support Program shall follow the intent and guidelines established under the National Family Caregiver Support Program and the requirements of these rules.

C. This program is subject to available appropriations. 10.402.9 Native American National Family Caregiver Support Program [Rev. eff. 12/1/10]

A. Tribal organizations may apply for grants from the AoA to carry out multifaceted systems of support services for caregivers as described under the National Family Caregiver Support Program.

B. In Planning and Service Areas, which border areas served by Tribal Organizations, the AAA for the PSA shall coordinate their service activities with those provided by the Tribal Organization.

10.403 CASE MANAGEMENT SERVICES 10.403.1 Case Management Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty (60) and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.403.2 Case Management Services Provider Responsibilities and Requirements [Rev. eff.

A. Case managers shall have a background in human services, and shall be responsible for arranging and monitoring a package of long-term care services for a consumer.

B. Case management activities shall include, at a minimum, the following:

1. Initial screening to determine that each applicant meets pre-established criteria prior to the conduct of a comprehensive assessment;

2. A comprehensive assessment to identify each applicant’s problems, resources, and needs, to confirm eligibility;

3. Appropriate care planning to specify the types and amounts of care that shall be provided to meet the identified needs of the consumer;

4. Service arrangement to implement the plan of care through formal and informal services;

5. Ongoing monitoring to assure services are appropriately delivered and to ensure the quality of those services; and, 6. Formalized reassessment conducted as necessary to adjust care plans to the consumer’s changing needs.

C. Each case management project shall have written policies and/or procedures to monitor the development, implementation, and management of case files.

D. Each case management provider shall maintain comprehensive and complete case files.

E. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations. 10.403.3 Case Management Services Registration [Rev. eff. 12/1/10]

All recipients of case management shall have a registration completed as prescribed by the SUA. 10.403.4 Case Management Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult before the delivery of services using the assessment tool approved by the SUA.

10.404 CHORE SERVICES (IN-HOME) 10.404.1 Chore Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty (60) and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. In-home services shall be made available to individuals with Alzheimer’s disease and related disorders or with neurological and organic brain dysfunction and their families. 10.404.2 Chore Services Provider Responsibilities and Requirements [Rev. eff. 2/1/16]

In-home service providers receiving funding under Title III, as defined at Section 10.120 “Definitions”, shall coordinate with other agencies to ensure there is no duplication of services. In-home providers shall comply with federal, state, and local regulations and standards for specific services provided to older adults under the OAA program and shall:

A. Develop written policies and procedures for the following:

1. Recruiting, selecting, retaining, and terminating employees;

2. Access to, duplication, and dissemination of information from the older adult’s records in accordance with State statutes on Confidentiality of Information at Section 26-1-114, 3. Protecting and promoting older adult’s rights;

4. Emergency procedures; and, 5. Handling and reporting of critical incidents, including accidents, suspicion of abuse, B. Establish documentation requirements for:

1. Maintaining a log of all complaints and critical incidents, which shall include documentation of the resolution of the problem;

2. Documenting changes in the older adult’s conditions or needs, as well as documentation of appropriate reporting and actions taken as a result; and, 3. Protecting and promoting older adults’ rights. 10.404.21 Chore Services Provider Responsibilities and Requirements (Recipient Rights)

Older adults receiving in-home services under the OAA shall have the following rights:

A. To be fully informed in advance about each in-home service provided under the OAA, and about any change in services that may affect the well-being of the older adult;

B. To participate in planning and changing an in-home service provided under the OAA, unless the C. To voice a grievance with respect to a service that is provided or fails to be provided, without D. To have their property treated with respect; and, E. To be fully informed, orally and in writing, of these rights under the OAA before receiving an inhome service. 10.404.3 Chore Services Registration [Rev. eff. 12/1/10]

All recipients of all in-home services shall have a registration completed as prescribed by the SUA. 10.404.4 Chore Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult prior to the delivery of in-home services using the assessment tool approved by the SUA.

10.405 COUNSELING SERVICES 10.405.1 Counseling Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.405.2 Counseling Services Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. Individuals providing counseling services to assist older adults to resolve concerns or make decisions, whether paid staff or volunteers, shall be knowledgeable or trained to provide the specific type of counseling services offered to the older adult.

B. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

C. All providers shall keep such records and information as necessary to document the services D. Additional services may be funded by the AAA to provide resources for older adults to access existing services, or assist in filling known gaps in the service continuum described in the Area 10.406 DISEASE PREVENTION/HEALTH PROMOTION SERVICES 10.406.1 Disease Prevention / Health Promotion Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.406.2 Disease Prevention/Health Promotion Provider Responsibilities and Requirements [Rev. eff. 2/1/16]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services C. Disease Prevention and Health Promotion services and information shall be provided at multipurpose senior centers, congregate meal sites, through home delivered meal programs or other appropriate sites.

10.407 HOME HEALTH AIDE SERVICES (IN-HOME) 10.407.1 Home Health Aide Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. In-home services shall also be made available to individuals with Alzheimer’s disease and related disorders or with neurological and organic brain dysfunction and their families. 10.407.2 Home Health Aide Services Provider Responsibilities and Requirements [Rev. eff. 2/1/16]

Home health aide service providers shall comply with federal, state, and local regulations and standards for specific services provided to older adults under the OAA program and shall:

A. Develop written policies and procedures for the following:

1. Recruiting, selecting, retaining, and terminating employees;

2. Access to, duplication, and dissemination of information from the older adult’s records in accordance with state statutes on Confidentiality of Information at Section 26-1-114, 3. Protecting and promoting consumers’ rights;

4. Emergency procedures; and, 5. Handling and reporting of critical incidents, including accidents, suspicion of abuse, B. Establish documentation requirements for:

1. Maintaining a log of all complaints and critical incidents, which shall include documentation of the resolution of the problem; and, 2. Documenting changes in the older adult’s conditions or needs, as well as documentation of appropriate reporting and actions taken.

C. In-home service providers receiving funding under Title III, as defined at Section 10.120 “Definitions”, shall coordinate with other agencies to ensure there is no duplication of services.

D. The home health aide must operate and furnish services in compliance with all applicable federal, state, and local laws and regulations.

E. The home health aide must comply with accepted professional standards and principles that apply to professionals furnishing services as a home health aide provider.

F. The home health aide provider must ensure that aides have completed a course of training and received a nurse’s aide certification, conducted by an educational or health care institution which implements the basic nurse aide curriculum prescribed and approved by the Colorado State Board of Nursing.

G. Home health aide services must be supervised according to Medicare Conditions of Participation for Home Health Agencies found at 42 CFR 484.36(d). No later amendments to or editions of 42 CFR 484.36(d) are included. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication H. Home health aide providers shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding privacy of records. Requirements shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication I. In-home service providers shall protect and promote older adults’ rights as described below. 10.407.21 Home Health Aide Services Provider Responsibilities and Requirements (Recipient Older adults receiving in-home services under the OAA shall have the following rights:

A. To be fully informed in advance about each in-home service provided under the OAA, and about any change in service that may affect the well-being of the older adult;

B. To participate in planning and changing an in-home service provided under the OAA, unless the C. To voice a grievance with respect to a service that is provided or fails to be provided, without D. To have their property treated with respect; and, E. To be fully informed, orally and in writing, of these rights under the OAA before receiving an inhome service. 10.407.3 Home Health Aide Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult prior to the delivery of services using the assessment tool approved by the SUA. Reassessment shall be completed as prescribed by the State Unit on Aging in policies and procedures. Supervisory visits shall be made to the older adult’s home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home’s condition, and assessment of the older adult’s satisfaction with services.

10.408 HOMEMAKER SERVICE (IN-HOME) 10.408.1 Homemaker Service Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.408.2 Homemaker Service Provider Responsibilities and Requirements [Rev. eff. 2/1/16]

A. Homemaker services shall be for the benefit of the older adult and not for the sole benefit of other persons living in the home.

B. Homemaker service providers shall comply with federal, state, and local regulations and standards for specific services provided to consumer under the OAA program and shall develop written policies and procedures for the following:

1. Recruiting, selecting, retaining, and terminating employees;

2. Access to, duplication, and dissemination of information from the older adult’s records in accordance with state statutes on Confidentiality of Information at Section 26-1-114, 3. Protecting and promoting older adult’s rights;

4. Emergency procedures; and, 5. Handling and reporting of critical incidents, including accidents, suspicion of abuse, C. Homemaker service providers shall establish documentation requirements for:

1. Maintaining a log of all complaints and critical incidents, which shall include documentation of the resolution of the problem; and, 2. Documenting changes in the older adult’s conditions or needs, as well as documentation of appropriate reporting and actions taken as a result.

D. Homemaker provider agencies shall document that all homemakers have received a minimum of eight (8) hours of training or have passed a skills validation test conducted by the provider prior to delivery of services in the provision of homemaker services.

E. A person who, at a minimum, has received the training or passed the skills validation test required of homemakers shall be qualified to supervise homemakers.

F. In-home service providers shall protect and promote older adults’ rights as described below.

G. In-home service providers receiving funding under Title III, as defined at Section 10.120 “Definitions”, shall coordinate with other agencies to ensure there is no duplication of services. 10.408.21 Homemaker Service Provider Responsibilities and Requirements (Recipient Older adults receiving homemaker services under the OAA shall have the following rights:

A. To be fully informed in advance about each in-home service provided under the OAA, and about any change in service that may affect the well-being of the older adult;

B. To participate in planning and changing of a homemaker service provided under the OAA, unless the older adult is judicially determined to be incompetent;

C. To voice a grievance with respect to a service that is provided or fails to be provided, without D. To have their property treated with respect; and, E. To be fully informed, orally and in writing, of these rights under the OAA before receiving a homemaker service. 10.408.3 Homemaker Service Registration [Rev. eff. 12/1/10]

All recipients of homemaker services shall have a registration completed as prescribed by the SUA. 10.408.4 Homemaker Service Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult prior to the delivery of services using the assessment tool approved by the SUA. Reassessment shall be completed as prescribed by the State Unit on Aging in policies and procedures. Supervisory visits shall be made to the older adult’s home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home’s condition, and assessment of the older adult’s satisfaction with services. 10.408.5 Homemaker Service Consumer Direction [Rev. eff. 12/1/10]

Consumer Directed Services shall allow the older adult to choose a qualified provider to provide services.

The AAA shall establish qualification requirements for each service type and maintain documentation for each older adult.

10.409 INFORMATION AND ASSISTANCE SERVICES 10.409.1 Information and Assistance Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.409.2 Information and Assistance Services Provider Responsibilities and Requirements A. Information and assistance providers shall:

1. Maintain current information about opportunities, benefits, and services available to individuals and their caregivers;

2. Refer individuals and their caregivers to services using most current information;

3. Employ, where feasible, specially trained staff to assess the needs of individuals and their caregivers, provide information and assist in utilization of opportunities and services;

4. In a PSA where a majority of older adults speak a language other than English as their principal language, information and assistance service shall also be provided in that language.

B. All providers shall keep such records and information as necessary to document the services 10.410 MATERIAL AID SERVICES 10.410.1 Material Aid Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.410.2 Material Aid Services Provider Responsibilities and Requirements [Rev. eff.

All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, All providers shall keep such records and information as necessary to document the services provided to older adults receiving material aid.

10.411 NUTRITION SERVICES (CONGREGATE) 10.411.1 Nutrition Services (Congregate) Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older and their self-declared spouses shall be eligible for nutrition services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas.

In accordance with procedures established by the AAA, the following have the option to receive meals on the same basis as participating older adults if such an opportunity does not deprive any other older adult from receiving congregate meals:

A. Individuals with physical or mental disabilities or who are blind age eighteen (18) through fiftynine (59), who reside in a housing facility primarily occupied by older adults and which has a congregate meal site funded by the Older Americans Act;

B. Individuals providing volunteer services in the congregate meal program;

C. Individuals with physical and/or mental disabilities or who are blind, age eighteen (18) through fifty-nine (59), who reside with and accompany older adults eligible under the Older Americans Act, to the congregate meal site. 10.411.2 Nutrition Services (Congregate) Consumer Contribution [Rev. eff. 2/1/16]

A. The provider shall establish a mechanism so that each eligible meal consumer shall be afforded an opportunity to contribute voluntarily and anonymously.

B. No eligible meal consumer shall be denied service because of a decision not to contribute.

1. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under Title III, as defined at Section 10.120 “Definitions”.

2. Methods of solicitation for voluntary contributions shall be non-coercive.

C. The AAA shall provide service providers with policy and guidelines for accepting voluntary 1. The AAA shall establish and maintain procedures to protect the privacy of the consumer’s 2. Eligible consumers shall not be denied service(s) provided under Title III, as defined at

Section 10.120 “Definitions”, because the consumer’s decision not to contribute.

3. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the D. The AAA and service providers shall not perform a means test for any service for which contributions are accepted or deny services to any eligible consumer who does not contribute to 10.411.3 Nutrition Services (Congregate) Program Income [Rev. eff. 12/1/10]

A. All program income earned under Title III, as defined at Section 10.120 “Definitions”, Part C-1 awards shall be used to accomplish one or more of the following:

1. Increase the number of meals served by the nutrition project;

2. Facilitate access to meals by providing supportive services such as outreach or transportation to meal sites; or, 3. Provide other supportive services directly related to nutrition services.

B. If the service provider operates both C-1 and C-2 programs, the contracting agency may authorize the provider to deposit the program income from each into one joint account if generally accepted accounting principles are used and/or the funds are accounted for separately.

C. When a C-1 contract or subcontract expires and is not renewed, or is suspended or terminated, any unexpended program income funds shall revert or be transferred to the awarding agency and subsequently transferred to the successor nutrition provider.

D. All purchase of service contracts shall contain a provision that unexpended program income funds on hand at the date the contract is terminated shall revert to the awarding agency, unless the contracting provider agency is awarded a purchase of services nutrition contract for the succeeding contract period.

E. If program income is transferred to an AAA following expiration, suspension, or termination of a provider contract, the AAA may withhold all or part of the transferred program income to fund access and other supportive services directly related to nutrition services through a provider agency other than the nutrition project contractor.

F. Nutrition Program Support Service Standards: If the provisions of program income are met, nutrition project income may be used to fund nutritional program services and Part B support services directly related to nutrition services. 10.411.4 Nutrition Services (Congregate) Guest Fees [Rev. eff. 2/1/16]

Guest fees are required charges equal to the full cost of the service to persons who are not eligible consumers of the program but are receiving services. Fees shall be determined using guidelines and 10.411.41 Nutrition Services (Congregate) Usage Fees [Rev. eff. 12/1/10]

A. Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-grant B. If nutrition project contractors or sub-contractors use equipment purchased with Title III, as defined at Section 10.120 “Definitions”, funds to produce meals sold to other organizations the compensation shall be directly credited to the cost of goods or services provided under the current contract, if the equipment was acquired under the current year’s contract.

C. If the equipment was acquired with a prior year’s contract, the compensation shall be recorded as 10.411.5 Nutrition Services (Congregate) Sales of Equipment and Supplies [Rev. eff. 12/1/10]

Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for 10.411.6 Nutrition Services Incentive Program (NSIP) [Rev. eff. 2/1/16]

A. Funds received from the Administration on Aging (AoA) shall be distributed by SUA.

B. The AAA allocation shall be based on the percentage of the number of eligible meals served each year by the AAA/nutrition service project to the total number of meals served under Colorado Nutrition projects.

C. The SUA shall have discretion in receiving:

1. Cash; or, 2. A combination of cash and commodities.

D. If the SUA chooses a combination of cash and commodities, nutrition providers that choose to receive a combination of cash and commodities shall complete documentation as directed by the E. All meals shall be reported to the SUA on a regular basis in the format required by the SUA.

F. NSIP cash funds shall only be used to purchase United States agricultural commodities and other raw foods for the nutrition program, and shall be used to increase the number of meals served.

G. NSIP cash funds shall not be applied to the costs of the nutrition project, except as stated above. 10.411.7 Nutrition Services (Congregate) General Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services C. Nutrition projects shall provide at least one hot or other appropriate meal per day, five (5) days or more per week and any additional meals the nutrition project elects to provide, except in rural areas where such frequency is not feasible and a lesser frequency is approved by the SUA. 10.411.71 Nutrition Services (Congregate) Food Safety and Sanitation [Rev. eff. 2/1/16]

A. Nutrition service providers shall comply with the applicable provisions of state or local laws regarding the safe and sanitary handling of food, equipment, and supplies used in the storage, preparation, service and delivery of meals to older adults including but not limited to the following:

1. The Colorado Department of Public Health and Environment’s (CDPHE) “Colorado Retail Food Establishments” rules (6 CCR 1010-2); and, 2. Health, fire, and safety codes and regulations; building codes; purchasing regulations; licensure requirements; and any other federal, state or local requirements as may be applicable.

B. Current food permits shall be posted at the nutrition site.

C. Inspection reports issued by the CDPHE shall be on file at the site and available for review.

D. If a nutrition project requests a variance from the CDPHE rules, the nutrition project shall send copies of both the variance request and the approval or denial from the CDPHE to the SUA and to the AAA. 10.411.72 Nutrition Services (Congregate) General Menu and Nutrition [Rev. eff. 12/1/10]

Nutrition service providers shall meet standards as defined in the Older Americans Act. These shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication Depository Library.

Nutrition providers shall provide meals that:

A. Comply with the most recent Dietary Guidelines for Americans, published by the Secretary of Health and Human Services and the Secretary of Agriculture. These shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication B. Comply with the most recent Dietary Guidelines for Americans and Dietary Reference Intakes established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. These shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any State Publication C. Provide each participating older adult:

1. A minimum of thirty-three and one-third percent (33-1/3%) of the dietary reference intakes if only one meal per day is provided.

2. A minimum of sixty-six and two thirds percent (66-2/3%) of the dietary reference intakes if two (2) meals per day are provided; and, 3. A minimum of one hundred percent (100%) of the dietary reference intakes if three (3) meals per day are provided. 10.411.73 Nutrition Services (Congregate) Additional Meals [Rev. eff. 12/1/10]

Nutrition providers may serve a second or third meal to older adults identified through nutrition screening to be at nutritional risk and/or socially or economically in need, if included as an objective in the Area 10.411.74 Nutrition Services (Congregate) Modified and Therapeutic Diets [Rev. eff. 2/1/16]

Modified diets, therapeutic diets, or special menus shall be provided, where feasible, to meet the particular dietary needs arising from health or religious requirements, or ethnic backgrounds of eligible older adults. The nutrition provider and a registered dietician shall determine feasibility and appropriateness of modified diets, therapeutic diets, or special menus. Registered dieticians shall be responsible for obtaining written orders for therapeutic diets from each participant’s physician, maintaining such orders on file and updating them with the physician every six months.

The AAAs shall comply with nutrition services as prescribed by the SUA.

A. Modified and Therapeutic Diets The AAAs shall provide modified and therapeutic diets, where feasible, in accordance with

Section 339 of the Older Americans Act. Therapeutic diets shall include:

1. Medical nutritional food as a supplement:

a. Nutrition supplement prescribed by a physician and monitored by a registered dietitian to determine if the prescription is feasible and appropriate.

b. Medical nutritional food as a supplement shall not be eligible for reimbursement under Nutrition Service Incentive Program (NSIP), Title III, as defined at Section 10.120 “Definitions”, C-1, or C-2.

2. Medical nutritional food as a meal replacement:

a. Prescribed by a physician as necessary to treat a diagnosed medical condition and meet primary nutritional needs. A registered dietitian shall monitor the nutrient content, feasibility and appropriateness, and referrals to insurance coverage and other resources.

b. Medical nutritional food as a meal replacement shall be eligible for reimbursement under NSIP if the meal replacement meets the thirty-three and one-third percent (33-1/3%) Dietary Reference Intakes (DRI) nutrient requirements by volume.

3. Therapeutic diets shall be:

a. Prescribed by a physician;

b. Monitored by a registered dietitian; and, c. Determined if feasible and appropriate by the registered dietitian and nutrition provider. 10.411.75 Nutrition Services (Congregate) Provider Responsibilities and Requirements (Nutrition Screening) [Rev. eff. 12/1/10]

All older adults shall receive nutrition screening defined as the process of identifying older adults at nutritional risk or with malnutrition when participating in:

A. Congregate meal programs;

B. Home delivered meal programs;

C. Nutrition counseling;

D. In-Home Services; and/or, E. Case Management. 10.411.76 Nutrition Services (Congregate) Provider Responsibilities and Requirements (Nutrition Counseling) [Rev. eff. 12/1/10]

Nutrition service providers shall:

A. Provide nutrition screening of all consumers and provide nutrition education and nutrition counseling; and, B. Maintain consumer records in a confidential manner. These files must be kept in a locked cabinet and shall be kept at the program office(s). 10.411.77 Nutrition Services (Congregate) Provider Responsibilities and Requirements (Nutrition Education) [Rev. eff. 12/1/10]

Nutrition education services shall be conducted on an ongoing basis and documented for older adults who participate in congregate and home delivered meal programs with content approved by a registered dietician, dietetic technician, registered, or nutritionist. Nutrition education shall include presentations or learning activities at congregate sites. A registered dietician, dietetic technician, registered, or nutritionist shall give nutrition education presentations and/or learning activities.

A. If a consumer is determined to be at high nutritional risk, nutrition education shall be offered to the consumer and/or his/her caregiver.

B. Congregate sites shall provide food safety information and nutrition education for nutrition project consumers. 10.411.78 Nutrition Services (Congregate) Data and Records, Registration and Assessment A. Data Records 1. Nutrition providers shall maintain an approved copy of the menu cycles and analyses on file and available for review by the AAA or SUA during normal business hours.

2. Menus and recipes shall be analyzed using a nutrient software package to ensure compliance with the most recent dietary guidelines and dietary reference intakes, and shall be approved by a registered dietitian, a dietetic technician, registered, or a nutritionist.

3. Only tested quality recipes, adjusted to yield the number of servings needed, shall be used.

4. Substitutions or deviations from the approved menu(s) shall be documented.

5. Menu cycles and nutrient analysis shall be maintained for a minimum of three years for audit purposes unless disposition is authorized by the contracting agency.

B. Registration All recipients of congregate meals, home delivered meals, and nutrition counseling shall have a registration completed as prescribed by the SUA.

C. Assessment All older adults participating in nutrition programs whether congregate or home delivered meal programs shall be requested to complete the Colorado Consumer Assessment. No older adult who refuses to complete the consumer assessment shall be refused a service. 10.411.8 Tribal Organizations [Rev. eff. 2/1/16]

Services provided under Title III, as defined at Section 10.120 “Definitions”, shall be coordinated, when appropriate, with the services provided under Title VI of the Older Americans Act.

A. The SUA shall not have responsibility for tribal organizations and reservations served by Title VI, as defined at Section 10.120 “Definitions”, of the Older Americans Act.

B. Geographic areas served under Title VI, as defined at Section 10.120 “Definitions”, shall not be included within any PSAs and are not required to meet the AAA designation criteria defined in

Section 10.201.

C. Coordination of Title III and Title VI, as defined at Section 10.120 “Definitions”, shall be included in the Area Plan of designated PSAs. 10.411.9 Supplemental Nutrition Assistance Program [Rev. eff. 12/1/10]

The Supplemental Nutrition Assistance Program (SNAP) is neither an Older Americans Act nor an Older Coloradans Act Program. If an AAA elects to participate in the Supplemental Nutrition Assistance Program, the AAA shall develop guidelines for participation in this program.

A. The nutrition service provider shall provide information and assistance about the Supplemental Nutrition Assistance Program to older adults who may be eligible for such benefits.

B. The nutrition service provider shall inform older adults if the nutrition program accepts the Supplemental Nutrition Assistance Program.

C. Congregate sites accepting SNAP shall display Supplemental Nutrition Assistance Program posters at the site.

D. A nutrition service provider receiving funds under the Older Americans Act shall not act as an authorized representative for an older adult in making an application for the Supplemental Nutrition Assistance Program.

10.412 NUTRITION SERVICES (HOME DELIVERED) 10.412.1 Nutrition Services (Home Delivered) Eligibility [Rev. eff. 2/1/16]

All adults age sixty and older and their self-identified spouses shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to lowincome older adults and older adults residing in rural areas. Priority may be given to emergency requests for older adults who are newly homebound or temporarily incapacitated.

A. In addition to general eligibility requirements, an older adult receiving home delivered meals shall be homebound.

B. Home delivered meals may be provided as supplemental services under the National Family Caregiver Support Program Title III, as defined at Section 10.120 “Definitions”, E, to persons aged sixty and over who are either care recipients (as well as their self-identified spouses of any age) or caregivers. These meals are also NSIP eligible.

C. If included in the AAA Area Plan and policies for nutrition service providers, home delivered meals may be made available to older adults who are geographically isolated when a congregate site is not reasonably available as an alternative, including:

1. Homebound, disabled dependents under sixty years of age, residing with a homebound or geographically isolated older adult must be assessed as homebound;

2. Spouses of homebound or geographically isolated home delivered meal recipients, or, 3. Individuals providing volunteer services in the home delivered meal program. 10.412.2 Nutrition Services (Home Delivered) Consumer Contribution [Rev. eff. 2/1/16]

Contribution Policy A. The provider shall establish a mechanism so that each eligible meal consumer shall be afforded an opportunity to contribute voluntarily and anonymously.

B. No eligible meal consumer shall be denied service because of a decision not to contribute.

1. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under Title III, as defined at Section 10.120 “Definitions”.

2. Methods of solicitation for voluntary contributions shall be non-coercive.

C. The AAA shall provide service providers with policy and guidelines for accepting voluntary 1. The AAA shall establish and maintain procedures to protect the privacy of the consumer’s 2. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the 3. The AAA and service providers shall not perform a means test for any service for which contributions are accepted, or deny services to any eligible consumer who does not contribute to the cost of the service. 10.412.3 Nutrition Services (Home Delivered) Program Income [Rev. eff. 2/1/16]

A. All program income earned under Title III, as defined at Section 10.120 “Definitions”, Part C-2 awards shall be used to accomplish one or more of the following:

1. Increase the number of meals served by the nutrition project;

2. Facilitate access to meals by providing supportive services such as outreach or transportation to meal sites; or, 3. Provide other supportive services directly related to nutrition services.

B. If the service provider operates both C-1 and C-2 programs, the contracting agency may authorize the provider to deposit the program income from each into one joint interest bearing account if generally accepted accounting principles are used and/or the funds are accounted for separately.

C. When a C-2 contract or subcontract expires and is not renewed, or is suspended or terminated, any unexpended program income funds shall revert or be transferred to the awarding agency and subsequently transferred to the successor nutrition provider.

D. All purchase of service contracts shall contain a provision that unexpended program income funds on hand at the date the contract is terminated shall revert to the awarding agency, unless the contracting provider agency is awarded a purchase of services nutrition contract for the succeeding contract period.

E. If program income is transferred to a AAA following expiration, suspension, or termination of a provider contract, the AAA may withhold all or part of the transferred program income to fund access and other supportive services directly related to nutrition services through a provider agency other than the nutrition project contractor.

F. Nutrition Program Support Service Standards: Nutrition project income may be used to fund nutritional program services and Part B support services directly related to nutrition services. 10.412.4 Nutrition Services (Home Delivered) Guest Fees [Rev. eff. 12/1/10]

Guest fees are required charges equal to the full cost of the service to persons who are not eligible consumers of the program but are receiving services. Fees shall be determined using guidelines and 10.412.41 Nutrition Services (Home Delivered) Usage Fees [Rev. eff. 2/1/16]

A. Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-contract B. If nutrition project contractors or sub-contractors use equipment purchased with Title III, as defined at Section 10.120 “Definitions”, funds to produce meals sold to other organizations the compensation shall be directly credited to the cost of goods or services provided under the current contract, if the equipment was acquired under the current year’s contract.

C. If the equipment was acquired with a prior year’s contract, the compensation shall be recorded as 10.412.5 Nutrition Services (Home Delivered) Sales of Equipment and Supplies [Rev. eff.

Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for 10.412.6 Nutrition Services (Home Delivered) Nutrition Services Incentive Program (NSIP) [Rev. eff. 2/1/16]

A. Funds received from the Administration on Aging (AoA) shall be distributed by SUA.

B. The AAA allocation shall be based on the percentage of the number of eligible meals served each year by the AAA/nutrition service project to the total number of meals served under Colorado nutrition projects.

C. The SUA shall have discretion in receiving:

1. Cash; or, 2. A combination of cash and commodities.

D. If the SUA chooses a combination of cash and commodities, nutrition providers that choose to receive a combination of cash and commodities shall complete documentation as directed by the E. All meals shall be reported to the SUA on a regular basis in the format required by the SUA.

F. NSIP cash funds shall only be used to purchase United States agricultural commodities and other raw foods for the nutrition program, and shall be used to increase the number of meals served.

G. NSIP cash funds shall not be applied to the costs of the nutrition project, except as stated above. 10.412.7 Nutrition Services (Home Delivered) Provider Responsibilities and Requirements (General) [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services C. Nutrition projects shall provide five (5) days or more per week, at least one home delivered hot, cold, frozen, dried, canned, fresh, or supplemental foods (with a satisfactory storage life) meal per day, and any additional meals which the nutrition project may elect to provide except in rural areas where such frequency is not feasible and a lesser frequency is approved by the SUA.

D. Each home delivered meal provider shall ensure delivery of emergency meals to older adults receiving home delivered meals. 10.412.71 Food Safety and Sanitation [Rev. eff. 12/1/10]

A. Nutrition service providers shall comply with the applicable provisions of federal, state or local laws regarding the safe and sanitary handling of food, equipment, and supplies used in the storage, preparation, service and delivery of meals to older adults, including, but not limited to:

1. The Colorado Department of Public Health and Environment’s (CDPHE) “Colorado Retail Food Establishments” rules and regulations (6 CCR 1010-2);

2. Health, fire, and safety codes and regulations; building codes; purchasing regulations; licensure requirements; and any other federal, state, or local requirements as may be applicable.

B. Current food permits shall be posted at the nutrition site.

C. Inspection reports issued by the CDPHE shall be on file at the site and available for review.

D. If a nutrition project requests a variance from the CDPHE, the nutrition project shall send copies of both the variance request and the approval or denial from the CDPHE to the SUA and to the AAA. 10.412.72 General Menu and Nutrition [Rev. eff. 12/1/10]

Nutrition service providers shall meet standards as defined in the Older Americans Act including but not limited to the most recent Dietary Guidelines for Americans and Dietary Reference Intakes. These shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any state publication depository library.

A. Nutrition service providers shall provide meals that:

1. Comply with the most recent dietary guidelines for Americans.

2. Provide each participating older adult:

a. A minimum of thirty-three and one-third percent (33-1/3%) of the dietary reference intakes;

b. A minimum of sixty-six and two-thirds percent (66-2/3%) of the dietary reference intakes if two (2) meals per day are provided; or, c. A minimum of one hundred percent (100%) of the dietary reference intakes if three (3) meals per day are provided.

B. Are adjusted, to the maximum extent practical, to meet any special dietary needs of program consumers including, special health, religious, or ethnic requirements; and, C. Have been specially modified and approved by a registered dietitian to meet therapeutic, religious, or ethnic requirements, but may not meet the minimum dietary requirements. 10.412.73 Nutrition Services (Home Delivered) Provider Responsibilities and Requirements (Additional Meals) [Rev. eff. 12/1/10]

Nutrition providers may serve a second or third meal to older adults identified through nutrition screening to be at nutritional risk and/or socially or economically in need, if included as an objective in the Area 10.412.74 Nutrition Services (Home Delivered) Provider Responsibilities and Requirements (Modified and Therapeutic Diets) [Rev. eff. 2/1/16]

A. Modified diets, therapeutic diets, or special menus shall be provided, where feasible, to meet the particular dietary needs arising from health or religious requirements, or ethnic backgrounds of eligible older adults. The nutrition provider and a registered dietician shall determine feasibility and appropriateness of modified diets, therapeutic diets, or special menus. Registered dieticians shall be responsible for obtaining written orders for therapeutic diets from each participant’s physician maintaining such orders on file and updating them with the physician every six months.

B. The AAAs shall comply with nutrition services as prescribed by the SUA.

C. The AAAs shall provide modified and therapeutic diets, where feasible. Therapeutic diets shall include:

1. Medical nutritional food as a supplement:

a. Nutrition supplement prescribed by a physician and monitored by a registered dietician to determine if the prescription is feasible and appropriate.

b. Medical nutritional food as a supplement shall not be eligible for reimbursement under Nutrition Service Incentive Program (NSIP), Title III, as defined at Section 10.120 “Definitions”, C1 or C2.

2. Medical nutritional food as a meal replacement shall be:

a. Prescribed by a physician as necessary to treat a diagnosed medical condition and meet primary nutritional needs. A registered dietician shall monitor the nutrient content, feasibility and appropriateness, and referrals to insurance coverage and other resources; and, b. Eligible for reimbursement under NSIP if the meal replacement meets the thirtythree and one-third percent (33-1/3%) Dietary Reference Intakes (DRI) nutrient requirements by volume.

3. Therapeutic diets shall be:

a. Prescribed by a physician;

b. Monitored by a registered dietician; and, c. Determined if feasible and appropriate by the registered dietician and nutrition provider.

D. In addition to following the regulatory compliance, home delivered meal providers shall:

1. Establish a nutritional screening procedure for determining individual needs and resources;

2. Verify all consumers in the home delivered meal program meet the homebound or geographically isolated eligibility requirements as specified at Section 10.412.1;

3. Maintain documentation of the consumer’s nutritional screen and ensure that data is recorded utilizing the State mandated data and reporting system(s); and, 4. Document homebound status at the nutrition project level. Homebound status shall be reassessed as prescribed by the State Unit on Aging in policies and procedures. 10.412.75 Nutrition Services (Home Delivered) Provider Responsibilities and Requirements (Nutrition Screening) [Rev. eff. 12/1/10]

All older adults shall receive nutrition screening defined as the process of identifying older adults at nutritional risk or with malnutrition when participating in:

A. Congregate meal programs;

B. Home delivered meal programs;

C. Nutrition counseling;

D. In-Home Services; and/or, E. Case Management. 10.412.76 Nutrition Counseling [Rev. eff. 12/1/10]

Nutrition service providers shall:

A. Provide for nutrition screening of all consumers and provide nutrition education and nutrition counseling; and, B. Maintain client records in a confidential manner. These files must be kept in a locked cabinet and shall be kept at the program office(s). 10.412.77 Nutrition Services (Home Delivered) Provider Responsibilities and Requirements (Nutrition Education) [Rev. eff. 12/1/10]

A. Nutrition education services shall be conducted on an ongoing basis and documented for older adults who participate in congregate and home delivered meal programs with content approved by a registered dietician, dietetic technician, registered, or nutritionist. Nutrition education shall include presentations or learning activities at congregate sites. A registered dietician, dietetic technician registered, or nutritionist shall give nutrition education presentations and/or learning activities.

B. If a consumer is determined to be at high nutritional risk, nutrition education shall be offered to the consumer or his/her caregiver.

C. Congregate sites shall provide food safety information and nutrition education for nutrition project consumers.

D. Consumers and/or caregivers of consumers in the home delivered meal program shall receive instruction on the handling and use of meals when the home delivered meal service is implemented, and as a reminder at each reassessment or more frequently if necessary. 10.412.8 Nutrition Services (Home Delivered) Data and Records, Registration and Assessment [Rev. eff. 12/1/10]

A. Data Records 1. Nutrition providers shall maintain an approved copy of the menu cycles and analyses on file and available for review by the AAA or SUA during normal business hours.

2. Menus and recipes shall be analyzed using a nutrient software package to ensure compliance with the most recent dietary guidelines shall be approved by a registered dietitian, a dietetic technician, registered, or a nutritionist.

3. Only tested quality recipes, adjusted to yield the number of servings needed, shall be used.

4. Substitutions or deviations from the approved menu(s) shall be documented.

5. Menu cycles and nutrient analysis shall be maintained for a minimum of three (3) years for audit purposes unless disposition is authorized by the contracting agency.

B. Registration All recipients of congregate meals, home delivered meals, and nutrition counseling shall have a registration completed as prescribed by the State Unit on Aging.

C. Assessment 1. Older adults requesting home delivered meals shall be assessed using the assessment tool approved by the State Unit on Aging. Only those determined to be homebound or geographically isolated shall be eligible for a home delivered meal. Homebound status shall be documented at the nutrition project level. Homebound status shall be reassessed as prescribed by the State Unit on Aging in policies and procedures.

2. All older adults participating in nutrition programs whether congregate or home delivered meal programs shall be requested to complete the Colorado Consumer Assessment. No older adult who refuses to complete the consumer assessment shall be refused a service. 10.412.9 Tribal Organizations [Rev. eff. 2/1/16]

Services provided under Title III shall be coordinated, when appropriate, with the services provided under Title VI, as defined at Section 10.120 “Definitions”, of the Act.

A. The SUA shall not have responsibility for tribal organizations and reservations served by Title VI of the Older Americans Act, as defined at Section 10.120 “Definitions”.

B. Geographic areas served under Title VI, as defined at Section 10.120 “Definitions”, shall not be included within any PSAs and are not required to meet the AAA designation criteria defined at

Section 10.201. 10.412.91 Supplemental Nutrition Assistance Program (SNAP) [Rev. eff. 12/1/10]

The Supplemental Nutrition Assistance Program (SNAP) is neither an Older Americans Act nor an Older Coloradans Act program. If an AAA elects to participate in the Supplemental Nutrition Assistance Program, the AAA shall develop guidelines for participation in this program.

A. The nutrition service provider shall provide information and assistance about Supplemental Nutrition Assistance Program to older adults who may be eligible for such benefits.

B. The nutrition service provider shall inform older adults if the nutrition program accepts SNAP.

C. Older adults receiving home delivered meals, who are unable to apply in person, shall be informed of their right to have a proxy apply for assistance on their behalf as an authorized D. A nutrition service provider receiving funds under the Older Americans Act shall not act as an authorized representative for a consumer in making an application for Supplemental Nutrition Assistance Program.

10.413 OUTREACH SERVICES 10.413.1 Outreach Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.413.2 Outreach Services Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services 1. Outreach efforts shall be conducted throughout the PSA to identify older adults and their caregivers, and inform them of the availability of services.

2. In a PSA where a majority of older adults speak a language other than English as their principal language, the outreach service shall also be provided in that language.

3. Special outreach activities shall be conducted for Native American older adults and their caregivers in an area where Native Americans comprise at least:

a. One percent (1%) of the PSA’s population age sixty (60) and over; or, b. Five percent (5%) or more of the state’s sixty (60) and over Native American population resides within a PSA.

10.414 PERSONAL CARE SERVICES (IN-HOME) 10.414.1 Personal Care Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. In-home services shall be made available to individuals with Alzheimer’s disease and related disorders or with neurological and organic brain dysfunction. 10.414.2 Personal Care Services Provider Responsibilities and Requirements [Rev. eff.

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services C. Personal care provider agencies shall meet the following personal care requirements:

1. Supervisory visits shall be made to the consumer’s home at least every three (3) months or more often as necessary for problem resolution, skills validation of staff, consumer specific or procedure-specific training of staff, observation of the consumer’s condition and care, and/or assessment of satisfaction with services. At least one of the assigned personal staff shall be present at supervisory visits; and, 2. Staff rendering personal care services to older adults shall receive at least twenty (20) hours of training related to performing personal care tasks or pass a skills validation test before providing the service.

D. Personal care services shall include direct assistance, stand-by assistance, supervision or cues of the following activities:

1. Bathing, when no skilled services are required in conjunction with the bathing;

2. Skin care, including application of lotions or solutions that are not medicated and/or do not require a physician’s prescription;

3. Hair care, including shampooing with shampoo that is not medicated or does not require a physician’s prescription, drying, combing, and styling of hair;

4. Nail care, including soaking of the nails, pushing back cuticles, and trimming and filing of nails;

5. Mouth care, including denture care and basic oral hygiene;

6. Shaving, when done with an electric razor;

7. Dressing assistance, including application of support stockings that can be purchased without a physician’s order, and orthopedic devices such as splints, braces or artificial limbs if the older adult has been fully trained in the use of the device or limb and is able to instruct the personal care staff;

8. Feeding, when the consumer is able to eat by mouth, using common eating utensils, such as forks, knives, spoons, and straws;

9. Assistance with ambulation, including transfers, if the older adult does not require skilled supervision, has been fully trained in the use of adaptive equipment (such as gait belts, walkers, canes, and wheelchairs) and is able to instruct the personal care staff;

10. Assistance with exercise when a licensed medical professional does not prescribe the exercises;

11. Assistance with transfers when the consumer has sufficient balance and strength to assist with the transfer:

a. Adaptive equipment other than Hoyer lifts may be used if the older adult is fully trained in the use of the equipment and can direct the transfer step by step.

b. Adaptive equipment may include gait belts, wheel chairs, tub seats, and grab bars.

12. Positioning to assist the consumer to change position or alignment in a bed, wheelchair, or other furniture;

13. Bowel and bladder care to include assisting the older adult to and from the bathroom, assistance with bed pans, urinals, and commodes; changing of clothing and pads used for incontinence:

a. Emptying of Foley catheter bags or suprapubic catheter bags if the personal care staff has been trained to understand what constitutes disruption of the closed system and is able to ensure that such a disruption does not occur; and, b. Emptying of ostomy bags and assistance with other consumer-directed ostomy care if there is no need for skilled skin care or observation and reporting to a nurse.

14. Medication reminding if the medications have been pre-selected by the older adult, the older adult’s family or caregiver, a nurse or a pharmacist, and are stored in containers other than prescription bottles, such as medication minders.

a. Medication reminding includes only:

1) Inquiries as to whether a medication has been taken;

2) Verbal prompting to take medications;

3) Providing the proper liquid and utensil with which to take medications;

4) Handing the appropriately marked medication minder to the older adult;

5) Opening the appropriately marked prescription minder container for the older adult if the older adult is physically unable to open the container.

b. Medication reminding shall not include taking the medication out of the container.

15. Respiratory care services shall include only cleaning or changing tubing for oxygen equipment, refilling the distilled water reservoir, and temporarily removing and replacing the cannula or mask from the older adult’s face for purposes of shaving or washing the older adult’s face.

16. Accompanying the older adult to medical appointments, banking errands, basic household errands, clothes shopping, and grocery shopping to the extent necessary and specified in the older adult’s service plan.

a. Personal care for accompanying the older adult shall only be approved when a personal care provider is needed during the trip to provide one or more unskilled personal care services.

b. Accompanying the older adult to provide companionship is not a covered benefit. 10.414.3 Personal Care Services Registration [Rev. eff. 12/1/10]

All recipients of personal care registered services shall have a registration completed as prescribed by the SUA. 10.414.4 Personal Care Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult prior to the delivery of services using the assessment tool approved by the SUA. Reassessment shall be completed as prescribed by the State Unit on Aging in policies and procedures. Supervisory visits shall be made to the older adult’s home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home’s condition, and assessment of the older adult’s satisfaction with services.

10.415 TRANSPORTATION SERVICES 10.415.1 Transportation Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. Priority shall be given to:

A. Older adults who lack the ability to transport themselves or lack other means of transportation;

B. Older adults in greatest economic need or greatest social need with preference given to lowincome minority older adults and older adults residing in rural or geographically isolated areas. 10.415.2 Transportation Services Provider Responsibilities and Requirements [Rev. eff.

All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, All providers shall keep such records and information as necessary to document the services provided to older adults receiving care.

A. Except private vehicles, all transportation providers rendering services to OAA older adults shall have all licenses, approvals, or certifications required by federal, state, and local law or

regulation.

B. All transportation providers not requiring licensure by the Public Utilities Commission (PUC) shall ensure that their drivers, vehicles, and auxiliary equipment meet all applicable regulations and standards for passenger and vehicle safety, as well as all applicable safety inspection and maintenance requirements, and shall comply with the State’s mandated minimum insurance coverage. 10.415.3 Transportation Services Registration (Assisted Transportation) [Rev. eff. 12/1/10]

All recipients of assisted transportation services shall have a registration completed as prescribed by the State Unit on Aging. 10.415.4 Transportation Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult before the delivery of registered services using the assessment tool approved by the SUA.

10.416 VISITING AND TELEPHONE REASSURANCE SERVICES 10.416.1 Visiting and Telephone Reassurance Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults who request the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. In-home services shall also be made available to individuals with Alzheimer’s disease and related disorders or with neurological and organic brain dysfunction. 10.416.2 Visiting and Telephone Reassurance Services Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. All providers shall keep such records and information as necessary to document the services C. Visiting and telephone reassurance service providers shall:

1. Establish emergency procedures to be used when an older adult does not call or answer as arranged; and, 2. Ensure that individuals serving as visiting and reassurance callers shall have training. 10.416.3 Visiting and Telephone Reassurance Registration [Rev. eff. 12/1/10]

All recipients of visiting and telephone reassurance services shall have a registration completed as prescribed by the State Unit on Aging. 10.416.4 Visiting and Telephone Reassurance Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult before the delivery of registered services using the assessment tool approved by the State Unit on Aging. 10.417 STATE FUNDING FOR SENIOR SERVICES (SFSS) [Rev. eff. 12/1/10]

State Funding for Senior Services (SFSS) Programs provide community-based and advocacy services to eligible persons to assist such persons to live in the least restrictive environment.

Services provided by State Funded Programs for Senior Services include one or more of the following: nutrition services, including congregate and home delivered meals; outreach, information, and assistance services; transportation services; in-home services; long-term care ombudsman services; legal assistance services; disease prevention and health promotion services; caregiver support services; elder abuse prevention services; and other services as described in the OAA or as approved by the SUA. 10.417.1 State Funding for Senior Services Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. Some services have additional eligibility requirements that are listed under each specific service. If resources are not available to serve all eligible persons requesting the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and older adults residing in rural areas. 10.417.2 State Funding for Senior Services Provider Responsibilities and Requirements All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, All providers shall keep such records and information as necessary to document the services provided to older adults receiving care. 10.417.3 State Funding for Senior Services Consumer Contribution [Rev. eff. 12/1/10]

A. Voluntary contributions shall be allowed and may be solicited for all services for which funds are received under SFSS.

B. Methods of solicitation for voluntary contributions shall be non-coercive.

C. The AAA shall provide service providers with policy and guidelines for accepting voluntary 1. The AAA shall establish and maintain procedures to protect the privacy of the consumer’s 2. Eligible consumers shall not be denied service(s) provided under SFSS because of the consumer’s decision not to contribute.

3. Service providers shall determine the costs of services provided and display a suggested contribution schedule as well as required guest fees for services at the entry point of the D. The AAA and service providers shall not perform a means test for any service for which contributions are accepted, or deny services to any eligible consumer who does not contribute to 10.417.4 State Funding for Senior Services Program Income [Rev. eff. 2/1/16]

A. Program income shall include all income earned by a contractor, or subcontractor directly generated by supported activities, the cost of which is borne by the contractor or subcontractor, B. All program income shall be used in accordance with the additional costs alternative and shall be added to funds committed to the project or program, and used to further eligible project or C. All program income, including earnings and expenditures of program income shall be reported D. Program income earned after contract support has ended shall be subject to the terms of the c ontract or subcontract. If this category of income is not specifically detailed in the contract document, the agency may dispose of the income as it chooses. 10.417.5 State Funding for Senior Services Guest Fees [Rev. eff. 12/1/10]

Guest fees are required charges equal to the full cost of the service to persons who are not eligible consumers of the program but are receiving services. Fees shall be determined using guidelines and 10.417.6 State Funding for Senior Services Usage Fees [Rev. eff. 2/1/16]

A. Usage fees include charges for the use of equipment or other fixed assets acquired with OAA funds. The minimum usage fee shall be charged when such assets are used for non-contract B. If nutrition project contractors or sub-contractors use equipment purchased with Title III, as defined at Section 10.120 “Definitions”, funds to produce meals sold to other organizations.

C. The compensation shall be directly credited to the cost of goods or services provided under the current contract, if the equipment was acquired under the current year’s contract.

D. If the equipment was acquired with a prior year’s contract, the compensation shall be recorded as 10.417.7 State Funding for Senior Services Sales of Equipment and Supplies [Rev. eff.

Proceeds from sale of equipment or supplies not used for replacement equipment shall be accounted for 10.417.8 State Funding for Senior Services Registration [Rev. eff. 2/1/16]

All recipients of registered services shall have a registration completed as prescribed by the SUA. 10.417.9 State Funding for Senior Services Assessment [Rev. eff. 12/1/10]

An assessment shall be completed for each older adult before the delivery of registered services using the assessment tool approved by the SUA. 10.417.91 State Funding for Senior Services [Rev. eff. 2/1/16]

A. The fiscal year shall be the State fiscal year (July 1 through June 30).

B. Funding shall be allocated and spent on a State fiscal year.

C. The SUA shall distribute SFSS funds using the same intrastate formula used to distribute funds available under Title III, as defined at Section 10.120 “Definitions”, of the Older Americans Act as described at Section 10.301 of these rules.

D. SFSS funds shall be allocated as a whole.

E. Fiscal accounting and management of SFSS funds shall be completed in accordance with the procedures and requirements established at Section 10.300 through 10.316.

F. The AAA may use ten percent (10%) of the funds received from the SFSS for administrative expenses as described at Section 26-11-205.5(2), C.R.S.

G. SFSS may be used for administrative expenses as determined by the SUA.

H. SFSS shall be used to supplement existing services and cannot be used to meet match requirements. 10.418 COLORADO LEGAL ASSISTANCE DEVELOPER PROGRAM [Rev. eff. 2/1/16]

The Colorado Department of Human Services, Division of Aging and Adult Services, is the State Unit of Aging (SUA) authorized under Title VII of the Older Americans Act, as defined at Section 10.120 “Definitions”, to establish and operate the Colorado Legal Assistance Developer (CLAD) office and local Legal Assistance (LA) Program provider offices throughout the state. 10.418.1 Selection and Designation of the Colorado Legal Assistance Developer [Ref. eff. 1/1/12]

The agency, program, or person(s) selected to serve as the CLAD shall have demonstrated expertise and experience in the field of elder law and advocacy. 10.418.2 Colorado Legal Assistance Developer Responsibilities and Requirements [Rev. eff.

The CLAD shall, personally or though representatives of the office, perform the following responsibilities and requirements in implementing a statewide Legal Assistance (LA) Program:

A. Establish and maintain a policy and procedure manual in collaboration with the SUA and AAAs.

B. Oversee and coordinate statewide legal assistance in planning, development, evaluation, and outcome measurement; and, C. Provide technical assistance, training, and support to the state, the AAAs, LA providers, and Colorado Long-Term Care Ombudsman (CLTCO), as directed by the SUA.

D. Establish procedures to analyze, monitor, and comment on:

1. The development and implementation of federal, state, and local laws and regulations, and other governmental policies and actions, pertaining to the health, safety, welfare, and rights of adults, with respect to elder law; and, 2. Information and trends regarding the legal concerns of older adults.

E. Promote and assist in coordinating the provision of LA services;

F. Evaluate LA providers through formal on-site evaluations, self-assessments, periodic reports, and other means of oversight;

G. Provide information and referral services and/or legal advice to the public, as appropriate; and, H. Prepare an annual report, as directed by the SUA.

10.419 LEGAL ASSISTANCE PROGRAM 10.419.1 Legal Assistance Program Eligibility [Rev. eff. 12/1/10]

All adults age sixty and older shall be eligible for services. If resources are not available to serve all eligible older adults requesting the services, preference and priority shall be given to those eligible persons of greatest social and economic need with particular attention to low-income older adults and 10.419.2 Selection of a Local Legal Assistance Program Provider [Rev. eff. 12/1/10]

A. Each Area Agency on Aging (AAA) shall fund, through contract, and monitor a Legal Assistance (LA) Program, ensuring:

1. The LA program acts in accordance with federal and state requirements;

2. That legal assistance services are available throughout the Planning and Service Area (PSA);

3. That priorities for legal assistance are identified in the Area Plan; and, 4. LA providers focus the use of funds on older adults with the greatest legal, economic, or social need.

B. Each AAA shall select a local attorney and/or legal services agency to serve as the local Legal Assistance (LA) Program provider(s), with assistance from the Colorado Legal Assistance Developer (CLAD) Office, as needed.

1. To be eligible for selection as a local LA Program provider, the attorney and/or agency supervising attorney shall:

a. Be licensed and in good standing in Colorado;

b. Demonstrate expertise to provide legal assistance and other advocacy to older adults in specific areas of law affecting older adults;

c. Have the capacity and ability to provide legal assistance:

1) To vulnerable older adults, including those older adults that are institutionalized, isolated, and homebound;

2) In the principal language spoken by older adults in planning and service areas where a majority of older adults do not speak English.

2. The selected attorney and/or agency shall serve as an official and identifiable link to the LA Program according to policies and procedures established by the SUA;

3. The attorney and/or legal services agency and supervising attorney shall be identified and its functions described in the AAA Area Plan. 10.419.3 Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. The Legal Assistance (LA) Program providers shall provide legal assistance to older adults in compliance with Federal and State laws and regulations, State Unit on Aging policy and procedure, and rules of professional conduct.

B. The LA provider shall decline to provide legal services under the LA Program for otherwise eligible older adults when:

1. The case is fee-generating;

2. Funding has been expended, unless prior written approval is received from the AAA to provide additional legal assistance;

3. The issue is outside the types of cases to be provided, based on the funding agreement with the AAA;

4. The complexity of the case may require a referral to an attorney with a different type of specialization and/or expertise; or, 5. A potential or actual conflict of interest exists.

C. LA providers shall only represent adults who are age sixty or older except when, due to a lack of capacity, it is necessary to promote the interest of the older adult by representing a family member.

D. LA providers shall maintain client confidentiality, including the identity of individual clients, and otherwise comply with rules of professional conduct. 10.419.4 Legal Assistance Program Services Costs and Voluntary Contributions [Rev. eff.

A. Legal Assistance Program services are available at no cost to older adults when the legal service need meets priorities identified within the Area Plan, as described in Section 10.419.1 and within available appropriations.

B. Older adults shall be offered an opportunity to voluntarily contribute to the cost of legal services.

C. When the older adult’s need is beyond the priorities of the LA Program, the LA provider shall advise the older adult that services are not available through the LA Program and the LA provider may choose to represent the older adult as a private attorney, for a fee, or may refer the adult to another attorney. 10.419.5 Legal Assistance Program Data and Records [Rev. eff. 12/1/10]

A. The AAAs shall ensure that legal assistance data is recorded utilizing the state mandated data and reporting system(s).

B. Program reports, free of individual identifying information, shall be compiled by the AAA and provided to the state and the CLAD using the State approved data system(s) and form(s). 10.419.6 Legal Assistance Program Requests for Waiver [Rev. eff. 12/1/10]

A. An Area Agency on Aging (AAA) may request a waiver of some or all funding for LA Program services, in accordance with those policies and procedures, when the legal assistance services needs within the Planning and Service Area (PSA) are adequately met through other agencies.

B. Approval of a waiver exempts the AAA from requirements to fund or provide LA Program services within the PSA.

C. The AAA shall fund LA Program services within the assigned PSA at or above the minimum required level if the request for a waiver is denied. 10.420 COLORADO LONG-TERM CARE OMBUDSMAN PROGRAM [Rev. eff. 2/1/16]

The Colorado Department of Human Services, Division of Aging and Adult Services, is the State Unit on Aging (SUA) authorized under Title VII of the Older Americans Act (OAA), as defined at Section 10.120 “Definitions”, and Section 26-11.5-104, C.R.S., to establish and operate the Colorado Long-Term Care Ombudsman (CLTCO) office and Local Long-Term Care (LTC) ombudsman offices throughout the State. 10.420.1 Selection and Designation of the Colorado Long-Term Care Ombudsman [Rev. eff 1/1/12]

A. The agency, program, or person(s) selected to serve as the CLTCO shall have demonstrated expertise and experience in the fields of long-term care and advocacy.

B. The office of the CLTCO shall not be administered by any agency or organization:

1. Responsible for licensing or certifying long-term care services in the state; or, 2. An association or an affiliate of such an association of long-term care facilities or of any other residential facilities for older adults. 10.420.2 Colorado Long Term Care Ombudsman Responsibilities and Requirements [Rev.

eff. 2/1/16]

The CLTCO shall serve on a full-time basis and shall, personally or through representatives of the Office, perform the following duties and responsibilities in implementing a statewide Long-Term Care Ombudsman:

A. Establish and publish statewide policies and procedures for operating the Long-Term Care Ombudsman in collaboration with the SUA, AAAs, and Local LTC Ombudsman offices. This shall include procedures to identify, investigate, and resolve complaints that are:

1. Made by, or on behalf of, elderly residents; and, 2. Related to actions, inactions, or decisions that may adversely affect the health, safety, welfare, or rights of the resident, including the welfare or rights of the residents with respect to the appointment and activities of guardians and representative payees, by:

a. Providers, or representatives of providers, of long-term care services;

b. Public agencies, including the Colorado Department of Human Services; or, c. Health and social service agencies, including County Department(s) of Social or Human Services;

B. Provide services to assist residents in protecting the health, safety, welfare, and rights of the residents;

C. Represent the interests of residents before governmental agencies;

D. Seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of residents;

E. Inform residents about means of obtaining services from providers or agencies;

F. Ensure that residents have regular and timely access to services provided through the CLTCO Program and that residents and complainants receive timely responses from representatives of the CLTCO Program to complaints as described at Section 10.420.4, E and F;

G. Residents under age sixty (60) are eligible for ombudsman services only when the assistance:

1. Would generally benefit all residents of the facility; or, 2. Is the only avenue of assistance available to the resident; and would not significantly diminish services for older residents.

H. Establish procedures to analyze, monitor, and comment on the development and implementation of federal, state, and local laws and regulations, and other governmental policies and actions, pertaining to the health, safety, welfare, and rights of residents, with respect to the adequacy of long-term care facilities and services in Colorado;

I. Provide information to public and private agencies, legislators and others, as deemed necessary by the CLTCO regarding the problems and concerns of older adults residing in long-term care facilities;

J. Recommend changes in laws, regulations, policies, and other actions as appropriate;

K. Facilitate public comment on laws, regulations, policies, and actions;

L. Provide administrative and technical assistance to local LTC ombudsman offices;

M. Promote the development of citizen organizations to participate in the program;

N. Provide technical support for the development of resident and family councils to protect the wellbeing and rights of residents;

O. Provide training as required for representatives of the CLTCO, including unpaid volunteers, as described in Section 10.420.6;

P. Prohibit any representative (other than the CLTCO) from carrying out any activities on behalf of the CLTCO unless the representative:

1. Has received the required training; and, 2. Has been certified by the CLTCO as qualified to carry out activity on behalf of the CLTCO.

Q. Coordinate LTC ombudsman services with the protection and advocacy systems for individuals with intellectual and developmental disabilities and mental illness established under state and federal laws;

R. In conjunction with the AAA and SUA, designate a Local LTC Ombudsman entity to serve each Planning and Service Area (PSA) of the State;

S. Prepare a notice informing residents of long-term care ombudsman services for display at longterm care facilities to include the following:

1. Name, address, and toll-free phone number of the CLTCO; and, 2. Name, address, and phone number of the nearest Local LTC Ombudsman.

T. Pursue administrative, legal, or other appropriate remedies on behalf of residents for the purpose of effectively carrying out the long-term care ombudsman program;

U. Coordinate, to the greatest extent possible, LTC ombudsman services with legal assistance services through adoption of Memoranda of Understanding or other means;

V. Coordinate services with state and local law enforcement agencies and courts of competent jurisdiction;

W. Prepare an annual report:

1. Describing the activities carried out by the CLTCO in the year for which the report is being prepared;

2. Containing and analyzing data collected as described in Section 10.420.8;

3. Evaluating the issues or problems experienced by, and the complaints made by, or on behalf of, residents;

4. Analyzing the success of the program including success in providing services to residents in facilities as described in Section 10.420.5;

5. Identifying of barriers that prevent optimal operation of the program;

6. Providing policy, regulatory, and legislative recommendations to:

a. Solve identified problems;

b. Resolve complaints;

c. Improve the quality of care and life for residents;

d. Protect the health, safety, welfare, and rights of residents; and, e. Remove barriers to optimal operation of the program and improve the quality of care and life in long-term care facilities.

7. Providing recommendations of program or policy changes.

X. Make the annual report available to the public and submit copies to the Assistant Secretary of Health and Human Services, the Governor, the State legislature, the State agency responsible for licensing or certifying long-term care facilities, the SUA, the AAA, Local LTC Ombudsman, and other appropriate governmental entities; and, Y. Any other duties and functions assigned to the CLTCO by the SUA. 10.420.3 Selection and Designation of Local (LTC) Ombudsman [Rev. eff. 12/1/10]

A. In conjunction with the CLTCO office and the SUA, each AAA shall select a local agency, program, or person(s) to serve as a Local LTC Ombudsman.

1. The entity selected shall be designated as the Local LTC Ombudsman upon recommendation of the CLTCO and approval by the SUA.

2. The Local LTC Ombudsman shall serve as an official and identifiable link to the CLTCO program.

3. The designated agency, program, or person(s) shall be identified and its functions described in the AAA Area Plan, including the name of the Local LTC Ombudsman lead B. To be eligible for designation as a Local LTC Ombudsman, an agency, program, or person shall:

1. Have demonstrated capability to carry out the responsibilities of the CLTCO at the local level;

2. Be free of any conflict of interest as described in Section 10.420.5;

3. Not stand to gain financially through an action or potential action brought on behalf of individuals served by the Local LTC Ombudsman;

4. Be a public or non-profit private entity; and, 5. Meet additional requirements as the CLTCO may specify. 10.420.31 Local LTC Ombudsman Responsibilities and Requirements [Rev. eff. 2/1/16]

The Local LTC Ombudsman shall:

A. Carry a valid identification card issued annually and signed by the CLTCO, and present the card to obtain access to residents and the facilities records;

B. Follow these rules, and the policies and procedures established by the CLTCO;

C. Provide services to protect the health, safety, welfare, and rights of residents;

D. Ensure residents in the service area of the local LTC ombudsman have timely access to representatives of the program, and timely responses to complaints and requests for assistance;

E. Receive, investigate, and resolve complaints:

1. Made by or on behalf of residents that relate to actions, inactions or decisions that may adversely affect the health, safety, welfare, or rights of the residents; or, 2. Referred to the CLTCO, in accordance with the OAA, these rules, and the policies and procedures established by the CLTCO.

F. Respond to complaints:

1. Within five (5) working days for routine complaints; or, 2. Within one (1) working day in emergency situations where the long-term care ombudsman representative believes the resident is in imminent danger.

G. Represent the interests of residents before government agencies and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of the residents;

H. Review and, if necessary, comment on any existing and proposed laws, regulations, and other government policies and actions, that pertain to the rights and well-being of residents;

I. Facilitate the ability of the public to comment on the laws, regulations, policies, and actions;

J. Assist with the development of resident and family councils;

K. Establish linkages with at least the following community agencies:

1. County Department(s) of Social or Human Services;

2. Mental health centers;

3. Local health departments;

4. Case management agencies; and, 5. Senior services agencies.

L. Visit, within the region it services:

1. At least monthly, all nursing care facilities (i.e., nursing homes) where persons who are age sixty (60) or over reside and which are licensed or certified, including certified swing bed facilities, as defined at Section 10.150, offering extended care services;

2. At least quarterly, all assisted living residences providing services to persons who are age sixty (60) or older, which are licensed or certified.

3. “Visit” means the on-site:

a. Provision of information about LTC ombudsman services and residents’ rights to residents and, if possible, the resident’s family; and/or, b. Investigation of complaints.

M. Compliance:

1. The CLTCO and SUA shall monitor these visit requirements for compliance.

2. If a Local LTC Ombudsman is found to be out of compliance with these requirements:

a. The Local LTC Ombudsman and the AAA shall submit a written plan of action to the SUA and the CLTCO, signed by the AAA director, indicating steps to bring the program into full compliance.

b. The SUA may withhold reimbursement for expenditures for services until the program comes into full compliance. 10.420.4 Conflict of Interest [Rev. eff. 12/1/10]

A. A conflict of interest occurs when an officer or employee of the CLTCO or its representatives, including the local LTC ombudsman entity or a member of the immediate family of the officer, employee or representative:

1. Has direct involvement in licensing and/or certifying long-term care facilities;

2. Is a provider of a long-term care service;

3. Has ownership or investment interest in a long-term care facility;

4. Has ownership or investment interest in a long-term care service;

5. Is employed by and/or manages a long-term care facility or association of long-term care facilities; or, 6. Receives or has the right to receive, directly or indirectly, remuneration under a compensation arrangement with an owner or operator of a long-term care facility or service.

B. No individual or member of the immediate family, involved in the designation of the CLTCO or Local LTC Ombudsman shall be subject to a conflict of interest. 10.420.5 LTC Ombudsman Training [Rev. eff. 12/1/10]

A. The CLTCO, in collaboration with the SUA, shall establish procedures for the training of representatives of the office, including unpaid volunteers.

B. The training procedures shall:

1. Specify a minimum number of hours of initial training;

2. Specify the content of the training including, but not limited to:

a. Federal, state, and local laws, regulations, and policies with respect to long-term care facilities in Colorado;

b. Investigative techniques; and, c. Other matters as the CLTCO, in collaboration with the SUA, deems appropriate.

3. Specify an annual number of hours of in-service training for all designated or certified representatives.

C. The CLTCO shall prohibit any representative, including employees or volunteers of Local LTC Ombudsman, from carrying out activities described in Section 10.420.4, unless the representative:

1. Has received the training required by CLTCO policies and procedures; and, 2. Has been certified by the CLTCO as qualified to carry out the activity on behalf of the CLTCO. 10.420.6 Access [Rev. eff. 12/1/10]

Representatives of the CLTCO, including local LTC ombudsmen, shall have access to:

A. Long-term care facilities and residents, including the following:

1. Nursing care facilities;

2. Skilled nursing facilities;

3. Assisted living residences; and, 4. Swing beds in extended care facilities.

B. The medical and social records of a long-term care resident if:

1. The Long-Term Care ombudsman has the permission of the resident, or the legal representative of the resident;

2. The resident is unable to consent to the review and has no legal representative; or, 3. Access to the records is necessary to investigate a complaint if:

a. A legal guardian of the resident refuses to give permission;

b. The Long-Term Care ombudsman has reasonable cause to believe the guardian is not acting in the best interests of the resident; and, c. The Long-Term Care ombudsman obtains the approval of the CLTCO.

C. The administrative records, policies, and documents of long-term care facilities, to which the residents or the general public has access; and, D. Upon request, copies of all licensing and certification records maintained by the state with respect to any long-term care facility. 10.420.7 Local LTC Ombudsman Data and Records [Rev. eff. 12/1/10]

A. Through the AAA, Local LTC Ombudsman shall:

1. Generate and analyze data from activities;

2. Compare results to the previous time period;

3. Identify trends and resolve discrepancies;

4. Provide recommendations for improvement or change; and, 5. Submit their reports to the Colorado Long-Term Care Ombudsman and/or the SUA at the time periods specified by the SUA.

B. The CLTCO shall:

1. Collect and analyze data relating to complaints and conditions in long-term care facilities and to residents;

2. Identify and assist in resolving significant problems using the automated data system required by the SUA; and, 3. Evaluate compliance with standards for complaint resolution and visit standards.

C. The data shall be submitted to the SUA at time periods specified by the SUA and to:

1. The agency of the state responsible for licensing or certifying long-term care facilities in the state;

2. Other state and federal entities that the SUA determines to be appropriate;

3. The Assistant Secretary of the Department of Health and Human Services; and, 4. The National Long-Term Care Ombudsman Resource Center. 10.420.8 Legal Issues 10.420.81 Local LTC Ombudsman Liability [Rev. eff. 12/1/10]

The CLTCO and its representatives, including local LTC ombudsmen, acting in good faith within the scope of its duties and functions as described at Sections 26-11.5-105 through 26-11.5-106, C.R.S., shall be immune from civil or criminal liability. 10.420.82 Local LTC Ombudsman Legal Representation [Rev. eff. 12/1/10]

A. Adequate legal counsel shall be available to the CLTCO and able, without conflict of interest, to:

1. Provide advice and consultation needed to protect the health, safety, welfare, and rights of residents; and, 2. Assist the CLTCO and its representatives, including Local LTC Ombudsman entities, in the performance of official duties.

B. Adequate legal counsel shall be available to any representative of the CLTCO for legal representation of a LTC ombudsman against whom legal action is brought in connection with the performance of long-term care ombudsman duties and functions as described in Sections 26- 11.5-101 through 26-11.5-108, C.R.S., the Colorado Long-Term Care Ombudsman. 10.420.9 Interference with Long-Term Care Ombudsman [Rev. eff. 12/1/10]

A. Willful interference with representatives of the CLTCO is prohibited.

B. Discriminatory, disciplinary, or retaliatory actions and reprisals shall not be taken by a long-term care facility or other entity against any of the following individuals for filing a complaint with, providing information to, or otherwise cooperating with any representative of the CLTCO:

1. Any resident eligible for LTC Ombudsman services under the OAA; or, 2. Any officer or employee of a facility or governmental agency providing services to residents of long-term care facilities eligible for long-term care ombudsman services under the OAA.

C. Any person listed in Item B, above, or any person acting on such a person’s behalf, including the CLTCO or its representatives, may file a complaint with the SUA against any individual or entity in violation of these rules.

D. Upon receipt of a complaint regarding interference with a LTC Ombudsman in the course of his/her duties, or a complaint regarding discriminatory, disciplinary, or retaliatory action against any individual, the SUA shall:

1. Conduct an investigation of the complaint;

2. Determine if the complaint is substantiated;

3. Provide a written notice regarding the outcome of the investigation, if substantiated, to include the nature of the violation and the amount of the fine to the violator;

a. If the complaint involves interference with an ombudsman in the course of his/her duties, the SUA shall assess and collect the fine of $2,500.00 per violation;

b. If the complaint involves discriminatory, disciplinary, or retaliatory action against any individual, the SUA shall assess and collect a fine of $5,000.00 per violation.

4. If the penalized person disagrees with the SUA findings, he/she may request an Administrative Law Judge (ALJ) hearing.

E. All fines collected by the SUA because of the complaint investigation process shall be transmitted to the State Treasurer. 10.420.91 Disclosure [Rev. eff. 2/1/16]

A. The SUA, in collaboration with the CLTCO, shall establish procedures for disclosure by the CLTCO and local LTC ombudsman of files maintained by the program, including records described in Section 10.420.7.

B. Such files and records shall be disclosed only at the discretion of the CLTCO (or the person designated by the CLTCO to disclose the files and records).

C. The disclosure of the identity of any complainant or resident with respect to whom the CLTCO maintains such files or records shall be prohibited unless:

1. The complainant or resident, or his/her legal representative, consents to the disclosure and the disclosure is given in writing;

2. The complainant or resident gives consent orally and the consent is documented contemporaneously in a writing made by a representative of the CLTCO in accordance with requirements established by the SUA; or, 3. The disclosure is required by court order.

D. Disclosure of protected health information by the CLTCO to other entities and written authorizations of disclosure shall meet all of the requirements of Section 10.206 of these rules and any CLTCO policies and procedures.

10.421 PROGRAM FOR ELDER RIGHTS AND PREVENTION OF ELDER ABUSE, NEGLECT, AND

EXPLOITATION [Rev. eff. 2/1/16]

A. The SUA or its designee, in consultation with AAAs, shall develop a comprehensive approach to enhance elder rights and to prevent and respond to elder abuse, neglect, and exploitation, including financial exploitation:

1. Consistent with relevant federal and state laws; and, 2. Coordinated with:

a. State and county Adult Protective Services for at risk adults and Adult Protection Teams described in 12 CCR 2518-1;

b. The CLTCO and local ombudsmen;

c. The Colorado Legal Assistance Developer (CLAD) and local legal assistance providers;

d. Local law enforcement agencies;

e. Facility and long-term care provider licensure and certification programs;

f. Medicaid fraud and abuse services, including services provided by the Colorado Medicaid fraud control unit;

g. Victim assistance programs;

h. Protection and advocacy programs;

i. Consumer protection programs;

j. State and local courts, and, k. Other agencies and programs that assist and work with vulnerable older adults.

B. Funds authorized for this program shall be used to develop programs and activities related to elder rights and the prevention of and response to elder abuse, neglect, and exploitation, and may include:

1. Identification of older adults who are vulnerable to abuse, neglect, and exploitation, and are living in state licensed facilities, unlicensed facilities, or domestic or community-based settings; and, 2. Enhancing services under the Long-Term Care Ombudsman Program; and/or, 3. Developing training and/or educational materials on the topics of:

a. Self-determination, autonomy, and individual rights;

b. Indicators of and prevention of elder abuse, neglect, and exploitation;

c. Financial literacy, prevention of identity theft, and other forms of financial exploitation;

d. Procedures for reporting suspected elder abuse, neglect, and exploitation to the Long-Term Care Ombudsman, Adult Protective Services, and/or law enforcement;

e. State and federal confidentiality requirements; and, f. Other topics determined by the SUA.

C. Services provided under the Elder Rights and Prevention of Elder Abuse, Neglect, and Exploitation Program shall be in addition to and shall not be used to supplant any funds that are or would be expended under any other federal, state, or local program.

D. Any information received by the SUA or its designee or the AAA that indicates suspected or actual elder abuse, neglect, or exploitation:

1. Should be reported to the Long-Term Care Ombudsman, Adult Protective Services described in 12 CCR 2518-1, any law enforcement agency, or a facility licensing or certification agency; and, 2. Shall remain confidential unless:

a. All parties to the complaint or report consent in writing to the release of such information as described at Section 10.206;

b. The release of such information is to make a referral to the Long-Term Care Ombudsman, Adult Protective Services, any law enforcement agency, or a facility licensing or certification agency;

c. Upon court order for good cause; or, d. The SUA or its designee or the AAA shall make all reasonable efforts to resolve any conflicts with other public agencies with respect to confidentiality by entering into a Memorandum of Understanding or interagency agreement that narrowly limits disclosure of information consistent with confidentiality requirements of the agencies.

E. Involuntary or coerced participation of alleged victims, abusers, or members of their household in programs or activities related to prevention of elder abuse, neglect, or exploitation is prohibited.

F. The SUA or its designee and the AAAs shall use the state mandated data or reporting system(s) to:

1. Quantify the programs and activities conducted under the Elder Rights and Prevention of Elder Abuse, Neglect, and Exploitation Program; and, 2. Conduct analyses of regional and/or statewide information to:

a. Identify unmet needs in the areas of elder rights and prevention of elder abuse, neglect, and exploitation; and, b. Provide technical assistance to programs that provide or have the potential to provide elder rights and prevention services for older adults and family members of victims. 10.422 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP) [Rev. eff. 12/1/10]

The Senior Community Service Employment Program (SCSEP) promotes useful, part-time employment opportunities in community service activities for persons with low incomes who are fifty-five (55) years of age or older. Eligible enrollees are paid minimum wage in community service assignments that assist enrollees to update their employability skills to obtain unsubsidized employment. Local community providers contract with the SUA to implement the program through non-profit or government host agencies. 10.422.1 SCSEP Eligibility [Rev. eff. 2/1/16]

A. Potential enrollees in the SCSEP shall meet eligibility criteria as described in Section 516(2) of the OAA.

B. Enrollees shall be eligible to remain in the program for a maximum duration of forty-eight (48) months in the aggregate (whether or not consecutive).

C. Enrollees shall re-certify income eligibility at least once every twelve months. Participants that become ineligible due to changes in income shall be given a written notice of termination within thirty days and terminated after thirty days from receipt of written notice. The enrollee shall be referred to the one stop delivery system or other partner programs. 10.422.11 SCSEP Priority for Placement [Rev. eff. 2/1/16]

A. Vacant authorized positions shall be filled according to the following order of priorities:

1. Individual is sixty-five (65) years of age or older; or, 2. Individual:

a. Is a veteran;

b. Has limited English proficiency or low literacy skills;

c. Resides in a rural area;

d. Has a disability;

e. Has low employment prospects;

f. Has failed to find employment after utilizing services provided under Title I of the Workforce Investment Act of 1989 (29 U.S.C. 2801, et seq.). This Act shall not include any later amendments to or editions of the incorporated material. Copies of these materials are available for public inspection by contacting:

Colorado Department of Human Services, Division of Aging and Adult Services, Manager, State Unit on Aging, 1575 Sherman Street, Denver, Colorado 80203; or any state publication depository library.

g. Or is homeless or at risk of being homeless.

B. Eligible individuals determined most in need shall be provided enrollment preference within these priorities. 10.422.12 SCSEP Enrollment [Rev. eff. 12/1/10]

Sub-grantees shall document and verify the accuracy of information concerning an applicant’s eligibility and ensure compliance with related federal and state regulations, using the policy procedures related to application, recertification, denials, and termination process. 10.422.2 Provider Responsibilities and Requirements [Rev. eff. 12/1/10]

A. All providers shall operate in full compliance with all applicable federal, state, and local fire, health, safety, sanitation, and other standards prescribed in law or regulations.

B. Sub-grantees shall provide assistance to each enrollee to obtain unsubsidized employment in private or public sector jobs as soon as practicable to provide additional opportunities for other eligible individuals with the funds available.

C. Sub-grantees shall develop job opportunities for job-ready enrollees.

D. Sub-grantees shall follow-up with each enrollee within ninety (90) calendar days following placement in unsubsidized employment or into job-training programs.

1. Enrollees who are found to be unemployed shall be considered for re-enrollment in a project.

2. Results of the follow-up shall be documented in the enrollee file.

E. Sub-grantees shall maintain adequate staffing and dedicate sufficient resources to ensure fulfillment of all program responsibilities, including enrollment.

F. Sub-grantees shall retain enrollee records for a period of three years. Hard copy files shall be held in locked file cabinets and electronic files shall be accessible to sub-grantee staff through secure passwords. 10.422.21 Host Agency Selection and Requirements [Rev. eff. 12/1/10]

A. Sub-grantees shall develop community service employment positions with local, state, federal or other publicly owned and operated facilities and projects that contribute to the general welfare of the community or projects sponsored by organizations, other than political parties, that are exempt from taxation.

B. Host agencies shall sign a host agency agreement with the sub-grantee, which shall become a

part of the contractor’s permanent record.

C. Host agency responsibilities shall include, but are not limited to providing:

1. Adequate supervision of the enrollee at least equal to supervision provided employees in similar positions;

2. Adequate orientation and instruction regarding the enrollee’s job responsibilities, duties, and job safety;

3. A sanitary and safe working environment that provides fair and impartial treatment of the enrollee;

4. First consideration to the enrollee for an unsubsidized position within the host agency when a vacancy occurs for which the enrollee has the qualifications and required experience;

5. Cooperation and access to enrollee records to the sub-grantee and the SUA for the purposes of on-site monitoring;

6. Training that is job-related and enhances the individual’s potential for unsubsidized employment; and, 7. Time off to attend training during work hours as approved and required by the subgrantee.

D. Training positions at the host agency shall meet the maintenance of effort provisions required under federal regulations as follows:

1. Training positions shall result in an increase in employment opportunities over and above those already available; and, 2. Training positions shall not result in the displacement of current employees including partial displacement such as the reduction of regular hours, wages or benefits.

E. A host agency may not be a worksite for a person if a member of that person’s immediate family is in an administrative capacity or a board member for the host agency. Immediate family Includes, in this context, wife, husband, son, mother, father, daughter, brother, brother-in-law, sister, sister-in-law, son-in-law, daughter-in-law, mother-in-law, father-in-law, aunt, uncle, niece, nephew, stepparent, stepchild, grandparent or grandchild. 10.422.22 On The Job Experience [Rev. eff. 2/1/16]

Sub-grantees shall develop relationships with other employment and training programs providing services to older adults and other agencies in the area to provide the most comprehensive employment and training services to eligible older adults.

A. Sub-grantees shall collaborate with the Colorado American Job Centers (formerly known as the Colorado Workforce Development Career Centers):

1. To recruit eligible individuals, targeting individuals who are economically and socially disadvantaged, veterans, minorities, limited English-speaking, and Native Americans;

2. To obtain unsubsidized employment for the job-ready individual; and, 3. To increase training and employment opportunities for eligible enrollees.

B. Sub-grantees shall develop and maintain relationships with the AAAs for a source of supportive services for the older worker and to provide a worksite for community service employment for eligible enrollees.

C. Sub-grantees shall develop a relationship with local, state, and federal agencies as potential host agency sites to:

1. Provide a variety of work assignments for enrollees; and, 2. Produce a variety of services to the community that would otherwise not be available.

D. Sub-grantees shall initiate close relationships with private employers in the area to:

1. Determine their needs and provide education on the benefits of hiring older adults;

2. Identify techniques that would increase opportunities for older adults; and, 3. Provide an employment source for enrollees ready to assume unsubsidized employment.

E. Sub-grantees shall maintain a working relationship and communication with other SCSEP grantees in the state to assure equitable distribution of available Title V, as defined at Section 10.120 “Definitions”, positions in the state grantee’s service delivery area. 10.422.23 Non-Discrimination [Rev. eff. 12/1/10]

A. Sub-grantee contracts shall include assurances concerning non-discrimination in all activities related to the administration of the program.

B. No sub-grantee or staff person of the sub-grantee shall discriminate, exclude from participation, or deny benefits to eligible individuals because of the individual’s race, ethnicity, color, religion, gender, sexual orientation, national origin, handicap, political beliefs, or age, except where age is a valid consideration as described in these rules. 10.422.24 Data and Records [Rev. eff. 12/1/10]

A. Sub-grantees shall maintain documentation that is sufficient to permit the preparation of reports as mandated by the Older Americans Act or as required by the U.S. Department of Labor or the SUA and to permit the tracking of funds to a level of expenditure adequate to ensure funds have not been spent unlawfully.

B. Documentation shall be completed based on the sub-grantee’s policy and procedures manual. 10.422.3 Provisions [Rev. eff. 2/1/16]

The SCSEP provisions of the Older Americans Act are designed to:

A. Enhance employment and training opportunities for older workers by reinforcing connections with the broader workforce investment system, including government agencies, community service organizations, and nonprofit organizations approved under Section 501(c)(3) of the Internal Revenue Code;

B. Establish an enhanced performance accountability system to hold each project sub-grantee accountable for attaining quality levels of performance with respect to core measures;

C. Improve the ability of states to coordinate services by providing for the broad participation of stakeholders in the development of an annual plan to ensure an equitable distribution of projects within the state;

D. Strengthen the administrative procedures and fiscal accountability provisions similar of other federal work programs; and, E. Revise the distribution of funding. 10.422.31 SCSEP Services [Rev. eff. 12/1/10]

Services available through the SCSEP shall include the following:

A. Enrollee wages and fringe benefits (including a physical examination);

B. Enrollee training, provided prior or subsequent to placement, including the payment of reasonable costs of instructors, classroom rental, training supplies, materials, equipment, and tuition;

C. Job placement assistance, including job development and job search assistance;

D. Enrollee supportive services;

E. Outreach, recruitment and selection, intake, orientation, and assessments; and, F. On the Job Experience (OJE) – training and employment opportunities through public or private employers not associated with community service. 10.422.4 SCSEP Procurement [Rev. eff. 2/1/16]

A. The SUA shall award Title V, as defined at Section 10.120 “Definitions”, funds to prospective subgrantees using a competitive bidding process pursuant to the Colorado Procurement Code (see

Section 24-103-202, C.R.S. “Competitive Sealed Bidding”).

B. Contracts shall be awarded for a defined period and may be renewed for additional option years at the sole discretion of the SUA, contingent upon:

1. Appropriation and budgeting of funding; and, 2. The sub-grantees’ successful satisfaction of contractual requirements, if applicable. 10.422.5 Program Monitoring and Reporting [Rev. eff. 2/1/16]

A. The SUA has designated responsibility for administering SCSEP funded under Title V, as defined at Section 10.120 “Definitions”, including all program activities prescribed by the Older Americans Act, the grant agreement, and United States Department of Labor bulletins and regulations.

B. The SUA conducts ongoing monitoring of performance, based on specific performance indicators and achievement of established program goals and objectives as indicated in the contractual agreement. 10.422.51 Performance Measures [Rev. eff. 2/1/16]

A. All sub-grantees shall be evaluated on the performance measures established by the Secretary of HHS and the SUA as a requirement for application, and as a condition of all contracts received under Title V, as defined at Section 10.120 “Definitions”. The performance measures include, but are not limited to:

1. Number of enrollees placed in unsubsidized employment by each sub-grantee during the program year shall be authorized through the SUA;

2. Completion of customer satisfaction surveys of host agency employers, unsubsidized employers, and participants; and, 3. Quarterly progress reports shall be submitted timely and accurately via the Federal data collection system.

B. Levels of performance may be adjusted with approval from the SUA only with respect to the following:

1. High rates of unemployment, poverty, or welfare recipients in areas served by a subgrantee relative to other areas of the state;

2. Significant numbers or proportions of enrollees with one or more barriers to employment served by a sub-grantee relative to sub-grantees serving other areas of the state; or, 3. Significant downturns in the areas served by the sub-grantee or in the national economy. 10.422.52 Non-Compliance with Performance Measures [Rev. eff. 12/1/10]

A. If a sub-grantee fails to meet its performance measures for a year the sub-grantee is required to submit a corrective action plan identifying:

1. The specific performance measure(s) that were not met;

2. Reasons why the sub-grantee was unable to meet the performance measure(s); and, 3. A plan for implementing changes and steps the sub-grantee will take to meet the standard(s).

B. An action plan shall be submitted in the time period specified by the state.

C. If the sub-grantee fails to meet performance measures for a second year, the State shall conduct a competition to transfer up to twenty-five percent (25%) of the services to another sub-grantee (minimizing to the extent possible, disruption of services provided to enrollees).

D. If the sub-grantee fails to meet performance measures during the third year, the SUA shall conduct a competition to award all of the funds to another sub-grantee. The sub-grantee that has failed to meet its performance measures shall not be included in the competition award process. 10.422.6 Enrollee Recruitment and Selection [Rev. eff. 2/1/16]

A. Sub-grantees shall implement recruitment and selection methods to ensure the maximum number of eligible individuals have an opportunity to participate in the SCSEP and vacant positions are kept to a minimum.

B. Sub-grantees shall ensure that recruitment efforts are targeted toward veterans, eligible minority individuals, limited English-speaking individuals, Native American individuals, and individuals with the greatest economic need, at least in proportion to their numbers in the sub-grantee area, and taking into consideration their rates of poverty and unemployment. 10.422.61 Physical Examination [Rev. eff. 12/1/10]

A. Each individual selected for enrollment shall be offered a physical exam.

B. Physical exams are a program benefit and shall not be used as a basis to deny enrollment unless the program activity would present a danger to the individual’s health or safety.

C. Additional physical exams or additional signed waivers shall be required during an individual’s participation in community service employment annually.

D. Individuals who are terminated and subsequently re-enrolled shall not be required to have a physical exam or sign a waiver, if their last exam or signed waiver occurred within twelve months of their date of re-enrollment.

E. Subsequent exams or waivers for terminated and re-enrolled individuals shall be scheduled within twelve months of the last exam. 10.422.62 Administrative Terminations [Rev. eff. 2/1/16]

A. Enrollees may be terminated immediately for cause.

B. If the enrollee is terminated for cause, the participant will be placed on leave without pay immediately, and a thirty (30) day notice of termination will be sent to the participant.

C. Reasons for administrative termination may include:

1. Refusal to cooperate in establishing eligibility;

2. Inability and/or unwillingness to perform assigned duties;

3. Refusal to accept a different community service assignment;

4. Frequent tardiness or unauthorized absences;

5. Falsification of time sheets or other official records;

6. Insubordination;

7. Non-compliance with substance abuse policy; or, 8. Inappropriate failure to cooperate with sub-grantee and/or host agency staff.

D. Behaviors that may lead to administrative termination shall be documented and included in subgrantee records.

E. The personnel policies and procedures of each sub-grantee shall include the reasons for administrative termination. 10.422.621 SCSEP Employability Plan Termination (Individual Development Plan) [Rev. eff.

A. Failure to participate in the Employability Plan process may be cause for corrective actions, up to and including termination as a last resort.

B. Repeated refusal by the enrollee to perform specific actions as agreed upon may lead to termination.

C. The personnel policies and procedures of each sub-grantee shall include a description of the enrollee’s responsibilities and obligations if included in the employability plan, and actions that may be taken by the sub-grantee sponsor if the enrollee fails to meet his/her obligations. 10.422.622 SCSEP Termination Notices [Rev. eff. 12/1/10]

Termination notices shall include:

A. The effective date of the termination;

B. Reason(s) for the termination; and, C. Appeal rights of the enrollee. 10.422.623 SCSEP Complaints, Adverse Actions and Appeals [Rev. eff. 12/1/10]

A. If an adverse action is taken against an enrollee, the enrollee shall receive written notice stating the reasons for the determination, the enrollee’s right to appeal, and the appeal procedures.

B. Sub-grantees shall develop complaint procedures and an appeal process to resolve issues arising between the host agency and an enrollee or applicant.

C. The enrollee shall be provided a copy of the complaint resolution process. Unresolved complaints alleging violations of law other than discrimination shall be filed with the appropriate office of the U.S. Department of Labor at: U.S. Department of Labor, 200 Constitution Avenue NW, Washington, D.C. 20210.

D. Unresolved complaints alleging discrimination due to race, ethnicity, color, religion, gender, sexual orientation, national origin, disability, or age (except where age is a valid consideration under SCSEP) shall be filed with the Director, Office of Civil Rights at: Colorado Civil Rights Division Commission, 1560 Broadway, Room 1050, Denver, CO 80202-5143. 10.422.7 SCSEP Orientation [Rev. eff. 12/1/10]

Sub-grantees shall provide formal program orientation for the enrollees as soon as practical. Program orientation shall be developed in accordance with the sub-grantee’s policies and procedures. 10.422.8 SCSEP Assessment and Evaluation [Rev. eff. 12/1/10]

Each new enrollee shall be assessed to determine the most suitable community service employment position for the enrollee. The assessment shall be made with the enrollee’s input and based on the assessment, and an employability plan shall be developed. The plan shall be developed in accordance with the sub-grantee’s policy and procedure manual. 10.422.81 SCSEP Pre-Job Training [Rev. eff. 12/1/10]

Pre-job training may be provided to new enrollees prior to and as preparation for community service A. The training shall be delivered through lectures, seminars, classroom training, or other arrangements at no cost or reduced cost to the project whenever possible.

B. Pre-job training and orientation shall be considered as employment under the sub-grantee and enrollees shall be compensated at the federal or state minimum wage, or the sub-grantees prevailing wage, whichever is higher. The enrollee must be assigned to community service prior to any compensation.

C. Pre-job training and orientation shall be completed within the first eighty (80) hours of the individual’s enrollment unless an extension is approved by the SUA. 10.422.82 SCSEP Community Service Employment [Rev. eff. 2/1/16]

A. Enrollees shall be assigned to useful part-time community service employment as soon as possible after the physical exam, orientation and pre-job training. A physical examination shall be offered to the enrollee and if the physical is refused it must be noted in the enrollee’s file.

B. Host agency assignment shall not exceed two (2) years without prior written approval of the SUA.

Wr itten approval shall be requested two (2) months prior to the end of the two year period, unless directed otherwise by the SUA.

C. At the end of the aggregate maximum forty-eight (48) month placement period, if unsubsidized employment is not found, the enrollee shall exit from the program, unless the sub-grantee submits a request for extension in writing and is granted approval by the SUA.

D. Hours worked by each enrollee, include paid hours of orientation, pre-job training, job related training, voluntary training, and necessary sick leave.

1. Sub-grantees shall not require an enrollee to work more than forty hours per week, nor offer an enrollee less than twenty hours of paid participation per week, on average, unless approved by the SUA and agreed to in writing by the enrollee.

2. An enrollee’s community service employment shall be during normal working hours unless otherwise agreed upon by the enrollee.

E. Enrollees shall be placed with host agencies in their own county of residence and shall be assigned to community service employment in or near the communities in which they reside.

F. Enrollees shall be assigned to community service employment positions that contribute to the general welfare of the community, such as social, health, welfare, library, education, conservation, maintenance or restoration of natural resources, economic development, and any other services essential and necessary to the community.

G. Enrollees shall be given first consideration for positions in the operation of sub-grantees where assignments are congruent with the skills and interests of the enrollee.

H. Enrollees employed in community service employment positions funded under Title V, as defined at Section 10.120 “Definitions”, shall not be considered federal or state employees.

I. Wages and Fringe Benefits 1. The pay rate for enrollees for active participation, including orientation and pre-job training shall be whichever of the following is higher:

a. The Federal minimum wage; or, b. The state or local minimum wage for that employment or the most nearly comparable employment covered under the state or local minimum wage laws.

2. Fringe benefits shall be administered by sub-grantees uniformly to all enrollees, including those in temporary positions.

a. State sponsored enrollees shall receive the same benefits afforded to national sponsored enrollees, where both state and national grants are administered by the sub-grantee.

b. Benefits may include, but are not limited to:

1) Workers’ compensation; and, 2) Other benefits as approved by the SUA.

c. Enrollees not covered by state workers’ compensation laws shall be provided with workers’ compensation benefits through a recognized carrier or by selfinsurance, as authorized by state law, equal to that provided by law for covered J. SCSEP Supportive Services 1. Supportive services shall be provided to assist enrollees in successful participation in community service employment and to assist in transition to unsubsidized employment.

2. Supportive services may include the following:

a. Personal and job related counseling;

b. Reimbursement for items such as work shoes, badges, uniforms, tools, safety glasses, and other items required for participation in subsidized or unsubsidized employment; and, c. Transportation when accomplished in the direct performance of employment or employment-related activities, or from central pickup points to work sites in cases where public transportation is inadequate.

3. Public transportation or transportation of no cost to the project shall be used whenever possible.

K. SCSEP Other Training 1. Sub-grantees may provide additional training to enrollees that provides or enhances skills required to perform community service employment or to obtain unsubsidized 2. Training may be classified as job-related or voluntary, and includes:

a. Skill training;

b. Job seeking skills;

c. Training in preparation for obtaining unsubsidized employment; and, d. Resume writing and interviewing skills.

3. “Job-related training” is training which provides or enhances skills necessary for successful participation in community service employment.

a. Required training shall be reasonable and consistent with the enrollee’s assignment.

b. Enrollees shall be paid the established wage rate of the sub-grantee during training.

4. “Voluntary training” provides or enhances skills necessary to obtain unsubsidized a. Voluntary training may be provided during subsidized employment participation and the enrollee need not be compensated for the hours of training.

b. If training is provided during SCSEP participation, uncompensated hours shall not apply to the 4,160 hour participation limit.

5. Sub-grantees shall develop training opportunities through other employment and training programs, including the Colorado American Job Centers (formerly known as the Colorado Workforce Development Career Centers) or other sources at no cost or reduced cost to the program whenever possible.

L. SCSEP Temporary Positions 1. Sub-grantees may enroll over the amount of the total authorized positions in temporary positions to serve as many individuals as possible and to expend authorized funds with maximum efficiency.

2. Sub-grantees shall notify temporary enrollees of their status in writing and file a copy of the notification in the enrollee’s permanent file.

M. Title V, as defined at Section 10.120 “Definitions”, Federal funds shall not be expended in excess of the authorized grant amount. 10.422.9 SCSEP Political Activities [Rev. eff. 2/1/16]

A. No political activity is allowed under a SCSEP project or sub-grantee.

B. No enrollee or staff person shall engage in partisan or non-partisan political activities during the hours compensated by Title V, as defined at Section 10.120 “Definitions”, funds, or represent himself/herself as a spokesperson for the SCSEP while engaging in partisan political activity at any time.

C. Enrollees and staff persons of a project or sub-grantee are further restricted from political activity as required by federal rules and regulations.

D. Each enrollee under Title V, as defined at Section 10.120 “Definitions”, shall be given a written explanation clarifying the law with respect to allowable and unallowable political activities.

E. Enrollees shall not be employed in the office of a member of Congress, a state or local legislator, or on the staff of a legislative committee.

F. Assignments to offices of any other local or state elected officials where the duties are of a nonpolitical nature may be allowed only with prior approval of the SUA and documented assurances that political activities shall not be engaged in by the enrollee.

G. No funds, provided under Title V, as defined at Section 10.120 “Definitions”, shall be directly provided to influence a member of Congress, state or local legislator. 10.500 COMPLAINTS, APPEALS AND HEARINGS [Rev. eff. 12/1/10]

A. All service providers, including Area Agencies on Aging (AAA), contractors, and sub-contractors receiving Older Americans Act (OAA) funds to provide services to older adults shall develop policies and procedures for the resolution of complaints and appeals as described at Section 10.205, G.

B. A complaint, in the context of this rule, is an expression of dissatisfaction by:

1. An older adult receiving services under the Older Americans Act (OAA) or State Funding for Senior Services (SFSS), or his/her representative or caregiver;

2. An applicant for services under the OAA or SFSS, or his/her representative or caregiver; or, 3. A service provider.

C. Older adults receiving services, applicants for services, or their representatives or caregivers may file a complaint related to the following:

1. Any action or failure to act which impacts the older adult’s experience with programs and services funded by the OAA or SFSS;

2. Dissatisfaction with services including issues related to quality and quantity of services;

3. Dissatisfaction with service providers; or, 4. Other issues related to OAA or SFSS programs raised by the older adult or his/her representative or caregiver.

D. Consumer complaints may initially be verbal or written.

1. If a verbal complaint is made in person, the agency staff or volunteer receiving the complaint shall assist the older adult in recording the complaint.

a. The narrative of the complaint shall be read back to the older adult to ensure that the older adult’s complaint is accurately documented and the older adult shall be asked to sign the complaint. The staff member shall sign and date the document to verify this step.

b. The older adult shall not be required to sign the complaint if he/she refuses or is unable to sign.

2. Complaints received by phone shall be documented by the agency staff/volunteer receiving the complaint.

3. Complaints shall be forwarded to the appropriate agency for follow-up and resolution.

E. Service providers may file written complaints for issues related to:

1. Reimbursement;

2. Matters pertaining to an executed contract between the service provider and the contracting agency; or, 3. The conduct of the grant process, limited to issues of compliance with the procedural requirements of applicable laws, regulations, and policies.

F. Service provider complaints shall not include issues related to withdrawal of designation as an AAA, or PSA modification as found in Section 10.506.

G. Complaint procedures for enrollees in the Senior Community Service Employment Program are located at Section 10.422.623. 10.501 CONSUMER COMPLAINTS [Rev. eff. 12/1/10]

A. Complaints (including complaints by older adults or by their representatives or caregivers), and complaints by applicants for services (or their representatives or caregivers) shall be resolved at the lowest possible level.

B. If the complaint cannot be resolved at the local level, it may be appealed to the SUA.

C. Complaints shall be filed in writing with the direct service provider within thirty (30) calendar days of the action or incident giving rise to the dissatisfaction.

D. The direct service provider receiving the complaint shall investigate and resolve the complaint.

The direct service provider may be the AAA or a contractor of the AAA or SUA.

E. Written notice of the resolution shall be sent to the complainant within fifteen (15) working days.

This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the service provider’s resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the service provider’s decision if he/she is dissatisfied with the resolution and instructions for filing such an appeal.

F. The provider shall maintain complaint files that include:

1. The complaint;

2. Investigative notes and findings;

3. The resolution of the complaint including any actions taken; and, 4. A copy of the written response to the complainant. 10.502 CONSUMER APPEAL [Rev. eff. 12/1/10]

A. If the complainant is dissatisfied with the complaint resolution, a written appeal may be filed with the SUA Director within ten (10) calendar days of receipt of the decision.

B. The SUA Director or designee shall complete a review of the complaint and resolution to that complaint, including all pertinent documentation or new information that may be available.

C. The SUA Director will provide a written response to the complainant within thirty (30) calendar days of receipt of the appeal.

D. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described at Section 10.507 of these rules if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing.

10.503 SERVICE PROVIDER COMPLAINTS AND APPEALS 10.503.1 Service Provider Complaint [Rev. eff. 12/1/10]

A. Service provider complaints shall be filed in writing directly with the service provider’s contracting agency (i.e., the AAA or SUA) within thirty (30) calendar days of the date the incident occurred.

B. The AAA or SUA receiving the complaint shall investigate and resolve the complaint within fifteen working days from the time the agency receives the complaint.

C. If the service provider is a contractor of the AAA, the complaint shall be investigated and resolved by the AAA director.

D. If the service provider is a contractor of the SUA, the complaint shall be investigated and resolved by a designated SUA staff person.

E. Written notice of the resolution shall be sent to the service provider complainant. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for filing such an appeal. 10.503.2 Service Provider Appeal [Rev. eff. 12/1/10]

A. If the service provider or contractor is dissatisfied with the resolution of the complaint, a written appeal may be filed with the SUA Director within ten (10) calendar days of the receipt of the initial decision.

B. The appeal shall be investigated and resolved by the SUA Director or designee. If a designee is selected, a supervisory level designee in the SUA not involved in the original complaint resolution shall resolve the appeal.

C. The SUA Director or designee shall complete a review of the complaint and complaint resolution, including all pertinent documentation or new information that may be available, and provide a written response to the complainant within fifteen (15) working days of receipt of the appeal.

10.504 LOCAL LONG-TERM CARE (LTC) OMBUDSMAN COMPLAINTS AND APPEALS 10.504.1 Local Long-Term Care Ombudsman Complaints [Rev. eff. 12/1/10]

A. Complaints made involving actions or inactions by a Local LTC ombudsman shall be filed with the appropriate AAA within thirty (30) calendar days of the date of the incident.

B. The AAA Director shall investigate and resolve the complaint.

C. The complainant shall be notified, in writing, by the AAA Director of the resolution within fifteen (15) working days of receipt of the complaint. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for making such an appeal.

D. If the complainant is dissatisfied with the complaint resolution by the AAA, a written appeal may be filed with the SUA Director within ten calendar days of the decision.

E. The SUA Director or designee shall complete a review of the complaint and complaint resolution, including all pertinent documentation or new information that may be available, and provide a written response to the complainant within fifteen (15) working days of receipt of the appeal. This decision is final.

10.505 COLORADO LONG-TERM CARE OMBUDSMAN (CLTCO) COMPLAINTS AND APPEALS 10.505.1 Colorado Long-Term Care Ombudsman Complaints [Rev. eff. 12/1/10]

A. Complaints made involving actions or inactions by the CLTCO shall be filed with the SUA within thirty (30) calendar days of adverse action.

B. The SUA shall investigate and resolve the complaint.

C. The complainant shall be notified in writing of the resolution within fifteen (15) working days. This notice shall include:

1. A summary of the concern or issue;

2. The results of the investigation into the complaint and the resolution of the concern; and, 3. Notification to the complainant of his/her right to appeal the decision if he/she is dissatisfied with the resolution, and instructions for making such an appeal.

4. This written response shall include notification of the complainant’s rights to an Administrative Law Judge hearing as described in Section 10.507 if he/she is dissatisfied with the resolution of the appeal, and instructions for requesting such a hearing. 10.506 AAA DESIGNATION AND WITHDRAWAL [Rev. eff. 12/1/10]

The AAAs may request an appeal to an ALJ of a decision by the SUA in the following circumstances:

A. Withdrawal of AAA designation resulting from:

1. Termination of the contract;

2. Disapproval by the SUA of the Area Plan, the One-Year Funding Request or revisions to the plan;

3. Non-compliance with the terms of the contract, state regulations, federal regulations or applicable laws;

4. Failure to apply or submit the Area Plan, the One-Year Funding Request or revisions to the plan; or, 5. Voluntary termination of the contract by the AAA.

B. Modification of planning and service areas when:

1. The applicant is denied a PSA modification;

2. An existing AAA is affected by an approved application for modification of a PSA; or, 3. Individuals or entities penalized as a result of an investigation into complaints of interference with an ombudsman in the course of his/her duties, or a complaint regarding discriminatory, disciplinary or retaliatory action as described in Section 10.420.9 may request an Administrative Law Judge (ALJ) hearing. 10.507 STATE ADMINISTRATIVE LAW JUDGE (ALJ) [Rev. eff. 12/1/10]

A. The purpose of a hearing before an Administrative Law Judge for a consumer appeal shall be to determine the pertinent facts to arrive at a fair and equitable decision.

B. The purpose of an ALJ hearing for a provider appeal shall be based on SUA’s response to the service provider’s complaint and shall be upheld unless arbitrary or capricious or contrary to another standard of judicial review per Section 24-4-106, C.R.S. and final agency action per

Section 26-1-106, C.R.S.

C. ALJ hearings shall be conducted in accordance with Section 24-4-105, C.R.S. and Section 26-1- 106, C.R.S. 10.507.1 Notification of Initial Decision [Rev. eff. 12/1/10]

A. Following conclusion of the hearing, the ALJ shall prepare and file an initial decision.

B. The initial decision shall include a statement of findings and conclusions upon all the material issues of fact, law or discretion presented by the record, and the appropriate order, sanction, relief or denial thereof.

C. The initial decision shall include a determination as to whether the respondent acted in accordance with, or properly interpreted, applicable state policies and regulations.

D. The initial decision shall be sent to each party involved in the hearing.

10.508 COLORADO DEPARTMENT OF HUMAN SERVICES FINAL AGENCY DECISION 10.508.1 Final Agency Decision [Rev. eff. 12/1/10]

A. After the Colorado Department of Human Services receives the initial decision from the ALJ, the designee at the Department shall review the decision in accordance with a procedure adopted by the State Board of Human Services pursuant to Section 26-1-106(1), C.R.S.

B. Any party may file exceptions to the decision submitted by the ALJ pursuant to Section 24-4- 105(14)(a)(I), C.R.S.

C. Parties interested in reversing or modifying the initial decision of the ALJ shall follow the procedures identified at Section 24-4-105(15)(a), C.R.S.

D. The Colorado Department of Human Services shall issue a final agency decision in accordance with Section 26-1-106, C.R.S. __________________________________________________________________________ Editor’s Notes

History Sections 10.150, 10.410, 10.710, 10.720, 10.730, 10.930, 10.940. eff. 06/01/2008.

Entire rule eff. 12/01/2010.

Sections SBP, 10.205, 10.302.3, 10.305.1, 10.309, 10.418.1, 10.420.1 eff 01/01/2012.

Entire rule eff. 02/01/2016.

## **2511** State and Veterans Nursing Homes (Volume 11)

##### **12 CCR 2511-1** Rule Manual Volume 11, State and Veterans Nursing Homes {#sec-12-ccr-2511-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2511-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 11 STATE AND VETERANS NURSING HOMES

12 CCR 2511-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT AND SPECIFIC STATUTORY

AUTHORITY OF REVISIONS MADE TO STAFF MANUAL VOLUME 11

Revisions to Sections 11.100.01; 11.201.01 were emergency adoption of Executive Director rules at the 8/1/86 meeting, with an effective date of 8/1/86 (Documents 1 E.D., 2 E.D.). Statement of Basis and

Purpose, Fiscal Impact and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Addition of Section 11.251.01 was emergency adopted at the 3/6/87 State Board meeting, with an effective date of 3/6/87 (Document 2 E.D.). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator. Department of Social Services.

Addition of Section 11.251.01 was finally adopted emergency at the 4/3/87 State Board meeting, with an effective date of 3/6/87 (Document 1 E.D.). Statement of Basis and Purpose, Fiscal Impart, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Addition of Sections 11.250.01 - 11.250.04 and 11.251.02 - 11.262.02 were finally adopted following publication at the 4/3/87 State Board meeting, with an effective date of 6/1/87 (Document 16) Statement of Basis and Purpose, Fiscal Impact and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to Sections 11.101.01 and 11.201.01 were final adoption following publication of Executive Director rules at the 5/1/87 State Board meeting, with an effective date of 7/1/87 (Documents 1 E.D. and 2 E.D.). Statement of Basis and Purpose, Fiscal Impact and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revisions to Section 11.300 through 11.301 were final adoption following publication at the 9/11/87 State Board meeting, with an effective date of 11/1/87 (Document 7). Statement of Basis and Purpose, Fiscal Impact and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Removal of Section 11.400 and addition of Section 11.500 was final adoption following publication at the 11/3/89 State Board meeting, with an effective date of 1/1/90 (CSPR# 89-6-6-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the State Board Office, Department of Social Services.

Revisions to Sections 11.100 through 11.300 were final adoption following publication at the 3/4/2000 State Board meeting, with an effective date of 10/1/2000 (CSPR# 00-5-25-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, State Board Administration.

Re-write of Sections 11.100 through 11.400 were final adoption following publication at the 8/3/2007 State Board meeting, with an effective date of 10/1/2007 (Rule-Making# 07-5-31-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, State Board Administration.

Revision of Sections 11.100, 11.110, and 11.400; and, deletion of Sections 11.500 through 11.500.6 were final adoption following publication at the 12/2/2011 State Board rule-making session, with an effective date of 2/1/2012 (Rule-Making# 11-8-11-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions to Section 11.200 were final adoption following publication at the 3/8/2013 State Board rulemaking session, with an effective date of 5/1/2013 (Rule-Making# 12-10-10-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 11.100 through 11.300 were final adoption following publication at the 10/3/2014 State Board rule-making session, with an effective date of 12/1/2014 (Rule-Making# 14-7-21-1).

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, State Board Administration. 11.000 COLORADO VETERANS COMMUNITY LIVING CENTERS [Rev. eff. 12/1/14] 11.100 DEFINITIONS [Rev. eff. 12/1/14]

"Applicant" means the individual applying for residency in a Veterans Community Living Center which includes the applicant’s legal representative.

"Colorado resident" means an individual who currently resides in Colorado, intends to reside in Colorado permanently and who does not maintain a primary residence in another state.

"Colorado State Veterans Center" means Veterans Community Living Center at Homelake and the Domiciliary at Homelake located in Monte Vista, Colorado.

"Legal representative" means an individual who has the legal authority to take a particular action on behalf of an applicant or resident.

"Medical leave" means absence of the resident from the Center due to admittance to a hospital or other institution as defined in the Department of Health Care Policy and Financing rules, Section 8.482.43 (10 CCR 2505-10).

"Surviving spouse" means a person who was married to a Veteran at the time of the Veteran's death, and who has not remarried or held himself or herself out to the public to be the spouse of another person.

"Veteran" means a person who served in the active military, naval, or air service, and who was discharged or released there from under conditions other than dishonorable.

"Veterans Community Living Center" means any State nursing home or a nursing home administered under contractual obligation with a party that has been designed and constructed to qualify for federal funds and that is operated so as to qualify for per diem payments from the United States Department of Veterans Affairs. 11.110 RESIDENT ELIGIBILITY [Rev. eff. 12/1/14]

An eligible resident in a Veterans Community Living Center shall:

A. Be a Colorado resident Veteran; or, B. Be a non-Colorado resident Veteran; or, C. Be a spouse/surviving spouse of a Colorado resident or non-Colorado resident Veteran; or, D. Be a surviving parent whose child(ren) who (all) died while serving in the armed forces of the United States; and, E. Be able to be served safely by the reasonable and customary care provided in the Veterans Community Living Center as determined by the Home’s admission staff in conjunction with any applicable state or federal law or regulation. 11.120 ADMISSION PROCESS, WAIT LIST, AND PRIORITY [Rev. eff. 12/1/14]

A. A person seeking admission to a Veterans Community Living Center may obtain an application form and information describing the application procedures from the individual Center. Staff shall provide the applicant with information regarding all required documentation, information and verifications necessary to complete the application when the application is requested.

B. Staff shall conduct a preadmission screening of the applicant to determine if the applicant meets the eligibility requirements stated in Section 11.110 within five business days of receipt of the application. If the requirements are met, the Center’s admissions staff shall review the submitted materials as outlined in Section 11.120, C. Once the applicant has been determined eligible, the applicant shall be admitted to the Center or placed on the Center’s wait list, if applicable.

C. Applicants shall provide the following information:

1. A signed admission application, including completed financial information, a functional assessment, medical information and authorization for release of information; and, 2. Verification of eligibility for admission, including proof of discharge from the armed services and a copy of the DD-214 Form, if applicable.

D. In the event admission is denied, admission’s staff shall provide the applicant with information regarding their right to request a review of the denial and the review process. The applicant can request a review of the denial by sending a request in writing to the administrator of the home within thirty (30) calendar days of the date on the applicant's notice of denial. The administrator shall conduct a final review of the admission’s staff decision within ten calendar days of receipt from the applicant and shall notify the applicant in writing of the final decision. The decision of the administrator shall constitute final agency action.

E. If a Veterans Community Living Center does not have a vacant bed for an approved admission, the applicant shall be placed on a wait list administered by each Center. Wait list protocols shall be based on the following rank:

1. Date of completed application.

2. Applicant is a resident Veteran.

3. Applicant is a non-resident Veteran.

4. Applicant is a spouse/surviving spouse.

5. Applicant is a parent of a child(ren) who (all) died while serving in the United States Armed Forces.

F. An applicant on the wait list offered admission has ten business days from the date of the written notice of admission to accept or decline admission to the Center. If the applicant declines the offer of admission, the applicant’s name shall be removed from the list, unless the applicant requests to be moved to the bottom of the wait list. If the applicant fails to respond to the offer of admission within ten business days from the date of the written notice, the applicant shall be moved to the bottom of the wait list.

G. The Veterans Community Living Center shall require all approved applicants to declare all sources and amounts of monthly income. Staff shall evaluate the financial status of an approved applicant to determine the person's ability to pay toward the cost of care and to calculate the maintenance rate. 11.130 VETERANS COMMUNITY LIVING CENTER RESPONSIBILITIES [Rev. eff. 12/1/14]

A. A resident shall be provided with the following information upon admission to a Veterans Community Living Center:

1. General information about the Center, resident care, services and activities available.

2. Resident Rights as found in Section 25-1-120, C.R.S.

3. Grievance procedures per the Colorado Department of Public Health and Environment Regulations for long-term care facilities (6 CCR 1011-1).

4. Other applicable Center policies including the Center’s rates, room reservation policy and charges.

B. The Center’s staff shall review the above stated information with the resident or the resident's legal representative. After reviewing this information, the resident or resident's legal representative shall sign a statement indicating the they have received and reviewed the information and agrees to abide by the Center’s rules and regulations. This statement shall be kept with the resident's admission agreement. If changes occur to the information, the Center shall inform the resident and provide a copy of the changes. The resident or resident's legal representative shall sign a statement indicating they have received and reviewed a copy of the changes and agrees to abide by the changes. 11.140 ROOM RESERVATION CHARGES [Rev. eff. 12/1/14]

A. The resident or the resident’s legal representative shall notify the Center twenty-four (24) hours in advance of any planned absences of over ten hours.

B. A resident whose bed is held during an absence shall be responsible for any charges that accrued before or during the leave period. If the resident or resident’s legal representative does not agree in writing to pay the reservation charge, the Center may reassign the resident’s bed to another resident or discharge the resident and place the resident on the Center’s wait list.

C. There shall be no room reservation charge to a Medicaid resident on medical leave if no source of payment, other than the resident’s funds, are available and the Center’s current occupancy is less than ninety percent (90%) of capacity.

D. Calculation of room reservation charges shall be as follows:

1. For non-Veteran Medicaid residents the room reservation charge shall be the Center’s current Medicaid per diem rate, less total food and linen service costs as computed from the most recent Med-13 Cost Report submitted to the Colorado Department of Health Care Policy and Financing (HCPF). In no case shall the charge be greater than the per diem rate less two dollars ($2).

2. For Veteran Medicaid residents the room reservation charge shall be the Center’s current Medicaid per diem rate less total food and linen service costs as computed from the most recent Med-13 Cost Report submitted to the HCPF. In no case shall the charge be greater than the per diem rate less two dollars ($2). If the resident is absent from the Center less than ninety-six (960 hours, the current per diem rate provided by the U.S.

Department of Veterans Affairs shall be subtracted from the room charge.

Room reservation charges for a Veteran Medicaid resident, whose absence results in a loss of U.S. Department of Veterans Affairs per diem payment (greater than 96 hours), shall include the current per diem reimbursement provided by the U.S. Department of Veterans Affairs, retroactive to the resident’s date of departure.

3. For private pay residents the room reservation charge shall be the Center’s private pay daily rate, less the daily total food and linen service costs as computed from the most recent Med-13 Cost Report submitted to HCPF.

4. Homelake Domiciliary residents shall be allowed thirty (30) days of approved leave per state fiscal year, excluding Medical Leave. Residents absent from the domiciliary over thirty days per fiscal year may be subject to discharge. The Homelake Domiciliary room reservation charge during any approved leave shall be the resident’s current daily rate at the time of leave. At the resident’s request, a domiciliary room shall be held for a resident admitted to the nursing home for up to thirty days at the resident’s current daily rate. If the resident fails to return to the facility within thirty days, the resident shall be evaluated for continued stay at the domiciliary. If the resident is not approved for continued stay, the resident shall be given five business days to vacate the Homelake Domiciliary. The resident shall be responsible for the payment of rent through the day of departure.

E. A bed may be held without charge for an approved applicant for up to two weeks from the date of acceptance of the offer of admission. Bed holds prior to admission may exceed two weeks from the date of acceptance with the approval of the Center’s administrator; however, the applicant shall be responsible for the daily rate following the first two weeks from the date of acceptance of the offer of admission. 11.150 FINANCIAL INFORMATION [Rev. eff. 12/1/14]

A. An applicant or resident shall be the primary source of financial information to determine ability to pay except when management of the applicant's or resident's financial affairs has been designated to the legal representative. If the applicant or resident is not the source of financial information, the reason shall be noted in the financial information file.

B. Residents shall apply for all federal and state benefits for which they may be eligible within thirty days of admission. The resident’s status with the Center and eligibility for continued care shall not be affected if the resident is denied benefits. 11.160 MAINTENANCE RATES – PAYMENT FOR CARE [Rev. eff. 12/1/14]

A. Pursuant to Section 26-12-108, C.R.S., the Department shall establish rates for care of residents as nearly equal to the cost of operation and maintenance of the Centers as practicable.

B. Current rates shall be given to each applicant. Each Center shall send a written notice of any increase in proposed rates to each resident no later than fourteen business days prior to the effective date of the new rate.

C. Each Home shall have the authority to request pre-payment from a resident. 11.170 PAST DUE ACCOUNTS [Rev. eff. 12/1/14]

A. A resident's account shall be deemed past due if the debt has not been paid by the close of business on the due date. The due date is ten calendar days from the end of the month for which a resident resided at the Center. Interest may be accrued on accounts which are thirty days past due, and may be referred to the State Controller for collection.

B. Discharge proceedings may be instituted per the Colorado Department of Public Health and Environment Regulations for long-term care facilities (6 CCR 1011-1) when an account is past due. Discharge proceedings shall be stopped if full payment is received by Center prior to the discharge taking place.

11.200 BURIAL AT THE COLORADO VETERANS COMMUNITY LIVING CENTER AT HOMELAKE [Rev. eff. 12/1/14]

A. Current cemetery operation protocols shall remain in effect until such time as adequate moneys are available to fund construction of the northernmost triangular parcel of the cemetery in its entirety. Adequate moneys shall include funds for surveys, design, testing and inspection, code review, and construction.

B. "Reservation" means the ability of an honorably discharged veteran, who is a Colorado resident, to reserve space in the cemetery for himself/herself and his/her spouse.

1. Reservations shall be contingent upon receipt of one-half of the published U.S.

Department of Veterans Affairs burial benefit at the time of the reservation.

2. Reservations shall begin upon completion of the construction of the triangular northernmost parcel of the cemetery. Eligible individuals may place their names on a waitlist for reservations until such time as construction is complete.

3. Any person who has made a reservation with the Department on or before May 3, 2012, shall retain such right to reservation.

C. Site selection shall be at the discretion of the Colorado Veterans Community Living Center at Homelake.

D. Only upright marble markers or headstones furnished by U.S. Department of Veterans Affairs shall be permitted. 11.300 LOCAL ADVISORY BOARD [Rev. eff. 12/1/14]

A. Each Veterans Community Living Center shall institute a local advisory board. The local advisory board shall ensure appropriate communication channels are in place between the Center, the local community, and other stakeholder groups in order to resolve issues or celebrate successes at the earliest opportunity.

B. The local advisory board shall consist of a minimum five members, at least one of the members shall be a resident of the Center or a person who at the time of his or her appointment is a family member of a resident at the Center.

C. The local advisory board shall submit a year-end report to the Office Director of the Veterans Community Living Centers by July 30 of each year beginning in 2008. The year-end report shall summarize board activities, member concerns, resident concerns, staffing vacancies, accomplishments and any other issues the board deems appropriate. 11.400 [Repealed eff. 02/01/2012] 11.500 OPERATION OF THE COUNTY VETERANS SERVICE OFFICER PROGRAM [Repealed eff. 02/01/2012] _______________________________________________________________________________

Editor's Notes

History Sections 11.100 thru 11.400 eff. 10/1/2007.

Sections 11.100; 11.110; Repealed Sections 11.400 through 11.500.6 eff. 02/01/2012.

Sections SB&P, 11.200 eff. 05/01/2013.

Entire rule eff. 12/01/2014.

## **2512** State Board of Human Services (Volume 12; Special Projects)

##### **12 CCR 2512-1** COLORADO MONTHLY REPORTING EXPERIMENT [Repealed eff. 04/30/2003] {#sec-12-ccr-2512-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2512-1}

DEPARTMENT OF HUMAN SERVICES

State Board of Human Services (Volume 12; Special Projects)

COLORADO MONTHLY REPORTING EXPERIMENT – Repealed eff. 04/30/2003 12 CCR 2512-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Editor’s Notes

History

##### **12 CCR 2512-2** Rule Manual Volume 12, Special Projects {#sec-12-ccr-2512-2 omnilex-key=us-co-regs-official--department-9--12 CCR 2512-2}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL VOLUME 12 SPECIAL PROJECTS

12 CCR 2512-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT AND SPECIFIC STATUTORY

AUTHORITY OF REVISIONS MADE TO STAFF MANUAL VOLUME 12

Revisions to Sections 12.500-Concl. - 12.500.12, 12.500 12 - 12.500.14-Concl. were finally adopted following publication at the 5/2/86 State Board meeting, with an effective date of 7/1/86 (Document 7).

Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Addition of Section 12.600 was finally adopted following publication at the 2/6/87 State Board meeting, with an effective date of 4/1/87 (Document 8). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to Section 12.203 were finally adopted following publication at the 5/1/87 State Board meeting, with an effective date of 7/1/87 (Document 11). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Addition of Sections 12.700 - 12.704 was finally adopted following publication at the 11/6/87 State Board meeting, with an effective date of 1/1/88 (Document 2). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Addition of Sections 12.800 - 12.805.12 was finally adopted following publication at the 4/6/90 State Board meeting, with an effective date of 6/1/90 (CSPR# 90-1-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Deletion of Section 12.500 was finally adopted following publication at the 11/02/90 State Board meeting, with an effective date of 1/1/91 (CSPR# 90-8-23-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.900 was adopted emergency at the 11/2/90 State Board meeting, with an effective date of 11/2/90 (CSPR# 90-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.900 was final adoption of emergency at the 12/7/90 State Board meeting, with an effective date of 11/2/90 (CSPR# 90-9-11-1). Statement of Basis and Purpose and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Revisions to Sections 12.200 through 12.203 were finally adopted following publication at the 2/7/91 State Board meeting, with an effective date of 4/1/92 (CSPR# 91-10-24-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Addition of Section 12.500 through 12.515 was adopted emergency at the 2/4/94 State Board meeting, with an effective date of 4/1/94 (CSPR# 93-10-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Liaison, Department of Social Services.

Addition of Section 12.500 through 12.515 was adopted emergency and final at the 3/4/94 State Board meeting, with an effective date of 4/1/94 (CSPR# 93-10-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Revisions to Sections 12.500 through 12.515 were final adoption following publication at the 10/7/94 State Board meeting, with an effective date of 12/1/94 (CSPR# 94-6-30-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of Sections 12.100 through 12.111 were final adoption following publication at the 12/6/96 State Board meeting, with an effective date of 2/1/97 (CSPR# 96-9-11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Sections 12.100 through 12.111 were re-promulgated as final adoption following publication at the 3/7/97 State Board meeting, with an effective date of 5/1/97 (CSPR# 96-9-11-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of External Affairs, Department of Human Services.

Addition of Sections 12.400 through 12.480 were adopted as emergency at the 8/4/2000 State Board meeting, with an effective date of 9/1/2000 (CSPR# 00-6-28-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, State Board Administration.

Addition of Sections 12.400 through 12.480 were adopted as emergency and final at the 9/8/2000 State Board meeting, with effective dates of 9/1/2000 and 9/8/2000 (CSPR# 00-6-28-1). Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, Revisions to Sections 12.440 and 12.470 were final adoption following publication at the 2/2/2001 State Board meeting, with an effective date of 4/1/2001 (CSPR# 00-11-15-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revisions to Section 12.101.1, and addition of Section 12.120-12.120.5 were adopted following publication at the 5/2/2003 State Board meeting, with an effective date of 7/1/2003 (Rule-making# 03-02- 11-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Sections 12.105.2 through 12.105.21 and addition of Section 12.105.22 were adopted as emergency at the 6/6/2003 State Board meeting, with an effective date of 7/1/2003 (Rule-making# 03-02- 13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Revisions to Sections 12.105.2 through 12.105.21 and addition of Section 12.105.22 were final adoption of emergency rules at the 7/11/2003 State Board meeting, with an effective date of 7/1/2003 (Rulemaking# 03-02-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Deletion of Sections 12.300, 12.600, 12.700, 12.800, and 12.900, et seq., and replacement of Section 12.500, et seq., with a new program, were final adoption following publication at the 5/7/2004 State Board meeting, with an effective date of 7/1/2004 (Rule-making#s 04-2-19-1 and 04-3-5-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, Revisions to Sections 12.200 through 12.203.6 were final adoption following publication at the 12/2/2005 State Board meeting, with an effective date of 2/1/2006 (Rule-making# 05-08-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, Deletion of Section 12.105.22 was final adoption following publication at the 2/3/2006 State Board meeting, with an effective date of 4/1/2006 (Rule-making# 05-10-25-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revision of Section 12.540 and addition of Section 12.541 were final adoption following publication at the 1/5/2007 State Board meeting, with an effective date of 3/1/2007 (Rule-making# 06-8-24-1). Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Office, State Board Administration.

Revision of Section 12.540 was adopted as emergency and final at the 6/6/2008 State Board meeting, with an effective date of 6/6/2008 (Rule-making# 07-11-13-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Re-write of Sections 12.200 through 12.203.6 were final adoption following publication at the 6/5/2009 State Board meeting, with an effective date of 8/1/2009 (Rule-making# 08-9-12-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Revisions and repeals in Sections 12.104 through 12.108, 12.200 through 12.200.7, 12.400 through 12.480 and 12.500 through 12.552 were final adoption following publication at the 4/6/2012 State Board meeting, with an effective date of 6/1/2012 (Rule-making#’s 11-9-7-3, 11-11-15-1, 11-12-27-1, and 12-2- 7-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Revisions of Sections 12.200 through 12.200.2 and 12.200.4 through 12.200.7 were final adoption following publication at the 3/8/2013 State Board meeting, with an effective date of 5/1/2013 (Rulemaking# 12-12-14-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions of Sections 12.200 through 12.201.9 (through new 12.202.4) were final adoption following publication at the 11/6/2015 State Board meeting, with an effective date of 1/1/2016 (Rule-making# 14- 11-17-1). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration.

12.100 COLORADO ELECTRONIC BENEFIT TRANSFER SERVICE (CO/EBTS)

12.100.1 AUTHORITY 12.100.11

Authority for the program is contained in Colorado Revised Statutes, Sections 26-2-104 and 26-1-122(2), as amended. 12.100.12 The Colorado Electronic Benefit Transfer Service (CO/EBTS) is intended to provide electronic benefit access, through use of a plastic debit card, to recipients of food assistance and public assistance programs. These programs include, but are not limited to, Food Stamps, Aid to Families with Dependent Children, Old Age Pension, Aid to the Needy Disabled, Aid to the Blind, and the Low-Income Energy Assistance Program. Through CO/EBTS, direct deposit payments will be made to providers of services for the Low-Income Energy Assistance Program, Child Care and Child Welfare (Subsidized Adoption and Foster Care) programs. Voucher payments (e.g., burial) will also be made by direct deposit. Other programs may be added as appropriate. Recipient payments will be made by direct deposit on a voluntary basis. Provision will be made for delivery of recipient payment of direct federal benefits by CO/EBTS.

12.101 GENERAL PROVISIONS

12.101.1 DEFINITIONS

A. Automated Teller Machine (ATM)

An “ATM” is a device which dispenses cash and provides benefit inquiries. The equipment is activated by inserting a plastic magnetic stripe card and entering a personal identification number (PIN).

B. Cash Account A “cash account” is an authorization file maintained by the Colorado Department of Human Services on behalf of a cardholder from which withdrawal of cash benefits and purchase transactions are authorized.

C. CO/EBTS Contractor The “CO/EBTS contractor” is a private company hired by the Colorado Department of Human Services.

The contractor will be responsible for operation of the CO/EBTS system including, but not limited to, card production, transaction processing, equipment installation/maintenance, customer service, conversion training, and account settlement.

D. Correcting Debit A “correcting debit” is an action taken by a retailer to correct a system error.

E. CO/EBTS Conversion “CO/EBTS conversion” is the project implementation period during which food stamps and public assistance recipients change over from receiving benefits through food coupons and warrants to accessing their benefits through CO/EBTS debit card transactions at authorized retailers' point-of-sale (POS) terminals and at automated teller (ATM) machines. Also, providers will begin receiving direct deposit payments, electronically transmitted to make accounts, rather than warrants.

F. Debit A “debit” is a transaction initiated by the cardholder at a terminal with use of a PIN resulting in a deduction against the balance of the cardholder's account, which has been credited by the value and category of public assistance benefits authorized.

G. Direct Deposit “Direct deposit” is the process by which the Colorado Department of Human Services credits a client's or provider's bank account upon authorization by the Colorado EBTS program.

H. Electronic Benefit Transfer Service (EBTS)

“EBTS” is the delivery of government benefits and payments through electronic means and equipment.

I. Food Stamp Account A “food stamp account” is an authorization file maintained by the Colorado Department of Human Services on behalf of a cardholder from which food stamp purchases at approved merchants are authorized.

J. Food Stamp Transaction A “food stamp transaction” is authorized from a food stamp account in which the entire transaction amount is for the purchase of food at an approved merchant in accordance with the Food Stamp Program. A food stamp transaction must not include cash back.

K. Encryption “Encryption” is the process which protects PIN data by altering the information to make it unrecognizable.

These data are encrypted before transmission over communications lines rendering them unintelligible.

L. Personal Identification Number (PIN)

The “PIN” is a four to six digit secret number or word either selected by the cardholder or randomly assigned by the card processor. The PIN is used by the cardholder to initiate an EBTS transaction.

M. Point of Sale (POS) Terminal “POS” terminals are electronic devices located at retail outlets through which cardholders can conduct EBTS food stamp and cash transactions by swiping their card and entering their PIN on a key pad.

N. Primary Account Number (PAN)

The “PAN” is a number embossed on the front of the debit card, by the card issuer, which identifies the cardholder.

O. Retailer “Retailer” is the commercial location, such as a grocery store or automated teller machine, where the EBT cardholder redeems food or cash benefits.

P. System Error A “system error” is an auditable processing failure at any point in the EBT redemption process that results in the improper crediting or debiting of an account or in the failure to credit or debit an account.

Q. Transaction A “transaction” is an electronic interchange at a point of sale device or ATM resulting in the exchange of financial information concerning a recipient account.

12.102 ACCOUNT SET-UP

The county department of social services shall input account set-up data into the various CDHS systems, using state department established file formats and data layouts, to facilitate system transmission of account set-up records to the CO/EBTS contractor. County departments may opt, particularly in emergency cases, to transmit account set-up files on-line directly to the CO/EBTS contractor.

12.103 CARD/ PIN ISSUANCE AND ACCOUNTABILITY

The county department of social services shall establish secure procedures for issuance of CO/EBTS debit cards and personal identification numbers. County departments may issue a card at the initial client interview, but under no circumstance shall a card for a non-expedited case be issued later than 30 calendar days after the application date.

12.103.1 OVER-THE COUNTER ISSUANCE 12.103.11 Card Stock Each county department of social services shall maintain the capability to issue cards on-site at its primary location and satellite offices. The CO/EBTS contractor will provide counties with an initial supply of sequentially numbered cards containing pre-embossed primary account numbers; county departments must reorder cards from the CO/EBTS contractor as needed to ensure an adequate supply at all times. 12.103.12 PIN Selection The county department of social services shall issue PINs through encryption devices supplied by the state department. Recipients shall select their own PINs when cards are issued over-the-counter. 12.103.13 Expedited Issuance The county department of social services shall issue CO/EBTS debit cards no later than the sixth day after application for recipients entitled to expedited benefits/payments as defined by specific program rules.

12.103.2 MAIL ISSUANCE

The county department of social services shall initiate issuance of cards and PINs through the mail during CO/EBTS conversion by submitting account set-up files to the CO/EBTS contractor. The county department may request mail issuance on a case-by-case basis thereafter by entering a positive mail indicator in the account set-up file transmitted to the CO/EBTS contractor.

After conversion, county departments may request mail issuance in those situations where in-person issuance would constitute an inconvenience to the recipient. County departments may also mail cards/PINs to clients residing a distance from the issuance site such that transportation would constitute a hardship.

12.104 REPORTS OF LOST, STOLEN CARDS AND UNAUTHORIZED USE

The county department of social services shall facilitate de-activation of CO/EBTS debit cards reported by cardholders to be lost, stolen, or used by unauthorized parties. Upon receiving such a report, the county department may instruct the recipient to phone the CO/EBTS contractor's customer service line to report the incident and request card de-activation. If the recipient cannot or refused to call, the county department shall immediately report the incident and request card de-activation to the CO/EBTS contractor customer service representative on behalf of the recipient. 12.105 CARD REPLACEMENT [Rev. eff. 6/1/12]

The county department of social services shall replace CO/EBTS debit cards for eligible recipients when cards are reported to be lost, stolen, or non-functioning. County departments may issue replacement cards over-the-counter or through a transmission to the CO/EBTS contractor requesting mail issuance. In addition, the county department shall maintain a record of cards replaced on the daily card issuance log. 12.105.1 Card Replacement Time Limit [Eff. 2/1/97]

The county department of social services shall replace cards within three working days of notification by the recipient. This may be accomplished by either over-the-counter or mail issuance. The CO/EBTS contractor is required to deliver replacement cards to the post office no later than 3:00 p.m. the day after a request is received for a mail issued card replacement.

12.106 PIN REPLACEMENT

The county department of social services shall provide cardholders with the opportunity to change PINs.

PIN replacements may be issued over-the-counter or by mail through the CO/EBTS contractor. Add eff. 2/1/97 12.107 DIRECT DEPOSIT Eligible recipients, or their designated payees, may elect to receive cash payments through direct deposit to an account at their financial institution. Direct deposit application forms and envelopes will be provided to county offices. The county department of social services shall inform cash assistance recipients of the availability of direct deposit, provide informational materials, and application forms. County offices shall assist recipients or payees in providing bank account information to allow for direct deposit. Add eff. 2/1/97 Counties shall issue a debit card to each new recipient and inform the recipient that he/she will access at least the first payment through the debit card.

12.108 AUTHORIZED REPRESENTATIVES

An eligible recipient may designate an authorized representative to receive a CO/EBTS debit card and PIN. Separate cards, primary account numbers, and PINs shall be issued to the eligible recipient and the authorized representative. The authorized representative shall have the ability to access food and/or cash benefits on behalf of the eligible recipient as provided by program regulations. Add eff. 2/1/97 12.109 CLIENT TRAINING The county department of social services may conduct client training through the mail or on-site in local offices. Add eff. 2/1/97 12.109.1 LOCAL OFFICE TRAINING The county department of social shall provide facilities within each food stamp/social services office to conduct on-site CO/EBTS client training. Add eff. 2/1/97 12.109.11 CO/EBTS Trainees The county department of social shall conduct on-site CO/EBTS training in local offices for eligible postconversion food stamps and cash assistance recipients. Add eff. 2/1/97 12.109.12 Training Content The county department of social services shall conduct training in a manner prescribed by state department procedures. Add eff. 2/1/97 12.109.13 Written Training Materials The county department of social services shall distribute written training materials, produced by the CO/EBTS contractor, to CO/EBTS recipients. These materials will include, but not be limited to, a pamphlet and a fact card. All written training materials will be available in Spanish and English and be at no higher than a fifth grade reading level. Add eff. 2/1/97 12.109.14 Other Client Assistance The county department of social services shall provide other client assistance, which the county department deems necessary, such as orientation classes, question and answer sessions, and “handson” card usage instructions. Counties shall identify special needs clients (e.g., blind, illiterate, disabled) and “customize” training to the needs of these individuals. Rev. eff. 5/1/97 12.109.2 MAIL TRAINING 12.109.21 Conversion The county department of social services shall update CDHS automated systems with the most current food stamp recipient, cash assistance recipient, substitute payee, and conservator addresses no later than two months before that county's conversion to CO/EBTS. The CO/EBTS contractor will mail debit cards, PINs, and written training materials to each current recipient one month before conversion. 12.109.22 Ongoing The CO/EBTS contractor will include written training materials with all CO/EBTS card mailings. The county department of social services shall transmit a positive mail indicator to the contractor for any recipient the county wishes to have the CO/EBTS card, PIN, and training materials issued by mail.

12.110 PROVIDER PAYMENTS

12 .110.1 COUNTY RESPONSIBILITIES 12.110.11 Conversion The county department of social services shall update provider information (e.g., name, address, mailing address, and provider tax identification number) contained within the various Human Services automated systems no later than four months prior to CO/EBTS conversion in that county to facilitate transition to direct deposit provider payments. 12.110.12 Ongoing The county department of social services shall enter all provider information into the appropriate automated system immediately upon a provider's approval to deliver program services. The county department shall give each prospective provider a direct deposit form requesting the provider's bank account number and supporting documentation. The provider must then submit the bank account information in order to receive direct deposit payments when and if the provider is approved to deliver services. The county department shall also give the provider written materials explaining the direct deposit payment procedure. County departments must maintain the ability to enter data related to provider bank account numbers into the various Human Services automated systems for transmission to the CO/EBTS contractor.

12.110.2 STATE RESPONSIBILITIES

The State Department will transmit provider information through the various Human Services automated systems to the CO/EBTS contractor. Transmissions will take place during conversion and on an ongoing

basis as new providers are added.

12.111 EXPUNGED BENEFITS

Food stamp benefits will be automatically expunged, or cancelled, after 270 days of no recipient account activity (food purchases or benefit inquiries); cash benefits will be expunged after 90 days of no recipient account activity (purchases, withdrawals, benefit inquiries). County staff may re-start the time period for any recipient in a manner prescribed by the State Department.

12.120 EBT CONTRACTOR ACCOUNT ADJUSTMENTS

12.120.1 EBT CONTRACTOR ACCOUNT ADJUSTMENT AUTHORITY

The EBT contractor, on behalf of impacted retailers, may adjust EBT cardholders' food or cash accounts through correcting debits to recoup SYSTEM error funds.

12.120.2 EBT CONTRACTOR NOTIFICATION TO THE COLORADO DEPARTMENT OF

HUMAN SERVICES

The EBT contractor shall notify the Colorado Department of Human Services, through a claim activity file, of the intention to adjust a recipient's food and/or cash account.

12.120.3 CLIENT NOTICE OF RIGHT TO A FAIR HEARING

A. any recipient shall be mailed a notice whose EBT account is to be adjusted by the EBT contractor, advising the recipient of the right to a fair hearing.

B. The notice shall stipulate:

1. The amount to be adjusted;

2. The name of the retailer;

3. The reason for the adjustment;

4. The date of the adjustment;

5. Procedures for requesting a state hearing; and, 6. The timeframe for requesting a hearing.

12.120.4 FAIR HEARING

Any request for a State level fair hearing shall be in accordance with State Food Stamp rules, as found in Staff Manual Volume 4B (10 CCR 2506-1), Sections B-4410, B-4410.3, and B-4410.34.

12.120.5 ACCOUNT ADJUSTMENT TIMEFRAMES

The EBT contractor may not adjust a recipient's EBT account for fifteen (15) calendar days from the issuance date of the fair hearing notice. If the recipient requests a fair hearing during this 15-day period, the EBT contractor is prohibited from adjusting the account until and unless the fair hearing disposition is rendered in the retailer's favor. After the 15-day noticing period has expired, or after a recipient appeal has been denied, the EBT contractor may adjust a recipient's current month or one future month's benefits. The EBT contractor may take no further adjustment actions if adequate funds are not available in either the month when the recovery action is initiated or in the subsequent month.

12.200 DOMESTIC VIOLENCE PROGRAM (DVP) 12.200.1 Purpose [Rev. eff. 5/1/13]

These rules set forth policies concerned with administering funding to support the provision of a statewide network of services to reduce the incidence of domestic violence in Colorado. 12.200.2 Definitions [Rev. eff. 10/1/18]

For the purposes of these rules, the following definitions are used:

A. “Behavioral health conditions” means illnesses such as mental health disorders or alcohol or substance misuse disorders that clients may exhibit.

B. “Client” means a victim or survivor of domestic violence, per the definition in E. below, who requests and receives services from a funded program. Clients may be adults or minor children.

C. “Domestic violence advocacy” means activities performed by individuals who work for or volunteer for an organization or a program with a mission to respond to and/or prevent domestic violence. Domestic violence advocacy activities may be provided by individuals trained in accordance with Section 13-90-107, C.R.S. as well as other professionals. Domestic violence advocacy is conducted in partnership with clients and may include but is not limited to providing information about crime victim rights, presenting an array of options clients may take to increase their safety, engaging with the client to create a safety plan, increasing clients’ knowledge of and access to available community resources, acting in an empathetic manner that encourages clients to self-determine strategies that lead to enhanced well-being, supporting clients’ informal and formal social support systems and, providing community education or prevention. Domestic violence advocacy does not include activities performed on behalf of or with perpetrators or offenders of domestic violence.

D. “Domestic violence advocate” means an employee or volunteer who works or volunteers for an organization or a program with a mission to respond to and/or prevent domestic violence.

Advocates shall receive specialized training to be knowledgeable about the dynamics of domestic violence, how domestic violence impacts individuals, how to engage with clients in safety planning, how to offer emotional support, information and referrals, and how to provide crisis intervention, crime victims’ rights information, and other assistance to clients and their families.

Advocates may also provide community education or engage in activities aimed at preventing domestic violence. Advocates do not provide services to perpetrators or offenders of domestic violence. Advocates may provide confidential services in accordance with Section 13-90-107, C.R.S., legal services, or services to address clients’ behavioral health conditions if they are qualified to do so.

E. “Domestic violence” is as defined in Section 18-6-800.3, C.R.S. and also includes non-criminal acts that comprise a pattern of abusive behavior. These behaviors may include but are not limited to physical violence, intimidation, control, coercion, sexual coercion, emotional manipulation, economic abuse, or other psychological tactics that may harm a person.

F. “Funded program” means an organization that receives funding from the Colorado Department of Human Services, Domestic Violence Program.

G. “Non-residential domestic violence advocacy services” means domestic violence advocacy services as defined above for clients who do not reside in a residential facility or otherwise receive residential services.

H. “Personally identifying client information” means data or information collected by a DVP funded program about a client receiving domestic violence advocacy including, but not limited to client name, a home or physical address, information regarding the client’s whereabouts or location, contact information such as a post office box or email address, a social security number, driver license number, passport number, date of birth or age, gender expression or identity, racial or ethnic background, religious affiliation, or disability.

I. “Residential facility” means a location such as a shelter, house, or transitional housing site where a client receives temporary housing and advocacy services and an organization or a program with a mission to respond to and/or prevent domestic violence owns or leases the location, operates the facility, and is responsible for maintenance and upkeep. A “residential facility” may include communal-style living quarters, or individual apartments or units for clients.

J. “Residential services” means domestic violence advocacy services as defined above for clients residing in a residential facility or at a motel, hotel, or other lodging paid for by a funded program. 12.200.3 Domestic Violence Program (DVP) Advisory Committee [Rev. Eff. 10/1/18]

An Advisory Committee will be established to provide feedback regarding the DVP’s direction. The Advisory Committee’s roles, responsibilities, and membership shall be determined by the Committee and, at a minimum, shall consist of:

A. Individuals who are knowledgeable in the field of domestic violence;

B. Individuals who are knowledgeable in nonprofit management and/or grant making;

C. Individuals representing community-based programs and government agencies;

D. At least one representative from the Colorado Coalition Against Domestic Violence; and, E. At least two representatives for programs that receive funding from DVP. 12.200.4 Announcements of Availability of Funding [Rev. Eff. 10/1/18]

The DVP will announce availability of funding and solicit responses as required by the State Procurement Code (24-101-101, C.R.S., et seq.) 12.200.5 Funded Program Monitoring and Compliance [Rev. Eff. 10/1/18]

A. Funded programs shall comply and cooperate with monitoring, which may include on-site visits, financial desk reviews, quality assurance reviews, or reviews for compliance with other federal or state requirements.

B. DVP shall provide funded programs with notice of all planned monitoring efforts. Monitoring may occur at regular intervals or at random periods if DVP is aware of programmatic or operational changes at a funded program that may impact compliance.

C. Upon conclusion of a monitoring effort, DVP will provide funded programs with a written report containing the following items:

1. The areas DVP reviewed during the monitoring activity;

2. Recommendations for the funded program to make improvements to programmatic services or operations;

3. Areas of non-compliance with DVP rules, the contract for funding, or other state or federal requirements; and, 4. A timeline for attaining compliance with areas of non-compliance.

D. Funded programs may request an extension of the timeline for attaining compliance.

E. If a funded program is not able to attain full compliance within 180 days of the date the report was issued, DVP may temporarily restrict access to contract funding until full compliance is attained.

F. If a funded program is not able to attain full compliance within 365 days of the date the report was issued, DVP may cancel the contract.

G. A funded program may appeal decisions regarding, restrictions placed upon funding, or denial of further funding:

1. For the purposes of these rules, an appeal is defined as an action that a funded program may take if the funded program disagrees with the decision to restrict access to contract funding.

2. All appeals shall be made in writing within thirty (30) business days of issuance of notification of funding restrictions to the DVP Advisory Committee.

3. The Advisory Committee shall review the appeal and provide the DVP with a recommended course of action.

4. DVP shall issue a written decision to the program within sixty (60) days of receipt of appeal.

5. The written DVP decision shall be the final agency decision. 12.200.6 Complaints [Rev. Eff. 10/1/18]

The DVP Advisory Committee shall advise DVP regarding how to proceed with reviewing complaints and shall hear and record complaints from concerned citizens, victims or survivors of domestic violence, clients of funded programs, employees or volunteers of funded programs, and other concerned parties, regarding potential violations of rules in sections 12.201 and 12.202. 12.200.7 Critical Incident Reporting [Rev. Eff. 10/1/18]

Funded programs shall inform DVP of critical incidents impacting the funded program’s ability to meet contractual obligations, comply with DVP rules, provide safe services for clients, maintain safe operations of the program, or sustain prudent financial stewardship of resources. 12.201 Operations and Administrative Rules for Funded Programs 12.201.1 Purpose of Operations and Administrative Rules [Rev. Eff. 10/1/18]

These rules, in accordance with Section 26-7.5-104, C.R.S., shall serve as minimum operations and administrative requirements for programs funded wholly or in part by DVP. Domestic abuse programs, as defined in Section 26-7.5-103, C.R.S., that currently do not receive DVP funding should use these rules to begin the process of establishing programs. Programs that currently receive DVP funding shall adhere to these rules to maintain funding from the DVP. All policies shall be written and approved according to the funded program’s internal policy approval process. 12.201.2 Confidentiality Requirements [Rev. Eff. 10/1/18]

All programs funded wholly or in part by DVP shall have the following written operations and administrative policies, in place to ensure protection of confidential client communications:

A. Training for employees and volunteers who provide domestic violence advocacy or have access to personally identifying client information to receive fifteen (15) or more hours of domestic violence-related training, per Section 13-90-107, C.R.S., prior to providing advocacy or having access to personally identifying client information.

B. Protecting confidential client advocacy communications to minimally include maintenance and destruction of, and access to the following records by individuals qualified per Section 12.201.2, A., above unless a funded program has received express written consent of the client to release non-aggregated personally identifying information to a third party:

1. Client and case file records;

2. Electronic data collection systems;

3. Electronic client communications such as e-email and text messages;

4. Communication logs domestic violence advocates use to communicate among each other;

5. Domestic violence advocacy or counseling meeting notes;

6. Client communications through an interpreter or translator; or, 7. Any other documents or materials produced by the program containing personally identifying client information.

C. Responding to subpoenas directing an employee or volunteer to testify or directing access to confidential client communications in B., above.

D. Making mandatory reports of known or suspected child maltreatment in accordance with statute.

E. Responding to the following circumstances within the confines of confidential client communications:

1. Client request for release of information to a third party;

2. Client medical emergencies when the client is unable to give consent for summoning emergency medical services;

3. Situation where a client is determined to pose a danger to self or others;

4. Known or suspected client criminal activity or behavior;

5. Law enforcement request for residential facility access to serve a warrant or subpoena on a client; and, 6. Working with county and court officials, such as a guardian ad litem, when a family is involved with child protection or custody matters;

F. Establishing a separate set of confidentiality, mandatory reporting, and duty to warn parameters for employees or volunteers acting within other professional standards such as attorneys, licensed social workers or licensed or unlicensed counselors, and parameters for required disclosures of such obligations to clients. 12.201.3 Reporting Requirements [Rev. Eff. 10/1/18]

All programs funded wholly or in part by DVP shall submit regular reports to DVP per contract requirements to minimally include but not be limited to federally required data and data required by

Section 26-7.5-104 (2) (B), C.R.S. 12.201.4 Fiscal Requirements [Rev. Eff. 10/1/18]

A. All programs funded wholly or in part by DVP shall demonstrate sound fiscal management as evidenced by written fiscal policies and procedures in accordance with generally accepted accounting principles, approved and reviewed by the board of directors, advisory board or other governing body that demonstrate sound fiscal controls and sufficient assurances to protect against theft or embezzlement.

B. Funded programs shall submit an annual independent financial audit or review to DVP within three hundred sixty five (365) days of the funded program’s fiscal year end. 12.201.5 Board of Directors, Advisory Board, or Governing Body Requirements [Rev. Eff. 1/1/16]

A. Funded programs’ boards of directors, advisory board, or other governing bodies such as a Tribal Council shall ensure that the funded program exercises sound ethical and legal governance and financial management.

B. Governing bodies shall make every effort to recruit and maintain membership that reflects the racial, ethnic, economic, and social composition of the community or region to be served, including former clients of the program and/or persons who have experienced domestic violence.

C. For funded Tribes, the Tribal Council may serve as the governing body. 12.201.6 General Operations and Administrative Requirements [Rev. Eff. 10/1/18]

All programs funded wholly or in part by DVP shall have the following in place to demonstrate sound administrative capacity:

A. Written plan, approved pertaining to disaster management to minimally include assurances to maintain emergency services in the event of a public health emergency or natural or environmental disasters;

B. Written safety policies and procedures to minimize risk to clients, employees, volunteers, and property, to minimally include responses to potential breaches of safety at each service location;

C. Written policy regarding participation in lobbying, political activity, and public demonstrations that states these activities may not be paid for with DVP funding;

D. Satisfactory fire safety inspection report completed annually by the local fire authority for all residential shelter facilities operated by the funded program that conforms to the fire safety standards as determined by each city, town, municipality, county or special district;

E. Documentation of a certificate of occupancy in accordance with local zoning, if applicable; and, F. Water safety inspection documentation if water at residential facility is not from a public water source. 12.201.7 Personnel Requirements [Rev. Eff. 10/1/18]

All programs funded wholly or in part by DVP shall have the following duties and responsibilities related to personnel and volunteer requirements:

A. Written personnel policies to minimally include:

1. Ethics policy regarding employee-client relationships and professional conduct;

2. Equal employment opportunity hiring policy;

3. Whistleblower policy;

4. Harassment-free workplace policy;

5. Employee grievance policy;

6. Criminal background check policy to minimally include, but not be limited to completion of a criminal history background check and notifications of convictions that exclude candidates from hire;

7. Policy for compliance with Section 27-90-111 C.R.S., if the executive director of the Colorado Department of Human Services, or designee, designates the funded program’s contract as a contract that involves direct contact with vulnerable persons;

8. Drug-free workplace; and, 9. Annual performance reviews of employees.

B. Written job descriptions for employees funded wholly or in part by DVP to minimally include assurances that staff serving as licensed or unlicensed counselors or social workers maintain appropriate licensure as required by law, and/or registration with the Colorado Department of Regulatory Agencies;

C. Current, accurate, and complete personnel records for all employees to minimally include the following documentation:

1. Completion of 15 hours of domestic violence-specific training in accordance with Section 13-90-107 C.R.S. prior to providing advocacy or having access to personally identifying client information;

2. Verification of legal status to be eligible to work in the United States;

3. Resume or application of employment;

4. Completion of performance reviews by direct supervisor;

5. Current wage rate and benefits;

6. Current, valid driver’s license and proof of insurance if using a personal or funded program-owned vehicle to conduct business; and, 7. Completed criminal history background check prior to employment start date. 12.201.8 Volunteer Requirements [Rev. Eff. 10/1/18]

Programs funded wholly or in part by DVP shall have the following duties and responsibilities related to volunteer requirements:

A. Written volunteer policies to minimally include:

1. Ethics policy regarding volunteer-client relationships and professional conduct;

2. Whistleblower policy;

3. Harassment-free volunteer environment policy;

4. Volunteer grievance policy;

5. Criminal background check policy to minimally include, but not be limited to completion of a criminal history background check and notifications of convictions that exclude candidates from volunteer service;

6. Drug-free volunteer work environment; and, 7. Reviews of volunteer performance.

B. Written volunteer job descriptions.

C. Current, accurate, and complete records for all volunteers to minimally include the following documentation:

1. Completion of 15 hours of domestic violence-specific training in accordance with Section 13-90-107 C.R.S. prior to providing advocacy or having access to personally identifying client information;

2. Resume or application to volunteer;

3. Completion of performance reviews by direct supervisor;

4. Current, valid driver’s license and proof of insurance if using a personal or funded program-owned vehicle to conduct business; and, 5. Completed criminal background check prior to volunteer start date. 12.201.9 Community Services Requirements (Eff. 1/1/16)

Funded programs shall make every effort to provide or make available the following services to the community:

A. Community education to inform the service region of the availability of domestic violence services;

B. Awareness and education to make known the impact of domestic violence;

C. Prevention activities to reduce the incidence of domestic violence;

D. Training and technical assistance to offer subject-matter expertise; and, E. Collaborative or cooperative efforts to increase coordination and avoid duplication of services. 12.202 Domestic Violence Advocacy Services Requirements 12.202.1 Purpose of Domestic Violence Advocacy Services Requirements [Rev. Eff. 10/1/18]

These rules, in accordance with Section 26-7.5-104, C.R.S., shall serve as minimum domestic violence advocacy services requirements for programs funded wholly or in part by DVP. Domestic abuse programs, as defined in Section 26-7.5-103, C.R.S., that currently do not receive DVP funding should use these rules to begin the process of establishing programs. Programs that currently receive DVP funding shall adhere to these rules to maintain funding from the DVP. All policies shall be written and approved according to the funded program’s internal policy approval process. 12.202.2 Crisis Response Services Requirements [Rev. Eff. 10/1/18]

All programs funded wholly or in part by DVP shall offer and provide free and confidential emergency and crisis response domestic violence advocacy services on a continuous basis by employees and volunteers trained in accordance with Section 13-90-107, C.R.S., which shall minimally include one or more of the A. Operation of a crisis telephone number accessible to the local community twenty-four (24) hours per day, seven days per week. The crisis line shall be accessible to all callers, including those:

1. Using a “blocked line” where their phone number reads on caller ID as “Unavailable”;

2. With limited spoken English language proficiency through the provision of interpreters or other communication method; and, 3. Who are deaf, hard of hearing, or deaf blind and use a third party telecommunication relay service (such as an IP relay service or a video relay service, teletypewriter (TTY) device) per the requirements of the Americans with Disabilities Act (ADA).

B. Availability of employees or volunteers trained in accordance with Section 13-90-107, C.R.S. who are able to respond to emergency crisis situations twenty-four (24) hours per day, seven days per week; or, C. Coordination of A and B, above, through a formal memorandum of understanding with a DVPfunded program in good standing serving the same region that operates its own crisis response services as outlined in A and B, above. 12.202.3 Domestic Violence Advocacy Services Requirements A. All programs funded wholly or in part by DVP shall provide domestic violence advocacy in the following manner:

1. By trained employees and volunteers in accordance with Section 13-90-107, C.R.S.;

2. Free of charge to clients;

3. Without income qualifications placed on receipt of services;

4. Without requirements that clients attend a religious activity or instruction as a prerequisite to receive services;

5. Without requirements for clients to show proof of residency in Colorado or the United States;

6. Without requirements for clients to submit to criminal background checks, credit checks, drug testing, or a release of information as a condition of services;

7. On a voluntary basis without any conditions;

8. Following an intake and assessment of needs and safety; and, 9. With provisions of referrals when requested services are not available or are denied by the funded program.

B. All programs funded wholly or in part by DVP shall establish a written document outlining the rights afforded to clients who request services. Written rights shall minimally include the following notices:

1. Identification of criteria for eligibility of domestic violence advocacy services;

2. Service accommodations for the following clients:

a. Those who are deaf or hard of hearing or have limited English proficiency; and, b. Disabilities including behavioral health conditions.

3. Availability of free, voluntary services to be provided without condition or prerequisites including non-proselytization;

4. Program adherence to confidential communications including legal exception to confidentiality of mandatory reporting of known or suspected child maltreatment;

5. Opportunity to provide feedback regarding experience with provision of or denial of services at the funded program;

6. Procedure to file a grievance or complaint to minimally include the funded program’s internal grievance or complaint policy and procedure, and the right to complain to DVP and other applicable regulating agencies regarding services provided or denied; and, 7. Ability to request access to own client file or record including electronic documentation services provided.

C. All programs funded wholly or in part by DVP shall establish written policies or procedures regarding:

1. Identification of criteria for eligibility of domestic violence advocacy services;

2. Language accessibility plan to minimally include the use of interpreters, translators, bilingual employees, and/or written materials to provide services to clients who are deaf or hard of hearing and those with limited English proficiency;

3. Service accommodation plans to minimally include nondiscrimination on the basis of clients’ age, disability, behavioral health conditions, sex, sexual orientation, race, color, national origin, religion, ethnicity, or gender identity or expression as well as accompanying protocols to ensure an environment that is accessible, culturally relevant, and trauma informed for all clients;

4. Transportation of clients by employees or volunteers of the funded program, if an available service; and, 5. Child care by employees or volunteers of the funded program, if an available service, while parent is on-site for a maximum of three hours.

D. Programs funded wholly or in part by DVP shall ensure full compliance with the requirements of the Federal Department of Health and Human Services Administration for Children and Families, 45 CFR Part 1370 (2017). No later editions or amendments are incorporated. These regulations are available at no cost from the U.S. Health Resources and Services Administration, Office of Communications 5600 Fishers Land, Rockville, MD 20857 or at https://www.ecf.gov. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Community Partnerships, 1575 Sherman St., Denver, CO 80203, during regular business hours. If a funded program wishes to provide sex segregated or sexspecific programming, they shall submit a written plan to be approved by DVP, which outlines the 1. Why the sex segregated or sex-specific programming is necessary for the essential safe operations of the program or service;

2. How they will provide comparable services to individuals who cannot participate in the sex segregated or sex-specific programming or service; and, 3. An analysis of research-supported best practices that justify the need for the sex segregated or sex-specific programming or service. 12.202.4 Residential Domestic Violence Advocacy Services Requirements [Rev. Eff. 10/1/18]

A. in addition to the requirements in sections 12.202.1 and 12.202.2, funded all programs funded wholly or in part by DVP that offering residential domestic violence advocacy programs services shall:

1. Notify DVP of intent to open a new or relocate a residential facility to include documentation of compliance with this section;

2. Notify DVP of the permanent or temporary closure of a residential facility;

3. Screen for appropriate access to a for residential facility services based on the client’s need for safe, temporary accommodations and/or fit for communal living;

4. Offer to develop a safety plan to minimally include the client’s safe contact with formal and informal support systems while in shelter receiving residential services;

5. Encourage but not mandate participation in supportive services, advocacy, or counseling as a condition of residency receiving residential services;

6. Maintain quality living conditions to address normal wear and tear to the residential facility, equipment, and furnishings; and, 7. Maintain safe living conditions of the residential facility to minimally include:

a. Locking doors and windows;

b. Appropriate lighting;

c. Mechanisms or devices for contacting emergency assistance; and, d. Compliance with applicable fire and safety codes.

B. All programs funded wholly or in part by DVP shall have minimal residential services staffing by employees or volunteers trained in accordance with Section 13-90-107, C.R.S., to include:

1. An adequate number of employees or volunteers to ensure the health and safety of residential services clients including those at a residential facility or staying in other accommodations such as a motel;

2. Residential services intake availability twenty-four (24) hours per day;

3. Twenty-four (24) hour access for residential services clients to trained employees or volunteers to offer safety planning, advocacy services, support, or assistance, consistent with residents’ schedules and needs in-person whenever feasible; and, 4. If not providing in-person twenty-four (24) hour staffing at a residential facility, a DVPapproved written plan to respond to residential program clients’ needs to minimally include employee or volunteer coverage and how clients can access emergency services in the event employees or volunteers are not physically present.

C. All Programs funded wholly or in part by DVP that offer residential services shall have the 1. Separate bedrooms for each family, whenever feasible;

2. Private space for bathing and personal hygiene needs;

3. Space or rooms designated for quiet time, whenever feasible;

4. Free food, clothing, toiletries, hygiene products, and other basic needs whenever feasible;

5. Unrestricted functioning telephone access for the purposes of reaching emergency assistance, securing resources, and maintaining social support;

6. Laundry facilities;

7. Access to residential services for victims with service animals;

8. Assistance with facilitating access to safe housing accommodations for victims with pets or other domesticated animals;

9. Marked and posted evacuation routes and exits, posting of fire extinguisher locations, and documentation of performance of regular fire drills; and, 10. Functioning heating, cooling, and ventilation systems.

D. Programs funded wholly or in part by DVP that offer residential services shall have the following written policies and procedures to minimally include:

1. Admission and eligibility criteria for residential services including provisions for referrals when unable to accommodate an individual or family;

2. Expectations of residential client conduct while receiving services;

3. Residents’ voluntary provision of housekeeping, food preparation, or other chores;

4. Residents’ voluntary participation in supportive services such as support groups;

5. Established involuntary exit criteria for residents;

6. Provision of locked storage of personal valuables and legally prescribed medication to minimally include:

A. Granting residents unrestricted access to personal valuables and prescribed medication; and, B. Employees or volunteers refraining from possessing or dispensing medication to residents unless they are licensed to do so as a health care professional.

7. Client use of legal substances including tobacco products, alcohol, and marijuana while on the residential facility property;

8. Safety protocol and procedures to minimally include a response to safety threats, availability of a First Aid kit, and documentation of performance of regular safety drills; and, 9. Universal precautions for infectious disease. 12.202.5 Domestic Violence Victim Advocacy Services for Children and Youth Requirements [Eff. 10/1/18]

A. All programs funded wholly or in part by DVP that have residential domestic violence advocacy services shall have written policies and procedures that ensure the following:

1. Employees and volunteers receive training specific to the dynamics of the impact of domestic violence on children and youth;

2. Trained advocates offer to conduct a voluntary intake and assessment of children and youth’s needs independent from that of the parent’s;

3. Trained advocates inform children and youth of their right to confidential communications and legal exceptions to confidentiality including mandatory reporting of known or suspected child maltreatment;

4. Accommodate any dependent adult children who have a developmental or physical disability for whom the adult victim is the primary caretaker;

5. Accommodate teenage children regardless of gender together with their victim parent; and, 6. Provide access to indoor and outdoor play spaces and recreational opportunities if feasible.

B. All programs funded wholly or in part by DVP that offer non-residential domestic violence advocacy to children and youth shall have written policies and procedures that ensure the 1. Employees and volunteers receive training specific to the dynamics of the impact of domestic violence on children and youth;

2. Trained advocates offer to conduct a voluntary intake and assessment of children and youth’s needs independent from that of the parent’s; and, 3. Trained advocates inform children and youth of their right to confidential communications and legal exceptions to confidentiality including mandatory reporting of known or suspected child maltreatment.

C. All programs funded wholly or in part by DVP that offer domestic violence advocacy for teens and youth impacted by violence in a dating or intimate relationship shall have written policies and procedures that ensure the following:

1. Employees and volunteers receive training specific to the dynamics of domestic violence that occurs within a youth or teen’s dating or intimate relationship;

2. Trained advocates conduct a voluntary intake and assessment of teens and youths needs regarding safety and community resources;

3. Trained advocates inform youth and teens of their right to confidential communications and legal exceptions to confidentiality including mandatory reporting of known or suspected child maltreatment; and, 4. A written policy that establishes the age of consent for which the funded program may provide domestic violence advocacy services to a minor without parental permission. 12.400 (None) [Rev. eff. 6/1/12]

12.500 COLORADO BRAIN INJURY TRUST FUND SERVICES

12.510 INTRODUCTION

These rules implement the Colorado Brain Injury Trust Fund Services administered by MINDSOURCE – Brain Injury Network (MINDSOURCE) as defined in Title 26, Article 1, Part 3, C.R.S. (Program).

Individuals who are eligible for Program services do not have an entitlement to these services. Program services are subject to available funding. If the demand for and need for program services exceeds the available funding, the entity under contract to provide services shall maintain a wait list of eligible persons. The MINDSOURCE Program Director, Brain Injury Board of Directors, and Contractor shall determine how eligible persons on the wait list are considered for Program services. Eligible persons may receive priority placement on the wait list by the brain injury Program Director, Brain Injury Board of Directors, and Contractor based on the health, safety, and welfare of the eligible person. As per section 26-1-304(5), “The Board may prioritize the services covered by the Trust Fund and eligibility for the services while ensuring fidelity to the Program’s original intent to serve individuals with traumatic brain injuries.”

12.520 DEFINITIONS

“Applicant” means an individual for whom an application or referral for services has been completed.

“Service Coordination and Skills Training” means a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet individual's needs, using communication and available resources to promote quality, cost effective outcomes.

“Contractor” means an organization or entity that is under contract with the Department to perform intake and eligibility determination services or to provide services to Program participants.

“Program” means the Colorado Brain Injury Program, as defined in Title 26, Article 1, Part 3, C.R.S.

“Program participant” means an individual for whom an application or referral for Program services has been completed, who has been determined to meet all of the Program eligibility criteria, and who has been referred to a contactor to receive Program services or to be placed on the Contractor’s wait list for services.

“Protected health information” means any information about an applicant or Program participant that is protected health information as defined in C.F.R 160.103 (2020), the regulations related to the Health Insurance Portability and Accountability Act of 1996. The definition of protected health information is hereby incorporated by reference, with no later amendments or editions. Copies of the regulation are available electronically at www.ecfr.gov and also available for review at MINDSOURCE, Colorado Department of Human Services, 1574 Sherman Street, Fourth Floor, Denver, Colorado 80203 during regular business hours.

“Brain Injury” refers to damage to the brain from an internal or external source, including a traumatic brain injury, that occurs post-birth and is noncongenital, nondegenerative, and nonhereditary, resulting in partial or total functional impairment in one or more areas, including but not limited to attention, memory, reasoning, problem solving, speed of processing, decision-making, learning, perception, sensory impairment, speech and language, motor and physical functioning, or psychological behavior.

Documentation of Brain Injury must be based on adequate medical history. A Brain Injury must be of sufficient severity to produce partial or total disability.

“Board” or “Board of Directors” means the Colorado Brain Injury Trust Fund Board created with the State Department of Human Services pursuant to Section 26-1-302(1), C.R.S.

12.530 ELIGIBILITY

Applicants who meet BOTH of the following criteria are eligible to receive Program services:

1. The applicant has a brain injury, and, 2. The applicant lives within the State of Colorado and considers Colorado to be their place of residency.

12.540 SERVICES

All Program participants who receive Program services shall receive service coordination and skills training. In addition to service coordination and skills training, the Board shall determine any additional services covered by the Trust Fund. 12.541 Case Closure The service coordination and skills training Contractor shall establish and publish written guidelines for closing cases. These guidelines shall respect and accommodate the cognitive and behavioral challenges following Brain Injury. Program participants shall be treated sensitively and fairly in any case closure discussions and decisions.

A. The MINDSOURCE Director and the Board of Directors shall approve the written guidelines for closing cases. Reasons for case closure may include a case when a Program participant:

1. Has met his or her goals and elects to discontinue services;

2. Has moved out of state;

3. Cannot be located by the contractor;

4. Has been institutionalized under circumstances which preclude delivery of services for at least six months;

5. Has been non-cooperative with, or abusive of, the Contractor staff and/or service providers to the extent that services cannot be delivered; or, 6. Has died.

B. When a case is closed, the Program participant shall be provided written notification of this action whenever possible and of his or her appeal rights and the process of how to appeal.

12.550 APPEALS AND GRIEVANCES

Applicants and Program participants shall have the right to file grievances and appeals. 12.551 Grievance Process A “grievance” is an oral or written complaint or expression of dissatisfaction about any matter other than a decision that may be appealed. A grievance may address issues such as the quality of services provided, the person providing services, the timeliness of services, the accessibility of service locations, or the availability of staff.

1. Applicants and Program participants shall have ninety (90) calendar days from the date of the incident to file a grievance expressing a complaint or dissatisfaction with any matter other than a decision that may be appealed.

2. The Contractor shall accept oral and written grievances and shall document oral grievances in writing.

3. The Contractor shall give applicants and Program participants reasonable assistance in filing a grievance and completing procedural steps in the grievance process, upon request.

4. The Contractor shall ensure that the individuals who make decisions on grievances are individuals who are not a subject of the grievance and who were not involved in any previous level of review or decision-making regarding the grievance.

5. The Contractor shall provide a reasonable opportunity for the individual making the grievance to present information in person as well as in writing.

6. The Contractor shall resolve each grievance and provide written notice within thirty (30) calendar days from the date the Contractor receives the grievance. The notice shall include the Contractor's proposed resolution to the grievance, the individual's right to further grieve the Contractor's proposed resolution to the MINDSOURCE Director or designee, and information on how to contact the Director or designee.

7. Applicants and Program participants shall have ninety (90) calendar days from the date of the Contractor's notice to submit their grievance to the MINDSOURCE Program Director or his/her designee.

8. The grievance process shall be an informal dispute resolution process. The decision of the MINDSOURCE Director or designee shall be final. 12.552 Appeal Process An “appeal” is a request to review a decision of a Contractor to deny or revoke Program eligibility or to deny, reduce, suspend, or terminate the delivery of Program services.

A. The Contractors performing eligibility determinations and providing Program services shall provide written notice to applicants and Program participants of decisions adversely impacting the individual's eligibility and Program services. The notice shall include the decision the Contractor has made, the reasons for the decision, the individual's right to appeal the Contractor's decision, and the appeal procedures.

B. Applicants and Program participants shall have ninety (90) calendar days to file an appeal from the date of the Contractor's notice.

C. The Contractor shall accept oral and written appeals, and shall document oral appeals in writing.

D. The Contractor shall give applicants and Program participants reasonable assistance in filing an appeal and completing procedural steps in the appeal process, upon request.

E. The Contractor shall ensure that the individuals who make decisions on appeals are individuals who were not involved in any previous level of review or decision-making regarding the decision under appeal.

F. The Contractor shall provide a reasonable opportunity for the individual making the appeal to present information, in person as well as in writing.

G. The Contractor shall resolve each appeal and provide written notice within thirty (30) calendar days from the date the Contractor receives the appeal. The notice shall include the Contractor's decision regarding the appeal, the individual's right to a second level appeal to the Colorado Department of Human Services, Executive Director or his or her designee, and information on how to contact the Executive Director or his or her designee.

H. Applicants and Program participants shall have ninety (90) calendar days from the date of the Contractor's notice to file a second-level appeal with the Department of Human Services, Executive Director or his or her designee.

I. The Executive Director or his or her designee shall have the right to additional information and may request oral argument or a hearing if it deems necessary.

J. The applicant, Program participant may represent himself/herself or use legal counsel or other spokesperson at a hearing.

K. The decision of the Executive Director or his or her designee shall constitute final agency action.

L. The Contractor whose decision is under appeal shall participate in the appeals process, provide any documentation required, and implement any decision made by the Executive Director or his or her designee.

M. The appeal process shall be conducted pursuant to Sections 24-4-105 and 106, C.R.S. _________________________________________________________________________ Editor’s Notes

History

Rule 12.540 emer. rule eff. 06/06/2008.

Rule 12.540 eff. 07/30/2008.

Rule 12.200 eff. 08/01/2009.

Rules SB&P, 12.105, 12.200, 12.500 eff. 06/01/2012. Rule 12.400 repealed eff. 06/01/2012.

Rules SB&P, 12.200-12.200.2, 12.200.4-12.200.7 eff. 05/01/2013.

Rules SB&P, 12.200-12.202.4 eff. 01/01/2016.

Rules 12.530, 12.551 eff. 07/01/2017.

Rule 12.202.3 D emer. rule eff. 09/07/2018.

Rules 12.200-12.202.5 eff. 10/01/2018.

Rule 12.202.3 D emer. rule eff. 12/07/2018.

Rule 12.202.3 D eff. 02/01/2019.

Rule 12.500 eff. 08/01/2021.

Annotations Rules 12.540.C. and 12.540.D. (adopted 01/05/2007) were not extended by Senate Bill 08-075 and therefore expired 05/15/2008.

## **2513** Division of Rehabilitation (Volume 9)

##### **12 CCR 2513-1** RULE MANUAL VOLUME 9, REHABILITATION SERVICES [Repealed eff. 09/01/2017] {#sec-12-ccr-2513-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2513-1}

DEPARTMENT OF HUMAN SERVICES

Division of Rehabilitation REHABILITATION SERVICES (STAFF MANUAL VOLUME 9) – Repealed eff. 09/01/2017 12 CCR 2513-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

Editor's Notes

History

Section 9.600 repealed eff. 11/01/2007.

Section 9.400 eff. 07/01/2008. Section 9.900 repealed eff. 07/01/2008.

Section 9.100 eff. 12/01/2008.

Sections SB&P, 9.100 eff. 06/01/2012.

Sections SB&P, 9.200 eff. 07/01/2012.

Sections SB&P, 9.102-9.108, 9.203.1-9.208, 9.209.2 eff. 04/01/2013.

Sections SB&P, 9.100 eff. 10/01/2014.

Sections SB&P, 9.207.3 eff. 05/01/2016.

Entire rule repealed eff. 09/01/2017.

## **2514** Food Distribution Program (Volume 13)

##### **12 CCR 2514-1** RULE MANUAL VOLUME 13, FOOD DISTRIBUTION PROGRAM [Repealed eff. 02/01/2012] {#sec-12-ccr-2514-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2514-1}

DEPARTMENT OF HUMAN SERVICES

Food Distribution Program

RULE MANUAL VOLUME 13, FOOD DISTRIBUTION PROGRAM - Repealed eff. 02/01/2012 12 CCR 2514-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT AND SPECIFIC STATUTORY

AUTHORITY OF REVISIONS MADE TO RULE MANUAL XIII

Addition of Sections 13.200,13.200.2,13.200.3, were finally adopted as a final adoption of emergency rule at the 3/7/86 State Board meeting, with an effective date of 3/7/86 (Document 6). Statement of Basis and

Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revision to Sections 13.200,13.200.2,13.200.3, were emergency adopted at the 4/11/86 State Board meeting, with an effective date of 4/11/86 (Document 22.Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revision of Section 13.111,13.200,13.200.2,13.200.3, were emergency adopted at the 7/11/86 State Board meeting, with an effective date of 7/11/86 (Documents 3, 4). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revision of Section 13.200,13.200.2 and 13.200.3, were finally emergency adopted at the 9/5/86 State Board meeting, With an effective date of 7/11/85 (Document 9). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revision of Section 13.111 was adopted emergency at the 6/5/87 State Board meeting with an effective date of 6/5/87 (Document 6). Statement of Basis and Purpose, Fiscal Impact, and specific statutory

authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Revision of Section 13.111 was final adoption of emergency at the 7/10/87 State Board meeting with an effective date of 6/5/87 (Document 15/CSPR# 87-4-1-1). Statement of Basis and Purpose, Fiscal Impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Office of the State Board Administrator, Department of Social Services.

Re-write of the manual - Sections 13.000 through 13.200.3 was final adoption following publication at the 5/5/2006 State Board meeting with an effective date of 7/1/2006 (Rule-making# 06-1-24-1). Statement of

Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, State Board Administration.

Deletion of Sections 13.000 through 13.200.2 (rule manual in its entirety) was final adoption following publication at the 12/2/2011 State Board meeting with an effective date of 2/1/2012 (Rule-making# 11 9 8-3). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. _______________________________________________________________________________

Editor's Notes

History Entire rule repealed eff. 02/01/2012.

## **2515** Adoption Intermediary Commission

##### **12 CCR 2515-1** Adoption Confidential Intermediaries {#sec-12-ccr-2515-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2515-1}

DEPARTMENT OF HUMAN SERVICES

Adoption Intermediary Commission ADOPTION CONFIDENTIAL INTERMEDIARIES 12 CCR 2515-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Addition of Section 15.100 were final adoption following publication at the 2/5/2013 Adoption Intermediary Commission meeting, with an effective date of 4/1/2013 (Rule-making# AIC 12-11-2). Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration. 15.100 ADOPTION INTERMEDIARY COMMISSION [Eff. 4/1/13]

A. The Adoption Intermediary Commission will maintain an up-to-date list of all of the persons who have completed training as Colorado confidential intermediaries, as persons who conduct searches for child placement agencies, or child placement agencies conducting searches.

B. The Adoption Intermediary Commission will provide this list to the judicial department on an annual

basis.

C. Rules that describe when and under what conditions the name of a confidential intermediary, a person who conducts searches for child placement agencies, or child placement agencies conducting searches shall be removed from the list that is available to the judicial department.

1. Failure to maintain confidentiality of information.

2. Failure to be able to work with all persons, regardless of differing cultural or ethnic backgrounds.

3. Failure to work cases in a confidential and timely manner.

4. Failure to follow specific procedures in conducting searches on behalf of the petitioners:

a. Proper documentation of all phases of the search;

b. Maintain the anonymity of all parties;

c. Confidentiality of all information until voluntary, informed, and written consent for contact has been received by the court;

d. Upon conclusion of the case, all records, including all copies, must be returned to the Chief Confidential Intermediary, who will close the case with the court;

e. The Intermediary shall provide to the petitioner a statement of services rendered without violating the confidentiality.

5. Failure to respect the privacy of all parties.

6. Failure to inform both the petitioner and the sought-after relative of the existence of the Voluntary Adoption Registry.

7. Failure to sign an Oath of Confidentiality for each case.

8. Failure to attend required training.

9. Failure to comply with an order from a Court of Jurisdiction.

10. Failure to comply with any applicable article or provision of the statute, rules, or manual of standards.

11. Failure to remedy a complaint as directed by the Commission.

12. Acceptance of fees without making a good faith attempt to locate the sought party.

D. The standards set forth by the Adoption Intermediary Commission for training of confidential intermediaries, persons who conduct searches for child placement agencies, or child placement agencies conducting searches as found in The Adoption Intermediary Commission’s Manual of Standards for Training Confidential Intermediaries (dated January 17, 1992) are incorporated in these rules by reference. No later amendments or editions are incorporated. Copies of these standards are available from the Colorado Department of Human Services, Child Welfare Division, 1575 Sherman Street, Denver, Colorado 80203, or at any State publications depository library. _________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 06/01/2012.

Entire rule eff. 04/01/2013.

##### **12 CCR 2515-2** STANDARDS FOR TRAINING CONFIDENTIAL INTERMEDIARIES [Repealed eff. 06/01/2012] {#sec-12-ccr-2515-2 omnilex-key=us-co-regs-official--department-9--12 CCR 2515-2}

DEPARTMENT OF HUMAN SERVICES

Adoption Intermediary Commission STANDARDS FOR TRAINING CONFIDENTIAL INTERMEDIARIES - Repealed eff. 06/01/2012 12 CCR 2515-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 06/01/2012.

##### **12 CCR 2515-3** REMOVAL OF CONFIDENTIAL INTERMEDIARIES AND TRAINING PROGRAMS [Repealed eff. 06/01/2012] {#sec-12-ccr-2515-3 omnilex-key=us-co-regs-official--department-9--12 CCR 2515-3}

DEPARTMENT OF HUMAN SERVICES

Adoption Intermediary Commission REMOVAL OF CONFIDENTIAL INTERMEDIARIES AND TRAINING PROGRAMS - Repealed eff. 06/01/2012 12 CCR 2515-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 06/01/2012.

##### **12 CCR 2515-4** STANDARDS FOR CHILD PLACEMENT AGENCIES CONDUCTING SEARCHES [Repealed eff. 06/01/2012] {#sec-12-ccr-2515-4 omnilex-key=us-co-regs-official--department-9--12 CCR 2515-4}

DEPARTMENT OF HUMAN SERVICES

Adoption Intermediary Commission STANDARDS FOR CHILD PLACEMENT AGENCIES CONDUCTING SEARCHES - Repealed eff. 06/01/2012 12 CCR 2515-4 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _______________________________________________________________________________ Editor’s Notes

History Entire rule repealed eff. 06/01/2012.

## **2516** Commission for the Deaf, Hard of Hearing, and DeafBlind (Volume 27)

##### **12 CCR 2516-1** Rule Manual 27, Commission for the Deaf, Hard of Hearing, and Deafblind {#sec-12-ccr-2516-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2516-1}

DEPARTMENT OF HUMAN SERVICES

RULE MANUAL 27, COMMISSION FOR THE DEAF, HARD OF HEARING, AND DEAFBLIND

12 CCR 2516-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

STATEMENT OF BASIS AND PURPOSE, FISCAL IMPACT, AND SPECIFIC STATUTORY

AUTHORITY OF REVISIONS MADE TO STAFF MANUAL VOLUME 27 (12 CCR 2516-1)

In creating a new manual for the Colorado Commission for the Deaf and Hard of Hearing (CCDHH), sections 27.100 through 27.191 were added as adopted following publication at the 6/6/2003 State Board meeting, with an effective date of 8/1/2003 (Rule-making# 03 3 26-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revisions to Sections 27.120 and 27.140 were adopted following publication at the 5/7/2004 State Board meeting, with an effective date of 7/1/2004 (Rule-making# 04-3-1-1). Statement of Basis and Purpose, fiscal impact, and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Addition of Sections 27.200-27.300 were final adoption following publication at the 9/7/2007 State Board meeting (Rule-making# 07-6-21-1), with an effective date of 11/1/2007. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Performance Improvement, Boards and Commissions Division, State Board Administration.

Revision of Sections 27.100 through 27.191 were final adoption following publication at the 2/1/2008 State Board meeting (Rule-making# 07-10-1-1), with an effective date of 4/1/2008. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the

rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Boards and Commissions Division, State Board Administration.

Revision of Sections 27.100 through 27.191 and Sections 27.200 through 27.300 were final adoption following publication at the 2/5/2010 State Board meeting (Rule-making#’s 09-9-17-1 and 09-10-22-2), with an effective date of 4/1/2010. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

Addition of Sections 27.400 through 27.480 were final adoption following publication at the 3/5/2010 State Board meeting (Rule-making# 09-10-22-1), with an effective date of 5/1/2010. Statement of Basis and

Purpose and specific statutory authority for these revisions were incorporated by reference into the rule.

These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Division of Boards and Commissions, State Board Administration.

27.100 COMMUNICATIONS TECHNOLOGY PROGRAM (CTP)

27.110 INTRODUCTION

The Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind administers and discharges funding as appropriated by the general assembly for the administration of a communications technology program (CTP), to distribute communications technology to qualified residents of Colorado.

27.120 DEFINITIONS

“Anniversary date” means the same date, but on subsequent years, that the applicant was approved for the Communications Technology Program.

“Applicant” means a person who applies to receive communications device(s) under the auspices of the Communications Technology Program.

“Application” means the official paperwork approved by the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind used for the Communications Technology Program.

“Approved date” means the date that all supporting documentation for the application is received and verified for acceptance by the Communications Technology Program.

“Certification” means professional verification of the applicant’s hearing acuity.

“Certifying professional” means those individuals who have been officially recognized by the Communications Technology Program to verify the applicant’s hearing acuity, as indicated in Section 27.130.

“Commission” means the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind (CCDHHDB), created pursuant to Section 26-21-104, C.R.S.

“Communications technology” means any communication device or application utilizing radio, television, cellular phone, computer and network hardware and software, satellite, cable, broadband systems, or similar medium and the services and applications associated with those mediums, including video and teleconference services pursuant to section 26-21-103(4), C.R.S.

“Device” means any tool or application that provides communications access.

“Fiscal constraint” means when seventy-five percent (75%) of the appropriated program funds have been disbursed or encumbered.

“Fraud” means the intentional deception and misreporting of information in order to obtain telecommunications equipment through this program.

“Natural disaster” means an event of nature such as tornadoes, earthquakes, blizzards, floods, forest fires, dust storms, avalanches, hailstorms, and lightning strikes.

“Resident” means an individual who lives in the State of Colorado as his/her primary residence.

“Tool” means any device or application that provides communications access.

“Vendor” means a company or individual who has successfully bid with the State of Colorado for the purposes of the Communications Technology Program and has received such designation.

“Wireless device” means a device that enables deaf, hard-of-hearing or deafblind individuals to access a wireless network.

27.130 ELIGIBILITY FOR THE COMMUNICATIONS TECHNOLOGY PROGRAM

To be eligible for communications devices under the Communications Technology Program, the applicant shall meet all of the following eligibility criteria:

A. The applicant must be a legal resident of the state of Colorado and provide a valid address on the application.

B. An applicant’s minimum age for a wireless device is thirteen (13) years old. The minimum age for all other devices is five (5) years old. The applicant must be able to benefit from and use the equipment for its intended communications technology purpose.

C. If the applicant is under eighteen (18) years of age; parents or guardians shall apply on behalf of child/minor and assume full responsibility for the device(s).

D. If the applicant is eighteen (18) years of age or older and has a guardian; the guardian shall apply on behalf of the applicant and assume full responsibility for the device(s).

E. The applicant must be deaf, hard of hearing or deafblind. This determination must be made at the applicant’s expense by one of the following:

1. A licensed physician or medical professional;

2. A licensed audiologist;

3. A Licensed Speech-Language Pathologist;

4. A Service professional from a public or private agency that serves deaf, hard of hearing or deafblind.

F. The applicant’s household income must be less than 400% of the Federal Poverty Guidelines (FPG) based on family size as indicated by the United States Department of Health and Human Services (HHS). FPG refers to figures set by the HHS annually. These figures, based on gross yearly income levels for corresponding household size, are included in the below table. Effective January 12, 2024, yearly gross income levels, for one hundred percent (100%) and four hundred percent (400%) of the FPG for the corresponding household size are as follows:

Family Size 100% Federal Poverty Guidelines 400% Federal Poverty Guidelines 1 $15,060 $60,240 2 $20,440 $81,760 3 $25,850 $103.280 4 $31,200 $124,800 5 $36,580 $146,320 6 $41,960 $167,840 7 $47,340 $189,360 8 $52,720 $210,880 Each Additional person $5,380 $21,520 The applicant must demonstrate proof of household annual gross income by providing a copy of his/her Federal Income Tax return (front page only), a Social Security Income award letter or other proof approved by the CTP Manager.

Applicants shall be placed on a waiting list during times of fiscal constraint.

27.140 APPLICATION PROCESS

The Communications Technology Program shall provide assistance in completing forms when requested by an applicant.

The applicant shall determine what accommodations are needed to ensure effective communications access based on demonstration and consultation. CTP may verify and certify the request and require further documentation and justification.

A. Information about how to obtain and submit an application, both paper and electronic, may be found through the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind office, its website, or designated public and private agencies.

B. The Communications Technology Program shall review all applications on a non-discriminatory

basis to determine whether:

1. All of the information is completed on the application.

2. The applicant has provided a valid street address. If a P.O. Box is used, then a physical address of the location where the applicant resides must be provided.

3. The application has the applicant’s original or electronic signature.

4. The application includes all required documentation. 27.141 Approved Applications Applicants who meet all of the eligibility requirements will be notified by email or mail of their application approval within 60 days of receipt.

Eligible applicants shall be awarded program participation on a first-come, first- served non-discriminatory

basis, in accordance with the approved date. 27.142 Pending Approved Applications During times of fiscal constraint, applications shall be accepted and held as pending until such time as funds become available. Such applications will be pending up to twelve (12) months. If after this time period funds are still not available, then a new application must be submitted. Applicants will be notified that they need to reapply. 27.143 Denied Applications A. Denial If the applicant is ineligible to participate in the program, the applicant shall be given written justification for the determination within sixty (60) calendar days of the denial determination.

B. The following are reasons for denying an application:

1. The applicant does not meet the eligibility requirements as established.

2. The applicant has received communications technology from the Communications Technology Program within the preceding four (4) years.

3. The applicant has negligently or willfully damaged the communications device(s) received from the Communications Technology Program or violated other provisions of the administrative regulations governing the Communications Technology Program.

4. The applicant fails to provide a police report of a stolen device or refuses to cooperate with the police investigation or in the prosecution of the suspect, including the refusal to testify in court when asked or subpoenaed to do so.

5. The applicant is found negligent in a police report of a stolen device, such as doors to the house or car left unlocked or unattended.

6. The applicant has lost or sold the communications technology.

C. Reapplication Any applicant who has been denied participation may reapply if, due to a change in conditions, the eligibility criteria as delineated in this document are met. 27.144 Dispute Resolution Process In order to resolve disputes between the Communications Technology Program and applicants/recipients, the Commission shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple non-adversarial format for the informal resolution of disputes.

27.150 DEVICE SELECTION

The approved applicant is responsible for selecting the appropriate communications device(s). If the communications device(s) that is currently provided by the Communications Technology Program does not meet the recipient’s needs:

A. The recipient may make a special request for an appropriate device that better meets his/her needs.

B. The recipient is responsible for the maintenance and repair of the device(s) selected through the Communications Technology Program. All communications technology will come with a warranty. 27.151 Replacing the Communications Technology Device A recipient may apply to replace the original communications technology device if:

A. The device is damaged through natural disaster;

B. There is a change in the recipient’s hearing or vision acuity;

C. New communications technology has become available through the Communications Technology Program which the CTP Manager determines to be more appropriate to the recipient’s communications needs; or, D. The identified anniversary date has passed and the recipient has had the communications technology for more than four (4) years. 27.152 Pending Replacement Applications During times of fiscal constraint, applications for replacement shall be accepted and held as pending until such time as funds become available. 27.153 Damaged Device Due to Natural Disasters A. The recipient must send the device(s) directly to the vendor that sent the device.

B. The manufacturer or vendor will certify that the equipment cannot be repaired due to a natural disaster.

If a device is stolen, for the purposes of program recordkeeping, the recipient shall:

A. Notify local police within fifteen (15) calendar days of the theft.

B. Forward a copy of the police report to Communications Technology Program within five (5) working days of the date the theft was reported.

27.160 VENDOR REQUIREMENTS

All vendors shall follow State procurement requirements. 27.161 Vendor Registration Vendors seeking to contract with the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind for any Communications Technology Program function must register for the Bid Information and Distribution System (BIDS) with the State Purchasing Office and be in accordance with the State Procurement Rules (1 CCR 101- 9) and these CTP rules. Vendors submit all information required by these rules to the Commission in order to be reimbursed. Vendors must register with the Secretary of State as a for-profit or not-for-profit business in the State of Colorado.

The following minimum standards shall apply to vendor participation in the Communications Technology Program:

A. Vendors shall submit documentation to the Commission that the vendor has registered with the State Purchasing Office and the Secretary of State’s Office as required in Section 27.161.

B. The Commission must receive all required registration information before a vendor will be reimbursed. Reimbursements will be made by electronic funds transfer into the vendor’s registered bank account.

C. If the submitted registration information is incomplete, the Commission will notify the vendor of any deficiency, if it is able to make contact based on the information provided.

D. Vendors are responsible for updating registration information. The Commission is not responsible for any loss resulting from incorrectly supplied registration information.

E. Vendors must submit vendor registration information prior to any sales transactions in order to ensure payment.

F. In the event that a vendor is suspended or disbarred from doing business in the State of Colorado or with the Federal government, the Commission shall notify the vendor that it is no longer eligible to receive reimbursements under this program.

27.170 FRAUD

If a recipient obtained communications technology under false premises or through intentional misrepresentation of facts on the Communications Technology Program application form, then the Communications Technology Program shall demand return of the equipment immediately. Upon demand, the recipient shall return the specified Communications Technology Program device(s). A determination of fraud will result in permanent disqualification from the program.

27.180 CONFIDENTIALITY

All applicant and recipient information shall be kept confidential in compliance with the Colorado Human Services Code (Section 26-1-114, C.R.S.). This is to prevent exploitation of applicants and recipients, to eliminate embarrassment to them, and is in recognition of their rights as self-determining individuals who are not limited because of their need for communications technology. 27.181 Information Not Considered to be Confidential for Data Purposes [Rev. eff. 4/1/10]

General program information not identified with any individual is not confidential and may be released for any purpose. This includes:

A. Total expenditures;

B. Number of applicants and/or recipients;

C. Statistical data obtained from studies;

D. Social data obtained from studies, reports, or surveys;

E. Expenditures by category of equipment;

F. Expenditures for administration;

G. Sum of all program expenditures.

27.190 ADMINISTRATION 27.191 Quarterly Report The CTP Manager shall provide the CCDHHDB Director and Commissioners a quarterly report on the operation of the Communications Technology Program. The report shall be due the 30th following the last month of the quarter, provide:

A. The number of persons served;

B. The number of each type of device distributed;

C. The expenditures of the program activities;

D. Discussion of any major policy or operational issues;

E. Suggestion(s) for program changes that do not require legislative action; and, F. Suggestions or proposals for legislative changes in the program.

27.200 LEGAL AUXILIARY SERVICES PROGRAM

The Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind administers the Legal Auxiliary Services (LAS) program to provide access to effective communication for deaf, hard of hearing, and deafblind individuals in court/legal settings, including the State Court System and state administrative proceedings.

LAS services include providing court and legal-qualified sign language interpreting and live, humangenerated captioning services for all state court and administrative proceedings. LAS issues specific Court/Legal credentials to qualified Auxiliary Services Providers and publishes a Referral Resource List for use by law enforcement, prosecutorial personnel, and other appointing authorities pursuant to sections 13-90-204 and 205.

These rules implement the provisions of sections 13-90-201 et seq., 13-71-137, and 26-21-106(4), C.R.S.

27.210 DEFINITIONS

“Appointing Authority” means the presiding officer or similar official of any court, board, commission, agency, or licensing or law enforcement authority of the state pursuant to section 13-90-202, C.R.S.

“Assistive Listening Device” (ALD) means a form of auxiliary aid working either with a hearing aid or cochlear implant, or alone, to improve hearing acuity for all interactions.

“Auxiliary Services” means qualified interpreters, Communication Access Realtime Translation (CART) providers, assistive listening devices/systems, or other services that assist in effective communication with a person who is deaf, hard of hearing, or deafblind pursuant to section 13-90-202(3), C.R.S.

“Auxiliary Services Provider” means a qualified interpreter or qualified CART provider to provide services under these Legal Auxiliary Services (LAS) rules.

“Commission” means the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind (CCDHHDB) pursuant to section 13-90-202(4), C.R.S.

“Communication Access Realtime Translation” (CART) means a speech-to-text translation service for the deaf, hard of hearing, or deafblind.

“Deaf, hard of hearing, or deafblind” means a person who has a functional hearing loss of sufficient severity to prevent aural comprehension, even with the assistance of hearing aids, pursuant to section 13-90-202(6), C.R.S. DeafBlind individuals exist on a continuum, ranging from no vision and/or hearing to varied combinations of usable hearing and/or vision, that presents difficulty in routinely accessing information.

“Effective Communication” means those methods of communication that are individualized and culturally appropriate to a person who is deaf, hard of hearing, or deafblind so that the person can easily access all auditory information pursuant to section 13-90-202(7), C.R.S.

“Legal Auxiliary Services Handbook” means the Colorado Commission for the Deaf, Hard of Hearing, and Deafblind Legal Auxiliary Services Handbook (2022) which is hereby incorporated by reference. No later additions or amendments are incorporated. The Legal Auxiliary Services Handbook is available at ccdhhdb.com/becomeLAS and is also available for public inspection at the Colorado Department of Human Services, Colorado Commission for the Deaf, Hard of Hearing, and Deafblind, 1575 Sherman Street, Garden Level, Denver, Colorado 80203, during regular business hours.

“Qualified Interpreter” means a person who has a valid certification of competency accepted by the Commission and includes, but is not limited to, oral interpreters, sign language interpreters, and intermediary interpreters pursuant to section 13-90-202(8), C.R.S.

“Referral Resource List” is a list of qualified Court/Legal interpreters and CART providers available for law enforcement and prosecutorial personnel for effective communication for arrest and witness/victim interview situations as required under sections 13-90-204(1)(d) and (f) and 13-90-205, C.R.S. LAS does not arrange for such services for law enforcement and prosecutorial personnel but publishes and maintains the list for their use.

“State Court System” means the system of courts, or any part thereof, established pursuant to Articles 1 to 9 of Title 13, C.R.S., and Article VI of the State Constitution. “State Court System” shall not include the municipal courts or any part thereof.

“Status I or II Court/Legal Interpreter” means an interpreter who has been credentialed by LAS as qualified for court and legal settings.

“Status I or II Court/Legal CART Provider” means a CART provider who has been credentialed by LAS as qualified for court and legal settings.

27.220 APPOINTMENT OF AUXILIARY SERVICES PROVIDERS AND PUBLISHING A REFERRAL

RESOURCE LIST

LAS will coordinate and pay for all qualified Auxiliary Services Providers when requested by an Appointing Authority. In addition, LAS will publish and maintain a Referral Resource List for use by law enforcement and prosecutorial personnel.

A. LAS shall determine the combination of services needed on a case-by-case basis in order to achieve effective communication between all parties.

B. LAS shall arrange and pay for auxiliary services in the following instances:

1. When a deaf, hard of hearing, or deafblind person is present and participating as the principal party of interest or witness at any state court civil or criminal proceeding, including court-ordered or court-provided probation, alternative dispute resolution, mediation, arbitration, pre-sentence interviews, or treatment.

2. When a deaf, hard of hearing, or deafblind person is present and participating as the principal party of interest or witness at any state administrative, commission, or agency hearing, or hearing of a licensing authority of the state.

3. When a person who is deaf, hard of hearing, or deafblind is involved in any stage of grand jury or jury proceedings as a potential or selected juror.

4. When a juvenile whose parent(s) or legal guardian(s) are deaf, hard of hearing, or deafblind is brought before a state court for any reason.

5. For meetings at the courthouse between an attorney and a client when the meeting is an extension of a court appearance (i.e., immediately before or after the appearance).

C. The Commission may coordinate and pay for qualified Auxiliary Services Providers for deaf, hard of hearing, and deafblind individuals who are not a principal party of interest when practicable and given consideration of advance notice and availability of service providers.

D. LAS shall maintain a publicly available Referral Resource List of qualified Auxiliary Services Providers for use by appointing authorities, including law enforcement and prosecutorial personnel. The list shall contain the names of interpreters and CART providers who are qualified to work in court/legal settings. Law enforcement and prosecutorial personnel shall utilize the Referral Resource List to secure necessary auxiliary services pursuant to section 13-90-205(2), 27.230 QUALIFICATIONS OF AUXILIARY SERVICES PROVIDERS Auxiliary Services Providers must meet certain requirements to provide interpreting and CART services for LAS.

Providers must hold a Status I or II Court/Legal credential and pass initial and subsequent Judicial Department background checks to be eligible for Court/Legal assignments. Status IV providers are eligible for all community assignments.

LAS shall review each Auxiliary Services Provider’s Status I, II, or IV designation annually based upon the

rule requirements and keep an updated Referral Resource List. Please refer to the Legal Auxiliary Services Handbook for more information about LAS policies and procedures.

A. Qualified Interpreters No qualified interpreter shall be categorized as a Status I or II Court/Legal Interpreter or be placed on a Referral Resource List with the Commission without first making an application and receiving a determination from LAS that they are qualified under Statuses I, II, and/or IV below.

Interpreting services may be provided onsite or virtually. Every effort will be made to provide optimal communication access.

Status I interpreters are preferred providers for all legal and court assignments.

1. Status I: Court/Legal Interpreter a. Certified Deaf Interpreters holding a current RID Certified Deaf Interpreter (CDI), BEI Intermediary Levels IV or V, or successor certification and who have passed the National Center for State Courts (NCSC) written exam Holders of this certificate are recommended for a broad range of assignments where an interpreter who is deaf or hard of hearing would be beneficial.

1) Initial Status I designation: interpreters in this category are required to complete 65 hours of training specific to legal interpreting and a minimum of 50 hours of mentoring pursuant to the Legal Auxiliary Services Handbook, to attain a Status I designation. In addition, they are required to have passed the National Center for State Courts (NCSC) written exam.

A. Compliance: current Status I Certified Deaf Interpreters must come into full compliance with the NCSC written exam requirement by June 30, 2025, in order to retain the Status I designation. Anyone who does not pass the NCSC exam by that date will be moved to Status II. Extensions may be granted on a case-by-case basis.

B. Court/Legal Interpreters new to the Colorado State Court System who completed the required number of mentoring hours out-ofstate must complete a Legal Auxiliary Services orientation and a minimum of ten hours of successful teaming with Colorado Status I or II Court/Legal Interpreters prior to being granted Status I, pursuant to the Legal Auxiliary Services Handbook.

2) Maintenance of Status I designation: interpreters in this category must maintain current certification and complete 2.0 (20 clock hours)

Handbook. The 2.0 of legal and/or court-related CEUs must be approved b. Certified Hearing Interpreters holding a current Registry of Interpreters for the Deaf (RID) Specialist Certificate: Legal (SC:L), Board for Evaluation of Interpreters (BEI) Court Interpreter, or successor certification 1) Initial Status I designation: holders of a current RID Legal SC:L certification and/or BEI Court Interpreter certification are not required to complete the Legal Auxiliary Services legal training and mentorship program to attain a Status I designation.

A. Court/Legal interpreters new to the Colorado State Court System must complete a Legal Auxiliary Services orientation and a minimum of ten hours of successful teaming with Colorado Status I or II Court/Legal Interpreters prior to being granted Status I, pursuant to the Legal Auxiliary Services Handbook.

2) Maintenance of Status I designation: each SC:L or BEI Court Interpreter certification holder must maintain current certification.

2. Status II: Court/Legal Interpreter a. Certified Deaf Interpreters Holders of this certificate are recommended for a broad range of assignments where an interpreter who is deaf or hard of hearing would be beneficial.

Interpreters holding a current RID Certified Deaf Interpreter (CDI), BEI Intermediary Levels IV OR V, or successor certification are eligible to attain a Status I or II designation if they comply with the following:

1) Initial Status II designation:

A. Prerequisite: interpreters must complete the community interpreting experience requirement set forth in the Legal Auxiliary Services Handbook before beginning legal interpreting i. Interpreters in this category are required to complete 65 hours of training specific to legal interpreting and a minimum of 50 hours of mentoring pursuant to the Legal Auxiliary Services Handbook to attain a Status II designation.

a. Compliance: current Status II interpreters must come into full compliance with the RID or BEI certification requirement by June 30, 2025, to retain the Status II designation. Not doing so will result in loss of the Status II designation.

Extensions may be granted on a case-by-case

basis.

ii. Interpreters from out-of-state who are experienced in court/legal settings but are new to the Colorado State Court System are eligible to attain a Status II designation by demonstrating that they have sufficient experience in court/legal settings, have completed a minimum of 65 hours of training specific to legal interpreting, and have completed a minimum of 50 hours of mentoring. They must complete a Legal Auxiliary Services orientation and a minimum of 20 hours of successful teaming with current Colorado Status I and II Court/Legal Interpreters prior to being granted Status II, pursuant to the Legal Auxiliary Services Handbook. Exceptions may be made on a case-by-case basis.

2) Maintenance of Status II designation: interpreters in this category must maintain current certification and complete 4.0 (40 clock hours) of Handbook. The 4.0 of legal and/or court-related CEUs must be approved 3) Moving from Status II to Status I: interpreters holding a current Status II designation may apply for a Status I designation upon meeting the Status I written test requirements, pursuant to the Legal Auxiliary Services Handbook.

b. Certified Hearing Interpreters with other certifications Interpreters holding a current Registry of Interpreters for the Deaf (RID), Board for Evaluation of Interpreters (BEI) Advanced or Master, or successor certification are eligible to attain a Status II designation if they comply with the following:

1) Initial Status II designation:

A. Prerequisite: interpreters must complete the community interpreting experience requirement set forth in the Legal Auxiliary Services Handbook before beginning legal interpreting i. Interpreters in this category are required to complete 65 hours of training specific to legal interpreting and a minimum of 50 hours of mentoring pursuant to the Legal Auxiliary Services Handbook to attain a Status II designation.

ii. Interpreters from out-of-state who are experienced in court/legal settings but are new to the Colorado State Court System are eligible to attain a Status II designation by demonstrating that they have sufficient experience in court/legal settings, have completed a minimum of 65 hours of training specific to legal interpreting, and have completed a minimum of 50 hours of mentoring. They must complete a Legal Auxiliary Services orientation and a minimum of 20 hours of successful teaming with current Colorado Status I and II Court/Legal Interpreters prior to being granted Status II, pursuant to the Legal Auxiliary Services Handbook. Exceptions may be made on a case-by-case basis.

2) Maintenance of Status II designation: interpreters in this category must maintain current certification and complete 4.0 (40 clock hours) of Handbook. The 4.0 of legal and/or court-related CEUs must be approved 3) Moving from Status II to Status I: interpreters holding a current Status II designation may apply for a Status I designation upon meeting the Status I certification requirements, pursuant to the Legal Auxiliary Services Handbook.

3. Status III: Communication Assistants Communication Assistants may or may not have formal training or certification but have experience with the unique communication needs of a particular deaf, hard of hearing, or deafblind individual (for example, foreign sign languages, home sign, deafblind-specific communications, etc.). Communication Assistants may be assigned on a case-by-case

basis and shall only work under the supervision of a Status I or Status II Court/Legal Interpreter. All on-the-record interpreting shall come from Status I or II Court/Legal Interpreters 4. Status IV: Community Interpreters Interpreters for court-ordered treatment or therapy must hold current (a) RID certification, (b) one of the following BEI certifications: Advanced, Master, Court Interpreter, Trilingual Advanced, Trilingual Master, Medical Interpreter, Level IV Intermediary, or Level V Intermediary, or (c) successor certification.

5. Non-resident court/legal interpreters: RID certified interpreters, BEI Advanced, Master, Intermediary certified interpreters, or successor certifications from out-of-state who are experienced in court/legal settings but do not hold a Colorado Status I or II Court/Legal Interpreter designation are eligible to interpret in the State Court System and other court/legal settings for up to 14 days per calendar year without a Status I or II designation. Exceptions to the 14-day period may be granted by LAS on a case-by-case

basis. Non-resident court/legal interpreters shall work only under the supervision of a Status I or II Court/Legal Interpreter.

Non-resident court/legal interpreters in this category must demonstrate that they have sufficient experience in court/legal settings and successfully complete pre-assignment orientation and preparation with the assigned interpreting team, pursuant to the Legal Auxiliary Services Handbook.

6. After-hours/weekend/holiday court and law enforcement requests: virtual interpreting services may be provided by a pre-approved agency to law enforcement and the Colorado State Court System in situations requiring immediate interpreting services, pursuant to the Legal Auxiliary Services Handbook. Interpreters must hold either: (1) a current RID SC:L, BEI Court Interpreter, or successor certification, or (2) a current RID certification or BEI Advanced, Master, or Intermediary certification, or successor certification and have completed a minimum of 20 hours of current legal interpreting B. CART Providers 1. A Communication Access Realtime Translation (“CART”) provider is a trained professional who provides live, immediate captioning from speech to text for deaf, hard of hearing, and deafblind consumers to provide communication access. The text appears on a computer or other screen or display. The CART provider also provides environmental cues to the consumer, such as phones ringing, laughter, door slamming, etc. CART is also referred to as real-time captioning, and live captioning.

2. Pursuant to the Legal Auxiliary Services Handbook, to attain an initial Status I or II Court/Legal credential, CART providers must:

a. Hold a current Certified Realtime Captioner (CRC) designation, or meet each of the following criteria:

1) Have graduated from an accredited court reporting program.

2) Have a minimum rate of 98% accuracy at 225 words per minute for captioning work.

3) Have two years of general CART experience post-graduation and a minimum average of 20 hours of CART services per week for each of the most recent two years of CART work. Exceptions will be reviewed on a case-by-case basis.

b. Successfully complete a minimum of six hands-on assignments in the State Court System, as supervised by a current Status I or II CART Provider and approved by Legal Auxiliary Services (LAS).

c. Complete an orientation provided by LAS.

3. CART Providers will be designated as:

a. Status I if they hold a current Certified Realtime Captioner (CRC) designation and meet the requirements listed in section 2.

Status I providers will be eligible to cover all court/legal LAS assignments where the consumer is a party to the case.

b. Status II if they meet the requirements listed in section 2 but do not hold a current CRC designation.

Status II providers will be eligible to cover all LAS assignments, except trials and hearings with testimony unless approved by LAS or the appointing authority.

c. Status IV if they meet the requirements listed in section 2(a)(1), (2), and (3).

Status IV providers will not be eligible to cover court/legal assignments but may cover court-ordered treatment or therapy assignments.

4. To maintain a Status I or II Court/Legal credential:

a. CART Providers must:

1) Maintain a current CRC designation for Status I.

2) Complete a sufficient number of CART assignments, as determined by LAS, within the State Court System within the last year for Status II.

b. Attend a refresher orientation program if requested by LAS.

5. The purpose of CART services is to facilitate communication accessibility in a live format.

CART providers do not provide a record of the proceedings and will not retain or distribute CART notes or print-outs. Court reporters are responsible for providing a verbatim record of the proceedings and persons wanting a transcript can order an official transcript through the courts.

6. CART services may be provided onsite or virtually. Every effort will be made to provide optimal communication access. Onsite cart services will be prioritized for trials, jury duty, and hearings with testimony.

C. Cued Language Transliterators Colorado recognizes Cued Language Transliterators who hold a Transliteration Skills Certificate (TSC) pursuant to section 6-1-707(1)(e)(i)(a), C.R.S., and the rules in section 27.500. Due to a lack of Cued Language Transliterator (CLT) providers with specific qualifications for court and legal settings, LAS will make CLT assignments on a case-by-case basis upon consultation with a provider that has expertise in CLT training and practice.

27.240 RESPONSIBILITIES OF STATUS I AND II PROVIDERS

All Status I and II Auxiliary Service Providers shall abide by the following responsibilities for court and legal settings:

A. Identify their LAS-issued credential and number.

B. Prepare for the assignment by contacting the appointing authority and reviewing case information in advance and arriving at the assignment early to be able to assess the consumer’s needs and establish effective communication.

C. Take an oath as directed by the presiding authority regarding the full and complete provision of interpreting or CART services to the best of the provider’s ability.

D. Make all necessary disclosures, on the record, about any perceived need for disqualification or acknowledging conflict of interest as being the sole holder of relevant information.

E. Take the necessary steps to promote effective communication, including ensuring proper set-up onsite or online.

F. Correct errors either on the record, or by notifying each party as soon as is practical.

G. Facilitate effective communication between deaf, hard of hearing, or deafblind individuals and their attorneys only when attorney-client privilege has been extended for the Auxiliary Service Provider.

H. Abide by LAS policies and procedures as outlined in the Legal Auxiliary Services Handbook, including following applicable codes of professional conduct.

27.241 RESPONSIBILITIES OF AUXILIARY SERVICE PROVIDERS FOR JURORS

Pursuant to 13-71-137, C.R.S., the following responsibilities apply to Status I and II Auxiliary Service Providers:

A. Provide effective communication during a trial for a juror who is deaf, hard of hearing, or deafblind.

B. Make true and complete translations and interpretations of all court proceedings to the best of the provider’s ability.

C. Abide by the same orders and admonitions given to the jurors.

D. Refrain from participating in any manner in the deliberation of the jury or having any communications with any member of the jury regarding deliberation, except as necessary for true and complete translations of jurors' remarks made during deliberation.

27.250 COMPENSATION, PAYMENT, AND REIMBURSEMENT

A. The amount of compensation shall be based on a fee schedule for Auxiliary Service Providers established by the Commission through LAS, subject to appropriations.

B. Funds are available for attorney-client communications only when such communications are an extension of a court appearance (i.e., immediately before or after the appearance).

27.260 COMPLAINT PROCESS

Consumers and service providers may file a complaint regarding LAS services. A “complaint” is an expression of dissatisfaction on matters such as the quality of services provided or a decision regarding an Auxiliary Service Provider’s Status. A complaint must be filed within 45 calendar days of the date of the incident.

LAS staff shall resolve complaints using simple, non-adversarial procedures adopted by the Commission.

If appropriate, Auxiliary Services Providers will be informed of a complaint about their services and given an opportunity to respond before LAS staff make a decision on the complaint. Any party who is dissatisfied with the resolution of a complaint may appeal the decision per the procedures to be adopted by the Commission. The Department’s Executive Director and/or designee shall have final decisionmaking authority on the complaint.

27.270 TRAINING AND TECHNICAL ASSISTANCE

LAS will collaborate with Commission staff to provide training and technical assistance for identified Judiciary, law enforcement and prosecutorial personnel, auxiliary services providers, and consumers regarding compliance with relevant regulations, policies, and procedures.

27.280 AUXILIARY AIDS AND DEVICES

LAS will coordinate the purchase, shipment, and receipt of Assistive Listening Devices and systems for the State Court System according to applicable state rules pursuant to section 26-21-106(4)(d), C.R.S.

27.290 AUXILIARY SERVICE ADVISORY COUNCIL

A. LAS shall convene a five-member advisory council. Membership shall consist of the following: three Status I or II Court/Legal Interpreters (at least one deaf and one hearing), one CART provider, and one member of the public.

B. The council shall meet at least two times per year to consult with LAS staff and make recommendations. The council may expand its membership or establish issue-specific work groups as needed for rulemaking.

C. Term limits of the Legal Auxiliary Service Council members shall be determined by the Commission.

27.300 RURAL COMMUNICATION ACCESS SERVICES PROGRAM

The Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind administers the Rural Communication Access Services (RCAS) program to provide access to effective communication for deaf, hard of hearing, and deafblind individuals in rural areas of the state. RCAS services include providing information, referrals, and qualified communication access services (e.g., sign language interpreters, realtime captioners, cued language transliterators). RCAS also provides communication access provider training and scholarships for people who are willing to accept assignments in rural areas.

Under the Americans with Disabilities Act (ADA), state and local governments, and businesses and nonprofit organizations that serve the public must communicate effectively with people who are deaf, hard of hearing, and deafblind. However, there are relatively few sign language interpreters and realtime captioners available in rural communities.

Although entities in rural areas are ultimately responsible for complying with the ADA, the RCAS program is a tool to assist such entities by providing information on providers who are willing to take assignments in rural areas. The program also has limited funding to arrange and pay for communication access services for eligible rural entities. The goal of the program is to remove communication barriers in rural communities to the benefit of everyone. These rules implement the provisions of section 26-21-106(9), 27.310 DEFINITIONS “Access to effective communication” means those methods of communication that are individualized, culturally appropriate, and appropriate to the nature, length, complexity, and context of the situation as well as the person’s normal method(s) of communication.

“Auxiliary Services” means those aids and services that assist in effective communication with a person who is deaf, hard of hearing, or deafblind pursuant to section 13-90-202(3), C.R.S.

"Business or nonprofit organization that serves the public" means a public accommodations entity that is required under Title III of the Americans with Disabilities Act to take steps necessary to communicate effectively with deaf, hard of hearing, and deafblind customers.

"Commission" means the Colorado commission for the deaf, hard of hearing, and deafblind in the department of human services created in section 26-21-104.

“Communication access services” includes qualified/certified sign language interpreting, realtime captioning (CART), cued language transliteration, and other services.

“Communication access services providers” include approved qualified/certified sign language interpreters, Communication Access Realtime Translation (CART) captioners, cued language transliterators, and other providers. Providers may be commission interpreting staff or vendors.

“Consumer” means all parties (deaf, hard of hearing, deafblind, or hearing) receiving services in rural areas. Consumers must be a state or local government; a business or nonprofit organization that serves the public; or a deaf, hard of hearing, or deafblind person.

“Deaf, hard of hearing, or deafblind” means a person who has a functional hearing loss of sufficient severity to prevent aural comprehension, even with the assistance of devices such as hearing aids, pursuant to section 13-90-202(6), C.R.S. Hearing aids include cochlear implants. DeafBlind individuals exist on a continuum, ranging from no vision and/or hearing to varied combinations of usable hearing and/or vision, that presents difficulty in routinely accessing information.

“Effective Communication” means those methods of communication that are individualized and culturally appropriate to a person who is deaf, hard of hearing, or deafblind so that he or she can easily access all auditory information pursuant to section 13-90-202(7), C.R.S.

“Qualified interpreter” means a person who has a valid certification of competency accepted by the commission and includes, but is not limited to, oral interpreters, sign language interpreters, and intermediary interpreters pursuant to section 13-90-202(8), C.R.S.

“Rural area” is defined in section 27.320.

“State or local government” means a public entity that is required under Title I of the Americans with Disabilities Act to take steps necessary to communicate effectively with deaf, hard of hearing, and deafblind persons. Primary consideration must be given to the type of auxiliary aid or service requested by the person with a disability.

27.320 PROGRAM DEFINITION OF “RURAL AREA”

For the purposes of the program, “rural area” is defined as:

1. A Colorado county with a population of fewer than 250,000 people, or 2. A Colorado city, town, or unincorporated area within Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, El Paso, Jefferson, Larimer, and Weld counties where:

a. The number of local qualified/certified communication access services providers is insufficient to meet the needs of the consumers in the community due to geographic barriers, and/or b. Requests for communication access are unfilled due to geographic barriers and the need for more readily available service providers.

Requests for exceptions to the above criteria may be reviewed by the program on a case-by-case basis.

The definition of “rural area” will be reviewed by the program every three years with input from the Rural Communication Access Services Advisory Council (RCASAC). In addition, county population data will be reviewed every ten years when updated census data becomes available.

27.330 INTAKE, REFERRAL INFORMATION, AND COMMUNICATION ACCESS SERVICES

On a case-by-case basis, the program will conduct a personalized intake process for each consumer to assess their needs and tailor services to their needs. The program will provide information and resources, and, if requested, schedule and pay for communication access services if resources permit.

A. The program shall establish, publish, and monitor/maintain a list of CART captioners and sign language interpreters who are willing to work in rural areas. This information is publicly available on the Commission’s website: https://ccdhhdb.colorado.gov/.

B. For requests regarding communication access services scheduling, staff will review how to fill out the online request form to ensure completeness of information and explain the program’s policies, including how to modify or cancel requests, information on best practices for communication access and resources, and the possibility of sign language interpreting students or apprentices being present and working with certified interpreters.

C. The program has full-time staff sign language interpreters to assist with filling service requests in rural areas. The program also has allocated funding each year to cover the cost of services, travel time, mileage, and per diem/lodging for vendors. Each fiscal year, the program will divide the funding allocation into twelve months and determine a monthly budget for payment of vendor services. If a given month’s expenditures reach 75% to 85% of the monthly allocation, the program will prioritize court and legal, health and wellness, and employment-related requests to conserve resources. The program may make exceptions on a case-by-case basis.

27.340 QUALIFICATIONS OF COMMUNICATION ACCESS SERVICES PROVIDERS

Communication access services providers must meet state and commission requirements to provide sign language interpreting, CART captioning, or cued language transliteration services.

A. The commission’s requirements for sign language interpretation and cued language transliteration are found in Rule 27.500.

B. The requirements for sign language interpreters and realtime captioners are found in Rule 27.230.

Vendors must meet the paperwork requirements of the State of Colorado. This information is posted on the commission website: https://ccdhhdb.colorado.gov/.

27.345 RESPONSIBILITIES OF COMMUNICATION ACCESS SERVICES PROVIDERS AND VENDOR

COMPENSATION

Providers (interpreting staff and communication access services vendors) shall abide by the following responsibilities:

A. Be prepared to show proof of certification or other credentials.

B. Abide by professional standards and codes of conduct.

C. Adhere to the highest ethical standards.

D. Prepare for the assignment in advance by contacting the relevant party/parties for assignment information.

E. Make travel arrangements or establish buffers between virtual assignments to allow on-time arrival for an assignment.

F. Arrive early enough to an assignment to be able to assess the deaf, hard of hearing, and deafblind consumer’s needs in establishing effective communication.

G. Take the necessary steps to promote effective communication, including ensuring proper set-up onsite or online.

H. Abide by RCAS policies and procedures.

I. Submit accurate and timely invoices, with all assignments invoiced within the applicable state fiscal year (July 1 to June 30).

Vendors will be asked to inform consumers that the RCAS program arranged and paid for their services.

Vendors also will be asked to give RCAS materials (such as a business card) to rural consumers for each assignment whenever appropriate. These activities will make RCAS’s impact transparent and act as a reference tool for new requests.

The amount of vendor compensation shall be based on the vendor agreement and fee schedule established by the commission. Vendors shall be compensated only for assignments that were confirmed in advance by the RCAS program.

27.350 PRIORITIZATION OF COMMUNICATION ACCESS SERVICES REQUESTS

The program does not prioritize incoming communication access services requests. However, in times of funding limitations, the program will resort to prioritizing requests for the most basic human needs, such as requests relating to medical/behavioral health, employment-related, and court/legal situations. This prioritization is applied as a last resort plan.

RCAS shall arrange and pay for communication access services in rural areas of Colorado as long as funding is available to do so. A deaf, hard of hearing, or deafblind consumer must be present onsite or virtually for the proceeding, event, or circumstance. When scheduling services, the program will consider the nature, length, complexity, and context of the request and the frequency of the need for services.

RCAS will not arrange communication access services for federal or state agencies or entities; (pre) K to grade 12 student-related academics or activities except for Individualized Education Program (IEP) meetings; post-secondary academics or environments; or personal events such as weddings, parties, or family gatherings.

Additionally, RCAS will not cover services requested by out-of-state entities.

1. RCAS Services are available in rural areas of the state. The request must involve providing communication access in a rural area to a deaf, hard of hearing, or deafblind individual, regardless of whether that person resides in or is visiting that rural area.

2. Communication access services may be provided in person, virtually, or a hybrid of in-person and virtual. RCAS staff shall make the final determination on whether communication access services will be provided in person and/or virtually.

3. RCAS services may be suspended or terminated for repeated misuse or abuse of program resources, including but not limited to multiple no-shows or short-notice cancellations.

4. During times of fiscal constraint, service requests will be prioritized with court and legal settings, health and wellness appointments, and employment-related events being of the highest priority.

On a case-by-case basis, shorter requests will be prioritized over lengthier (e.g., half-day, full day, or multiple day) requests.

5. The RCAS program is charged with increasing the number of qualified communication access services providers available in rural areas of the state. Thus, vendors on RCAS assignments may be accompanied by sign language interpreting students and apprentices. The program will inform consumers in advance whenever possible.

27.360 TRAINING AND SCHOLARSHIP OPPORTUNITIES

The RCAS program sets aside a portion of its funding each year for the training of communication access services providers. To be eligible for RCAS-sponsored training and scholarship, the training program must be aligned with RCAS program goals. In addition, the person must meet the requirements of the specific training or scholarship program; be willing to take assignments in rural areas; and, once qualified or certified, become an active RCAS program vendor and accept a minimum of five assignments per year (with RCAS or not) in rural areas for two years.

RCAS interpreting staff provide ongoing sign language interpreting workshops at professional conferences and other locations. Information about training and scholarship programs is posted on the commission website.

27.370 PROGRAM OUTREACH

The RCAS program conducts outreach to rural consumers and potential vendors. Staff provide education on the ADA, communication access services, resources, and how to use the program. When appropriate, program staff will request that rural consumers credit the program for providing communication access services and provide contact information for RCAS. This will make the program’s impact transparent and act as a reference tool for new requests.

The commission will provide educational and program materials in accessible and diverse formats, such as short videos with voice-over, captions, and sign language, and business cards or brochures. Program staff will track outreach efforts and utilize the data in modifying and improving outreach efforts.

27.380 COMPLAINT PROCESS

Consumers and vendors who are unhappy with the services provided are strongly encouraged to address the situation with the other party or parties first. If the parties are unable to resolve the complaint to satisfaction amongst each other, the parties may contact the RCAS program for assistance. If there is a need to escalate the complaint or the complaint involves the program itself, the person may file a complaint via the Department of Human Services’ Client Services as found on the Department’s website: https://cdhs.colorado.gov/contact-cdhs.

27.390 RURAL COMMUNICATION ACCESS SERVICES ADVISORY COUNCIL

A. The RCAS program shall convene a five-member advisory council. Membership shall consist of the following: two rural consumers who use or are familiar with RCAS services; two communication access services vendors who take assignments in rural areas; and one member of the public.

B. The council shall meet at least two times per year to consult with RCAS program staff and make recommendations. The council may expand its membership or establish issue-specific workgroups as needed.

C. Term limits of the Rural Communication Access Services Advisory Council shall be determined by the commission.

27.400 GRANT PROGRAM

The Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind provides funding, as appropriated by the General Assembly and after considering the recommendations made by the Grant Program Committee, for local government, state agencies, state-operated programs, or private nonprofit or not-for-profit organizations to address priorities of the deaf, hard of hearing, and deafblind community.

27.410 DEFINITIONS

“Auxiliary services” mean those services defined in Section 26-21-103(1), C.R.S.

“Commission” means the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind (CCDHHDB), as referenced in Colorado Revised Statutes, Title 26, Article 21.

“Commissioners” means members appointed by the Governor to serve on the Commission, pursuant to

Section 26-21-104, C.R.S., “Committee” means the Grant Program Committee authorized pursuant to Section 26-21-107.7(1)(a.5)(I), “Entity” means a local government, state agency, state-operated program, or private nonprofit or not-forprofit organization.

27.420 GRANT PROGRAM COMMITTEE

The Commission shall convene a five-member committee consisting of members, including the director of the Commission as an ex-officio member, who have knowledge and awareness of innovative strategies that address challenges of the deaf, hard of hearing, and deafblind community.

A. The Commission shall provide information to the general public about the establishment of the committee and the process for interested persons to apply to become a committee member.

B. The Commission shall screen the candidates for the Grant Program Committee positions and make recommendations to the Commissioners for approval.

C. Membership of the committee shall be comprised of four appointed members, as described in

Section 26-21-107.7(1)(a.5)(II), C.R.S., in addition to the Commission director serving as an exofficio member of the committee.

1. The members shall serve a three-year term, with the original members’ terms staggered pursuant to Section 26-21-107.7(1)(d), C.R.S.

2. The individual staggered term limits shall be determined by the Commissioners.

D. This committee shall meet to review applications and make recommendations to the Commission for approval, with recommended grant amounts, or disapproval of applications and advise the Grant Program.

E. The Commission shall share the committee’s recommendations with the Commissioners for their review and feedback.

F. The committee shall make recommendations to the Commission to determine distribution of the amount(s) up to the total amount of money appropriated for this purpose when needed.

27.430 PURPOSE OF GRANT

The purposes of the grant awards shall be to address priorities of the deaf, hard-of-hearing, and deafblind community, including, but not limited to, the following projects:

A. Access to communication or environmental information where auxiliary services and aids are made available;

B. Community planning to improve coordination and access to services (e.g., involvement of the community stakeholders to conduct an environmental scan, gap analysis, priority setting and strategic planning of any program);

C. Start-up programs that the state lacks;

D. Support for existing services and programs;

E. Other projects that meet the overall purpose of the grant program as determined by the committee.

27.440 GRANT APPLICATION PROCESS

Applications shall be submitted on a form provided by the Commission and shall include:

A. Letter of interest submitted by the governing body of the entity;

B. The mission statement of the entity that reflects support of the purposes underlying the grant program;

C. Documentation of appropriate legal status or standing as a private nonprofit or not-for-profit agency or corporation as required by Federal or Colorado law, if the entity is a non-governmental agency;

D. A list of a functioning board of directors or advisory committee, which provides oversight and governance if applicable or the organizational structure of the government agency;

E. Concisely written grant proposal that sets forth, at a minimum, the objective(s) to be achieved in accordance with the purpose of the grant, the community need that the grant proposal addresses, the timeline for achieving the objective(s) and the measurable outcomes to be met;

F. Letters of support from three (3) entities;

G. The proposed budget, tied to activities and outcomes and, if required by the application instructions, fifty percent (50%) of match and source(s) committed and its narrative;

H. A certified copy of latest fiscal audit/financial review if the applicant is an established program, and/or a plan to manage the grant if the entity is newly created; and, I. A copy of the entity’s Equal Employment Opportunity (EEO) statement.

27.450 TIMELINES AND SELECTION CRITERIA

A. The grant program application timeline shall be:

1. May 1: Distribution of the grant application;

2. June 30: Deadline for final applications;

3. July 31: Review and approval or disapproval of the applications by the committee and submittal of the recommendations to the Commission; and, 4. September 1: After considering the recommendations of the committee, announcement of the grant recipient(s) by the Commission will be made through a public electronic newsletter or at a regular or special meeting B. Grant Applications will be reviewed and selected according to the following:

1. Completion of all application requirements;

2. Assurances of matching funds readily available or committed when required by the application;

3. Demonstration of fiscal and programmatic management capability as evidenced by operating experience, audit or financial review as appropriate, or a plan of grant management if the agency is newly created;

4. Cost of the project compared to other projects, including indirect costs not to exceed 20 percent (20%) of the total budget;

5. A demonstrated community priority, which the grant proposal addresses;

6. Demonstration of community support as evidenced by direct community contributions, a volunteer component, and letters of support from other community agencies; and, 7. The availability of grant funds for the project.

27.460 DISPUTE RESOLUTION PROCESS

In order to resolve disputes between the Commissioners and committee, the Commission shall adopt procedures for the resolution of disputes consistent with this section. The procedures shall be designed to establish a simple and non-adversarial format for the resolution of disputes. If, after following the dispute resolution process defined by the Commission, the Commissioners disagree with a recommendation of the committee, the Department’s Executive Director shall have final decision-making authority to approve or disapprove the application and to set grant amounts.

27.470 CONTRACTUAL AUTHORITY

All successful grant recipients must be willing to enter into a contractually binding agreement as prescribed by the Department and the State of Colorado Fiscal Rules. Adherence to confidentiality laws and proof of insurance are required if the recipient intends to provide direct serves to clients through the grant proceeds.

27.480 REPORTING

Each grantee shall be responsible for the maintenance and reporting of any required specifications as outlined in the grant report guidelines, as found on the Commission’s website; https://ccdhh.com/index.php/grant-program/.

27.500 CERTIFICATION/CERTIFICATE FOR SIGN LANGUAGE INTERPRETATION AND CUED

LANGUAGE TRANSLITERATION

In addition to section 6-1-707(1)(e)(I)(A), C.R.S. where it identifies the Registry of Interpreters for the Deaf certifications, the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind is authorized by

section 6-1-707(1)(e)(I)(B), C.R.S. to review and validate certifications and certificate pertaining to the sign language interpretation and cued language transliteration to consumers who are deaf, hard of hearing, deafblind, and hearing.

27.510 DEFINITIONS

“Board for Evaluation of Interpreters” or “BEI” means the program operated by The Office of Deaf and Hard of Hearing under Texas Department of Health and Human Services which tests and certified individuals in sign language interpretation.

“Certification” or “Certificate” means an official document attesting to a status or level of achievement that is generally recognized and accepted by a profession and governed by an independent party.

“Certified Deaf Interpreter” (CDI) means an individual who is deaf or hard of hearing and who has been certified to provide an accurate interpretation between English and variants of sign language and other foreign sign languages by acting as an intermediary between the deaf, hard of hearing, or deafblind individual and the interpreter who can hear.

“Commission” means the Colorado Commission for the Deaf, Hard of Hearing, and DeafBlind.

“Intermediary” means effective communication between the sign language interpreter with the natural language of spoken English and the deaf, hard of hearing, or deafblind (DHDBB) consumer with the natural language of American Sign Language (ASL) is being facilitated by a deaf or hard of hearing person with a natural language of ASL when there is a disconnect between the natural language of the “hearing” interpreter and the natural language of the DHHDB consumer.

“Sign language interpretation” means the process of translating between a spoken Language and a signed language.

Testing, Evaluation, and Certification Unit” or “TECUnit” means the national certifying body for cued language transliterators and testing organization for cued language.

“Transliteration” means the process of moving messages between different forms of the same language, as occurs between spoken English and cued English.

“Trilingual” means a person who communicates in three languages fluently, e.g. Spanish, English, and American Sign Language.

27.520 CERTIFICATIONS AND CERTIFICATE

The Commission identified the following BEI certifications:

A. Basic, B. Advanced, C. Master, D. Court Interpreter, E. Trilingual Advanced, F. Trilingual Master, G. Medical Interpreter, H. Level III Intermediary, I. Level IV Intermediary, J. Level V Intermediary, or K. a successor certification, such as BEI CDI, and TECUnit certificate:

A. Transliteration Skills Certificate (TSC) as valid and reliable. _________________________________________________________________________ Editor’s Notes

History Add rules 27.200-27.300 eff. 11/01/2007.

Rules 27.100-27.191 eff. 04/01/2008.

Entire rule eff. 04/01/2010.

Rules 27.400-27.480 eff. 05/01/2010.

Rules 27.400-27.480 eff. 06/30/2019.

Rules 100-190 eff. 07/30/2019.

Rule 27.130 F emer. rule eff. 02/07/2020.

Rules 27.100, 27.400 eff. 03/01/2020.

Rule 27.130 F eff. 04/30/2020.

Rule 27.230 emer. rule eff. 11/06/2020.

Rule 27.130 F emer. rule eff. 02/05/2021.

Rule 27.230 eff. 03/02/2021.

Rule 27.410 eff. 04/01/2021.

Rule 27.130 F eff. 04/30/2021.

Rules 27.500, 27.510, 27.520 eff. 09/30/2021.

Rule 27.130 F emer. rule eff. 02/04/2022.

Rule 27.130 F eff. 05/30/2022.

Rule 27.400 eff. 07/31/2022.

Rule 27.200, rule 27.300 renumbered to 27.290 eff. 08/30/2022.

Rule 27.130 F emer. rule eff. 02/03/2023.

Rule 27.130 F eff. 05/30/2023.

Rule 27.130 F emer. rule eff. 02/09/2024.

Rule 27.130 F eff. 04/30/2024.

Rules 27.300-27.390 eff. 05/31/2024.

## **2517** Juvenile Parole Board

##### **12 CCR 2517-1** Juvenile Parole Board {#sec-12-ccr-2517-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2517-1}

DEPARTMENT OF HUMAN SERVICES

Juvenile Parole Board JUVENILE PAROLE BOARD 12 CCR 2517-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Revisions to Section 28.100 were adopted following publication by the Juvenile Parole Board, effective 12/1/2004. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

Revisions to Sections 28.100-28.110 were final adoption following publication at the 11/13/2013 Juvenile Parole Board meeting (Rule-making# JPB 13-6-20-1), with an effective date of 1/14/2014. Statement of

Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, Division of Boards and Commissions, State Board Administration.

28.100 JUVENILE PAROLE BOARD 28.110 Parole Decision Criteria [Rev. eff. 1/14/14]

Parole release decisions shall be made in a manner that is in the best interests of the juvenile, the victim, and the community. In making a decision concerning the granting of parole, each member shall consider the following criteria:

A. Juvenile 1. The number and severity of the committing offense(s) and other adjudications or convictions.

2. The juvenile’s successes and negative behaviors in a program while in the Division of Youth Corrections commitment and while on parole.

3. The existence of an acceptable parole plan that provides a foundation for the youth to successfully transition into the community.

4. The review of the juvenile’s therapeutic, educational, and behavioral progress within Division of Youth Corrections programs.

5. The results of the objective risk assessment administered by the State of Colorado Department of Human Services, the Division of Youth Corrections.

B. Victim 1. The rights of the crime victims as defined by the Victims Rights amendment, Section 24-4.1- 301 through 24-4.1-304, C.R.S.

2. Demonstrated understanding of the victim impact and safety concerns.

C. Community 1. The juvenile’s adjustment into the community as evidenced by conduct during home passes, school, work, special events or other community release.

2. The juvenile’s payment of restitution and completion of community services hours as required by the courts.

3. Demonstrated understanding of community safety. _________________________________________________________________________ Editor’s Notes

History

Rule 28.100 eff. 12/01/2004.

Entire rule eff. 01/14/2014.

## **2518** Adult Protective Services

##### **12 CCR 2518-1** Adult Protective Services {#sec-12-ccr-2518-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2518-1}

DEPARTMENT OF HUMAN SERVICES

ADULT PROTECTIVE SERVICES

12 CCR 2518-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ 30.000 ADULT PROTECTIVE SERVICES 30.100 DEFINITIONS The following definitions shall apply to these rules.

“Abuse”, pursuant to Section 26-3.1-101(1), C.R.S., means any of the following acts or omissions committed against an at-risk adult:

A. The non-accidental infliction of physical pain or injury, as demonstrated by, but not limited to, substantial or multiple skin bruising, bleeding, malnutrition, dehydration, burns, bone fractures, poisoning, subdural hematoma, soft tissue swelling, or suffocation;

B. Confinement or restraint that is unreasonable under generally accepted caretaking standards; or, C. Unlawful sexual behavior as defined in Section 16-22-102(9), C.R.S.

“Adult Protective Services (APS) Program” means the State Department supervised, county department administered program that has the authority to investigate and/or assess allegations of mistreatment and self-neglect of at-risk adults. The APS Program offers protective services to prevent, reduce, or eliminate the current or potential risk of mistreatment or self-neglect to the at-risk adult using community based services and resources, health care services, family and friends when appropriate, and other support systems. The APS Program focuses on the at-risk adult and those services that may prevent, reduce, or eliminate further mistreatment or self-neglect. The APS Program refers possible criminal activities to law enforcement and/or the district attorney for criminal investigation and possible prosecution.

“Allegation” means a statement asserting an act or suspicion of mistreatment or self-neglect involving an at-risk adult.

“Alternative Response” means the pilot program authorized by 26-3.1-103.3, C.R.S., allowing pilotparticipant county departments to engage in a dual-track response model for response to allegations of mistreatment and self-neglect against at-risk adults beginning January 4, 2023. The two response options are the traditional response track and the alternative response track.

“Alternative response track” means the response track established as an option for allegations of mistreatment or self-neglect determined by a pilot-participant county department to be low risk. No finding shall be made in the alternative response track.

“Assessment” means the process of evaluating a client’s functional abilities to determine the client’s level of risk and, in cooperation with the client whenever possible, to identify service needs for the case plan.

“Assumed responsibility”, as used in the definition of caretaker, means a person who is providing or has provided recurring or temporary assistance to help meet the basic needs of an at-risk adult. The assumption of responsibility can attach by entering into a formal or informal agreement, whether paid or unpaid; by identifying oneself as a caretaker to others; or based on the nature of the situation or relationship between the caretaker and the at-risk adult.

“At-risk adult”, pursuant to Section 26-3.1-101(1.5), C.R.S., means an individual eighteen (18) years of age or older who is susceptible to mistreatment or self-neglect because the individual is unable to perform or obtain services necessary for his or her health, safety, or welfare, or lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his or her person or affairs.

“Authorized requestor” as used in section 30.960, means an employer, a person or entity conducting the employee CAPS check on behalf of the employer, or the court that are required to request CAPS checks.

“CAPS” means the Colorado Adult Protective Services data system that includes records of reports of mistreatment of at-risk adults.

“CAPS check” means a check of the Colorado Adult Protective Services data system pursuant to Section 26-3.1-111, C.R.S.

“Caretaker”, pursuant to Section 26-3.1-101(2), C.R.S., means a person who:

A. Is responsible for the care of an at-risk adult as a result of a legal relationship; or B. Has assumed responsibility for the care of an at-risk adult; or, C. Is paid to provide care, services, or oversight of services to an at-risk adult.

“Caretaker neglect”, pursuant to Section 26-3.1-101(2.3), C.R.S., means neglect that occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, habilitation, supervision, or other treatment necessary for the health, safety, or welfare of the at-risk adult is not secured for an atrisk adult or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise, or when a caretaker knowingly uses harassment, undue influence, or intimidation to create a hostile or fearful environment for an at-risk adult.

However, the withholding, withdrawing, or refusing of any medication, any medical procedure or device, or any treatment, including but not limited to resuscitation, cardiac pacing, mechanical ventilation, dialysis, artificial nutrition and hydration, any medication or medical procedure or device, in accordance with any valid medical directive or order, or as described in a palliative plan of care, is not deemed caretaker neglect. In addition to those exceptions identified above, pursuant to 25-48-1-16(2), C.R.S., access to medical aid-in-dying medication in good faith shall not be considered caretaker neglect.

“Case” means the process by which a county department provides services to an at-risk adult. A case begins when a report identifies an at-risk adult and allegations that qualify as a mistreatment or selfneglect, and the report is screened in for investigation and assessment. The county department may continue to provide services under a case after the investigation has concluded.

“Caseload average” means the fiscal year monthly average of new cases and the sum of cases carried over from the prior fiscal year, per caseworker. The fiscal year caseload average is calculated as: [(new cases/12) + cases carried over from prior FY] / FTE on June 30 = caseload average]. Caseload average will fluctuate on a monthly basis that may be influenced by a number of factors; therefore, the caseload average is based on the fiscal year average.

“Case planning” means using the information obtained from the investigation and/or assessment to identify, arrange, and coordinate protective services in order to reduce the client’s level of risk for mistreatment and self-neglect and improve safety.

“Certification due date” means the date by which new APS staff must complete certification training. The certification due date for supervisors, lead caseworkers, and caseworkers is six months from the date the supervisor, lead caseworker, or caseworker was hired or transferred to the APS program. The certification due date for case aides and screeners is one month from the date the case aide or screener was hired or transferred to the APS program.

“Clergy member”, pursuant to Section 26-3.1-101(2.5), C.R.S., means a priest; rabbi; duly ordained, commissioned, or licensed minister of a church; member of a religious order; or recognized leader of any religious body.

“Client” means an actual or possible at-risk adult for whom a report has been received and the county department has made a response.

“Collateral contact” means a person who has relevant knowledge about the client’s situation that supports, refutes, or corroborates information provided by a client, reporting party, or other person involved in the case. Examples of contacts include, but are not limited to, family members, law enforcement, health care professionals, service providers, facility staff, neighbors, the reporting party, friends, and any person who provides/provided ongoing care or support to the client.

“Conclusion”, as used in alternative response track investigations, means a determination of whether mistreatment or self-neglect occurred as alleged.

“County Department” means a county department of human/social services.

“Court”, as used in Section 30.960, means the Denver probate court or a state district court that hears petitions for and appoints guardians and/or conservators for at-risk adults.

“Date of notice” means the date that the notice of a substantiated finding against a perpetrator(s) is mailed to the last known mailing address(es) of the perpetrator(s).

“Direct care”, pursuant to Section 26-3.1-101(3.5), C.R.S., means services and supports, including case management services, protective services, physical care, mental health services, or any other service necessary for the at-risk adult’s health, safety, or welfare.

“DORA” as used in Section 30.520, means the Department of Regulatory Agencies, Division of Professions and Occupations that oversees the licensure of healthcare professionals.

“Employee”, pursuant to Section 26-3.1-111(2)(a), C.R.S., means a person, other than a volunteer, who is employed by or contracted with an employer and includes a prospective employee.

“Employer”, pursuant to Section 26-3.1-111(2)(b), C.R.S., means a person, facility, entity, or agency described in Section 26-3.1-111(7), C.R.S., and includes a prospective employer. “Employer” also includes a person hiring someone to provide Consumer-Directed Attendant Support Services pursuant to C.R.S. Article 10 of Title 25.5, if the person requests a CAPS check.

“Enhanced supervision” means CAPS security access that prevents a caseworker from finalizing an investigation, assessment, case plan, or case closure without supervisory approval.

“Exploitation”, pursuant to Section 26-3.1-101(4), C.R.S., means an act or omission that:

A. Uses deception, harassment, intimidation, or undue influence to permanently or temporarily deprive an at-risk adult of the use, benefit, or possession of anything of value; or, B. Employs the services of a third party for the profit or advantage of the person or another person to the detriment of the at-risk adult; or, C. Forces, compels, coerces, or entices an at-risk adult to perform services for the profit or advantage of the person or another person against the will of the at-risk adult; or, D. Misuses the property of an at-risk adult in a manner that adversely affects the at-risk adult’s ability to receive health care or health care benefits or to pay bills for basic needs or obligations.

“Facility” means a medical or long-term care facility that provides 24 hour care and oversight for residents, and includes a group home, alternative care facility, state regional center, or state mental health facility.

“Financial institution”, pursuant to Section 26-3.1-101(5), C.R.S., means a state or federal bank, savings bank, savings and loan association or company, building and loan association, trust company, or credit union.

“Fiscal Year” means the State Department fiscal year, which begins July 1 and ends June 30.

“Flagged check”, as used in Section 30.960, means any substantiated finding of mistreatment made after the initial CAPS check that is provided to the authorized requestor, employer, or to the employee/employer’s parent company and/or oversight agency(ies).

“FTE” means Full Time Equivalent. The actual percentage of time a person works on the APS program shall be considered that person’s FTE.

“Good cause”, except as applied by a court, means emergency conditions or other circumstances which would prevent a reasonable person from meeting a deadline or complying with APS rule or practice.

Examples include, but are not limited to, law enforcement request to delay the APS investigation; inability to locate the client or collaterals despite reasonable, documented attempts; additional time required to obtain documents which were timely requested but not delivered; lack of proper notice to the substantiated perpetrator of the availability of an appeal; etc.

“Harmful act”, pursuant to Section 26-3.1-101(5.5), C.R.S., means an act committed against an at-risk adult by a person with a relationship to the at-risk adult when such act is not defined as abuse, caretaker neglect, or exploitation but causes harm to the health, safety, or welfare of an at-risk adult.

“Health Insurance Portability and Accountability Act of 1996 (HIPAA)” means the healthcare privacy law and its accompanying regulations found at p.l. 104-191, 110 stat. 1936 (Aug. 21, 1996), 45 C.F.R. parts 160, 162, 164 (2021), which are herein incorporated by reference. No later additions or amendments are incorporated. The public law is available at https://www.govinfo.gov. The regulations are available at https://www.ecfr.gov. Both the public law and the regulations are also available for public inspection and copying at the Colorado Department of Human Services, Office of Adult, Aging and Disability Services, 1575 Sherman St., Denver, CO 80203, during regular business hours.

“Inconclusive finding”, as used in traditional response track investigations, means that indicators of mistreatment or self-neglect may be present but the investigation could not confirm the evidence to a level necessary to substantiate the allegation.

“Investigation” means the process of determining whether mistreatment or self-neglect occurred pursuant to Section 26-3.1-101, C.R.S.. In traditional response track investigations, this includes reaching a finding as determined by a preponderance of the evidence. In alternative response track investigations, a conclusion will be determined.

“Least restrictive intervention” means acquiring or providing services, including protective services, for the shortest duration and to the minimum extent necessary to remedy or prevent mistreatment or self-neglect.

“Licensed healthcare professional” as used in Section 30.520, means a person who is licensed through the Department of Regulatory Agencies, Division of Professions and Occupations (DORA) for a healthcare profession or healthcare occupation, as defined in DORA’s healthcare professions and occupations scope statute, Section 12-30-101, C.R.S.

“Medical Directive or Order”, pursuant to Section 26-3.1-101(2.3)(c), C.R.S., includes a medical durable power of attorney, a declaration as to medical treatment executed pursuant to Section 15-18-104, C.R.S., a medical order for scope of treatment form executed pursuant to Article 18.7 of Title 15, C.R.S., and a cardiopulmonary resuscitation (CPR) directive executed pursuant to Article 18.6 of Title 15, C.R.S.

“Minor impact” means the client may experience some difficulty with the assessment risk indicator, but there is very little impact on the client’s overall health, safety, and/or welfare and no intervention is necessary to improve overall safety.

“Mistreatment”, pursuant to Section 26-3.1-101(7), C.R.S., means:

A. Abuse;

B. Caretaker neglect;

C. Exploitation; or, D. A harmful act.

“Mistreatment occurred - not culpable finding”, as used in traditional response track investigations, means the investigation established by a preponderance of the evidence that mistreatment occurred but the individual who caused the mistreatment is not culpable. Documentation must clearly support that the individual who caused the mistreatment is an at-risk adult or a minor child with cognitive functioning that prevents the at-risk adult or child from having awareness of the consequences of their actions, as demonstrated by county department observations of cognition or behaviors, and/or interviews with expert collaterals, and/or medical or neuro-psych records, and/or behavioral plans developed by the adult’s or child’s service agency. A “mistreatment occurred – not culpable finding” must be used if the individual who caused the mistreatment is a child under the age of ten (10) years old.

“Person with a relationship”, as applied to the definition of harmful act, means a person who can be identified as having a relationship or attempting to develop a relationship with an at-risk adult. The relationship may include but is not limited to a familial, legal, caretaking, pastoral, friendship, or other relationship and excludes strangers.

“Potential appointee”, as used in Section 30.960, means a person nominated in a petition filed with the court who may be appointed by the court as a guardian or conservator of an at-risk adult.

“Preponderance of the evidence” means credible evidence that a claim is more likely true than not.

“Protective Services” means services by the state or political subdivisions or agencies thereof in order to prevent the mistreatment or self-neglect of an at-risk adult. Such services include, but are not limited to:

A. Providing casework services;

B. Arranging for, coordinating, delivering where appropriate, and monitoring services, including medical care for physical or mental health needs;

C. Protection from mistreatment and self-neglect;

D. Assistance with applications for public benefits;

E. Referral to community service providers; and, F. Initiation of probate proceedings.

“Reassessment” means the process of updating the assessment status areas and the case plan, including the status of any services implemented and any new services and/or goals identified since the last assessment.

“RED Team” is an acronym that stands for Review, Evaluate, and Direct. The RED Team is a decision making process that utilizes a structured framework to determine the county department’s response to reports.

“Report” means an oral, electronic, or written report of suspected mistreatment or self-neglect of a suspected at-risk adult, received by the county department.

“Risk” means conditions and/or behaviors that create increased difficulty or impairment to the client’s ability to ensure health, safety, and welfare.

“Safety” means the extent to which a client is free from harm or danger, or to which harm or danger is lessened.

“Self-Determination” means the right to decide for one’s self; the ability or right to make one's own decisions without interference from others.

“Self-neglect”, pursuant to Section 26-3.1-101(10), C.R.S., means an act or failure to act whereby an atrisk adult substantially endangers his or her health, safety, welfare, or life by not seeking or obtaining services necessary to meet the adult's essential human needs. Choice of lifestyle or living arrangements shall not, by itself, be evidence of self-neglect. Refusal of medical treatment, medications, devices, or procedures by an adult or on behalf of an adult by a duly authorized surrogate medical decision maker or in accordance with a valid medical directive or order, or as described in a palliative plan of care, shall not be deemed self-neglect. Refusal of food and water in the context of a life-limiting illness shall not, by itself, be evidence of self-neglect. “medical directive or order” includes, but is not limited to, a Medical Durable Power of Attorney, a Declaration as to Medical Treatment executed pursuant to Section 15-18- 104, C.R.S., a Medical Orders for Scope of Treatment Form executed pursuant to Article 18.7 of Title 15, C.R.S., and a CPR Directive executed pursuant to Article 18.6 of Title 15, C.R.S. In addition to those exceptions identified above, access to Medical Aid in Dying, pursuant to Title 25, Article 48, C.R.S., shall not be considered self-neglect.

“Severity Level” means the extent of the impact caused to the client as a result of mistreatment.

A. Minor – Mistreatment occurred that resulted in little to no harm or change to the client’s health, safety, welfare, or finances.

B. Moderate – Mistreatment occurred that resulted in harm or change to the client’s health, safety, welfare, or finances.

C. Severe – Mistreatment occurred that resulted in substantial harm or change to the client’s health, safety, welfare, or finances.

“Significant impact” means that the client’s impairment diminishes the client’s health, safety, and/or welfare and intervention is necessary to improve overall safety.

“Staffing a case” means the review of an APS case between the supervisor and caseworker to ensure the appropriateness of the investigation findings, client assessment, case plan, service provision, need for ongoing services, plans to terminate services, documentation, and overall intervention as it relates to APS rules and best practices. Staffing a case may include the county department APS unit, the State Department APS unit, and/or the APS Team in addition to the supervisor and caseworker.

“Staffing agency”, as used in these rules, means an individual or organization, including any partnership, limited liability partnership, limited liability company, limited liability limited partnership, association, trust, joint stock company, insurance company, or corporation, whether domestic or foreign, engaged in the business of providing and assigning workers to placements with employers described in Section 30.960.A and pursuant to Section 26-3.1-111(7). C.R.S.. “Staffing agency” includes, but is not limited to, supplemental health-care staffing agencies defined in Section 8-4-125 (1)(e), C.R.S.

“State Department” means the Colorado Department of Human Services.

“Substantiated finding”, as used in traditional response track investigations, means that the investigation established by a preponderance of the evidence that mistreatment or self-neglect has occurred.

“Support network” means persons who provide consistent, recurrent, or ongoing care or support to the client, such as family members, doctors, care providers, or guardians.

“Traditional response track” means the response track established for allegations of mistreatment or selfneglect that includes completion of a traditional response track investigation as outlined in Section 30.520. The traditional response track shall be assigned to all allegations that are not determined to be low risk by county departments participating in the Alternative Response pilot program described in 26- 3.1-103.3, C.R.S.

“Unable to investigate/not required” means an investigation was not possible because the county department was unable to gather any investigative evidence and exhausted all options and leads by which to conduct an investigation; or the report was screened in and later determined it did not meet APS criteria for investigation, as outlined in Section 30.510.B.

“Undue Influence” means the use of influence to take advantage of an at-risk adult’s vulnerable state of mind, neediness, pain, or emotional distress.

“Unsubstantiated finding”, as used in traditional response track investigations, means the investigation did not establish any evidence that mistreatment or self-neglect has occurred.

30.200 ADULT PROTECTIVE SERVICES PROGRAM ADMINISTRATION AND OVERVIEW 30.210 APS PROGRAM ADMINISTRATION [Rev. eff. 1/30/17]

A. The Adult Protective Services (APS) Program is mandated by Title 26, Article 3.1, of the Colorado Revised Statutes. The county department shall administer the APS Program in accordance with the statutes and rules governing the APS Program and in general State Department fiscal and program regulations.

B. The county department shall utilize funding appropriated by the State Legislature to make reasonable efforts to maintain a fiscal year caseload average of no more than twenty to one (20:1).

C. In order to ensure the security of CAPS and the Personal Identifying Information (PII) and Personal Health Information (PHI) contained within, the county department shall notify the State Department through a CAPS support request within three (3) working days upon learning of a change in APS staffing, but no later than the CAPS user’s last day of employment. An email to the State Department may substitute for a CAPS support ticket in the event a CAPS support ticket cannot be submitted.

D. The county department shall make reasonable efforts to advise county residents of services available through the APS Program by such methods as Adult Protection Team mandated community education, as defined at Section 30.830, B, 4, press releases, presentations, pamphlets, and other mass media.

E. The county department shall handle responses to requests for services from other agencies, including the State Department, other county departments, or another state’s APS Program, in the same manner and time frames as requests received from within the county.

F. The county department shall report to the State Department at such times and in such manner and form as the State Department requires, including through CAPS, manually generated reports, quality improvement and assurance processes, and other forms of reporting.

30.220 APS PROGRAM REVIEW AND OVERSIGHT

A. Under Section 26-1-111(1)(D), C.R.S., the county departments are supervised by the State Department in providing welfare services and shall be subject to the rules of the Executive Director and the State Board of Human Services, which require the State Department to ensure that the county department complies with requirements provided by statute, State Board of Human Services and Executive Director rules (9 CCR 2501-1), federal laws and regulations, and contract and grant terms. More information about the state and county relationship can be found in Sections 26-1-115 through 26-1-119, C.R.S.

B. The county department shall be subject to routine quality control and program monitoring, to minimally include:

1. Targeted review of CAPS documentation;

2. Review and analysis of data reports generated from CAPS;

3. Case review;

4. Targeted program review conducted via phone, email, or survey; and, 5. Onsite program review.

C. The focus of the monitoring shall be to identify:

1. Compliance with program statute and rules;

2. Best practices that can be shared with other county departments; and, 3. Training needs.

D. The county department may be subject to a performance improvement plan to correct areas of identified non-compliance as stated in the APS Oversight Plan, herein incorporated by reference; no later amendments or editions are incorporated. The APS oversight plan can be found at https://bit.ly/APS-OP and is available for public inspection and copying during normal business hours at Adult Protective Services, 1575 Sherman St., Denver, Colorado, 80203.

E. If the county fails to make improvements required under the performance improvement plan, the county department may be subject to corrective action, and/or sanctions, as authorized by

Section 26-1-109(4), C.R.S., 9 CCR 2501-1, and the APS oversight memo in Subsection D, above.

30.230 ELIGIBILITY

A. Adult Protective Services (APS) receives and investigates reports of mistreatment and selfneglect and provides protective services to at-risk adults:

1. Who need services and/or ongoing protection due to a report of actual or suspected mistreatment or self-neglect; and/or, 2. For whom the county department has been appointed guardian and/or conservator, or has been designated as representative payee; and/or, 3. Who are residents of long term care facilities, such as nursing homes and assisted living residences, who must relocate due to the closure of the facility and:

a. The county department has been appointed guardian and/or conservator; or, b. They are in need of protective services due to a lack of case management and/or assistance from any other reliable source.

4. Without regard to income, resources, or lawful presence.

30.240 APS PRINCIPLES – CONSENT, SELF DETERMINATION, AND LEAST RESTRICTIVE

INTERVENTION

A. The client’s consent is not required for the county department to investigate or assess allegations of mistreatment or self-neglect.

B. The final decision as to acceptance of protective services shall rest with the client unless the client has been adjudicated incapacitated by the court or as outlined in Section 30.600.

1. It shall not be construed that a person is being mistreated or is self-neglecting for the sole reason that he or she is being furnished or is relying upon treatment or practices in accordance with the tenets and practices of that person’s recognized church or religious denomination.

C. Protective services provided to and other services arranged for the client shall constitute the least restrictive intervention and be those services provided for the shortest duration and to the minimum extent necessary to meet the needs of the client.

30.250 CONFIDENTIALITY

A. Pursuant to Section 26-3.1-102(7)(a), C.R.S. and except as provided in Section 26-3.1-102(7)(b), C.R.S. and Section 30.250, B, reports of the mistreatment or self-neglect of any at-risk adult, including the name and address of any at-risk adult, member of said adult’s family, or informant, or any other identifying information contained in such reports and subsequent cases resulting from the reports, is confidential, and is not public information. The county and state departments shall treat all information related to the report and the case, whether in written or electronic form, as confidential and such information includes, but is not limited to, the following:

1. Identifying information, such as the name, address, relationship to the at-risk adult, Date of Birth, or Social Security Number of the:

a. At-risk adult;

b. At-risk adult’s family members;

c. Reporting party;

d. Alleged perpetrator; and, e. Other persons involved in the case.

2. Allegations, assessment, and investigative findings, including, but not limited to:

a. The initial report of allegations and concerns;

b. The client’s safety and risk as determined by the client assessment;

c. Medical and behavioral diagnoses, past medical conditions, and disabilities;

d. Services provided to or arranged for the adult;

e. Information learned as a result of a criminal investigation;

f. Information obtained during the APS investigation and the substantiation or nonsubstantiation of the allegations; and, g. Legal protections in place including, but not limited to, wills, advance directives, powers of attorney, guardianship, conservatorship, representative payeeship, and protective orders.

B. Pursuant to Section 26-3.1-102(7)(b), C.R.S., disclosure of a report of the mistreatment or selfneglect of an at-risk adult and information relating to an investigation of such a report and subsequent cases resulting from the report is permitted only when authorized by a court for good cause. A court order is not required, and such disclosure is not prohibited when:

1. A criminal investigation into an allegation of mistreatment is being conducted, when a review of death by a coroner is being conducted when the death is suspected to be related to mistreatment, or when a criminal complaint, information, or indictment is filed and the report and case information is relevant to the investigation, death review, complaint, or indictment.

2. There is a death of a suspected at-risk adult from mistreatment or self-neglect and a law enforcement agency files a formal charge or a grand jury issues an indictment in connection with death.

3. The disclosure is necessary for the coordination of multiple agencies’ joint investigation of a report or for the provision of protection services to an at-risk adult, such as, but not limited to:

a. Coordination with law enforcement to conduct a joint investigation;

b. Providing protective services, such as establishing eligibility for, arrangement and implementation of services and benefits, and appointment of a guardian and/or c. A review of a power of attorney is requested under the uniform power of attorney act, as outlined at C.R.S. Title 15, Article 14, Part 7 or review of a fiduciary under C.R.S. Title 15, Article 10, Part 5.

d. Reviewing a case with the Adult Protection Team to find solutions to cases with complex service provision needs, in accordance with the Adult Protection Team’s by-laws, and when in executive session with members who have signed a confidentiality agreement.

4. The disclosure is necessary for purposes of an audit of a county department of human or social services pursuant to Section 26-1-114.5, C.R.S.

5. The disclosure is made for purposes of the appeals process relating to a substantiated case of mistreatment of an at-risk adult pursuant to Section 26-3.1-108(2), C.R.S.

a. This Subsection is in addition to and not in lieu of other federal and state laws concerning protected confidential information. Disclosures allowed are:

i. Notification made by the county department to substantiated perpetrator(s) of mistreatment pursuant to Section 26-3.1-108, C.R.S.

ii. Disclosure by the State Department for purposes of the appeals process relating to a substantiated case of mistreatment of an at-risk adult pursuant to Section 26-3.1-108(2), C.R.S.

6. The disclosure is made by the State Department to an employer, or to a person or entity conducting employee screening on behalf of the employer, as part of a CAPS check pursuant to Section 26-3.1-111, C.R.S. or by a county department pursuant to Section 26-3.1-107, C.R.S.

7. The disclosure is made to the at-risk adult who is the subject of the report, or if the at-risk adult is otherwise incompetent at the time of the request, to the guardian or guardian ad litem for the at-risk adult who is the subject of the report, with the following conditions:

a. The disclosure shall not be made until after investigation is complete; and, b. The disclosure shall not include any identifying information related to the reporting party or any other appropriate persons, as follows:

i. The county or state department shall redact any and all identifying information related to the reporting party; and, ii. The county or state department must redact Personal Identifying Information (PII) related to the client, any minor children, and alleged or substantiated perpetrators; and, iii. The county or state department may redact PII related to the supports and collaterals as deemed necessary by the county or state department;

c. The county or state department shall redact all Personal Health Information (PHI) of the reporting party, supports, collaterals, and alleged or substantiated perpetrator that is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as incorporated by reference in Section 30.100, above, state and/or federal law, and, d. The county or state department shall obtain from the guardian a copy of the guardianship order or guardian ad litem appointment, independently verify that the order or appointment remains valid, and attach the order or appointment to the client’s case in CAPS; and, e. If the guardian is a substantiated perpetrator in a case of mistreatment of an atrisk adult, the disclosure must not be made without authorization by a court for good cause, unless the disclosure is being made for the purposes of the guardian’s appeal process pursuant to Section 26-3.1-102(7)(b)(V), C.R.S. If the request for disclosure is not part of the appeal process, the county or state department shall require the guardian to obtain a court order and the county or state department shall obtain a copy of the court order from the guardian and attach the order to the case in CAPS.

8. The disclosure is made to a county department that assesses or provides protective services for children when the information is necessary to adequately assess for safety and risk or to provide protective services for a child. A county department that assesses or provides protective services for at-risk adults is similarly permitted to access information from a county department that assesses or provides protective services for children pursuant to Section 19-1-307(2)(X), C.R.S.

a. Information must be limited to information regarding prior or current reports, assessments, investigations, or case information related to an at-risk adult or an alleged perpetrator.

b. The provisions of this Subsection 30.250.B.8 are in addition to and not in lieu of other federal and state laws concerning protected or confidential information.

i. The county department may not share Personal Identifying Information (PII) or Personal Health Information (PHI) protected by HIPAA, as incorporated by reference in Section 30.100, above, that is not necessary to the child welfare investigation, assessment, or provision of services for the child(ren).

ii. Information provided to child welfare staff must be the minimum necessary for worker safety concerns for child welfare staff, the investigation, assessment, and provision of services for the child(ren).

iii. County department APS staff may share information with any county department’s child welfare staff.

iv. The county department’s child welfare staff shall not be provided access to CAPS, unless that child welfare staff person is also the county department’s APS staff person.

9. The disclosure is made to an employer required to request a CAPS check pursuant to

Section 26-3.1-111 or to the State Department agency that oversees the employer when the information is necessary to ensure the safety of other at-risk adults under the care of the employer. The information must be the minimum information necessary to ensure the safety of other at-risk adults under the care of the employer or oversight of the State Department agency.

10. The disclosure is made pursuant to Section 26-3.1-111(12), C.R.S. to a health oversight agency, as defined in 45 CFR 164.501 incorporated by reference in Section 30.100, , within the Department of Regulatory Agencies or a regulator within such a health oversight agency, as defined in Section 12-20-102(14), C.R.S.

a. The State Department, not county departments, shall provide this information to DORA.

b. County departments must observe all confidentiality requirements in the event DORA contacts them during an investigation.

11. The disclosure is made to the court pursuant to Section 26-3.1-111(3)(b) and (8.5)(b), C.R.S.

C. Whenever there is a question about the legality of releasing information the requestor shall be advised to submit a written request to the appropriate court to order the county department to produce the desired records or information within the custody or control of the county department.

D. Information released under Section 30.250.B, shall be the minimum information necessary to secure the services, conduct the investigation, or otherwise respond to the court order. The county department shall:

1. Provide the information only to persons deemed essential to the court order, criminal or APS investigation, adult protection team activities, or the provision of services;

2. Edit the information prior to its release to physically remove or redact information not essential to the court order, criminal or APS investigation, adult protection team activities, or provision of services and benefits;

3. Redact all information that would identify the reporting party unless ordered by the court, the reporting party has given written consent, or when sharing the report with law enforcement, per Section 26-3.1-102(3), C.R.S;

4. Always redact all HIPAA protected information, as incorporated by reference in Section 30.100, above, and any other confidential information which is protected by law unless specifically ordered by a court; and, 5. Redact all other report and case information not directly related to the court order. _________________________

Section 26-3.1-111(5)(h), C.R.S. refers to a health oversight agency defined in federal regulation at 42 CFR 164.501. This appears to be a typographical error as no such regulation exists. The definition for health oversight agency can be found at 45 CFR 164.501.

E. In a criminal or civil proceeding or in any other circumstance in which the APS report and/or case record is subpoenaed or any request for disclosure has been made, or any county department or State Department representative is ordered to testify concerning an APS report or case, the court shall be advised, through proper channels, of the statutory provisions, rules, and policies concerning disclosure of information.

1. Confidential information shall not be released unless so ordered by the court for good cause, except as outlined in Section 26-3.1-102 (7)(b), C.R.S. and Section 30.250.B.

2. The county department or State Department shall comply within the time frame ordered by the court, unless a motion to quash is pending, or, if there is no stated timeline within the court order, in accordance with county department or State Department policy and provide a written notice with the information to be released regarding the legality of sharing confidential information.

F. Individuals or groups requesting information regarding APS reports and/or investigations shall be informed of the confidential nature of the information and shall be advised that a court order is required to release information held by the county department, except as provided in section 26- 3.1-102(7)(b), C.R.S., and at Section 30.250.B above. These persons or groups include, but are not limited to:

1. Federal and state legislators;

2. Members of other governmental authorities or agencies, including county commissioners, city councils, school boards, and other city and county department boards, councils, officials, and employees;

3. Courts;

4. Attorneys, guardians, conservators, agents under powers of attorney, representative payees, and other fiduciaries;

5. Family members, reporting parties, or other interested parties;

6. Any alleged perpetrator; and, 7. Media representatives.

G. Any person who violates any provision of Section 26-3.1-102(7) and/or Subsection 30.250, A through F, is guilty of a civil infraction and, upon conviction thereof, shall be punished by a fine of not more than one hundred dollars as provided in Section 26-3.1-102(7), C.R.S.

H. All confidential APS information and data shall be processed, filed and stored using safeguards that prevent unauthorized personnel from acquiring, accessing, or retrieving the information.

1. Client files created prior to July 1, 2014 when CAPS was implemented shall be kept in a secured area when not in use. All other documents related to APS reports and cases shall be kept in CAPS, as outlined in Section 30.260, B and C.

2. Laptops and other mobile devices used to document in the field shall be protected and encrypted in compliance with HIPAA security requirements, as incorporated by reference in Section 30.100, above.

3. Email correspondence that contains APS confidential information shall be sent through secure encryption programs.

4. The State Department shall ensure that only State Department and county department staff persons with a business need to do so shall have access to CAPS.

a. All CAPS users must electronically sign the CAPS Security and Confidentiality Agreement annually and follow the requirements therein.

b. County departments shall not access information in CAPS that is not necessary to serve the client.

c. Violations of CAPS security and confidentiality requirements may result in loss of access to CAPS, at the discretion of the State Department.

I. Clients shall be referred to the Colorado Address Confidentiality Program (ACP) as appropriate to determine their eligibility for services including the legal substitute mailing address and mail forwarding services. The State Department and county department shall comply with any applicable provisions for APS clients enrolled in the ACP. 30.260 DOCUMENTATION [Rev. eff. 5/30/18]

A. The county department shall thoroughly document all Adult Protective Services (APS) reports and case information in CAPS. There shall be no parallel paper or electronic system used to enter APS documentation. Documentation shall include all aspects of the APS case, including:

1. Initial report;

2. Investigation;

3. Assessment;

4. Case plan;

5. Contact records for the client, alleged perpetrator, reporter, and all support network individuals;

6. All collaterals;

7. Ongoing case notes;

8. Case closure; and, 9. Any other processes related to the case.

B. All documents and evidence relevant to the investigation, assessment, and identification of needed services for the client shall be scanned into CAPS, to include:

1. A release of information form(s) signed by the client, when appropriate;

2. A copy of a power of attorney, living will declaration, and/or other advance directive if the county department receives or discovers information that the client has one in place, except when:

a. The client has fiduciary authority in place but the client or the fiduciary refuses to provide copies of the document, the county department shall attempt to review the documents to determine the authority provided within.

b. If unable to obtain or review relevant documentation for good cause the county department shall document all attempts to obtain a copy and review the document(s), and if able to review the document(s) shall document the authority provided.

3. A copy of all associated documents if the county department is appointed guardian, conservator, or representative payee or receives or discovers information that the client has one in place, the county department shall scan and upload documentation as follows:

a. All court documents, court reports, Social Security Administration appointments, correspondence, and other documents related to the county-held guardianship, conservatorship, or representative payeeship shall be scanned and uploaded to CAPS.

b. A copy of the court order or representative payee assignment for non-county held guardianship, conservatorship, or representative payeeship shall be scanned and uploaded to CAPS, except when:

i. The client has a guardianship, conservatorship, or representative payeeship in place but the client or the fiduciary refuses to provide copies of the document, the county department shall attempt to review the documents to determine the authority provided within.

ii. If unable to obtain or review relevant documentation for good cause the county department shall document all attempts to obtain a copy and review the document(s), and if able to review the document(s) shall document the authority provided within.

4. Other documentation and evidence collected during the investigation and assessment, such as medical reports, results of psychiatric evaluations, photographic documentation, etc. If unable to obtain relevant documentation for good cause the county department shall document all attempts to collect the evidence and why the evidence was unattainable.

C. All documentation pertaining to APS reports and cases, including interview and case notes, evidence gathered, such as photos, medical records, and bank statements shall be kept in a secure location until documented in CAPS and then shall be destroyed.

1. Hardcopy and electronic APS files created prior to July 1, 2014 shall be kept in a secured location.

2. All APS files created July 1, 2014 or later shall be documented in CAPS and the file/notes destroyed.

3. Original legal documents such as guardianship, representative payeeship, birth certificates, or tax documents may be retained in a hardcopy file, in addition to CAPS, that is in a secured location.

D. The county department shall use CAPS to document all other APS program activities, including Adult Protection team activities, APS staff qualifications, FTE, new worker and continuing education received, cooperative agreements, and other activities required by rule.

E. Case records that do not pertain to substantiated perpetrators shall be retained for a minimum of three (3) years, plus the current year, after the date of case closure.

F. Case records pertaining to substantiated perpetrators shall be retained indefinitely.

30.300 STAFF QUALIFICATIONS, TRAINING, AND DUTIES

30.310 EDUCATION AND EXPERIENCE QUALIFICATIONS

A. Prior to making a formal offer to a candidate for an APS position, the county department shall ensure that all personnel who will be working in the APS program possess the following minimum qualifications for education and experience, or have an approved waiver in place as outlined in 30.310.B. The State Department may suspend or deny training and/or CAPS access to persons who do not meet the requirements outlined or have an approved waiver in place.

B. The APS caseworker position requires a Bachelor’s degree or higher with an equivalent of thirty (30) semester or forty-five (45) quarter hours in human behavioral sciences or health care related courses, such as, social work, sociology, psychology, psychiatry, gerontology, nursing, special education, family intervention techniques, diagnostic measures, therapeutic techniques, guidance and counseling, criminal justice, or other human behavioral sciences, or a medical field relevant to the APS program and/or at-risk adults.

C. The casework supervisor position, including managers, administrators, and/or county directors who provide direct casework supervision (herein known collectively as supervisors) requires:

1. A bachelor’s degree with an equivalent of thirty (30) semester or forty-five (45) quarter hours in human behavioral sciences or health care related courses, such as, social work, sociology, psychology, psychiatry, gerontology, nursing, special education, family intervention techniques, diagnostic measures, therapeutic techniques, guidance and counseling, criminal justice, or other human behavioral sciences or medical field relevant to the APS program and/or at-risk adults; and, 2. Three (3) years of professional caseworker, case management, or human services experience in a public or private human services agency; or, 3. A master’s degree or higher in a social work or human behavioral sciences, as described in Section 30.310.a.3.a; and, 4. Two (2) years of professional caseworker, case management, or human services experience in a public or private human services agency.

D. The Case Aide and Intake Screener positions, if available in the county department, require a high school diploma or a General Equivalency Diploma (GED) plus at least six (6) months full time public contact in human services or a related field. Substitution for public contact is successful completion of a certificate program relevant to human services, and/or at least six (6) semester or nine (9) quarter hours in a human behavioral sciences or health care field, as described in Section 30.310.A.1.

E. If proven recruitment difficulty exists or a current county employee has exhibited qualifying knowledge and work skills, as determined by the county department and the candidate does not meet the education and experience requirements outlined in Section 30.310.A, the county department may request a waiver of the requirements using the state-approved form. The request shall include.

1. The position for which the county department is requesting a waiver, including the percentage of time the position will be performing the duties of the APS program (% FTE), and the type of waiver requested, as follows:

a. Temporary educational waiver. Request this type of waiver when the pool of candidates is limited due to recruitment difficulty and/or there is an internal candidate who has not yet completed his or her educational requirements.

Provide documentation on the:

i. Recruitment efforts made by the county department and identified difficulties, and/or documentation of the current employee’s experience with the county department; and, ii. Educational progress of the proposed candidate, including the type of degree and major that is being sought.

iii. Anticipated completion date of the candidate’s degree.

b. Permanent educational waiver. Request this waiver when the pool of candidates is limited due to recruitment difficulties and/or when there is an internal candidate, and meeting the educational requirements is not a reasonable expectation of the candidate. The county department must submit its request with documentation on the qualifying knowledge and skills that would allow the candidate to successfully carry out the requirements of the APS position, as i. The recruitment efforts made by the county department and identified difficulties, and/or documentation of the current employee’s experience with the county department; and, ii. The reason the completion of the educational requirement is not a reasonable expectation for the candidate; and, iii. The type and years of work experience with at-risk adults or other vulnerable populations applicable to the APS program and clients, which may substitute for the required education; and, iv. Other relevant qualities and information that demonstrate the candidate could successfully carry out the requirements of the APS position; and, v. The county department’s plan to provide support in the person’s knowledge and skill growth.

2. The State Department will review the waiver request and will issue a:

a. Temporary educational waiver for up to two (2) years, to allow the applicant to complete their degree. The county department may request an extension of the waiver near the end of the waiver term if more than two years is needed to complete the degree; or, b. Permanent educational waiver if the county department has sufficiently supported the request for a permanent educational waiver; or, c. Denial of the waiver, including the reason for the denial.

F. All APS staff education and experience shall be documented in CAPS.

30.320 BACKGROUND CHECK REQUIREMENTS

A. Pursuant to Section 26-3.1-107(2), C.R.S, beginning January 1, 2019, county departments shall complete a CAPS check prior to hiring a new APS employee who will have direct contact with atrisk adults, and may complete a CAPS check for existing APS employees, using one of two methods:

1. Method One: The county APS supervisor searches for the new or existing employee in CAPS to determine if the employee has been substantiated for mistreatment in an APS case.

a. The county department APS supervisor shall exclude findings, as outlined in

Section 30.960.K.

b. The county department APS supervisor shall attest to completing the CAPS check when submitting the request for CAPS access for the new APS employee.

2. Method Two: The county department registers as an employer and requests the CAPS check through the process outlined in Section 30.960. The county department APS supervisor shall attest to utilizing method two for the CAPS check when submitting the request for CAPS access for the new APS employee.

B. The county department may use the information received through a CAPS check to inform an employment decision or as grounds to conduct further investigation, as outlined in Section 26-3.1- 111(6)(c), C.R.S.

C. Information obtained through a CAPS check shall only be released pursuant to Section 26-3.1- 111(6)(d), C.R.S.

D. The county department shall complete a criminal background check on all prospective APS employees who, while in their employment, have direct, unsupervised contact with any actual or potential at-risk adult.

E. If the county department has not previously requested and received a criminal background check on a current employee hired on or after May 29, 2012, the county department shall immediately request a fingerprint criminal background check. The county department shall pay the fee.

F. The county department shall require a fingerprint background check for all prospective employees.

1. The county department shall submit to the Colorado Bureau of Investigation (CBI), pursuant to Section 26-3.1-107(1), C.R.S, a complete set of fingerprints taken by a qualified law enforcement agency or qualified fingerprint agency to obtain any criminal record held by the CBI.

2. The background check shall include a check of the records at the Colorado Bureau of Investigation and the Federal Bureau of Investigation.

3. The county department is strongly urged to require the background check be flagged for future notification of arrest and/or conviction.

4. The prospective employee shall pay the fee for the criminal record check unless the county department chooses to pay the fee.

5. The prospective employee’s employment shall be conditional upon a satisfactory criminal background check.

a. The current employee or applicant shall be disqualified from employment, regardless of the length of time that may have passed since the discharge of the sentence imposed, for any felony criminal offenses as defined in Title 18, Articles 2-10, 12-13, 15-18, 20, 23 of the Colorado Revised Statutes, or any felony offense in any other state the elements of which are substantially similar to the elements of any of the offenses included herein.

b. At the county department’s discretion, a person shall be disqualified from employment either as an employee or as a contracting employee if less than ten years have passed since the person was discharged from a sentence imposed for conviction of any of the following criminal offenses:

1) Third degree assault, as described in Section 18-3-204, C.R.S.;

2) Any misdemeanor, the underlying factual basis of which has been found by the court on the record to include an act of domestic violence, as defined in Section 18-6-800.3, C.R.S.;

3) Violation of a protection order, as described in Section 18-6-803.5, C.R.S.;

4) Any misdemeanor offense of child abuse, as defined in Section 18-6- 401, C.R.S.;

5) Any misdemeanor offense of sexual assault on a client by a psychotherapist, as defined in Section 18-3-405.5, C.R.S.;

6) Any misdemeanor offense of arson, burglary and related offenses, robbery, or theft, as defined in Title 18, Articles 1-4, C.R.S.;

7) A pattern of misdemeanor convictions within the ten years immediately preceding the date of submission of the application, or;

8) Any misdemeanor offense in any other state, the elements of which are substantially similar to the elements of any of the offenses described above.

6. Prospective employees who are transferring from one county department to another are not required to be re-fingerprinted if they complete the following process:

a. New employees must obtain their CBI clearance letter or a photocopy of their processed fingerprint card from their former employer. They must attach it to a new fingerprint card, with the top portion completed.

b. The new fingerprint card must include the new employer's address. “Transfer – County Department” must be inserted in the “Reason Fingerprinted” block.

c. The CBI clearance letter (or photocopy of the old fingerprint card) and the new fingerprint card shall be sent with payment by the county department to the CBI.

d. County departments that have accounts with CBI are not required to send payment, but the county department shall enter its CBI account number in the OCA block of the new fingerprint card.

30.330 TRAINING REQUIREMENTS

A. The county department shall ensure that all APS staff complete required APS training as outlined in Section 30.330.

B. APS caseworkers, lead caseworkers, and supervisors whose job titles are identified in Section 30.310.A and B must meet the required initial certification requirements and recertification requirements each fiscal year thereafter in order to perform the duties of an APS caseworker or supervisor.

C. Certification for new caseworkers and supervisors includes successful completion of the preacademy workbook (PAW), CAPS training, and Training Academy, as outlined below.

1. The PAW shall be completed within one (1) month of hire or transfer to the APS program.

a. The PAW must be completed at least two business days prior to attending CAPS training; and, b. The PAW must be completed at least five business days prior to attending Training Academy.

2. CAPS training must be completed prior to receiving access to CAPS and must be completed before beginning any APS casework, as outlined in Section 30.330.C.3, and in no situation later than six months following hire or transfer to the APS program.

3. Caseworkers and supervisors who have completed the PAW and CAPS training may begin working in the APS program. They shall obtain consultative support until fully certified on all reports and cases from a certified county APS supervisor or lead worker or from the State Department. This consultative support must continue until full certification is obtained through the completion of Training Academy.

4. Training academy must be completed within six (6) months of hire or transfer to the APS program.

5. If an APS caseworker or supervisor does not complete certification requirements by the certification due date, as outlined above, CAPS access shall be revoked and they will not be able to continue to perform APS casework or supervisory duties until new worker certification is completed.

i. the staff person must complete certification for new workers during the next available Training Academy and/or CAPS training session.

ii. If certification is obtained after the certification due date, recertification hours may also be required, as outlined in Section 30.330.E.

6. If a newly hired APS caseworker or supervisor has held certification as an APS caseworker or supervisor in the state of Colorado in the previous four (4) years and has successfully completed basic investigation training, completion of the certification process is not required. Caseworkers and supervisors who are transferring from one county APS program to another in the same fiscal year must continue to meet their continuing education hours for recertification, as outlined in Section 30.330.F.

D. All case aides and screeners shall complete the pre-academy workbook (PAW) and CAPS training within one (1) month of hire or transfer to the APS program and shall not be provided CAPS training until the PAW has been completed.

1. The PAW must be completed at least two business days prior to CAPS training.

2. Case aides and screeners may attend APS training academy, space permitting.

3. The certification due date is used to determine when the staff person’s recertification requirement begins. If certification was obtained after the certification due date, recertification hours may also be required, as outlined in Section 30.330.E.

E. Other State-Department approved county department staff with a business need for view-only access to CAPS shall complete the PAW at least two business days prior to CAPS training.

F. The county department shall ensure that all APS staff members fulfill recertification requirements each fiscal year.

1. Recertification requirements begin the first state fiscal year after the earlier of the certification completed date or the certification due date, as outlined in Sections 30.100 and 30.330.C and D.

2. County department APS staff shall complete continuing education hours by June 30 each state fiscal year.

a. Unless mandated by the State Department, attendance at any specific training event is at the supervisor’s discretion.

b. APS staff who have a break in service during a fiscal year, for example for extended medical leave or a transition from one county APS program to another, shall complete recertification hours on a prorated basis for that fiscal year, as i. Up to 25% time in service must complete 25% of required recertification ii. Up to 50% time in service must complete 50% of required recertification iii. Up to 75% time in service must complete 75% of required recertification iv. Up to 100% time in service must complete 100% of required recertification hours.

3. If the APS staff person does not complete new worker certification by the certification due date and completes the certification in the following state fiscal year, the staff person shall complete recertification requirements as well as the new worker certification that fiscal year. An exception to the recertification hours requirement may be approved by the State Department for good cause.

4. Continuing education hours for recertification must be related to APS casework and client populations, including, but not limited to:

a. Client populations, such as behavioral health, cognition, brain injury, disabilities, etc.

b. Provision of casework services, such as best practices, Medicaid and other public benefits training, community resources, etc.

c. Interview, investigation, and client assessment skills.

d. Legal topics and issues, such as guardianship, end of life decision-making, etc.

e. Mistreatment related, such as identifying signs of mistreatment, understanding medical reports, sexual assault training, etc.

f. Worker safety, resiliency, and self-care.

g. Supervisors may obtain training on leadership and supervision for up to fifty percent (50%) of required hours. Lead workers who are performing supervisory duties may obtain leadership and supervision training for up to twenty-five percent (25%) of required hours.

5. At least half of all required continuing education hours must be acquired through stateprovided training opportunities. Non-state provided training hours may be used for up to half of all required continuing education hours and may include:

a. National APS organizations’ webinar training;

b. Child welfare training academy coursework that has cross-over relevance and has been approved by the State Department APS unit;

c. Other state or national APS conferences;

d. Training conducted by agencies or professionals that work with older adults or people with disabilities such as a Community Centered Board, Alzheimer’s Association, Colorado Coalition for Elder Rights and Abuse Prevention (CCERAP).

e. Reading professional journals or watching educational videos about current APS best practices, research, and interventions.

5. The number of hours required for recertification each fiscal year is based on the person’s position and the percentage of time the person works in the APS program, as designated in CAPS, as follows:

a. Supervisors, lead caseworkers, and caseworkers:

i. Up to twenty-five percent (25%) APS FTE shall complete at least ten (10)

ii. Up to fifty percent (50%) APS FTE shall complete at least twenty (20)

iii. Up to seventy-five percent (75%) APS FTE shall complete thirty (30)

iv. Up to one hundred percent (100%) APS FTE shall complete forty (40)

b. Case Aides:

i. Up to twenty-five percent (25%) APS FTE shall complete at least five (5)

ii. Up to fifty percent (50%) APS FTE shall complete at least ten (10) hours.

iii. Up to seventy-five percent (75%) APS FTE shall complete fifteen (15)

iv. Up to one hundred percent (100%) APS FTE shall complete twenty (20)

G. All training hours shall be documented in CAPS within fourteen (14) calendar days of the end of each fiscal year.

30.340 STAFF DUTIES AND RESPONSIBILITIES

A. The direct supervisor or lead worker shall, at a minimum:

1. Receive reports of mistreatment and self-neglect as outlined in Section 30.400.

2. Evaluate the report, determine the response, and develop a plan for caseworker safety, as outlined in Sections 30.400.

3. Staff open cases of each caseworker monthly to ensure cases meet program requirements related to the provision of protective services.

4. Review and provide final approval of all findings and conclusions as outlined in Section 30.520.A.8 and 30.525.A.7, and ensure timely notification is made to perpetrators who have substantiated findings made against them in APS cases, as outlined in Section 30.910. Findings made by lead workers shall be reviewed by a supervisor.

5. Review cases to ensure:

a. Timely casework;

b. Investigation, assessment, and case planning were thorough and complete;

c. Case closure, if applicable, was appropriate; and, d. Documentation in CAPS is complete and accurate.

6. Review of cases shall be completed using one of two approved methods:

a. Method One: using the case review score card in CAPS, each month review not less than fifteen percent (15%) of each caseworker’s cases that were open and/or closed during the month; or, b. Method Two: approve every county APS case at key junctures of the APS casework process utilizing the automated approval process in CAPS, as follows:

1) Upon completion of the initial investigation, assessment, and case plan;

2) Upon completion of a six month reassessment for cases open longer than six months; and, 3) At case closure.

7. Assess APS caseworkers’ professional development needs and provide opportunities for training.

8. Respond to APS reports or have a contingency plan to respond within assigned time frames, including emergencies, and to provide protective services when no caseworker is available.

B. APS caseworkers shall, at a minimum:

1. Receive reports of mistreatment and self-neglect as outlined in Section 30.400;

2. Investigate allegations and assess the client’s safety and needs as outlined in Section 30.500;

3. Provide timely notification to perpetrators who have substantiated findings made against them in APS cases, as outlined in Section 30.910.

4. Develop, implement, and monitor case plans, conduct required client visits, and provide protective services as outlined in Section 30.600;

5. Document case findings as outlined throughout 12 CCR 2518-1; and, 6. Assume responsibility for own learning and required training hours.

C. APS case aides may assist caseworkers in completing non-professional level tasks that do not require casework expertise, but shall not perform the duties of the caseworker or supervisor, such as completing:

1. The investigation and/or assessment;

2. The case plan;

3. The required monthly client contact visits; or, 4. Required reports to the court, for cases in which the county department is the guardian or D. APS intake screeners or administrative support staff may:

1. Receive and document intake reports in CAPS;

2. Assign all reports to the supervisors for determination of appropriate response; and, 3. Direct urgent calls to the appropriate internal and external authorities.

30.400 REPORT RECEIPT AND RESPONSE 30.410 INTAKE [Rev. eff. 1/30/17]

A. The county department shall receive oral, electronic, or written reports of at-risk adult mistreatment and self-neglect, occurring in the community or in a facility.

B. The county department shall have an established process during business and non-business hours for receiving such reports.

C. The county department shall input oral reports directly in CAPS. Reports received via mail, or voicemail, or email shall be documented in CAPS within twenty-four (24) hours of receipt. As applicable to this rule, reports received by the county via mail, voicemail, or electronic means during non-business hours may be considered to be received by the county department no later than the first business day following the report. If unable to enter the report in the system timely, the county department shall document the reason in CAPS.

D. Reports that include an allegation of mistreatment must be forwarded to the appropriate law enforcement agency within twenty-four (24) hours after receipt of the report. As applicable to this

rule, reports made via mail, voicemail, or electronic means during non-business hours may be considered to be received by the county department no later than the first business day following the report.

E. CAPS shall guide the information gathered for the report to include:

1. The client’s demographic information, such as name, gender, date of birth or approximate age, address, current location if different from permanent address, and phone number;

2. The reporter’s demographic information, unless the reporter requests anonymity, such as name, phone number, address, relationship to client and, if applicable, the reporter’s agency or place of business;

3. Allegations of mistreatment or self-neglect;

4. Safety concerns for the client;

5. Safety concerns for the caseworker; and, 6. The alleged perpetrator’s information, such as name, gender, mailing and email address, phone number, date of birth, and relationship to the client, when mistreatment is alleged.

F. The county department shall determine jurisdiction for responding to the report.

1. The county department with jurisdiction for responding to a report is the county in which the adult resides.

2. When the adult is homeless, as defined in 42 U.S.C. Section 11302, the county department with jurisdiction is the county in which the adult’s primary nighttime residence is located.

3. If jurisdiction is unable to be determined by 1 or 2, above, the county department with jurisdiction is the county in which the adult is currently present.

4. If an emergency response is necessary, the county department where the adult is located at the time of the report is the responsible county department until jurisdiction is determined.

5. In rare situations a county department may conduct a joint investigation with another county department or may take primary ownership of a case that would not typically be within the county department’s jurisdiction.

a. The original county departments of jurisdiction shall be responsible for responding to the report and beginning the investigation until the involved county departments have reached a decision regarding the responsible county department to manage the cases.

b. There must be good cause for a joint response/investigation or for taking ownership outside of the county department’s normal jurisdiction, such as multiple clients being mistreated by the same alleged perpetrator(s), whether in a facility or community setting, when those clients’ residences are in different counties; and, c. The county departments involved must all agree to the joint response/investigative and/or primary owner of a case; and, d. The good cause for the change in jurisdiction must be documented in CAPS.

G. County departments shall utilize all available resources to determine jurisdiction, such as:

1. History within CAPS;

2. Colorado Benefits Management System (CBMS);

3. Colorado Courts;

4. Where services are being provided; and/or, 5. The adult’s school.

H. If a county department receives a report and determines that the report was made to the wrong county, the receiving county department shall transfer the report to the responsible county department as soon as possible, but no later than eight (8) hours after determining the correct county.

30.420 REPORT CATEGORIZATION

A. The county department shall review and evaluate all reports received utilizing the RED Team process and framework or a review by a supervisor or lead worker to determine whether the report should be screened in for investigation or screened out. If RED Team is the selected method, the county shall utilize the RED Team framework in CAPS.

B. The county department shall first determine whether the report involves mistreatment or selfneglect of an adult the county department could reasonably conclude was an at-risk adult at the time of the mistreatment, based upon information in the report related to physical, medical, and/or cognitive deficits or diagnoses and/or information in prior APS reports or cases.

C. If the report does not involve mistreatment or self-neglect of an at-risk adult the report shall be screened out no later than the third working day after receipt of the report.

D. If the report does involve mistreatment or self-neglect of an at-risk adult, the county department shall then make a screening decision based on a determination as to whether the report meets one of the exceptions outlined below:

1. The report shall be screened out and the county department shall not complete an investigation when:

a. The alleged incidence was previously investigated and there is no new information in the report that impacts the client’s current health, safety, or welfare;

b. The only allegation is self-neglect of an adult who has been assessed by APS within the past six months, and, the self-neglect is substantively unchanged from the previous APS case, and the adult has a recent history of refusing services, and there is no reported decline in the adult’s abilities and/or change in circumstances;

c. There is no information to locate the client and no ability to obtain additional information necessary to proceed with an investigation;

d. The only allegation is self-neglect and the county department has confirmed with the reporting party or other professional that the adult has been moved to a stable, long-term and safe placement, the client has sufficient services in place to mitigate risks, or the adult died prior to the county department’s screening decision.

2. The report may be screened out when:

a. The mistreatment occurred more than one hundred-eighty (180) days prior to the report; and, b. The county department can reasonably determine that the alleged perpetrator no longer has contact with the client and/or is no longer providing direct care to atrisk adults, pursuant to Section 30.960.A.

c. The county department may screen the report in for investigation at the county department’s discretion.

3. Reports not subject to an exception outlined in Section 30.420.D.1 and 2 shall be screened in for investigation and are determined to be a case; except when a new allegation(s) is received and the county department has a current open case, the new report shall be screened out and the new allegation shall be added to and investigated in the current open case.

E. If the report is screened out, the county department may:

1. Contact the adult to offer services for another program in the county department, such as Medicaid or behavioral health services, and/or provide referral information to the adult for another service agency, or refer the reporting party to another agency or resource.

2. Inform the reporting party of the decision not to investigate.

F. The county department shall document the reason the report was screened out.

30.430 RESPONSE PRIORITY AND ASSIGNMENT

A. The county department shall determine a time frame response to the case based upon the reported level of risk.

B. When factors present indicate the client is in clear and immediate danger or urgent and significant risk of harm due to the severity of the mistreatment or self-neglect, or due to the vulnerability or physical frailty of the client, the county department shall:

1. Determine the case to be an emergency;

2. Call 911, if appropriate based on the circumstances of the report; and, 3. For counties participating in the Alternative Response pilot, allegations of mistreatment meeting this emergency criteria shall be assigned to the traditional response track.

4. Make an initial response as soon as possible, but no later than twenty-four (24) hours including non-business days, after the receipt of the report. An initial response shall be:

a. An in-person visit with the client; or, b. An attempted in-person visit with the client; or, c. An outreach to another professional who is not alleged to be the perpetrator, who can evaluate the client’s immediate safety when conducting an in-person visit would be detrimental to the client and/or unsafe to the client and/or the county department.

5. If the initial response was not an in-person contact with the client and the county department was unable to ascertain the client’s safety, the county department shall attempt an in-person client contact each day following the initial attempt at contact, including non-business days.

a. A law enforcement welfare check may be substituted for attempts at contact during non-business days. The county department shall follow up on the next working day.

b. If the county department has confirmed the client to be unavailable or safe, such as in the intensive care unit (ICU), the reason for delayed response shall be documented.

c. Initial and subsequent attempts at contact shall begin immediately when the d. Following the third day of unsuccessful attempts at contact, the county department may choose to call, email, text, or send a letter requesting an appointment with the client.

e. If attempts at contact remain unsuccessful, the county department shall close the case no later than thirty-five (35) calendar days after the last attempt at contact.

f. The county department shall document all attempts to contact the client.

6. If the initial response was not an in-person contact with the client but the county department was able to ascertain safety, it shall make an in-person client contact on the first working day following the report.

a. If the county department has confirmed the client to be unavailable, such as in the intensive care unit (ICU), the reason shall be documented.

b. Initial and subsequent attempts at contact shall begin immediately when the c. Following the third day of unsuccessful attempts at contact, the county department may choose to call, email, text, or send a letter requesting an appointment with the client.

d. If attempts at contact remain unsuccessful, the county department shall close the case no later thirty-five (35) calendar days after the last attempt at contact.

e. The county department shall document all attempts to contact the client.

C. When the report and subsequent supervisory review and/or RED Team process indicate the client is not in immediate danger or urgent risk of harm the county department shall:

1. Determine the case to be a non-emergency.

2. For counties participating in the alternative response pilot, determine a track assignment for each allegation according to the requirements set forth in Section 30.440.

3. Make an initial response no later than three (3) working days beginning the day after the county department’s receipt of the report. An initial response shall be:

a. An in-person visit with the client; or i. For allegations assigned to the traditional response track, initial in-person visits shall be unannounced and in private whenever possible.

ii. For allegations assigned to the alternative response track, initial visits may be scheduled at the discretion of the county.

iii. If the initial report has multiple allegations and one or more allegations can be tracked to the alternative response track and one or more allegations must be tracked to the traditional response track, the initial response shall be conducted pursuant to Subsection (i) above b. An attempted in-person visit with the client;

c. An outreach to another professional who can evaluate the client’s immediate safety when conducting an in-person visit would be detrimental to the client and/or unsafe to the client and/or the county department. For allegations assigned to the traditional response track, the county shall ensure the outreach is made to a professional who is not alleged to be the perpetrator.

4. When the initial response was not an in-person contact with the client or the county department was unable to ascertain the client’s safety, the county department shall attempt an in-person client contact every other working day for a minimum of three attempts.

a. A law enforcement welfare check may be substituted for one attempt at contact and qualifies as one of the three required attempts at contact.

b. If the county department has confirmed the client to be unavailable or safe, the reason for delayed response shall be documented.

c. Initial and subsequent attempts at contact shall begin immediately when the d. For traditional response track investigations, the county department may attempt to schedule an appointment with the client following the third unsuccessful attempt at contact.

e. If attempts at contact remain unsuccessful, the county department shall close the case no later than thirty-five (35) calendar days after the last attempted contact.

f. The county department shall document all attempts to contact the client.

5. If the county department was able to ascertain safety, a. The county department shall attempt an in-person client contact within the response time frame or beginning on the first working day after ascertaining safety if safety were ascertained on the last day of the response time frame.

Attempts at contact shall continue every other working day for a minimum of three attempts.

b. If the county department has confirmed the client to be unavailable, the reason shall be documented.

c. Initial and subsequent attempts at contact shall begin immediately when the d. Following the third unsuccessful attempt at contact, the county department may choose to call, email, text, or send a letter requesting an appointment with the client.

e. If attempts at contact remain unsuccessful, the county department shall close the case no later than thirty-five (35) calendar days after the last attempt at contact.

f. The county department shall document all attempts to contact the client.

D. Prior to the initial in-person client contact visit, the county department shall determine whether:

1. The visit and investigation should be made in conjunction with law enforcement and/or personnel from other agencies in accordance with the county department’s cooperative agreements;

2. The client is in CAPS and/or is otherwise known to the county department;

3. Safety concerns exist, based on historical data and information provided in the report, requiring the caseworker to be accompanied by:

a. Law enforcement;

b. The supervisor;

c. Another case worker; or, d. Emergency, medical, and/or mental health personnel, if known or suspected medical or psychiatric conditions exist.

30.440 ALTERNATIVE RESPONSE PILOT

A. Beginning January 4, 2023, Section 30.440 only applies to those counties participating in the Alternative Response pilot as described in 26-3.1-103.3.

B. Allegations that are determined to be low risk as outlined in these rules shall be assigned to the alternative response track.

C. Allegations of self-neglect are considered low risk and shall be assigned to the alternative response track.

D. An allegation shall not be considered low risk and shall be assigned to the traditional response track if it contains any of the following:

1. Allegations of a sexual nature including but not limited to: sexual abuse, exploitation of a sexual nature, or harmful acts of a sexual nature.

2. Allegations involving alleged perpetrators who are professional legally appointed guardians; conservators, or representative payees for the client and the allegations relate to the duties for which they are appointed.

3. Allegations involving alleged perpetrators who are employees of employers identified pursuant to 26-3.1-111(7), C.R.S., and the allegations relate to the duties for which they are appointed. this exclusion does not apply if:

a. The employee was a relative, spouse, or friend of the client prior to their appointment as a paid provider to the client.

b. The employee is a consumer directed care attendant pursuant to Article 10 of Title 25.5.

4. Allegations of abuse as defined in 26-3.1-101(1), C.R.S., that:

a. Appear likely to result in a moderate to severe severity level, based on the information available in the report; and/or, b. Involve confinement or restraint that is unreasonable under generally accepted caretaking standards, pursuant to 26-3.1-101(1)(b), C.R.S.

5. Allegations of caretaker neglect as defined in 26-3.1-101(2.3), C.R.S., that:

a. Appear likely to result in a moderate to severe severity level, based on the information available in the report; and/or, b. Involve the alleged perpetrator knowingly using harassment, undue influence, or intimidation to create a hostile or fearful environment, pursuant to 26-3.1-101 (2.3)(a), C.R.S.

6. Allegations of exploitation as defined in 26-3.1-101(4), C.R.S., that involve:

a. The use of deception, harassment, intimidation, or undue influence to permanently or temporarily deprive an at-risk adult of the use, benefit, or possession of anything of value, pursuant to 26-3.1-101(4)(a), C.R.S.; and/or, b. Forcing, compelling, coercing, or enticing an at-risk adult to perform services for the profit or advantage of another person against the will of an at-risk adult, pursuant to 26-3.1-101(4)(c), C.R.S..

7. Allegations of mistreatment meeting emergency criteria as outlined in section 30.430.B E. Allegations not meeting criteria set forth in section 30.440.C and D may be considered low risk at the discretion of the county department. Counties may use discretion to determine whether the allegation is low risk based on factors that may include but are not limited to:

1. Present danger to the client and/or other at-risk adults, and/or;

2. Multiple reports involving the client and/or alleged perpetrator resulting in increased concern for the health, safety, or well-being of the client or other at-risk adults, and/or;

3. Unresolved patterns of mistreatment resulting in increased concern for the health, safety, or well-being of the client.

F. Allegations assigned to the alternative response track require:

1. Completion of an alternative response track investigation as outlined in sections 30.510 and 30.525;

2. Completion of an assessment of safety and risk as outlined in section 30.530; and, 3. Development of a case plan as outlined in section 30.610; and, 4. Provision of services as outlined in section 30.620 G. The caseworker may, with supervisory approval, change tracks to the traditional response track due to circumstances indicating the situation does not meet low risk criteria as outlined in Section 30.440.D and E.

H. The caseworker may, with supervisory approval, change tracks to the alternative response track due to circumstances indicating the situation meets low risk criteria as outlined in section 30.440.D and E.

30.500 INVESTIGATION AND ASSESSMENT

30.510 INVESTIGATION AND ASSESSMENT OVERVIEW

A. Beginning January 4, 2023, provisions in this Section 30.510 apply to investigations and/or assessments regardless of whether they are assigned to the alternative response track or the traditional response track.

B. The county department shall conduct a thorough and complete investigation into the allegations, with the following exceptions:

1. If the assessment and/or further investigation confirms that the client is not an at-risk adult, the county department shall close the APS case, as outlined in Section 30.660.

a. The client assessment status areas of activities of daily living (ADLS)/ instrumental activities of daily living (IADLS), cognition, behavioral concerns, and medical shall be used as the key determiners of whether an adult is at-risk, by definition.

b. The county department may provide the adult referrals to resources or continue to assist the adult through other county department programs.

c. The finding for the allegation(s) shall reflect that an investigation was not required.

2. If the only allegation is self-neglect and the county department is able to determine by confirming with other professionals that the client’s health, safety, and welfare is no longer at risk because the client’s needs are being met by a safe placement or an appropriate and adequate level of services, the county department shall close the case as outlined in Section 30.660.

3. If the client has passed away and the only allegation in the case is self-neglect the county department shall stop the investigation and close the case, as outlined in Section 30.660.

C. In cases where there is an allegation of mistreatment and the client is deceased the county department shall conduct an investigation.

D. The investigation and assessment may be conducted independent of one another or simultaneously, depending on the nature of the allegations.

E. If upon initial investigation, the county department determines a different county has jurisdiction, the originating county department shall transfer the case in CAPS. The county department determined to have jurisdiction shall uphold the screening decision and conduct the investigation and assessment, unless:

1. Additional or new information related to the safety of the adult or alleged mistreatment or self-neglect indicating the case may be closed is gathered by the county department determined to have jurisdiction.

2. The basis for the decision to close the case shall be documented in CAPS.

F. If upon initial investigation, a change in jurisdiction is appropriate, as outlined in Section 30.410.F.5, the ongoing investigation will follow the established agreement.

G. For counties participating in the Alternative Response pilot, investigations shall be conducted as 1. For allegations assigned to the traditional response track, a traditional response track investigation must be completed in accordance with requirements set forth in Section 30.520.

2. For allegations assigned to the alternative response track, an alternative response track investigation must be completed in accordance with requirements set forth in Section 30.525.

H. For counties not participating in the Alternative Response pilot, all investigations must be conducted in accordance with requirements set forth in 30.520.

I. The county department shall complete the investigation into the allegation(s) within sixty (60) calendar days of the receipt of the report. When allegations are received or identified after the initial report, the county department shall complete the investigation into the additional allegation(s) within sixty (60) days of the receipt or identification of the additional mistreatment or self-neglect. For all investigations the county department shall ensure that documentation of the investigation occurs in CAPS throughout the investigation process, as follows:

1. All interviews, contacts, or attempted contacts with the client, collaterals, alleged perpetrators, and other contacts during the investigation shall be documented within fourteen (14) calendar days of receipt of the information.

2. All evidence collected during the investigation shall be scanned and attached to the case by the completion of the investigation.

3. If the county is unable to complete the investigation timely for good cause, the cause shall be documented in CAPS.

J. Each employer defined by section 30.960.A must provide access to the county department to conduct an investigation into an allegation of mistreatment. Access includes the ability to request interviews with relevant persons and to obtain relevant documents and other evidence, as 1. The patient, client, resident, or consumer of the agency who is the client in an APS case of mistreatment or who is relevant to the APS investigation; and, 2. Personnel, including paid employees, contractors, volunteers, and interns who are relevant to the investigation; and, 3. Individual patient, client, resident, or consumer records relevant to the investigation, including:

a. Health records;

b. Incident and investigative reports;

c. Care and behavioral plans;

d. Staffing schedules and time sheets; and, e. Photos and other technological evidence.

4. Entrance to the employer’s premises as necessary to complete a thorough investigation.

At the time of entry, county department staff must identify themselves and the purpose of the investigation to the person in charge of the entity.

5. The professional license number issued by DORA for any current or former staff person who is a licensed healthcare professional and who is substantiated of mistreatment during the provision of their duties.

6. Attorneys and their staff who are providing legal assistance pursuant to a contract with an area agency on aging, and the long-term care ombudsman are not subject to the requirements in this Section 30.510.J.

30.520 TRADITIONAL RESPONSE TRACK INVESTIGATIONS

A. The county department shall conduct an investigation to determine findings related to allegations of mistreatment or, in counties not participating in the Alternative Response pilot, self-neglect, as required by Section 30.510. The investigation shall include, but may not be limited to:

1. Determining the need for protective services. If the client is in clear and immediate danger, the county shall intervene immediately by notifying the proper emergency responders.

2. Determining if the investigation should be conducted jointly with another entity, except in self-neglect only cases, such as:

a. Law enforcement and/or the district attorney;

b. Community Centered Board;

c. Health Facilities Division;

d. Attorney General’s Medicaid Fraud Unit;

e. The long-term care ombudsman; and/or, f. County department Child Welfare programs.

3. Making reasonable efforts to conduct interviews, as outlined below. The interviews and collection of evidence must address the specific allegations identified in the report and any new mistreatment or self-neglect that may be identified during the assessment or investigation. If an interview cannot be conducted for good cause, the attempts and the cause shall be documented.

a. An in-person initial interview with the client, unannounced and in private, whenever possible.

i. The county department shall document in CAPS that the visit was unannounced and in private and if not unannounced and/or in private for good cause, the cause shall be documented in CAPS.

ii. If the client is unable to be interviewed for good cause, the cause shall be documented in CAPS.

b. Ongoing interviews with the client to complete the investigation and assessment as outlined in Section 30.530. If the client refuses to participate in the investigation or cannot be located, the county department shall make reasonable efforts to complete the investigation by gathering evidence and interviewing other collateral contacts that have knowledge of the client and/or the alleged mistreatment or self-neglect.

c. Interviews with all collateral contacts. In the event a collateral contact cannot be located or interviewed for good cause, the cause shall be documented in CAPS;

d. Interview(s) with the alleged perpetrator(s), with or without law enforcement. In the event the alleged perpetrator is unable to be located or interviewed for good cause, the cause shall be documented in CAPS. The following information shall be collected related to the alleged perpetrator(s), to the fullest extent possible, in addition to information about the allegations:

i. Full name of the alleged perpetrator(s) with accurate spelling;

ii. Current email address, when available;

iii. Current physical and mailing address;

iv. Date of birth; and, v. Whether the alleged perpetrator is a licensed healthcare professional, as defined in Section 30.100,; and, vi. Other identifying demographic and contact information.

4. Collecting evidence and documenting with photographs or other means, when appropriate, such as:

a. Police reports;

b. Any available investigation report from a currently or previously involved facility and the occurrence report from the Health Facilities Division;

c. Medical and mental health records;

d. Bank or other financial records;

e. Care plans for any person in a facility or receiving other services that require a care plan and any daily logs or charts; and/or, f. Staffing records and employee work schedules when investigating in a facility.

5. Making a finding regarding each allegation and alleged perpetrator, including the severity level of the mistreatment when there is a substantiated finding. A severity level shall not be assigned to a substantiated self-neglect allegation.

6. If it is identified through interviews, collateral contacts, or other investigation that a substantiated perpetrator is a licensed healthcare professional, the county department shall document the license number in CAPS. The county department may ascertain the license number using the methods outlined below:

A. Request the license number from the substantiated perpetrator’s employer. if the substantiated perpetrator’s current or former employer is an agency required to request caps checks, as outlined in Section 30.960, A, and the mistreatment occurred while the substantiated perpetrator was engaged in professional duties, the employer is required to provide the DORA license number to the county department upon request, as outlined in Section 26-3.1-103(1.3)(a)(V), C.R.S., and Section 30.510.J.5; or B. Request the license number from the substantiated perpetrator. if the substantiated perpetrator is a licensed healthcare professional, and the mistreatment occurred while engaged in their professional duties, the substantiated perpetrator is required by section 26-3.1-103(1.4), C.R.S., to provide their DORA license number upon request of the county department; or C. Utilize the DORA online Colorado professional or business license verification system to ascertain the license number.

D. If the license number was provided by the substantiated perpetrator or their employer, the county department shall attempt to verify the license number by using the DORA online verification system or another means of verification.

E. If the county is unable to obtain the license number using one or more of the methods above, the county must document its attempts to obtain the license number in CAPS to show good cause for the inability to obtain the license number.

7. Determining whether there are additional mistreatment or self-neglect concerns not reported in the initial allegations. If there are additional concerns the county department shall enter the mistreatment and alleged perpetrator or self-neglect into the case.

a. Alternative Response pilot participating counties shall make a traditional or alternative response track assignment as outlined in section 30.440 and complete an investigation in accordance with the applicable traditional response or alternative response track investigation rules.

b. Non-pilot participating counties shall complete an investigation in accordance with the rules in this section 30.520.

8. Supervisory review of all findings and approval only when the county department has completed a thorough investigation and the evidence justifies the findings.

9. Notifying law enforcement when criminal activity is suspected.

B. Beginning July 1, 2018 all substantiated perpetrators shall be provided notice of the substantiation and their appeal rights, as outlined in section 30.910.

C. In the event that a finding is determined to be incorrect after supervisory approval, the county department shall take the following applicable steps:

1. If the finding was originally unsubstantiated and the finding is changing to inconclusive, correct the finding in CAPS.

2. If the finding was originally inconclusive and the finding is changing to unsubstantiated, correct the finding in CAPS.

3. If the finding was originally unsubstantiated or inconclusive and the finding is changing to substantiated, correct the finding in CAPS and notify the alleged perpetrator as outlined in Section 30.910.A-C.

4. If the finding was originally substantiated and the finding is changing to unsubstantiated or inconclusive, correct the finding in CAPS and notify the alleged perpetrator of the correction as outlined in Section 30.910.C. If there is an open appeal at the time of the correction, the county department shall notify the State Department of the change in finding no later than ten (10) calendar days of identifying the need to correct the finding.

D. Pursuant to Section 26-3.1-111(12), beginning on or before January 1, 2022, the State Department shall provide information to DORA when a licensed healthcare professional is substantiated for mistreatment of an at-risk adult.

1. Notification to DORA shall be made by the State Department within ten (10) calendar days after a substantiated finding.

2. The information provided shall include, at a minimum:

a. The professional’s name;

b. The professional’s license number;

c. The name of the mistreated adult;

d. The location or residence of the mistreated adult;

e. The location where the mistreatment occurred;

f. The date of the finding;

g. The county that investigated the mistreatment;

h. The type and severity of mistreatment;

i. The professional’s right to an appeal of the finding and the time frame to file an appeal and, j. The unique CAPS identifier that ties the perpetrator to the substantiated finding.

3. Information provided to DORA regarding a substantiated finding of mistreatment caused by a licensed healthcare professional is confidential, not subject to Part 2 of Article 72 of Title 24, of the C.R.S., and must be used for purposes of a regulatory investigation conducted pursuant to Section 12-20-401, C.R.S.

30.525 ALTERNATIVE RESPONSE TRACK INVESTIGATIONS

A. County departments approved to participate in the Alternative Response pilot shall conduct an investigation to determine conclusions related to allegations of mistreatment and self-neglect that have been determined to be low risk as outlined in section 30.440. The investigation shall include, but may not be limited to:

1. Determining the need for protective services. if the client is in clear and immediate danger, the county shall intervene immediately by notifying the proper emergency responders.

2. Determining if the investigation should be conducted jointly with another entity, except in self-neglect only cases, such as:

A. Law enforcement and/or the district attorney;

B. Community Centered Board;

C. Health Facilities Division;

D. Attorney General’s Medicaid Fraud Unit;

E. The long-term care ombudsman; and/or, F. County department Child Welfare programs.

3. Making reasonable efforts to conduct interviews, as outlined below. the interviews and collection of evidence must address the specific allegations identified in the report and any new mistreatment or self-neglect that may be identified during the assessment or investigation. if an interview cannot be conducted for good cause, the attempts and the cause shall be documented.

A. An in-person initial interview with the client whenever possible.

i. The initial visit may be scheduled or unannounced, at the discretion of the county department.

ii. If the client is unable to be interviewed for good cause, the cause shall be documented in CAPS.

B. Ongoing interviews with the client to complete the investigation and assessment as outlined in section 30.530. If the client refuses to participate in the investigation or cannot be located, the county department shall make reasonable efforts to complete the investigation by gathering evidence and interviewing other collateral contacts that have knowledge of the client and/or the alleged mistreatment or self-neglect.

C. Interviews with all collateral contacts. In the event a collateral contact cannot be located or interviewed for good cause, the cause shall be documented in CAPS;

D. Interview(s) with the alleged perpetrator(s), with or without law enforcement. In the event the alleged perpetrator is unable to be located or interviewed for good cause, the cause shall be documented in CAPS. The following information shall be collected related to the alleged perpetrator(s), to the fullest extent possible, in addition to information about the allegations:

i. Full name of the alleged perpetrator(s) with accurate spelling;

ii. Current email address, when available;

iii. Current physical and mailing address;

iv. Date of birth; and, v. Other identifying demographic and contact information.

4. Collecting evidence and documenting with photographs or other means, when appropriate, such as:

a. Police reports;

b. Any available investigation report from a currently or previously involved facility and the occurrence report from the health facilities division;

c. Medical and mental health records;

d. Bank or other financial records;

e. Care plans for any person in a facility or receiving other services that require a care plan and any daily logs or charts; and/or, f. Staffing records and employee work schedules when investigating in a facility.

5. Determining a conclusion related to the allegations.

6. Determining whether there are additional mistreatment or self-neglect concerns not reported in the initial allegations. If there are additional concerns, the county department shall enter the mistreatment and alleged perpetrator or self-neglect into the case, make a traditional or alternative response track assignment as outlined in Section 30.440, and complete an investigation in accordance with the applicable traditional response or alternative response track investigation rules.

7. Supervisory review of all alternative response track conclusions.

8. Notifying law enforcement when criminal activity is suspected. 30.530 ASSESSMENT [Rev. eff. 1/30/17]

A. The county department shall begin an assessment of the client’s risk, safety, and strengths during the initial in-person visit.

B. Using the assessment tool in CAPS, the county department shall complete a baseline assessment of the client to determine the client’s risk and safety, whether the client is an at-risk adult, and if there is a need for protective services.

1. If the client is in clear and immediate danger, the county shall intervene immediately by notifying the proper authorities or arranging for appropriate emergency responders.

2. If the client dies while the county department is completing the initial assessment, the assessment shall be completed using the information that was obtained prior to the client’s death. If the client passed away prior to the beginning of the investigation and assessment, an assessment shall not be completed.

3. If the client is not an at-risk adult, as defined in Section 30.100, the case shall be closed, per Section 30.510, A. The assessment status areas of ADLS/IADLS, cognition, behavioral concerns, and medical shall be used as the key determiners of whether an adult is at-risk.

C. The county department shall complete and document the assessment in CAPS within forty-five (45) calendar days of the receipt of the report, as follows:

1. All impacts (significant, minor, no, and unknown) and mitigating services, and the assessment narrative and/or case notes supporting selected impacts and services, shall be documented and the assessment marked complete no later than forty-five (45) calendar days from receipt of the report.

2. If the assessment cannot be completed within this time frame for good cause, the county department shall document the cause.

30.600. CASE PLANNING AND IMPLEMENTATION 30.610. CASE PLAN DEVELOPMENT [Rev. eff. 1/30/17]

A. The county department shall develop a case plan for protective services based upon the findings of the investigation and assessment and in accordance with APS principles.

B. A case plan shall not be developed and the case shall be closed when there are no identified needs, when the client’s needs have already been addressed at the time of the investigation and assessment, when the client is not an at-risk adult, or when the client passed away prior to the development of a case plan.

C. The case plan shall include:

1. The service needs necessary to successfully achieve safety improvement for any identified risk factors, characterized with a significant impact, for which there is no adequate mitigating service in place at the time of APS initial response;

2. The person responsible for arranging each identified service need, and if other than the county department, document the individual’s agreement to arrange the service need;

3. The status of all identified service needs.

D. The county department shall complete and document the case plan within forty-five (45) calendar days of the receipt of the report. If the case plan cannot be completed within this time frame for good cause, the county department shall document the cause in CAPS. The county department shall add newly identified service needs to the case plan throughout the life of the case.

E. The county department shall implement services, upon consent of the client, that are available in the community and that the client is eligible to receive at no or reduced cost or is able to pay for privately. The county department shall not be required to provide and/or pay for services that are not available in the community or those that the client is not eligible to receive at no or reduced cost or is able to pay for privately.

F. If services are unavailable through other government programs or local service providers and the APS client is unable to pay for the services, the county shall utilize APS client services funds, within available appropriations, to purchase goods and services for the APS client.

1. The county department shall not open an APS case only to purchase a service for a community member and shall not use APS client services funds for any service that is not intended to improve the health, safety, and/or welfare of the APS client.

2. Client services funds may be used in the following situations:

a. Emergency situations, such as emergency shelter, food, medicine, or utilities;

b. When the purchase(s) resolves the immediate need; or, c. For one-time, temporary, or short-term needs while the APS client is waiting for other service providers or funding sources to be approved and services begun; and/or, 3. Goods and services acceptable for purchase with client services funds shall be the minimum necessary to resolve the safety concern.

4. Client services funds may be used to develop a county or regional contract with an agency or professional to provide a specific service for multiple APS clients throughout the contract duration, such as a specialist to conduct in-home capacity evaluations, a registered nurse to do in-home medical evaluations, or a long-term care facility to provide emergency shelter beds.

30.620 PROVISION OF SERVICES

A. The county department shall provide protective services for the shortest duration necessary to ensure the client’s safety by implementing case plan goals as quickly as possible in order to stabilize the client’s situation and prevent further mistreatment or self-neglect.

B. If the client appears to have capacity to make decisions:

1. The client may refuse protective services, but the county department shall attempt to obtain the client’s consent to additional visits or phone calls from the caseworker if the situation appears to require further services. The caseworker shall document the consent or refusal to additional visits or phone calls.

2. Caseworkers shall provide clients who refuse services with the county department contact information for future reference.

C. If a client is suspected to lack capacity to make decisions, is at risk for harm, and refuses to consent to services, the county department shall document the client’s inability to provide consent.

1. Documentation shall include:

a. Observations of client behaviors and actions;

b. Medical documentation of client’s suspected incapacity and safety concerns to support involuntary case planning; and/or, c. Investigative evidence.

2. The county department shall ensure immediate safety and make its best effort to obtain an evaluation of the client’s decision making capacity from a qualified professional.

3. These situations shall be staffed with the supervisor and/or county attorney to:

a. Determine the client’s risk and safety;

b. Assess the client’s ability to consent;

c. Determine urgency of safety concerns if intervention is not taken;

d. Review previous interventions; and, e. Ensure the intervention is done ethically and is the least restrictive intervention to ensure the client’s safety.

4. The county department shall intervene when appropriate to coordinate with the responsible agency in taking action to protect the immediate safety and health of the client, such as:

a. Gaining access to the client with assistance from law enforcement, family, or another person the client trusts;

b. Emergency hospitalization;

c. Coordinating with municipal authorities to arrange a home clean up, when there is a clear biohazard;

d. Mental health hold, per Title 27, Article 65, C.R.S.;

e. Coordinating with family members, law enforcement, or financial institutions to freeze client bank accounts to prevent further loss of assets;

f. Recommending a delayed disbursement of finances from the client’s brokerdealer pursuant to Title 11, Article 51, C.R.S.;

g. Emergency protection order, per Title 13, Article 14, C.R.S.;

h. Authorization of a Medical Proxy Decision Maker, per Title 15, Article 18.5, C.R.S.;

i. Requesting a judicial review of a fiduciary, per Title 15, Article 10, Part 5, C.R.S., and Title 15, Article 14, Part 7, C.R.S.;

j. Contacting the Social Security Administration or other pension administrator to secure a representative payee;

k. Petitioning the court for emergency guardianship and/or special conservatorship, per Title 15 Article 14, Parts 3 and 4, C.R.S., or, l. Alcohol and drug involuntary commitment, per Title 27, Article 81, Part 112 and Title 27, Article 82, Part 108.

D. If a client lacks capacity and has a fiduciary to make decisions on behalf of the client, the county department shall consult with supervisors, the county director, the county attorney, law enforcement, and/or the district attorney to determine whether the county department should petition the court for a review of the fiduciary’s actions if:

1. The fiduciary refuses to allow the provision of protective services, which places the client at-risk for continued mistreatment or self-neglect; or, 2. There are allegations and evidence of mistreatment of the client by the client’s fiduciary.

3. The county department shall petition the court under the appropriate statute:

a. Uniform Power of Attorney Act, as outlined in Title 15, Article 14, Part 7, C.R.S.;

b. Guardianship or conservatorship statutes as outlined in Title 15, Article 14, Parts 3 and 4, C.R.S.; and/or, c. Fiduciary oversight statute, as outlined in Title 15, Article 10, Part 5, C.R.S.

E. The county department shall maintain ongoing client contact as long as the case is open.

1. For clients living in the community, an in-person client contact shall occur at least once every month, not to exceed thirty five calendar days (35) from the last in-person contact.

2. For clients living in a facility, an in-person client contact shall occur at least once every month, not to exceed thirty five calendar days (35) from the last in-person contact.

a. The county department has the option of substituting a phone call to the direct care provider to ascertain the client’s current status, in lieu of an in-person visit for every other required monthly in-person contact.

b. If it has been reported that the client has been mistreated at the facility, whether caused by a staff person, visitor, or other resident, and the facility has not appropriately resolved the cause of the mistreatment or put adequate safety measures in place, then a phone call to ascertain the client’s current status is not appropriate and the required monthly contact shall be an in-person visit.

3. During the monthly contact, the county department shall:

a. Continue the investigation of allegations, if applicable;

b. Continue assessment of client’s strengths and needs, including changes to the client’s status;

c. Pursue the continued safety improvement and reduction and/or mitigation of risk;

d. Monitor the effectiveness of arranged services to determine whether continued APS intervention is needed; and, e. Document information gathered during the contact per the above monthly contact requirements and update all contact records as information is obtained and/or changes occur for the client, alleged perpetrator, reporting party, and supports within fourteen (14) calendar days of the visit.

F. County departments may, as a courtesy, complete monthly visits on behalf of other county departments, as follows:

1. When a client temporarily or permanently relocates to a licensed facility more than seventy-five (75) miles outside the county boundary and the county department of original jurisdiction maintains the case, the county department of original jurisdiction shall ensure ongoing protective services.

2. Monthly contacts, required by Section 30.620, E, may be conducted by the county of original jurisdiction or may be conducted via courtesy visits by the county department in which the facility is located or by another county department that is visiting the facility.

3. No county department should be expected to provide more than three courtesy visits per twelve (12) month period at the request of the county department of original jurisdiction.

County departments may negotiate to provide more than three courtesy visits.

4. Upon completion of each courtesy visit, the county department that conducted the visit shall document the monthly contact in CAPS, including any identified need for services or follow up by the county department of original jurisdiction, as required in Section 30.620, E, within fourteen (14) calendar days of the monthly contact. The county department of original jurisdiction shall be advised immediately of any need for emergency services identified during the courtesy visit.

5. The county department of original jurisdiction is responsible for ensuring the courtesy visit is conducted and is responsible for implementing any necessary services or follow up identified during the courtesy visit.

6. A county department conducting a courtesy visit shall not document the visit as a new report or case for the purpose of data collection.

G. If the client permanently relocates to another county and the client no longer needs protective services, or the client permanently relocates to another state, the county department shall close the case, as outlined in Section 30.660.

H. If the client relocates to another county and the client continues to need protective services:

1. If either county is participating in the Alternative Response pilot, the original county department must consult with the state department to determine whether a transfer of case is required, based on considerations including, but not limited to, equity to the client, consistency of APS practice, and efficiency of case processes.

2. If neither the original county nor the client’s new county of residence are participating in the Alternative Response pilot, the original county department shall transfer the case to the client’s new county of residence within five (5) calendar days of learning the move is permanent.

3. When a transfer of case is required, the original county department shall update the case in CAPS prior to completing the transfer, as follows:

A. Update the client, perpetrator, reporting party, and collateral contact information;

B. Update the investigation, assessment, case plan, and case notes to include all information gathered to date; and, C. Call the receiving county department supervisor to staff the case prior to the transfer.

I. When a client permanently relocates to a new county, the case may remain with the former county department only when:

1. The case is within thirty-five (35) calendar days of resolution and the former county department chooses to retain the case; OR, 2. The former county department holds representative payeeship and chooses to retain the case; and/or, 3. The former county department holds guardianship or conservatorship. Either county department may, with the agreement of the receiving county department, petition the court for a transfer of guardianship and/or conservatorship to the receiving county department; and/or, 4. The jurisdiction assignment has been authorized or required as a result of State consultation as outlined in 30.620.H.1 J. County departments shall work collaboratively to provide protective services to clients, as needed.

K. The county department shall reassess the client’s needs and review the provision of protective services as long as the case remains open, as follows:

1. For cases in which the county department is the guardian, conservator, or representative payee:

a. An updated assessment shall be completed at least annually; and, b. A determination shall be made as to the appropriateness of continued protective services, including whether the client:

I. Continues to be an at-risk adult, as defined in Section 30.100, II. Continues to be in need of fiduciary support; and, III. Needs updated services to address identified needs or implement independence in areas of strength; and, c. The case plan shall be updated to include the client’s services, service status, persons responsible for implementing each service, and service dates.

2. For cases in which the county department is not the appointed guardian, conservator, or representative payee:

a. An updated assessment shall be completed no later than 180 days from the baseline assessment and every 60 days thereafter; and, b. A determination shall be made as to the appropriateness of continued protective services, including whether the client:

I. Continues to be an at-risk adult, as defined in Section 30.100, II. Continues to be in need of protective services; and, III. Needs updated services to address identified needs or implement independence in areas of strength; and, c. The case plan shall be updated to include the client’s services, service status, persons responsible for implementing each service, and service dates.

30.630 COURT INTERVENTION

A. When the investigation and assessment indicates probable incapacity and there is danger to the client’s health, safety, and welfare and the client is unable and/or unwilling to accept services, the county department is urged to petition the court for an order authorizing the appointment of a guardian and/or conservator in order to resolve the safety concern(s).

B. Prior to reaching a decision to petition the court for guardianship or conservatorship, the county department shall ensure that the following factors are met and have been documented in CAPS:

1. No other method of intervention will meet the client's needs;

2. There are no other responsible parties, such as family or friends, to act as guardian or 3. Court intervention will resolve safety concerns;

4. The county department does not seek guardianship solely to make medical decisions on behalf of the client (See Section 15-18.5-103(8), C.R.S.); and, 5. Court intervention is warranted by either:

a. The degree of incapacity, as supported by medical or psychiatric evidence, and the degree of risk, as supported by investigative evidence; or, b. The suspected incapacity of the client and the degree of risk, as supported by the investigative evidence, where medical or psychiatric evidence of incapacity cannot be obtained without court intervention.

C. If all factors in Section 30.630.B have been met, the county department is urged to accept guardianship and/or conservatorship.

1. The county department’s attorney shall represent the county department in the legal process.

2. The county department shall provide all information deemed necessary by legal counsel.

3. A representative of the county department shall be prepared to testify in support of the petition.

4. The type of court intervention sought must be the least restrictive intervention required to meet the needs of the client and only for those areas in which the client lacks the capacity or the ability to understand the consequences of decisions, as medically or psychiatrically substantiated.

5. When a county department is appointed by the court to act as guardian or conservator, a copy of the letter of appointment and all other court documents and reports shall be maintained in CAPS and the client’s case record updated to reflect fiduciary information.

D. The county department may choose to accept or reject any appointment of guardianship, based upon county department policy.

E. The county department shall initiate proceedings to withdraw as guardian and/or conservator when:

1. Medical or psychiatric evidence indicates a guardian and/or conservator is no longer necessary;

2. Another appropriate guardian or conservator has been identified; or, 3. The county department is no longer able to fulfill guardianship responsibilities, as appointed.

F. When a person or agency other than the county department is requesting appointment as the guardian and/or conservator of the client, the county department shall assist responsible parties, as needed, in identifying legal counsel or providing other assistance in initiating the petition(s).

30.640 REPRESENTATIVE PAYEE

A. The county department shall only apply for appointment as a representative payee when no other reliable person or agency is available and willing to seek the appointment and:

1. The reported financial issues pertaining to mistreatment and/or self-neglect have been substantiated and determined to present significant harm to the client’s health, safety, or welfare without intervention; and, 2. Other less restrictive intervention options have been assessed and found to be inadequate to protect and assist the client; and, 3. Medical, psychiatric, and/or financial evidence exists to show the client is unable to manage his/her personal finances.

B. The county department shall follow the procedures and guidelines for payees as set forth by the SSA or other organization(s).

C. The county department shall initiate procedures, as outlined by the SSA or other organization(s), to discontinue its services as representative payee when:

1. Medical, psychiatric, and/or financial evidence indicates a payee is no longer necessary;

2. Another appropriate payee has been identified;

3. The county department is no longer able to fulfill payee responsibilities, as appointed; or, 4. The client dies.

30.645 TRUST ACCOUNTS

A. The county department shall ensure that all guardianships, conservatorships, representative payeeships, and personal needs accounts that are held by the county department, and in which the county department has some financial authority or responsibility, have an established trust account.

B. The established trust account shall bear the name of the county department or the name and the title of the director of the county department as trustee for the client or as otherwise required by the Social Security Administration (SSA).

1. Withdrawals from savings, checking, or investment accounts shall require two signatures, neither of which may be the caseworker or the bookkeeper.

2. Shortages in trust accounts are the responsibility of the county department.

C. The county department shall manage any trust account established pursuant to such department’s fiduciary duty as a guardian, conservator, representative payee, or other purpose in accordance with any State and Federal requirements for said accounts.

30.660 CASE CLOSURE

A. Cases not requiring additional protective services shall be closed within thirty-five (35) calendar days of the last monthly contact with the client.

1. If the client cannot be located and the county department has sent a letter to the client or is reaching out to others who might know the client’s location, the case may remain open until the county department exhausts all attempts to locate the client.

2. The county department shall document all attempts to locate the client.

B. Cases in which the client is relocated to a long-term care facility may remain open for up to thirtyfive (35) calendar days in order to ensure the placement is appropriate for the client’s needs. The county department may keep the case open past the thirty-five (35) days if there is good cause and the department documents the cause in CAPS.

C. Cases in which the county department has been appointed as the client’s guardian, conservator, and/or representative payee shall remain open for the duration of the court order or for as long as the county remains as the representative payee. If the client has died, the case shall be closed immediately following completion of any investigative and/or fiduciary responsibilities.

D. A decision to close a case shall be made for any or all of the following reasons:

1. After assessment, the client does not meet the definition of an at-risk adult.

2. After investigation and assessment there are no identified needs or all of the client’s needs were met prior to the report to the county department.

3. The investigation and/or assessment identified needs but the client is competent to make decisions and refuses services.

4. If, after completion of the investigation and after repeated and documented efforts, the whereabouts of the client cannot be established or the client refuses contact.

5. The client no longer needs protective services.

6. Service goals are completed.

7. Repeated efforts at service delivery have proven to be ineffective and no additional alternatives exist.

8. Critical services necessary to improve safety are unavailable in the community or to the client.

9. The client moved out of the state.

10. The client has been sentenced to incarceration for longer than thirty (30) calendar days.

11. The client died. Prior to closing the case, the investigation must be completed as outlined in Sections 30.510, 30.520, and 30.525.

E. The county department shall document the case closure, to minimally include:

1. A final assessment, if applicable, to determine the safety improvement as a result of APS intervention;

2. Update of all case, client, perpetrator, reporting party, and collateral contact information to reflect the most current data and information;

3. Reason for case closure;

4. Whether there is continued perpetrator involvement; and, 5. A narrative to address the overall outcome of APS intervention, to include why safety was or was not increased and why risk was or was not decreased.

30.800 COMMUNITY COLLABORATION

30.810 COOPERATIVE AGREEMENTS

A. Per Section 26-3.1-103(2), C.R.S., the county department shall implement cooperative agreements in conjunction with its local:

1. Law enforcement agencies;

2. District Attorney;

3. Long-Term Care Ombudsman; and, 4. Community Centered Board.

B. The focus of such agreements shall be the coordination of investigations and protective services that promote the protection of at-risk adults and each agreement shall provide that each agency shall maintain the confidentiality of the information exchanged pursuant to state and federal statute.

C. The agreement with law enforcement agencies shall include, at a minimum:

1. A process outlining the role of law enforcement for receiving, assessing, referring, and responding to reports received during the county department's non-business hours, if applicable;

2. A procedure regarding sharing of reports of mistreatment between the local law enforcement agency(ies) and the county department;

3. Procedures for the provision of assistance from one agency upon the request of the other agency;

4. Procedures to coordinate investigative duties; and, 5. The beginning and ending date of the agreement, the term of which shall not exceed five years.

D. The agreements with the District Attorney, long-term care ombudsman, and Community Centered Board shall, at a minimum, include:

1. Procedures for the provision of assistance from one agency upon the request of the other agency;

2. Procedures to coordinate investigative duties; and, 3. The beginning and ending date of the agreement, the term of which shall not exceed five years.

30.830 ADULT PROTECTION TEAMS

A. The director of each county department with ten (10) or more screened in reports of at-risk adult mistreatment and/or self-neglect in the prior state fiscal year is required to establish an Adult Protection Team.

1. The county department may establish its own Team or may coordinate with another contiguous county department(s) that is required to establish a Team.

2. The Team shall meet quarterly, at a minimum.

3. The county department shall determine the level of decision making authority for the Team. The role of the Team may be advisory only.

B. The purpose of the Team shall be to:

1. Review the processes used to report and investigate mistreatment and self-neglect of atrisk adults;

2. Staff particular cases or possible cases with Team members, such as those that:

a. Have proven difficult to resolve and Team members may be able to identify solutions;

b. Are situations where early intervention by other community systems may prevent mistreatment; and/or, c. Are valuable for educating Team members on APS program processes and requirements.

3. Facilitate interagency cooperation regarding services to at-risk adults including the development of solutions and action steps necessary to reduce risk and improve safety;

4. Provide community education on the mistreatment and self-neglect of at-risk adults. The county department shall be the primary training agency, but may utilize training provided by team members or another designee. The county department shall:

a. Determine the topic to be presented, based upon county department or community need;

b. Use materials developed by the county department, the State Department, national associations, or other professional adult protective services agencies;

c. At a minimum, provide five (5) training activities per fiscal year, in any combination of the following:

1) A live presentation to a community or professional group;

2) Participation in a senior or community forum, such as:

a) Providing an article for a newsletter or local community newspaper; or, b) Providing brochures or other written materials at a county department or other community event.

3) Sponsorship of a community Elder Abuse Awareness Day or similar event.

C. The director of the county department or the director's designee shall identify and recruit team members consistent with professional groups as specified in Section 26-3.1-102(1)(b), C.R.S., and other relevant community agencies.

D. Each Team member shall be advised of the confidential nature of his or her responsibilities in accordance with Section 26-3.1-102(7), C.R.S., and shall be required to sign a confidentiality agreement at least once each fiscal year.

E. The Team shall develop and adopt written by-laws or a Memorandum of Understanding that minimally include the Team's:

1. Purpose;

2. Structure, including:

a. Meeting facilitation. Teams that conduct education to the community as part of the Team meeting shall adjourn to executive session prior to staffing any case or discussing any APS client or community member;

b. Frequency of meetings; and, c. Composition of the Team.

3. Rules for membership, including:

a. Member duties;

b. Process for resignation and causes for termination from the Team.

4. Process for handling potential conflicts of interest.

F. The county department shall review and update all team documents, such as by-laws and confidentiality agreements when statute or rule changes occur that impact the team’s process or every five years, whichever occurs first.

G. The county department shall enter all Team activities, including but not limited to cases staffed, training provided, and confidentiality agreements, in CAPS within fourteen (14) calendar days of the activity.

30.900 NOTICE TO SUBSTANTIATED PERPETRATORS AND STATE LEVEL APPEALS PROCESS 30.910 NOTICE TO THE SUBSTANTIATED PERPETRATOR OF MISTREATMENT [Eff. 5/30/18]

A. Beginning July 1, 2018, the county department shall notify perpetrator(s) substantiated in cases involving mistreatment of an at-risk adult of the finding via first class mail to their last known mailing address, as documented in CAPS, using a form approved by the State Department.

Notice shall be mailed no later than ten (10) calendar days following the date of finding on the perpetrator. A copy of the notice showing the date the notice was mailed shall be maintained in CAPS.

B. At a minimum, the notice shall include the following information:

1. Type of mistreatment and severity level, name of the county department that conducted the investigation, date the finding was made in CAPS, and information concerning individuals or agencies that have access to the information.

2. The circumstances under which information contained in CAPS will be provided to other individuals or agencies.

3. The right of the substantiated perpetrator to request a state level appeal, as set forth in

Section 30.920, and the State approved appeal form.

4. Notice that the scope of an appeal is limited to challenges that the finding(s) are not supported by a preponderance of the evidence or that the actions substantiated as mistreatment do not meet the legal definition of mistreatment. The State Department will be responsible for defending the determination at the state level fair hearing.

5. An explanation of appeal options and deadlines contained in Section 30.920.

C. In the event that a notice regarding a substantiated finding was sent to an alleged perpetrator in error, the county department shall correct the finding in CAPS, as outlined in Section 30.520.B, and notify the alleged perpetrator of the correction as soon as possible, but no later than ten (10) calendar days from the discovery of the error.

D. Information contained in CAPS records related to a person who has been substantiated in a case of mistreatment of an at-risk adult prior to July 1, 2018 shall be expunged and shall not be released for the purposes of notification or a CAPS check. The State Department and county departments may maintain such information in CAPS to assist in future risk and safety assessments.

30.920 STATE LEVEL APPEALS PROCESS

A. Substantiated perpetrator(s) of mistreatment shall have the right to a State level appeal to contest the substantiated finding. The request for appeal of the decision shall first be submitted to the State Department unit designated to handle such appeals. If the State Department and the appellant are unable or unwilling to resolve the appeal in accordance with the provisions set forth below in this section, the State Department shall forward the appeal to the Office of Administrative Courts (OAC) to proceed to a fair hearing before an Administrative Law Judge (ALJ).

B. The grounds for appeal shall consist of the following:

1. The substantiated finding(s) are not supported by a preponderance of credible evidence; or, 2. The actions ultimately found to be substantiated as mistreatment do not meet the statutory or regulatory definition of mistreatment.

C. The substantiated perpetrator(s) of mistreatment shall have ninety (90) calendar days from the date of notice of substantiation of mistreatment to appeal the finding in writing to the State Department. The written appeal shall be submitted via the State approved online form or using the hard copy appeal form provided to the substantiated perpetrator by the county department and shall include:

1. The contact information for the appellant;

2. A statement detailing the basis for the appeal; and, 3. Notice of finding of responsibility for mistreatment of an at-risk adult sent to the appellant by the county department.

D. The State level appeal process must be initiated by the substantiated perpetrator(s) of mistreatment or his/her attorney. The appellant does not need to hire an attorney to file an appeal. If the substantiated perpetrator(s) is a minor child, the appeal may be initiated by his/her parents, legal custodian, or attorney.

E. The appeal must be submitted to the State Department within ninety (90) calendar days of the date of the notice of the substantiated finding. If the appeal is filed more than ninety (90) calendar days from the date of notice of the substantiated finding, the appellant must show good cause for not appealing within the prescribed time period as set forth in Section 30.920.C. A failure to request State review within the ninety-day (90) period without good cause shall be grounds for the State Department to not accept the appeal.

F. The substantiated finding shall continue to be used for safety and risk assessment, employment and background screening by the State Department while the administrative appeal process is pending.

G. The appellant shall have the right to appeal, even if a court action or criminal prosecution is pending as a result of the mistreatment. The State Department shall hold in abeyance the administrative appeal process pending the outcome of the court action or criminal prosecution if requested by the appellant, or if the State Department determines that awaiting the outcome of the court case is in the best interest of the parties. If the appellant objects to the continuance, the continuance shall remain in place, but the continuance of the appeal shall not exceed one hundred eighty (180) calendar days without the appellant having the opportunity to seek a review of the continuance by an administrative law judge. The pendency of other court proceedings shall be considered good cause to extend the continuance of the appeal past the one hundred eighty (180) day timeframe.

H. The following circumstances shall be considered to be admissions to the factual basis of the substantiated finding(s) of the responsibility for the mistreatment of an at-risk adult in CAPS and shall be considered conclusive evidence of the factual basis of the individual's responsibility for the mistreatment to support a motion for summary judgment submitted to the Office of Administrative Courts:

1. The appellant has been found guilty of a crime against an at-risk adult pursuant to

Section 18-6.5-103, C.R.S. arising out of the same factual basis as the substantiated finding in CAPS.

2. The appellant has been found guilty or has pled guilty or nolo contendere as part of any plea agreement including, but not limited to, a deferred judgement agreement to a crime against an at-risk adult pursuant to Section 18-6.5-103, C.R.S. arising out of the same factual basis as the substantiated finding in CAPS.

3. The appellant has been found guilty or has pled guilty or nolo contendere as part of any plea agreement including, but not limited to, a deferred judgment agreement, in a case in which a crime against an at-risk adult was charged pursuant to Section 18-6.5-103, C.R.S., arising out of the same factual basis as the substantiated finding in CAPS. The offense to which the appellant pled guilty must be related to the same factual basis as the substantiated finding in CAPS.

I. After the appellant requests an appeal, the State Department shall inform the appellant of the details regarding the appeal process, including timeframes for the appeals process and contact information for the State Department.

1. The appellant, as the party in interest, shall have access to the investigative record relied upon by the county department to make the finding in order to proceed with the appeal.

The appellant's use of the investigative record for any other purpose is prohibited unless otherwise authorized by law.

2. Prior to providing access to the appellant, the State Department shall redact identifying information contained in the investigative record and documents to ensure compliance with all state and federal confidentiality laws and rules regarding adult mistreatment records or other protected information, including but not limited to: reporting party name(s) and address(es), Social Security Number or alien registration number and information pertaining to other parties in the case that the appellant does not have a legal right to access.

J. The State Department is authorized to enter into settlement negotiations with the appellant as

part of the litigation process. The State Department is authorized to enter into settlement agreements that modify, overturn or expunge the reports and/or findings as reflected in the State portion of CAPS. The State Department is not authorized to make any changes in the county portion of CAPS. In exercising its discretion, the State Department shall take into consideration the best interests of the at-risk adults, the weight of the evidence, the severity of the mistreatment, any patterns of mistreatment reflected in the record, the results of any court processes, the rehabilitation of the appellant and any other pertinent information.

K. The county department's findings shall not be changed to reflect the State Department's response to the appeal. The State Department shall document all decisions and the outcome of the appeal in CAPS.

L. The State Department and the appellant shall have one hundred twenty (120) calendar days from the date the State Department receives the appeal to resolve the issue(s) on the appeal. The one hundred twenty (120) day time frame may be extended by agreement of both the appellant and the State Department if it is likely that the additional time will result in a fully executed settlement agreement or resolution of the appeal.

M. As soon as it is evident within the one hundred twenty (120) days that the appellant and State Department will not resolve the issue(s) on appeal, the State Department shall forward a copy of the appellants original appeal document(s) to the Office of Administrative Courts to initiate the Office of Administrative Courts fair hearing process.

N. If, by the end of the one hundred twenty (120) day period, the State Department has been unable to contact the appellant using the information submitted by the appellant, including by first class mail, and the appellant has not contacted the State Department, the appeal shall be deemed abandoned. The substantiated finding entered into CAPS by the county department shall be upheld in CAPS without further right of appeal. The State Department shall notify the appellant of this result by first class mail to the address provided by the appellant.

O. A health oversight agency is defined consistent with the provisions of federal regulations found at 45 CFR 164.501 as of 2021, herein incorporated. This rule does not contain any later amendments or editions. The regulation are available at https://www.ecfr.gov. This regulation is also available for inspection and copying at the Colorado Department of Human Services, Administrative Review Division, 3550 W. Oxford Ave., Denver CO, 80236, during regular business hours.

Pursuant to section 26-3.1-111(5)(h), C.R.S., a health oversight agency within DORA or a regulator as defined in section 12-20-102(14), C.R.S., may request appeal information from the State Department for the purpose of a regulatory investigation conducted pursuant to section 12- 20-401, C.R.S. when making the request to the State Department, a health oversight agency within DORA or regulator must include the information provided to DORA through the notification process outlined in 30.520 D(2), if such notification occurred. If such notification did not occur, a health oversight agency within DORA or regulator must include, at minimum, the following information:

1. The professional’s name, 2. The name of the mistreated adult, and 3. The nature of the allegation(s), to include the type and severity of the mistreatment, if known.

P. After the State Department receives the request from a health oversight agency within DORA or a regulator, the State Department will provide that agency with the appeal summary for the purposes of the regulatory investigation.

Q. Appeal information provided to a health oversight agency within DORA or a regulator is confidential, not subject to part 2 of article 72 of title 24, C.R.S., and must be used only for purposes of a regulatory investigation conducted pursuant to section 12-20-401.

30.930 STATE FAIR HEARING BEFORE THE OFFICE OF ADMINISTRATIVE COURTS (OAC)

A. When the Office of Administrative Courts receives the appeal documents from the State Department, the Office of Administrative Courts shall docket the appeal and enter a procedural order to the parties indicating the following:

1. The date and time for a telephone scheduling conference with the parties. _________________________

Section 26-3.1-111(5)(h), C.R.S., refers to a health oversight agency defined in federal regulation at 42 CFR 164.501. This appears to be a typographical error as no such regulation exists. The definition for health oversight agency can be found at 45 CFR 164.501.

2. During the telephone scheduling conference, the Office of Administrative Courts shall determine the date for the hearing. Following the scheduling conference, the Office of Administrative Courts will issue a further procedural order and notice of hearing. The order/notice will contain the hearing date, the fourteen (14) day deadline for the notice of issues, the fourteen (14) day deadline for the appellant’s response and deadline for filing pre-hearing statements. Any party requiring an extension or modification of any of the deadlines in the order may file a request with the Administrative Law Judge. The office of administrative courts shall also issue a protective order which will protect and govern the handling of all pleadings, discovery, and evidence. The order must be signed by an administrative law judge and must state that:

a. Any documents exchanged by the parties containing confidential information, including, but not limited to pleadings, APS reports and investigative records, medical records, law enforcement investigation records, and documents regarding at-risk adults will be used for the sole purpose of proceeding with this appeal.

b. The parties may disclose confidential information to their attorneys or any expert witness only as necessary for the prosecution or defense of the appeal. The appellant is not authorized to disclose or use confidential information for any other purpose.

c. The parties may exchange discovery containing information that is confidential under department rule 12 CCR 2518-1, § 30.920.

d. To the extent that the parties may disclose confidential records to expert witnesses, the parties shall provide a copy of the protective order to the expert witnesses and advise the expert witness of his or her obligation not to disclose the records or information learned from the confidential records.

e. The exchange and use of the confidential information or records does not waive the right of either party to object to the admission of the documents into evidence on any grounds.

f. If the parties use or offer confidential information or records as evidence during the course of the hearing, counsel and the parties shall take reasonable measures to protect such information or records from public disclosure including but not limited to filing records under seal.

g. The appellant must return to the department all protected health information (including all copies made) at the end of the appeal or, should the appellant choose to pursue any further administrative remedies, when those remedies have been exhausted.

h. The hearing regarding the factual basis for the adult mistreatment finding shall be closed to the public.

i. This order does not prohibit the department from using documents or information as authorized, required, or permitted by law.

3. The notice of issues shall include the following:

a. The specific allegations(s) that form the basis of the county department’s substantiated finding that the appellant was responsible for mistreatment of an at-risk adult;

b. The specific type of mistreatment for which the appellant was substantiated and the legal authority supporting the finding, and c. To the extent that the State Department determines that the facts contained in CAPS support a modification of the type and/or severity level of mistreatment determined by the county department, the State Department shall so notify the county department and the appellant of that modification and the process shall proceed on the modified type of mistreatment.

4. The appellant shall respond to the State Department’s notice of issues by providing the factual and legal basis supporting the appeal to the State Department and to the Office of Administrative Courts.

5. If the appellant fails to participate in the scheduling conference referenced above, or fails to submit a response to the State Department’s notice of issues within 14 days, the Office of Administrative Courts shall deem the appeal to have been abandoned by the appellant and render an initial decision dismissing the appeal. In accordance with the procedures set forth below, the Office of Appeals may reinstate the appeal for good cause shown by the appellant.

6. In the event that either party fails to respond to a motion to dismiss filed in the appeal, the Administrative Law Judge shall not consider the motion to be confessed and shall render a decision based on the merits of the motion.

B. The Administrative Law Judge shall conduct the appeal in accordance with the Administrative Procedure Act, Section 24-4-105, C.R.S. the rights of the parties include:

1. The State Department shall have the burden of proof to establish the facts by a preponderance of the evidence and that the facts support the conclusion that the appellant is responsible for the mistreatment indicated in the notice of issues provided by the State Department. The Administrative Law Judge can consider evidence other than the case record in CAPS in concluding that the finding is supported by a preponderance of evidence;

2. Each party shall have the right to present his or her case or defense by oral and documentary evidence, to submit rebuttal evidence and to conduct cross-examination;

3. Subject to these rights and requirements, where a hearing will be expedited and the interests of the parties will not be subsequently prejudiced thereby, the Administrative Law Judge may receive all or part of the evidence in written form, or by oral stipulations;

4. A telephonic hearing may be conducted as an alternative to a face-to-face hearing unless either party requests a face-to-face hearing in writing. The written request for a face-toface hearing must be filed with the Office of Administrative Courts and the other party at least ten (10) calendar days before the scheduled hearing. A request for a face-to-face hearing may necessitate the re-setting of the hearing; and, 5. Where facilities exist that have videoconferencing technology local to the county department that made the finding, either party may request that the hearing be conducted via that technology. The requesting party shall investigate the feasibility of this approach and shall submit a written request outlining the arrangements that could be made for video conference. The Office of Administrative Courts shall hold the hearing via videoconferencing for the convenience of the parties whenever requested and feasible. A request for a hearing via videoconferencing may necessitate the re-setting of the hearing.

C. At the conclusion of the hearing, unless the Administrative Law Judge allows additional time to submit documentation, the Administrative Law Judge shall take the matter under advisement.

After considering all the relevant evidence presented by the parties, the Administrative Law Judge shall render an initial decision for review by the Colorado Department of Human Services, Office of Appeals.

D. The initial decision shall uphold, modify or overturn/reverse the county finding. The Administrative Law Judge shall have the authority to modify the type and/or severity level of mistreatment to meet the evidence provided at the hearing. The Administrative Law Judge shall not order the county to modify its record; rather, the State Department shall indicate the outcome of the appeal in its portion of CAPS.

E. When an appellant fails to appear at a duly scheduled hearing having been given proper notice, without having given timely advance notice to the Office of Administrative Courts of acceptable good cause for inability to appear at the hearing at the time, date and place specified in the notice of hearing, then the appeal shall be considered abandoned and the Administrative Law Judge shall enter an initial decision dismissing the appeal. In accordance with the procedures set forth in

Section 30.940, the Office of Appeals may reinstate the appeal for good cause shown by the appellant.

30.940 STATE DEPARTMENT OFFICE OF APPEALS FUNCTIONS

A. Review of the initial decision and hearing record and entry of the final agency decision shall be pursuant to state rules at Sections 3.850.72 - 3.850.73 (9 CCR 2503-8).

B. Review shall be conducted by a State adjudicator in the Office of Appeals not directly involved in any prior review of the county report being appealed.

C. The final agency decision shall advise the appellant of his/her right to seek judicial review in the State District Court, City and County of Denver, if the appellant had timely filed exceptions to the initial decision.

D. If the appellant seeks judicial review of the final agency decision, the State Department shall be responsible for defending the final agency decision on judicial review.

E. In any action, in any court challenging a county’s substantiated finding against a perpetrator of mistreatment, the State Department will defend the statutes, rules, and State-mandated procedures leading up to the finding, and will defend all county actions that are consistent with statutes, rules, and State-mandated procedures. The State Department shall not be responsible for defending the county department for actions that are alleged to be in violation of, or inconsistent with, State statutes, State rules or State-mandated procedures.

30.950 CONFIDENTIALITY OF APPEAL RECORDS

A. All records submitted by the parties as part of the State level appeal process and all notices, orders, agency notes created by or made part of the State Department’s agency record shall be confidential and shall not be released or disclosed unless such release or disclosure is permitted by the applicable State statutes or 12 CCR 2518, Volume 30.250.

B. Initial and final agency decisions where information identifying the appellant, victim(s), other family members, or minors have been redacted may be released to the public.

30.960 EMPLOYER CAPS CHECKS

A. Pursuant to Section 26-3.1-111(6)(a)(I), C.R.S., beginning January 1, 2019, the following employers shall request a CAPS check prior to hiring or contracting with a new employee who will provide direct care to an at-risk adult, except when the employer is hiring or contracting with an employee provided by a staffing agency, if the staffing agency completed a CAPS check and provided the results to the employer as directed in Section 30.960.D and pursuant to Section 26- 3.1-111 (6)(a)(V), C.R.S. employers, and may request a CAPS check for existing employees or volunteers who provide direct care to an at-risk adult.

1. Health facilities licensed pursuant to Section 25-1.5-103, C.R.S., including those wholly owned and operated by any governmental unit;

2. Adult day care facilities, as defined in Section 25.5-6-303(1), C.R.S.;

3. Community integrated health care service agencies, as defined in Section 25-3.5- 1301(1);

4. Community-Centered Boards or program-approved service agencies that provide or contract for services and supports, pursuant to C.R.S. Article 10 OF Title 25.5;

5. Single Entry Point agencies, as described in Section 25.5-6-106, C.R.S.;

6. Area Agencies on Aging, as defined in Section 26-11-201(2), C.R.S., and any agency or provider the Area Agency on Aging contracts with to provide services;

7. Facilities operated by the State Department for the care and treatment of persons with mental illness, pursuant to C.R.S. Article 65 OF Title 27;

8. Facilities operated by the State Department for the care and treatment of persons with intellectual and developmental disabilities, pursuant to C.R.S. Article 10.5 OF Title 27;

9. Veterans Community Living Centers, operated pursuant to C.R.S. Article 12 OF Title 26;

10. The Office of Public Guardianship pursuant to Section 13-94-105(6), C.R.S.; and, 11. Staffing agencies, as defined in Section 30.100, when they are placing employees with an employer described in Section 30.960.A and pursuant to Section 26-3.1-111(7)(a) to (7)(j), C.R.S.

B. Pursuant to Section 26-3.1.-111(3)(b), C.R.S., beginning January 1, 2022, the state department shall provide the courts the results of a CAPS check, upon the court’s request, for a potential appointee as a conservator or guardian of an at-risk adult, with the exception of county department Adult Protective Services staff who are already required to undergo a CAPS check pursuant to Section 26-3.1-107(2), C.R.S., and the Office Of Public Guardianship staff required to undergo a CAPS check pursuant to Section 26-3.1-111(7)(j), C.R.S.

C. Pursuant to Section 26-3.1-111(8), a person hiring someone to provide consumer-directed attendant support services (CDASS), pursuant to C.R.S. Article 10 of Title 25.5, may request a CAPS check at the person’s expense.

D. Pursuant to Section 26-3.1-111(6)(a)(V), C.R.S., beginning January 1, 2024, a staffing agency shall request a CAPS check for an employee it is placing with an employer outlined in Section 30.960.A. The staffing agency shall provide the employer with a copy of the official results of the CAPS check received from the state department and a copy of any official flagged check, pursuant to Section 26-3.1-111(10), C.R.S., against the employee that is received by the state department, within five business days after receipt of the information, for the duration of the employee's placement with the employer.

E. Employers identified in Section 30.960.A shall provide access to county departments conducting investigations of mistreatment of at-risk adults pursuant to Section 26-3.1-103(1.3), C.R.S and

Section 30.510.J F. Authorized requestors shall register prior to requesting a CAPS check to allow for verification of the authorized requestor’s legal authority to request the check.

1. The authorized requestor is responsible for ensuring the registration information is up to date.

2. There shall be no fee to the authorized requestor to register.

3. The authorized requestor shall only access the CAPS check system for business needs related to CAPS check requirements.

a. All authorized requestors must electronically sign the security and confidentiality agreement when registering and follow the requirements therein.

b. All authorized requestors shall not share username or password information with any other individual, regardless of whether that individual is also an authorized requestor. Each authorized requestor must have their own username and password.

c. Violations of security and confidentiality requirements may result in loss of access to the system, at the discretion of the state department.

G. Using a form developed by the State Department, authorized requestors shall obtain written authorization and any required identifying information from the new or existing employee or volunteer or potential appointee prior to requesting a CAPS check. Required identifying information necessary to request the CAPS check includes information such as name, date of birth, and email address, etc.

1. The form must be completed and signed by the employee, volunteer, or potential appointee.

2. Knowingly providing inaccurate information on the written authorization form is a class 2 misdemeanor as set forth in Section 26-3.1-111(6)(e.7), C.R.S.

3. The CAPS Check Unit (CCU) may request the employee’s, volunteer’s, or potential appointee’s written authorization form from the employer or the court as supporting documentation.

H. The state department of human services does not determine:

1. Which employees or volunteers provide direct care as described in Section 30.100 and pursuant to Section 26-3.1-101(3.5), C.R.S. employers are responsible for determining which employees and/or volunteers will provide direct care, thereby requiring CAPS checks. Employers shall make determinations based on the definition of direct care outlined in Section 30.100 and/or any guidance or regulations set forth by the employer’s oversight agency.

2. Whether a substantiated finding reported on an initial CAPS check and/or a flagged check disqualifies an employee from providing care to at-risk adults. Employers are responsible for determining whether the results of the CAPS check disqualify the employee or volunteer from employment. Employers shall make determinations based on any internal processes and/or any guidance or regulations set forth by the employer’s oversight agency.

I. Authorized requestors shall request a CAPS check using an online or hard copy form developed by the State Department.

1. If more than thirty (30) days have elapsed between an employer’s request for a CAPS check for a potential employee or volunteer, and the employer’s decision to initiate hiring, the employer must request a new CAPS check prior to hiring the employee or volunteer.

2. If an employee or volunteer leaves employment but is considered for rehire after more than thirty (30) days have elapsed since leaving employment, the employer must request a new CAPS check prior to rehire.

3. If the court does not appoint the potential appointee as a guardian or conservator but the person is considered for appointment as a guardian or conservator of an at-risk adult more than thirty (30) days after the court’s case was closed, the court must request a new CAPS check prior to appointment in a new case. Until such time as the court closes the case or is no longer considering the potential appointee’s original petition for appointment, the 30-day time limitation on the CAPS check does not begin to run.

a. If a potential appointee is nominated for appointment as a guardian or conservator of an at-risk adult in multiple courts, each court must conduct its own CAPS check on said potential appointee to ensure that each court is notified in the event of a flagged check.

b. Potential appointees who are professionals, are defined as, “an individual or entity engaged in the business of providing services as guardian or conservator, who is not related to the respondent in a case by blood, law, or marriage. Such professionals usually act as guardian or conservator for two or more individuals”.

If said professional appointee is nominated for appointment as a guardian or conservator:

i. Of an at-risk adult in multiple courts, each court must conduct its own CAPS check on said appointee to ensure each court is notified in the event of a flagged check.

ii. For multiple at-risk adults in a single court, that court will only need to conduct one CAPS check on said potential appointee.

4. If an authorized requestor requests the results of a previously completed CAPS check to be re-sent:

a. If the request is submitted to the state department within 180 days of the completion of the CAPS check, the CAPS check results will be re-sent to the authorized requestor at no additional cost.

b. If the request is submitted to the state department more than 180 days after initial completion, a new CAPS check request may need to be submitted by the authorized requestor, as described in Section 30.960.I and J, based on the circumstances of the request and the discretion of the state department 5. If the information provided for the CAPS check is incomplete the CCU may request additional information from the employer or the court.

a. If the additional information is not provided by the employer or the court the CCU will close the request and will not conduct the CAPS check.

b. the fee for the CAPS check shall not be refunded to the employer or the court.

6. If an employer or the court provides information the CCU has reason to believe is inaccurate:

a. The CCU will contact the employer or the court regarding the information believed to be inaccurate.

b. The CCU may request the employer or the court to provide the written authorization form to the CCU. If the employer or the court does not provide the written authorization form, the CCU will close the request and will not conduct the CAPS check. The CAPS check fee will not be refunded.

c. If the CCU identifies a pattern of inaccurate information being provided by an employer or court, the CCU will implement steps to address the pattern, which may include, but are not limited to, contacting the agency administrator, requiring submission of the written authorization form with each CAPS check request, and/or requesting legal assistance to resolve the concerns.

d. Knowingly providing inaccurate information on a CAPS check request is a class 2 misdemeanor, as outlined in Section 26-3.1-111(6)(e.7), C.R.S.

7. If a screening company that requests CAPS checks on behalf of an employer provides information the CCU has reason to believe is inaccurate:

a. The CCU will contact the employer and/or screening company regarding the information believed to be inaccurate.

b. The CCU may request the screening company to provide the written authorization form to the CCU. If the screening company does not provide the written authorization form, the CCU will close the request and will not conduct the CAPS check. The CAPS check fee will not be refunded.

c. If the CCU identifies a pattern of inaccurate information being provided by a screening company hired by an employer, the CCU will implement steps to address the pattern, which may include, but are not limited to, contacting the employer that hired the screening company, requiring submission of the written authorization form with each CAPS check request, prohibiting the screening company from requesting CAPS checks, and/or requesting legal assistance to resolve the concerns.

d. Knowingly providing inaccurate information on a CAPS check request is a class 2 misdemeanor, as outlined in Section 26-3.1-111(6)(e.7), C.R.S.

8. Submitting a CAPS check request for an individual who is not being considered for an employee or volunteer position providing direct care to at-risk adults or providing care through Consumer Directed Support Services or for a person who is not a potential appointee is a class 2 misdemeanor, as outlined in Section 26-3.1-111(6)(e.3), C.R.S.

J. The fee for the CAPS check shall be:

1. Established to provide adequate revenue to support all direct and indirect costs related to the administrative appeals processes for substantiated perpetrators and the CAPS checks.

2. No greater than $16.50 per CAPS check, unless the State Board of Human Services approves an increased fee based upon increased direct and indirect costs of the administrative appeals and CAPS checks.

a. The current CAPS check fee shall be posted ON THE CAPS check website.

b. The current CAPS check fee may be adjusted with THIRTY (30) days’ notice, provided via the CAPS check website.

3. Paid by the authorized requestor at the time of the request.

a. If the authorized requestor chooses to request the CAPS check via the online form, payment must be made through the online payment system at the time of the request. A CAPS check will not be completed without payment.

b. If the authorized requestor chooses to request the CAPS check via first class mail, payment in the form of an agency warrant or bank check must be attached to the form. A CAPS check will not be completed without payment.

c. Authorized requestors may choose to request that the employee, volunteer, or potential appointee reimburse the authorized requestor for the cost of the check.

K. The State Department shall complete the CAPS check and respond to the employer’s request as soon as possible, but no later than five (5) business days following the receipt of the request. The State Department shall complete the CAPS check and respond to the court’s request as soon as possible, but no later than seven (7) calendar days following the receipt of the request.

1. The State Department shall provide the CAPS check results to the authorized requestor via email, unless receipt of the results via first class mail is requested.

a. If the employee is also the employer who requested the CAPS check on themselves, such as a facility administrator or owner, or an independent owner operator, and the employee/employer is determined not to have a substantiated finding of mistreatment, the results will be provided to the employee/employer.

b. If the employee is also the employer who requested the CAPS check on themselves, such as a facility administrator or owner, or an independent owner operator, and the employee/employer is determined to have a substantiated finding of mistreatment, the results will be provided to the employee/employer and to the parent company and/or oversight agency(ies).

L. The CAPS check results shall indicate:

1. Whether there is or is not a substantiated finding for the employee, volunteer, or potential appointee;

2. The purposes for which the information in CAPS may be made available;

3. The consequences of improper release of the information in CAPS;

4. If the person does have a substantiated finding, the results will also provide the date(s) of the substantiated finding(s), county department(s) that completed the investigation(s), the type(s) and severity level(s) of the mistreatment, and the substantiated perpetrator’s right to appeal and the time frame allowed by rule to request an appeal. No additional information about the mistreatment and/or substantiated finding will be provided through the CAPS check process.

5. For CAPS check results for the court in which there is a substantiated finding, the CAPS check results will also include whether there is an active appeal at the time of the court’s request. No additional information about the mistreatment and/or substantiated finding will be provided through the CAPS check process.

M. Notification of any flagged check shall be provided to the authorized requestor, the employer, or to the employee/employer’s parent company and/or oversight agency(ies), as outlined in Section 30.960.K.1.b, at the time the new finding is completed in CAPS, after verification that the flagged check relates to a current employee or volunteer.

N. Findings shall not be included in CAPS check results when:

1. The finding was made prior to July 1, 2018 when due process for substantiated perpetrators began, as outlined in Section 30.910; and/or, 2. The finding was expunged or overturned through the appeals process, as outlined in

Section 30.920; and/or, 3. A positive match of at least two data points between the employee and a substantiated perpetrator in CAPS, such as name, date of birth, or address, cannot be determined with certainty.

O. An employer, or a person or entity conducting screening on behalf of an employer, shall obtain CAPS checks for the purpose of informing hiring and employment decisions.

1. A staffing agency providing direct care staff to an employer described in Section 30.960.A and pursuant to Section 26-3.1-111(7), C.R.S. shall provide the employer with a copy of the official results of the CAPS check and a copy of any official flagged checks, as described in Section 30.960.M and pursuant to Section 26-3.1-111(10), C.R.S., within five business days after receipt of the information, for the duration of the employee's placement with the employer.

2. Nothing in this section prohibits an employer from hiring or contracting with an employee who will provide direct care to an at-risk adult prior to receiving the results of the CAPS check.

P. Information obtained through a CAPS check by an authorized requestor is confidential and shall only be released pursuant to Section 26-3.1-111(6)(d), C.R.S.

1. CAPS checks shall only be released by the state department to an employer, a person or entity conducting employee screening on behalf of an employer, or to a county department conducting CAPS checks on potential APS employees, as outlined in Section 30.320.

2. An employer, or a person or entity conducting employee screening on behalf of an employer, may lawfully release information received through a CAPS check as outlined below:

a. To the employer;

b. To a state agency or its contractor, upon the request of the agency or contractor, for purposes of an employer inspection or survey or for purposes of a regulatory investigation conducted by a health oversight agency, as defined in 42 CFR 164.501 pursuant to Section 12-20-401, C.R.S.; or, c. At the request of a current or prospective employer of a health-care worker or caregiver in accordance with Section 8-2-111.6 or Section 8-2-111.7, C.R.S.

3. Section 26-3.1-111(6)(e), C.R.S., creates a criminal penalty for any person who improperly releases or who willfully permits or encourages the release of data or information obtained through a CAPS check to persons not permitted access to the information pursuant to C.R.S. Title 26, Article 3.1.

4. An employer, or a person or entity conducting employee screening on behalf of an employer, who releases the results of a CAPS check to anyone other than those directly involved in the employer’s hiring process, except as required of staffing agencies in

Section 30.960.O.2., violates the law pursuant to Section 26-3.1-111(D)(I)(B), C.R.S.

5. The provisions of this subsection are in addition to and not in lieu of other applicable federal and state laws or requirements concerning protected confidential information.

Employers are responsible for ensuring adherence to applicable federal and state requirements regarding the use of information obtained during any pre-employment screening and/or hiring processes. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 08/01/2012.

Rules SB&P, 30.250, 30.640, 30.645 eff. 04/01/2013.

Rules SB&P, 30.100, 30.210, 30.330, 30.410, 30.520, 30.610-30.620, 30.830 eff. 04/01/2014.

Rules SB&P, 30.100-30.220 B.5, 30.230-30.310, 3.330-30.640, 30.650-30.810, 30.830 eff. 09/01/2014.

Entire rule eff. 02/01/2017.

Rules 30.100, 30.250 B, 30.250 E-30.250 G, 30.320 B, 30.330, 30.510 A, 30.510 B, 30.520, 30.620 C.4 eff. 04/01/2018.

Rules 30.100, 30.250 E.10, 30.260 E-F, 30.340 A-B, 30.410 D.6, 30.520 A.7-11, 30.520 B, 30.900 eff. 06/01/2018.

Rules 30.100, 30.250 E.11, 30.320, 30.960 eff. 07/30/2018.

Rules 30.100, 30.250, 30.520 A.2.d-f emer. rules eff. 08/02/2019.

Rules 30.100, 30.250, 30.520 A.2.d-f eff. 10/01/2019.

Rules 30.100, 30.210 B, 30.260 A-B, 30.330 B.4, 30.340 A.4, 30.340 D.1, 30.410 C, 30.420 F-G, 30.430 C, 30.510, 30.520, 30.530, 30.610, 30.620 K.3, 30.660 B,D 30.910 B.4,C eff. 12/30/2019. Rule 30.430 E repealed eff. 12/30/2019.

Rules 30.920 I, 30.930 A.2 emer. rules eff. 05/08/2020.

Rules 30.920 I, 30.930 A.2 eff. 08/01/2020.

Rules 30.100, 30.230-30.250, 30.310-30.330, 30.410-30.430, 30.510-30.530, 30.610-30.630, 30.660, 30.810, 30.830, 30.910, 30.930, 30.960 emer. rules eff. 09/13/2020.

Rules 30.100, 30.230-30.250, 30.310-30.330, 30.400, 30.500, 30.610-30.630, 30.660, 30.810, 30.830, 30.910, 30.930, 30.960 eff. 11/30/2020.

Rule 30.220 eff. 06/30/2021.

Rules 30.920 O-30.920 Q emer. rules eff. 12/03/2021.

Rules 30.100, 30.250 B.7.c, 30.250 B.8.b.i, 30.250 B.10-11, 30.520 A.3.d.iv-vi, 30.520 B.5-6, 30.520 D-E, 30.960 B,D-N emer. rules eff. 01/01/2022.

Rules 30.100, 30.250 B.7.c, 30.250 B.8.b.i, 30.250 B.10-11, 30.520 A.3.d.iv-vi, 30.520 B.5-6, 30.520 D-E, 30.920 O-30.920 Q, 30.960 B,D-N eff. 03/02/2022.

Rules 30.100, 30.220 D, 30.250 D-H, 30.330 G, 30.340 A, 30.420, 30.430, 30.440, 30.510, 30.520, 30.525, 30.620 H-I, 30.660, 30.920 O, 30.960 eff. 11/01/2022.

Rules 30.100, 30.250 A, 30.250 B.7,11, 30.250 D, 30.960 eff. 01/01/2024.

Annotations The definition of “self-neglect” in Rule 30.100 (adopted 02/02/2018) was not extended by Senate Bill 19- 168 and therefore expired 05/15/2019.

## **2519** Child Protection Ombudsman Program

##### **12 CCR 2519-1** CHILD PROTECTION OMBUDSMAN PROGRAM [Repealed eff. 01/01/2016] {#sec-12-ccr-2519-1 omnilex-key=us-co-regs-official--department-9--12 CCR 2519-1}

DEPARTMENT OF HUMAN SERVICES

Child Protection Ombudsman Program CHILD PROTECTION OMBUDSMAN PROGRAM - Repealed eff. 01/01/2016 12 CCR 2519-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Creation of 12 CCR 2519-1, Sections 31.000 through 31.900, were final adoption following publication at the 12/5/2014 State Board meeting (Rule-making# 13-10- 29-1), with an effective date of 2/1/2015.

Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Enterprise Partnerships, State Board Administration.

Sections 31.000 through 31.900 were repealed in their entirety upon final adoption following publication at the 11/6/2015 State Board of Human Services rule-making session (Rule-making# 15-8-14-1), with an effective date of 1/1/2016. Statement of Basis and Purpose and specific statutory authority for these revisions were incorporated by reference into the rule. These materials are available for review by the public during normal working hours at the Colorado Department of Human Services, Office of Strategic Communications and Legislative Relations, State Board Administration. _________________________________________________________________________ Editor’s Notes

History Entire rule eff. 02/01/2015.

Entire rule repealed eff. 01/01/2016.