Protective Services for Adults at Risk of Mistreatment or Self-neglect

C.R.S. tit. 26, art. 3.1
in effect

C.R.S. § 26-3.1-101 Definitions

26-3.1-101. Definitions. As used in this article 3.1, unless the context otherwise requires: (1) "Abuse" means any of the following acts or omissions committed against an at-risk adult: (a) The nonaccidental infliction of physical pain or injury, as demonstrated by, but not limited to, substantial or multiple skin bruising, bleeding, malnutrition, dehydration, burns, bone fractures, poisoning, subdural hematoma, soft tissue swelling, or suffocation; (b) Confinement or restraint that is unreasonable under generally accepted caretaking standards; or (c) Unlawful sexual behavior as defined in section 16-22-102 (9). (1.5) "At-risk adult" means an individual eighteen years of age or older who is susceptible to mistreatment or self-neglect because the individual is unable to perform or obtain services necessary for his or her health, safety, or welfare, or lacks sufficient understanding or capacity to make or communicate responsible decisions concerning his or her person or affairs. (1.7) "CAPS" means the Colorado adult protective services data system that includes records of reports of mistreatment of at-risk adults. (1.8) "CAPS check" means a check of the Colorado adult protective services data system pursuant to section 26-3.1-111. (2) "Caretaker" means a person who: (a) Is responsible for the care of an at-risk adult as a result of a legal relationship; or (b) Has assumed responsibility for the care of an at-risk adult; or (c) Is paid to provide care, services, or oversight of services to an at-risk adult. (2.3) (a) "Caretaker neglect" means neglect that occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, habilitation, supervision, or other treatment necessary for the health or safety of the at-risk adult is not secured for an at-risk adult or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise, or a caretaker knowingly uses harassment, undue influence, or intimidation to create a hostile or fearful environment for an at-risk adult. (b) Notwithstanding the provisions of paragraph (a) of this subsection (2.3), the withholding, withdrawing, or refusing of any medication, any medical procedure or device, or any treatment, including but not limited to resuscitation, cardiac pacing, mechanical ventilation, dialysis, artificial nutrition and hydration, any medication or medical procedure or device, in accordance with any valid medical directive or order, or as described in a palliative plan of care, is not deemed caretaker neglect. (c) As used in this subsection (2.3), "medical directive or order" includes a medical durable power of attorney, a declaration as to medical treatment executed pursuant to section 15-18-104, C.R.S., a medical order for scope of treatment form executed pursuant to article 18.7 of title 15, C.R.S., and a CPR directive executed pursuant to article 18.6 of title 15, C.R.S. (2.5) "Clergy member" means a priest; rabbi; duly ordained, commissioned, or licensed minister of a church; member of a religious order; or recognized leader of any religious body. (3) "County department" means a county or district department of human or social services. (3.5) "Direct care" means services and supports, including case management services, protective services, physical care, mental health services, or any other service necessary for the at-risk adult's health, safety, or welfare. (4) "Exploitation" means an act or omission that: (a) Uses deception, harassment, intimidation, or undue influence to permanently or temporarily deprive an at-risk adult of the use, benefit, or possession of any thing of value; or (b) Employs the services of a third party for the profit or advantage of the person or another person to the detriment of the at-risk adult; or h, safety, or welfare. (4) "Exploitation" means an act or omission that: (a) Uses deception, harassment, intimidation, or undue influence to permanently or temporarily deprive an at-risk adult of the use, benefit, or possession of any thing of value; or (b) Employs the services of a third party for the profit or advantage of the person or another person to the detriment of the at-risk adult; or (c) Forces, compels, coerces, or entices an at-risk adult to perform services for the profit or advantage of the person or another person against the will of the at-risk adult; or (d) Misuses the property of an at-risk adult in a manner that adversely affects the at-risk adult's ability to receive health care or health-care benefits or to pay bills for basic needs or obligations. (5) "Financial institution" means a state or federal bank, savings bank, savings and loan association or company, building and loan association, trust company, or credit union. (5.5) "Harmful act" means an act committed against an at-risk adult by a person with a relationship to the at-risk adult when such act is not defined as abuse, caretaker neglect, or exploitation but causes harm to the health, safety, or welfare of an at-risk adult. (6) "Least restrictive intervention" means acquiring or providing services, including protective services, for the shortest duration and to the minimum extent necessary to remedy or prevent situations of actual mistreatment or self-neglect. (7) "Mistreatment" means: (a) Abuse; (b) Caretaker neglect; (c) Exploitation; or (d) A harmful act. (e) Repealed. (8) Repealed. (9) "Protective services" means services provided by the state or political subdivisions or agencies thereof in order to prevent the mistreatment or self-neglect of an at-risk adult. Such services include, but are not limited to: Providing casework services and arranging for, coordinating, delivering, where appropriate, and monitoring services, including medical care for physical or mental health needs; protection from mistreatment and self-neglect; assistance with application for public benefits; referral to community service providers; and initiation of probate proceedings. (10) "Self-neglect" means an act or failure to act whereby an at-risk adult substantially endangers his or her health, safety, welfare, or life by not seeking or obtaining services necessary to meet his or her essential human needs. Choice of lifestyle or living arrangements shall not, by itself, be evidence of self-neglect. Refusal of medical treatment, medications, devices, or procedures by an adult or on behalf of an adult by a duly authorized surrogate medical decision maker or in accordance with a valid medical directive or order, or as described in a palliative plan of care, shall not be deemed self-neglect. Refusal of food and water in the context of a life-limiting illness shall not, by itself, be evidence of self-neglect. As used in this subsection (10), "medical directive or order" includes, but is not limited to, a medical durable power of attorney, a declaration as to medical treatment executed pursuant to section 15-18-104, C.R.S., a medical orders for scope of treatment form executed pursuant to article 18.7 of title 15, C.R.S., and a CPR directive executed pursuant to article 18.6 of title 15, C.R.S. (11) "Undue influence" means the use of influence to take advantage of an at-risk adult's vulnerable state of mind, neediness, pain, or emotional distress.

C.R.S. § 26-3.1-102 Reporting requirements

26-3.1-102. Reporting requirements. (1) (a) A person specified in subsection (1)(b) of this section who observes the mistreatment or self-neglect of an at-risk adult or who has reasonable cause to believe that an at-risk adult has been mistreated or is self-neglecting or is at imminent risk of mistreatment or self-neglect is urged to report such fact to a county department not more than twenty-four hours after making the observation or discovery. (a.5) As required by section 18-6.5-108, C.R.S., certain persons specified in paragraph (b) of this subsection (1) who observe the mistreatment, as defined in section 18-6.5-102 (10.5), C.R.S., of an at-risk elder, as defined in section 18-6.5-102 (3), C.R.S., or an at-risk adult with IDD, as defined in section 18-6.5-102 (2.5), C.R.S., or who have reasonable cause to believe that an at-risk elder or an at-risk adult with IDD has been mistreated or is at imminent risk of mistreatment shall report such fact to a law enforcement agency not more than twenty-four hours after making the observation or discovery. (b) The following persons, whether paid or unpaid, are urged to report as described in subsection (1)(a) of this section: (I) Any person providing health-care or health-care-related services including general medical, surgical, or nursing services; medical, surgical, or nursing speciality services; dental services; vision services; pharmacy services; chiropractic services; or physical, occupational, musical, or other therapies; (II) Hospital and long-term care facility personnel engaged in the admission, care, or treatment of patients; (III) First responders, including emergency medical service providers, fire protection personnel, law enforcement officers, and persons employed by, contracting with, or volunteering with any law enforcement agency, including victim advocates; (IV) Code enforcement officers; (V) Medical examiners and coroners; (VI) Veterinarians; (VII) Psychologists, addiction counselors, professional counselors, marriage and family therapists, and unlicensed psychotherapists, as those persons are defined in article 245 of title 12; (VIII) Social workers, as defined in part 4 of article 245 of title 12; (IX) Staff of case management agencies, as defined in section 25.5-6-1702; (X) Staff, consultants, or independent contractors of service agencies, as defined in section 25.5-10-202 (34), C.R.S.; (XI) Staff or consultants for a licensed or unlicensed, certified or uncertified, care facility, agency, home, or governing board, including but not limited to long-term care facilities, home care agencies, or home health providers; (XII) Caretakers, staff members, employees of, or consultants for, a home care placement agency, as defined in section 25-27.5-102 (5), C.R.S.; (XIII) Persons performing case management or assistant services for at-risk adults; (XIV) Staff of county departments of human or social services; (XV) Staff of the state departments of human services, public health and environment, or health care policy and financing; (XVI) Staff of senior congregate centers or senior research or outreach organizations; (XVII) Staff, and staff of contracted providers, of area agencies on aging, except the long-term care ombudsmen; (XVIII) Employees, contractors, and volunteers operating specialized transportation services for at-risk adults; (XIX) Landlords and staff of housing and housing authority agencies for at-risk adults; (XX) Court-appointed guardians and conservators; (XXI) Personnel at schools serving persons in preschool through twelfth grade; rs, of area agencies on aging, except the long-term care ombudsmen; (XVIII) Employees, contractors, and volunteers operating specialized transportation services for at-risk adults; (XIX) Landlords and staff of housing and housing authority agencies for at-risk adults; (XX) Court-appointed guardians and conservators; (XXI) Personnel at schools serving persons in preschool through twelfth grade; (XXII) Clergy members; except that the reporting requirement described in paragraph (a) of this subsection (1) does not apply to a person who acquires reasonable cause to believe that an at-risk adult has been mistreated or has been exploited or is at imminent risk of mistreatment or exploitation during a communication about which the person may not be examined as a witness pursuant to section 13-90-107 (1)(c), C.R.S., unless the person also acquires such reasonable cause from a source other than such a communication; and (XXIII) Persons working in financial services industries, including banks, savings and loan associations, credit unions, and other lending or financial institutions; accountants; mortgage brokers; life insurance agents; and financial planners. (c) In addition to those persons urged by this subsection (1) to report known or suspected mistreatment or self-neglect of an at-risk adult and circumstances or conditions that might reasonably result in mistreatment or self-neglect, any other person may report such known or suspected mistreatment or self-neglect and circumstances or conditions that might reasonably result in mistreatment or self-neglect of an at-risk adult to the local law enforcement agency or the county department. Upon receipt of such report, the receiving agency shall prepare a written report within twenty-four hours. (2) Pursuant to subsection (1) of this section, the report must include: (a) The name and address of the at-risk adult; (b) The name and address of the at-risk adult's caretaker, if any; (c) The age, if known, of the at-risk adult; (d) The nature and extent of the at-risk adult's injury, if any; (e) The nature and extent of the condition that will reasonably result in mistreatment or self-neglect; and (f) Any other pertinent information. (3) A copy of the written report prepared by the county department in accordance with subsections (1) and (2) of this section that includes an allegation of mistreatment must be forwarded within twenty-four hours after receipt of the report to a local law enforcement agency. A written report prepared by a local law enforcement agency must be forwarded within one business day of the receipt of the report to the county department. (4) A person, including a person specified in subsection (1) of this section, shall not knowingly make a false report of mistreatment or self-neglect to a county department or local law enforcement agency. Any person who willfully violates the provisions of this subsection (4) commits a class 2 misdemeanor and shall be punished as provided in section 18-1.3-501, and shall be liable for damages proximately caused thereby. (5) Any person, except a perpetrator, complicitor, or coconspirator, who makes a report pursuant to this section shall be immune from any civil or criminal liability on account of such report, testimony, or participation in making such report, so long as such action was taken in good faith and not in reckless disregard of the truth or in violation of subsection (4) of this section. (6) A person shall not take any discriminatory, disciplinary, or retaliatory action against any person who, in good faith, makes a report or fails to make a report of suspected mistreatment or self-neglect of an at-risk adult. cipation in making such report, so long as such action was taken in good faith and not in reckless disregard of the truth or in violation of subsection (4) of this section. (6) A person shall not take any discriminatory, disciplinary, or retaliatory action against any person who, in good faith, makes a report or fails to make a report of suspected mistreatment or self-neglect of an at-risk adult. (7) (a) Except as provided in subsection (7)(b) of this section, reports of the mistreatment or self-neglect of an at-risk adult, including the name and address of any at-risk adult, member of said adult's family, or informant, or any other identifying information contained in such reports and subsequent cases resulting from the reports, is confidential and is not public information. (b) Disclosure of a report of the mistreatment or self-neglect of an at-risk adult and information relating to an investigation of such a report and subsequent cases resulting from the report is permitted only when authorized by a court for good cause. A court order is not required, and such disclosure is not prohibited, when: (I) A criminal investigation into an allegation of mistreatment is being conducted, when a review of death by a coroner is being conducted when the death is suspected to be related to mistreatment, or when a criminal complaint, information, or indictment is filed and the report and case information is relevant to the investigation, death review, complaint, or indictment; (II) There is a death of a suspected at-risk adult from mistreatment or self-neglect and a law enforcement agency files a formal charge or a grand jury issues an indictment in connection with the death; (III) The disclosure is necessary for the coordination of multiple agencies' joint investigation of a report or for the provision of protective services to an at-risk adult; (IV) The disclosure is necessary for purposes of an audit of a county department of human or social services pursuant to section 26-1-114.5; (V) The disclosure is made for purposes of the appeals process relating to a substantiated case of mistreatment of an at-risk adult pursuant to section 26-3.1-108 (2). The provisions of this subsection (7)(b)(V) are in addition to and not in lieu of other federal and state laws concerning protected or confidential information. (VI) The disclosure is made by the state department to an employer, or to a person or entity conducting employee screening on behalf of the employer, as part of a CAPS check pursuant to section 26-3.1-111 or by a county department pursuant to section 26-3.1-107. (VII) The disclosure is made to the at-risk adult who is the subject of the report, or if the at-risk adult is otherwise incompetent at the time of the request, to the guardian or guardian ad litem for the at-risk adult who is the subject of the report. The information disclosed pursuant to this subsection (7)(b)(VII) must not be disclosed until after the investigation is complete and must not include any identifying information related to the reporting party or any other appropriate persons. If the guardian is the substantiated perpetrator in a case of mistreatment of an at-risk adult, the disclosure must not be made without authorization by a court for good cause unless the disclosure is being made for the purposes of the guardian's appeal process described in subsection (7)(b)(V) of this section. If the court authorizes the release of information to a substantiated perpetrator, any protected or confidential information pursuant to federal or state law must not be disclosed. t, the disclosure must not be made without authorization by a court for good cause unless the disclosure is being made for the purposes of the guardian's appeal process described in subsection (7)(b)(V) of this section. If the court authorizes the release of information to a substantiated perpetrator, any protected or confidential information pursuant to federal or state law must not be disclosed. (VIII) The disclosure is made to a county department that assesses or provides protective services for children, when the information is necessary to adequately assess for safety and risk or to provide protective services for a child. The information disclosed pursuant to this subsection (7)(b)(VIII) is limited to information regarding prior or current referrals, assessments, investigations, or case information related to an at-risk adult or an alleged perpetrator. A county department that assesses or provides protective services for at-risk adults is similarly permitted to access information from a county department that assesses or provides protective services for children pursuant to section 19-1-307 (2)(x). The provisions of this subsection (7)(b)(VIII) are in addition to and not in lieu of other federal and state laws concerning protected or confidential information. (IX) The disclosure is made to an employer required to request a CAPS check pursuant to section 26-3.1-111 or to the state department agency that oversees the employer when the information is necessary to ensure the safety of other at-risk adults under the care of the employer. The information must be the minimum information necessary to ensure the safety of other at-risk adults under the care of the employer or oversight of the state department agency. (X) The disclosure is made pursuant to section 26-3.1-111 (12) to a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator, as defined in section 12-20-102 (14), within such a health oversight agency; and (XI) The disclosure is made to the court pursuant to section 26-3.1-111 (3)(b) and (8.5)(b). (c) Any person who violates any provision of this subsection (7) commits a civil infraction.

C.R.S. § 26-3.1-103 Evaluations - investigations - training - exception for counties participating in alternative response program - rules

26-3.1-103. Evaluations - investigations - training - exception for counties participating in alternative response program - rules. (1) The county department receiving a report of mistreatment or self-neglect of an at-risk adult shall immediately assess the reported level of risk. The immediate concern of the evaluation is the protection of the at-risk adult. The decision regarding the level of risk must, at a minimum, include a determination of a response time frame and whether the report meets the criteria for an investigation of the allegations, as set forth in state department rule. If a county department determines that an investigation is required, the county department is responsible for ensuring an investigation is conducted and arranging for the subsequent provision of protective services to be conducted by persons trained to conduct investigations and provide protective services. (1.3) (a) Pursuant to state department rule, each employer as defined by section 26-3.1-111 (7) shall provide, upon request of the county department, access to conduct an investigation into an allegation of mistreatment. Access must include the ability to request interviews with relevant persons and to obtain documents and other evidence and have access to: (I) Patients who are the subject of the investigation into mistreatment of an at-risk adult and patients who are relevant to an investigation into an allegation of mistreatment of an at-risk adult; (II) Personnel, including paid employees, contractors, volunteers, and interns, who are relevant to the investigation; (III) Clients or residents who are the subject of the investigation into mistreatment of an at-risk adult and clients or residents who are relevant to an investigation into an allegation of mistreatment of an at-risk adult; (IV) Individual patient, resident, client, or consumer records, including disclosure of health records or incident and investigative reports, care and behavioral plans, staff schedules and time sheets, and photos and other technological evidence; and (V) The professional license number issued by the division of professions and occupations in the department of regulatory agencies for a current or former employee who holds a health-care provider or health-care occupation license and who, as a result of the investigation, is substantiated in a case of mistreatment of an at-risk adult during the employee's professional duties. (b) The county department and its employees shall comply with applicable federal laws related to the privacy of information when requesting or obtaining documents pursuant to this subsection (1.3). (c) County department staff conducting an investigation pursuant to this section have the right to enter the premises of any employer as defined by section 26-3.1-111 (7) as necessary to complete a thorough investigation. County department staff shall identify themselves and the purpose of the investigation to the person in charge of the entity at the time of entry. uant to this subsection (1.3). (c) County department staff conducting an investigation pursuant to this section have the right to enter the premises of any employer as defined by section 26-3.1-111 (7) as necessary to complete a thorough investigation. County department staff shall identify themselves and the purpose of the investigation to the person in charge of the entity at the time of entry. (d) Attorneys at law providing legal assistance to individuals pursuant to a contract with an area agency on aging, the staff of such attorneys at law, and the long-term care ombudsman are exempt from the requirements of this section. (1.4) Upon request of the county department, any person who holds a health-care provider or health-care occupation license issued by the division of professions and occupations in the department of regulatory agencies and, as a result of the investigation, is substantiated in a case of mistreatment of an at-risk adult while performing the person's professional duties shall provide the person's professional license number to the county department. (1.5) The state department shall provide training to all current county department adult protective services caseworkers and supervisors no later than July 1, 2018, and to new county department adult protective services caseworkers and supervisors hired after July 1, 2018, to achieve consistency in the performance of the following duties: (a) Investigating reports of suspected mistreatment or self-neglect of at-risk adults and making findings concerning cases and alleged perpetrators; (b) Notifying a person who has been substantiated in a case of mistreatment of an at-risk adult of the finding and of the person's right to appeal the finding to the state department; (c) Assessing the client's strengths and needs and developing a plan for the provision of protective services; (d) Determining the appropriateness of case closure; (e) Entering accurate and complete documentation of the report and subsequent casework into CAPS; and (f) Maintaining confidentiality in accordance with state law. (2) Each county department, law enforcement agency, district attorney's office, and other agency responsible under federal law or the laws of this state to investigate mistreatment or self-neglect of at-risk adults shall develop and implement cooperative agreements to coordinate the investigative duties of such agencies. The focus of such agreements is to ensure the best protection for at-risk adults. The agreements must provide for special requests by one agency for assistance from another agency and for joint investigations. The agreements must further provide that each agency maintain the confidentiality of the information exchanged pursuant to such joint investigations. (3) Each county or contiguous group of counties in the state in which a minimum number of reports of mistreatment or self-neglect of at-risk adults are annually filed shall establish an at-risk adult protection team. The state board shall promulgate rules to specify the minimum number of reports that will require the establishment of an adult at-risk protection team. The at-risk adult protection team shall review the processes used to report and investigate mistreatment or self-neglect of at-risk adults, review the provision of protective services for such adults, facilitate interagency cooperation, and provide community education on the mistreatment and self-neglect of at-risk adults. The director of each county department shall create or coordinate a protection team for the respective county in accordance with rules adopted by the state board of human services. The state board rules shall govern the establishment, composition, and duties of the team and must be consistent with this subsection (3). (4) Repealed.

C.R.S. § 26-3.1-103.3 Alternative response pilot program for the provision of protective services for at-risk adults - creation - report - rules - repeal

26-3.1-103.3. Alternative response pilot program for the provision of protective services for at-risk adults - creation - report - rules - repeal. (1) On or after January 1, 2022, the alternative response pilot program for the provision of protective services for at-risk adults, referred to in this section as the "pilot", is created in the state department. The pilot allows a county department that is participating in the pilot, pursuant to this section and rules promulgated by the state department, to address, through a separate process from that set forth in section 26-3.1-103, any report, related to an at-risk adult, of mistreatment or self-neglect that was initially assessed by the county department to be low risk, as defined by rule. (2) The state department shall select a maximum of fifteen county departments to participate in the pilot. The state department is strongly encouraged to include county departments from throughout the state, including a diverse mix of urban, suburban, frontier, and rural. (3) (a) If a participating county department receives a report, related to an at-risk adult, of mistreatment or self-neglect, that was initially assessed by the county department to be low risk, as defined by rule of the state department, the participating county will not make a finding concerning the alleged mistreatment or self-neglect of the at-risk adult, nor is it required to complete unannounced initial in-person interviews. (b) If, upon further investigation, the participating county department determines that the risk level to the at-risk adult is, in fact, more than low risk, or when the participating county department cannot fully assess, through the pilot process, the health, safety, and welfare of the at-risk adult or other at-risk adults, the participating county department shall follow the procedures set forth in section 26-3.1-103. (4) The state department shall provide initial training and ongoing technical assistance to the participating county departments upon implementation of the pilot. The state department shall administer the pilot in accordance with the requirements of this section and any rules promulgated pursuant to this section. (5) The state department shall promulgate rules for the implementation of this section. The rules must include, at a minimum, a description of the risk levels and the parameters around unannounced in-person interviews. (6) The state department is authorized to seek, accept, and expend gifts, grants, or donations from private or public sources for the purposes of this section. (7) (a) The state department shall contract with a third-party evaluator to evaluate the pilot's success or failure, including a consideration of the pilot's effectiveness in achieving outcomes over a two-year period. (b) As necessary to conduct the evaluation and complete the reports required pursuant to this subsection (7), each participating county department shall submit to the state department a report concerning the participating county department's administration and utilization of the pilot. The report must include relevant data from the participating county as required by the state department to evaluate the pilot and to prepare its report to the general assembly pursuant to subsection (7)(c) of this section. each participating county department shall submit to the state department a report concerning the participating county department's administration and utilization of the pilot. The report must include relevant data from the participating county as required by the state department to evaluate the pilot and to prepare its report to the general assembly pursuant to subsection (7)(c) of this section. (c) In January 2025 and January 2026, the state department shall report on the implementation and effect of the pilot to the health and human services committee of the senate and the public and behavioral health and human services committee of the house of representatives, or any successor committees, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required by section 2-7-203. The report must include, at a minimum: (I) A description of any specific problems that the state department or any participating county department encountered during the administration of the pilot, along with recommendations that the state department has for legislation to address such problems; and (II) A recommendation by the state department regarding whether the general assembly should repeal the pilot, continue the pilot for a specified time period, or establish the pilot statewide on a permanent basis. (8) This section is repealed, effective July 1, 2027.

C.R.S. § 26-3.1-104 Provision of protective services for at-risk adults - consent - nonconsent - least restrictive intervention

26-3.1-104. Provision of protective services for at-risk adults - consent - nonconsent - least restrictive intervention. (1) If a county director or his or her designee determines that an at-risk adult is being mistreated or self-neglected, or is at risk thereof, and the at-risk adult consents to protective services, the county director or designee shall immediately provide or arrange for the provision of protective services, which services shall be provided in accordance with the provisions of 28 CFR part 35, subpart B. (2) If a county director or his or her designee determines that an at-risk adult is being or has been mistreated or self-neglected, or is at risk thereof, and if the at-risk adult appears to lack capacity to make decisions and does not consent to the receipt of protective services, the county director is urged, if no other appropriate person is able or willing, to petition the court, pursuant to part 3 of article 14 of title 15, C.R.S., for an order authorizing the provision of specific protective services and for the appointment of a guardian, for an order authorizing the appointment of a conservator pursuant to part 4 of article 14 of title 15, C.R.S., or for a court order providing for any combination of these actions. (3) Any protective services provided pursuant to this section shall include only those services constituting the least restrictive intervention.

C.R.S. § 26-3.1-106 Training

26-3.1-106. Training. The general assembly strongly encourages training that focuses on detecting circumstances or conditions that might reasonably result in mistreatment or self-neglect of an at-risk adult for those persons who are urged by section 26-3.1-102 (1) to report known or suspected mistreatment or self-neglect of an at-risk adult.

C.R.S. § 26-3.1-107 Background check - adult protective services data system check

26-3.1-107. Background check - adult protective services data system check. (1) Each county department shall require each protective services employee hired on or after May 29, 2012, to complete a fingerprint-based criminal history record check utilizing the records of the Colorado bureau of investigation and the federal bureau of investigation. The employee shall pay the cost of the fingerprint-based criminal history record check unless the county department chooses to pay the cost. Upon completion of the fingerprint-based criminal history record check, the Colorado bureau of investigation shall forward the results to the county department. The county department shall require a name-based judicial record check, as defined in section 22-2-119.3 (6)(d), for an applicant or an employee when the results of a fingerprint-based criminal history record check performed pursuant to this section reveal a record of arrest without a disposition. (2) For each adult protective services employee hired on or after January 1, 2019, each county department shall conduct a CAPS check to determine if the person is substantiated in a case of mistreatment of an at-risk adult. The county department shall conduct the CAPS check pursuant to state department rules.

C.R.S. § 26-3.1-108 Notice of report - appeals - rules

26-3.1-108. Notice of report - appeals - rules. (1) The state department shall promulgate appropriate rules for the implementation of this article 3.1. (2) In addition to rules promulgated pursuant to subsection (1) of this section, the state department shall promulgate rules to establish a process at the state level by which a person who is substantiated in a case of mistreatment of an at-risk adult may appeal the finding to the state department. At a minimum, the rules promulgated pursuant to this subsection (2) must address the following: (a) The process by which a person who is substantiated in a case of mistreatment of an at-risk adult receives adequate and timely written notice from the county department of that finding and of his or her right to appeal the finding to the state department; (b) The effective date of the notification of finding and appeal process; (c) A requirement for and procedures to facilitate the expungement of and prevention of the release of any information contained in CAPS records for purposes of a CAPS check related to a person who is substantiated in a case of mistreatment of an at-risk adult that existed prior to July 1, 2018; except that the state department and county departments may maintain such information in CAPS to assist in future risk and safety assessments. (d) The timeline and process for appealing the finding of a substantiated case of mistreatment of an at-risk adult; (e) Designation of the entity other than the county department with the authority to accept and respond to an appeal by a person substantiated in a case of mistreatment of an at-risk adult at each stage of the appellate process; (f) The legal standards involved in the appellate process and a designation of the party who bears the burden of establishing that each standard is met; (g) The confidentiality requirements of the appeals process; and (h) The process to share information about an appeal, including the appeal outcome with a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator, as defined in section 12-20-102 (14), within such a health oversight agency, if the health oversight agency or its regulator requests information about an appeal for the purpose of a regulatory investigation conducted pursuant to section 12-20-401. Appeal information shared pursuant to this subsection (2)(h) is confidential and must be used only for the regulatory investigation. (3) Repealed.

C.R.S. § 26-3.1-109 Limitation

26-3.1-109. Limitation. Nothing in this article 3.1 means that a person is mistreated or self-neglecting or in need of emergency or protective services for the sole reason that he or she is being furnished or relies upon treatment by spiritual means through prayer alone in accordance with the tenets and practices of that person's recognized church or religious denomination, nor does anything in this article 3.1 authorize, permit, or require any medical care or treatment in contravention of the stated or implied objection of such a person.

C.R.S. § 26-3.1-110 Report concerning the implementation of mandatory reporting of elder abuse and exploitation - repeal

26-3.1-110. Report concerning the implementation of mandatory reporting of elder abuse and exploitation - repeal. (Repealed)

C.R.S. § 26-3.1-111 Access to CAPS - employment checks - conservatorship and guardianship checks - confidentiality - fees - rules - legislative declaration - definitions

26-3.1-111. Access to CAPS - employment checks - conservatorship and guardianship checks - confidentiality - fees - rules - legislative declaration - definitions. (1) The general assembly finds and declares that individuals receiving care and services from persons employed in programs or facilities described in subsection (7) of this section or from persons appointed to be a conservator or guardian of an at-risk adult are vulnerable to mistreatment, including abuse, neglect, and exploitation. It is the intent of the general assembly to minimize the potential for employment of, or appointment as conservators or guardians, persons with a history of mistreatment of at-risk adults in positions that would allow those persons unsupervised access to these adults. As a result, the general assembly finds it necessary to strengthen protections for vulnerable adults by requiring certain employers and the courts to request a CAPS check by the state department to determine if a person who will provide direct care to an at-risk adult or who may be appointed as a conservator or guardian for an at-risk adult has been substantiated in a case of mistreatment of an at-risk adult. The general assembly also finds that it is necessary to require that certain employers cooperate with, and provide access to, county departments during county investigations of mistreatment of at-risk adults pursuant to section 26-3.1-103 (1.3). (2) As used in this section, unless the context otherwise requires: (a) "Employee" means a person, other than a volunteer, who is employed by or contracted with an employer, and includes a prospective employee. (b) "Employer" means a person, facility, entity, or agency described in subsection (7) of this section and includes a prospective employer. "Employer" also includes a person hiring someone to provide consumer-directed attendant support services pursuant to article 10 of title 25.5, if the person requests a CAPS check. (c) "Staffing agency" means an individual or organization, including any partnership, limited liability partnership, limited liability company, limited liability limited partnership, association, trust, joint stock company, insurance company, or corporation, whether domestic or foreign, engaged in the business of providing and assigning workers to placements with employers described in subsection (7) of this section. "Staffing agency" includes, but is not limited to, supplemental health-care staffing agencies defined in section 8-4-125 (1)(e). (3) (a) Employer CAPS checks. The state department shall establish and implement a state-level program for employers to obtain a CAPS check to determine if a person who will provide direct care to an at-risk adult is substantiated in a case of mistreatment of an at-risk adult. The state department's program must be operational for an employer CAPS check on and after January 1, 2019. (b) Conservatorship and guardianship CAPS checks. Beginning January 1, 2022, the state department shall provide the courts the results of a CAPS check, upon the court's request and using forms approved by the state department, to determine if a person who may be appointed as a conservator or guardian of an at-risk adult is substantiated in a case of mistreatment of an at-risk adult. This subsection (3)(b) does not apply to office of public guardianship employees required to undergo a CAPS check pursuant to section 13-94-105 and subsection (7)(j) of this section, or adult protective services employees required to undergo a CAPS check pursuant to section 26-3.1-107 (2). (4) The state department shall not release information relating to any person during a CAPS check unless the person is substantiated in a case of mistreatment of an at-risk adult. (5) The state department shall promulgate rules for the implementation of this section, which rules must include the following: ve services employees required to undergo a CAPS check pursuant to section 26-3.1-107 (2). (4) The state department shall not release information relating to any person during a CAPS check unless the person is substantiated in a case of mistreatment of an at-risk adult. (5) The state department shall promulgate rules for the implementation of this section, which rules must include the following: (a) The employer process for requesting a CAPS check for an employee who has an active application for employment for a position in which the person will provide direct care to an at-risk adult; (b) The state department or county department employees or employee positions granted access to CAPS; (c) The process for completing a CAPS check and the parameters for establishing and collecting the fee charged to an employer or the court for each CAPS check; (d) The information in CAPS that will be made available to an employer or the court requesting a CAPS check; (e) The purposes for which the information in CAPS may be made available; (f) The consequences of the improper release of the information in CAPS; (g) The process for the state department to notify a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator within such a health oversight agency when a professional regulated by a regulator within such a health oversight agency, as those terms are defined in section 12-20-102 (13) and (14), is substantiated in a case of mistreatment of an at-risk adult pursuant to subsection (12) of this section; and (h) The information that will be made available to a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator, as defined in section 12-20-102 (14), within such a health oversight agency, for the purpose of conducting a regulatory investigation pursuant to section 12-20-401. (6) (a) (I) On and after January 1, 2019, prior to hiring or contracting with an employee who will provide direct care to an at-risk adult, an employer described in subsection (7) of this section shall request a CAPS check by the state department pursuant to this section to determine if the person is substantiated in a case of mistreatment of an at-risk adult; except when the employer is hiring or contracting with an employee provided by a staffing agency, if the staffing agency completed a CAPS check and provided the results to the employer pursuant to subsection (6)(a)(V) of this section. Within ten days after the date of the employer's request, if the employee was substantiated in a case of mistreatment of an at-risk adult, unless the finding was expunged through a successful appeal to the state department, the state department shall provide the employer with information concerning the mistreatment through electronic means, or other means if requested by the employer, including the date of the substantiated finding, the type of mistreatment reported, and the county that investigated the report of mistreatment. If an employer receives a CAPS check on a person and does not initiate the hiring process at the time of receiving the check but wants to hire the person at a subsequent time that is more than thirty days from receipt of the prior CAPS check results, the employer shall request a new CAPS check prior to hiring the person pursuant to state department rules. (II) A person or entity conducting employee screening on behalf of an employer may request a CAPS check pursuant to this section and may receive the results of the CAPS check from the state department. The person or entity conducting employee screening on behalf of the employer shall provide the employer with the results of the CAPS check. to hiring the person pursuant to state department rules. (II) A person or entity conducting employee screening on behalf of an employer may request a CAPS check pursuant to this section and may receive the results of the CAPS check from the state department. The person or entity conducting employee screening on behalf of the employer shall provide the employer with the results of the CAPS check. (III) If the employer is also an employee or volunteer, the employer shall request the CAPS check on himself or herself. If the employee or volunteer is determined during either the initial CAPS check or subsequently as provided in subsection (10) of this section to have a substantiated finding of mistreatment, both the employer and the employer's parent company or oversight agency shall receive the CAPS check results. (IV) An employer described in subsection (7) of this section or a person may request a CAPS check by the state department pursuant to this section on a volunteer who will provide direct care to an at-risk adult to determine if the volunteer is substantiated in a case of mistreatment of an at-risk adult. The volunteer shall provide to the employer written authorization and any required identifying information necessary to conduct a CAPS check pursuant to this section. Within ten days after the date of the employer's request, if the volunteer was substantiated in a case of mistreatment of an at-risk adult, unless the finding was expunged through a successful appeal to the state department, the state department shall provide the employer with information concerning the mistreatment through electronic means, or other means if requested by the employer, including the date of the substantiated finding, the type of mistreatment reported, and the county that investigated the report of mistreatment. For purposes of this subsection (6)(a)(IV), "employer" includes a person or entity conducting volunteer screening on behalf of the employer. The provisions of subsections (6)(d), (6)(e), (6)(e.3), and (6)(e.7) of this section apply to this subsection (6)(a)(IV). (V) A staffing agency shall request a CAPS check for an employee it is placing with an employer described in subsection (7) of this section. The staffing agency shall provide the employer with the results of the CAPS check and any subsequent notifications of substantiated findings, as described in subsection (10) of this section, against the employee, within five business days after receipt of the information, for the duration of the employee's placement with the employer. (b) As a condition of employment or contracting, a person seeking employment or to contract with the employer in a position in which the person will provide direct care to an at-risk adult shall provide to the employer, or to a person or entity conducting employee screening on behalf of the employer, written authorization and any required identifying information necessary to conduct a CAPS check pursuant to this section. The employer shall pay a fee established by the state department for each CAPS check, or may require the person seeking employment or to contract with the employer to pay the required fee for the CAPS check. on or entity conducting employee screening on behalf of the employer, written authorization and any required identifying information necessary to conduct a CAPS check pursuant to this section. The employer shall pay a fee established by the state department for each CAPS check, or may require the person seeking employment or to contract with the employer to pay the required fee for the CAPS check. (c) (I) An employer, or a person or entity conducting employee screening on behalf of the employer, that relies upon information obtained through a CAPS check in making an employment decision or concludes that the nature of any information disqualifies a prospective employee from employment is immune from civil liability in an action brought by the prospective employee for that conclusion or decision unless the CAPS information relied upon is false and the employer, or a person or entity conducting employee screening on behalf of the employer, knows the information is false. (II) Nothing in this subsection (6)(c) amends, supersedes, or otherwise limits the civil liability of the employer, or a person or entity conducting employee screening on behalf of the employer, with respect to any claim or action related to the employment decision other than a claim or action relating to the information received by the employer, or a person or entity conducting employee screening on behalf of the employer, pursuant to a CAPS check. (d) (I) Except as provided in subsection (6)(d)(II) of this section, an employer, or a person or entity conducting employee screening on behalf of the employer, is deemed to have violated subsection (6)(e) of this section if the employer, or a person or entity conducting employee screening on behalf of the employer: (A) Requests a CAPS check pursuant to this section for a person who is not an existing employee or who does not have an active application for or is not contracting with the employer, or who does not have an active application to contract with the employer, for a position providing direct care to an at-risk adult; or (B) Releases information obtained pursuant to the CAPS check or a subsequent notification to any person or entity other than a person or entity directly involved in the employer's hiring process, except as required by subsection (6)(a)(V) of this section. (II) An employer, or a person or entity conducting employee screening on behalf of the employer, has not violated subsection (6)(e) of this section if the employer, or a person or entity conducting employee screening on behalf of the employer, releases information received through a CAPS check: (A) To a state agency or its contractor, upon the request of the agency or contractor, for purposes of an employer inspection or survey or for purposes of a regulatory investigation conducted by a health oversight agency, as defined in 42 CFR 164.501 pursuant to section 12-20-401; or (B) At the request of a current or prospective employer of a health-care worker or caregiver in accordance with section 8-2-111.6 or section 8-2-111.7. or, upon the request of the agency or contractor, for purposes of an employer inspection or survey or for purposes of a regulatory investigation conducted by a health oversight agency, as defined in 42 CFR 164.501 pursuant to section 12-20-401; or (B) At the request of a current or prospective employer of a health-care worker or caregiver in accordance with section 8-2-111.6 or section 8-2-111.7. (e) Any person who improperly releases or who willfully permits or encourages the release of data or information obtained through a CAPS check to persons not permitted access to the information pursuant to this article 3.1 commits a class 2 misdemeanor and is punished as provided in section 18-1.3-501. (e.3) A person commits a class 2 misdemeanor punishable pursuant to section 18-1.3-501 if the person requests a CAPS check for a person who is not: (I) An employee or a volunteer providing direct care, or is not being considered for such employment; or (II) A care provider or is not being considered as a care provider for a recipient of consumer-directed attendant support services pursuant to article 10 of title 25.5; or (III) A person who may be appointed as a conservator or guardian of an at-risk adult. (e.7) An employee who knowingly provides inaccurate information to the employee's employer for a CAPS check, an employer or other person or entity conducting an employee screening on behalf of the employer that knowingly provides inaccurate information in the request for a CAPS check, or a person who may be appointed as a conservator or guardian of an at-risk adult who knowingly provides inaccurate information to the court for a CAPS check commits a class 2 misdemeanor and shall be punished pursuant to section 18-1.3-501. (f) Nothing in this section prohibits an employer from hiring or contracting with an employee who will provide direct care to an at-risk adult prior to receiving the results of the CAPS check. (7) The following employers shall request a CAPS check pursuant to this section: (a) A health facility licensed pursuant to section 25-1.5-103, including those wholly owned and operated by any governmental unit; (b) An adult day care facility, as defined in section 25.5-6-303 (1); (c) A community integrated health-care service agency, as defined in section 25-3.5-1301 (1); (d) A program-approved service agency or contracted agency providing or contracting for long-term services and supports pursuant to article 10 of title 25.5; (e) A case management agency, as defined in section 25.5-6-1702 (2); (f) An area agency on aging, as defined in section 26-11-201 (2), and any agency or provider the area agency on aging contracts with to provide services; (g) A facility operated by the state department for the care and treatment of persons with mental health disorders pursuant to article 65 of title 27; (h) A facility operated by the state department for the care and treatment of persons with intellectual and developmental disabilities pursuant to article 10.5 of title 27; (i) Veterans community living centers operated pursuant to article 12 of this title 26; (j) The office of public guardianship pursuant to section 13-94-105; and ith mental health disorders pursuant to article 65 of title 27; (h) A facility operated by the state department for the care and treatment of persons with intellectual and developmental disabilities pursuant to article 10.5 of title 27; (i) Veterans community living centers operated pursuant to article 12 of this title 26; (j) The office of public guardianship pursuant to section 13-94-105; and (k) Staffing agencies when they are placing employees with an employer as described in subsections (7)(a) to (7)(j) of this section. (8) A person hiring someone to provide consumer-directed attendant support services pursuant to article 10 of title 25.5 may request a CAPS check pursuant to this section at the person's expense. The person requesting the CAPS check must comply with state department rules and the provisions of subsection (6) of this section relating to the release of information obtained through a CAPS check. (8.5) (a) On and after January 1, 2022, prior to appointing a person as a conservator or guardian of an at-risk adult, the court that receives a filing of a petition for conservatorship or guardianship shall request a CAPS check by the state department using forms approved by the state department to determine if the person is substantiated in a case of mistreatment of an at-risk adult. The court shall require the petitioner for conservatorship or guardianship to complete the state-department-approved written authorization prior to requesting a CAPS check. The court shall pay a fee established by the state department for each CAPS check and may require the petitioner for conservatorship or guardianship to pay the court the required fee for the CAPS check. (b) Within seven calendar days after the date of the court's request, if the person who may be appointed as a conservator or guardian has been substantiated in a case of mistreatment of an at-risk adult, the state department shall provide the court with information concerning the mistreatment, which information must include, at a minimum, the date of the substantiated finding, the type and severity of the mistreatment, and the county that investigated the report of mistreatment. (c) The state department shall disclose to the court that the person substantiated in a case of mistreatment of an at-risk adult has the right to initiate an appeal of the substantiated finding within the time frame set forth in state department rules. If the appeal is active at the time the state department notifies the court of the results of the CAPS check, the state department shall inform the court that such appeal is active. The state department shall not provide the court the information specified in subsection (8.5)(b) of this section if the finding about the person was expunged through a successful appeal. (d) The court shall have the discretion to consider the results of the CAPS check and determine the weight of the information and its probative value. epartment shall inform the court that such appeal is active. The state department shall not provide the court the information specified in subsection (8.5)(b) of this section if the finding about the person was expunged through a successful appeal. (d) The court shall have the discretion to consider the results of the CAPS check and determine the weight of the information and its probative value. (e) Nothing in this subsection (8.5) delays or precludes the court's appointment of an emergency guardian or conservator of an at-risk adult pursuant to section 15-14-312 or 15-14-412, regardless of the timing of the state department's notification of the CAPS check results. (9) Except for the costs incurred for the development and initial implementation of the program, direct and indirect costs incurred for the administrative appeals process for persons appealing claims of mistreatment of at-risk adults and the direct and indirect costs of conducting employer-requested or court-requested CAPS checks pursuant to this section are funded through a fee assessed on an employer or the court for each CAPS check. The state department shall establish and collect the fee pursuant to parameters set forth in rule established by the state board. At a minimum, the state board's rules must include a provision requiring the state department to provide notice of the fee to interested persons and the maximum fee amount that the state department shall not exceed without the express approval of the state board. The fee established must not exceed direct and indirect costs incurred for the administrative appeals process for persons appealing claims of mistreatment of at-risk adults and the direct and indirect costs of conducting employer-requested or court-requested CAPS checks pursuant to this section. Fees collected for CAPS checks shall be transferred to the state treasurer and credited to the records and reports fund created in section 19-1-307 (2.5). (10) Notification to employer. The state department shall provide notification to the employer if a substantiated finding of mistreatment by an employee is subsequently entered into CAPS. (11) Notification to court. The state department shall provide notification to the court within seven calendar days after a substantiated finding of mistreatment by a person appointed as a conservator or guardian for an at-risk adult is subsequently entered into CAPS. The state department shall provide the court with information concerning the mistreatment, which information must include, at a minimum, the date of the substantiated finding, the type and severity of the mistreatment, and the county that investigated the report of mistreatment. The state department shall disclose to the court the time frame by which an appeal may be initiated by the person substantiated in a case of mistreatment of an at-risk adult. rmation concerning the mistreatment, which information must include, at a minimum, the date of the substantiated finding, the type and severity of the mistreatment, and the county that investigated the report of mistreatment. The state department shall disclose to the court the time frame by which an appeal may be initiated by the person substantiated in a case of mistreatment of an at-risk adult. (12) Notification to DORA. (a) The state department shall provide notification to a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator within such a health oversight agency within ten calendar days after a substantiated finding of mistreatment by a professional regulated by a regulator, as those terms are defined in section 12-20-102 (13) and (14). The notification must provide a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator within such a health oversight agency with information concerning the mistreatment by the professional, which information must include, at a minimum, the professional license number of the person substantiated in a case of mistreatment, the date of the substantiated finding, the name of the mistreated at-risk adult, the type and severity of the mistreatment, the location or residence of the mistreated at-risk adult, the location where the mistreatment occurred, and the county that investigated the report of mistreatment. The state department shall disclose to a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies, or a regulator within such a health oversight agency, that the person substantiated in a case of mistreatment of an at-risk adult has the right to initiate an appeal of the substantiated finding within the time frame set forth in state department rules. (b) Any information the state department provides to a health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator within such a health oversight agency pursuant to subsection (12)(a) of this section is confidential, not subject to part 2 of article 72 of title 24, and must be used for purposes of a regulatory investigation conducted pursuant to section 12-20-401. If the information is admitted as evidence during a disciplinary hearing held pursuant to section 12-20-403 or used as the basis of public discipline, the information must be de-identified to protect the privacy of the at-risk adult. A health oversight agency, as defined in 42 CFR 164.501, within the department of regulatory agencies or a regulator within such a health oversight agency shall have the discretion to consider the results of the CAPS check and determine the weight of the information and its probative value. (c) Repealed.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-26.docxFetched: 10/6/2026