Current through Register Vol. 47, No. 5, March 10, 2024
A.
The county department shall conduct an investigation to determine findings
related to allegations of mistreatment or, in counties not participating in the
Alternative Response pilot, self-neglect, as required by Section 30.510 . The
investigation shall include, but may not be limited to:
1. Determining the need for protective
services. If the client is in clear and immediate danger, the county shall
intervene immediately by notifying the proper emergency responders.
2. Determining if the investigation should be
conducted jointly with another entity, except in self-neglect only cases, such
as:
a. Law enforcement and/or the district
attorney;
b. Community Centered
Board;
c. Health Facilities
Division;
d. Attorney General's
Medicaid Fraud Unit;
e. The
long-term care ombudsman; and/or,
f. County department Child Welfare
programs.
3. Making
reasonable efforts to conduct interviews, as outlined below. The interviews and
collection of evidence must address the specific allegations identified in the
report and any new mistreatment or self-neglect that may be identified during
the assessment or investigation. If an interview cannot be conducted for good
cause, the attempts and the cause shall be documented.
a. An in-person initial interview with the
client, unannounced and in private, whenever possible.
i. The county department shall document in
CAPS that the visit was unannounced and in private and if not unannounced
and/or in private for good cause, the cause shall be documented in
CAPS.
ii. If the client is unable
to be interviewed for good cause, the cause shall be documented in
CAPS.
b. Ongoing
interviews with the client to complete the investigation and assessment as
outlined in Section 30.530 . If the client refuses to participate in the
investigation or cannot be located, the county department shall make reasonable
efforts to complete the investigation by gathering evidence and interviewing
other collateral contacts that have knowledge of the client and/or the alleged
mistreatment or self-neglect.
c.
Interviews with all collateral contacts. In the event a collateral contact
cannot be located or interviewed for good cause, the cause shall be documented
in CAPS; and,
d. Interview(s) with
the alleged perpetrator(s), with or without law enforcement. In the event the
alleged perpetrator is unable to be located or interviewed for good cause, the
cause shall be documented in CAPS. The following information shall be collected
related to the alleged perpetrator(s), to the fullest extent possible, in
addition to information about the allegations:
i. Full name of the alleged perpetrator(s)
with accurate spelling;
ii. Current
email address, when available;
iii.
Current physical and mailing address;
iv. Date of birth; and,
v. Whether the alleged perpetrator is a
licensed healthcare professional, as defined in Section 30.100,; and,
vi. Other identifying demographic and contact
information.
4. Collecting evidence and documenting with
photographs or other means, when appropriate, such as:
a. Police reports;
b. Any available investigation report from a
currently or previously involved facility and the occurrence report from the
Health Facilities Division;
c.
Medical and mental health records;
d. Bank or other financial records;
e. Care plans for any person in a facility or
receiving other services that require a care plan and any daily logs or charts;
and/or,
f. Staffing records and
employee work schedules when investigating in a facility.
5. Making a finding regarding each allegation
and alleged perpetrator, including the severity level of the mistreatment when
there is a substantiated finding. A severity level shall not be assigned to a
substantiated self-neglect allegation.
6. If it is identified through interviews,
collateral contacts, or other investigation that a substantiated perpetrator is
a licensed healthcare professional, the county department shall document the
license number in CAPS. The county department may ascertain the license number
using the methods outlined below:
A. Request
the license number from the substantiated perpetrator's employer. if the
substantiated perpetrator's current or former employer is an agency required to
request caps checks, as outlined in Section 30.960 , A, and the mistreatment
occurred while the substantiated perpetrator was engaged in professional
duties, the employer is required to provide the DORA license number to the
county department upon request, as outlined in Section
26-3.1-103 (1.3)(a)(V), C.R.S.,
and Section 30.510.J.5; or
B.
Request the license number from the substantiated perpetrator. if the
substantiated perpetrator is a licensed healthcare professional, and the
mistreatment occurred while engaged in their professional duties, the
substantiated perpetrator is required by section
26-3.1-103 (1.4), C.R.S., to
provide their DORA license number upon request of the county department;
or
C. Utilize the DORA online
Colorado professional or business license verification system to ascertain the
license number.
D. If the license
number was provided by the substantiated perpetrator or their employer, the
county department shall attempt to verify the license number by using the DORA
online verification system or another means of verification.
E. If the county is unable to obtain the
license number using one or more of the methods above, the county must document
its attempts to obtain the license number in CAPS to show good cause for the
inability to obtain the license number.
7. Determining whether there are additional
mistreatment or self-neglect concerns not reported in the initial allegations.
If there are additional concerns the county department shall enter the
mistreatment and alleged perpetrator or self-neglect into the case.
a. Alternative Response pilot participating
counties shall make a traditional or alternative response track assignment as
outlined in section 30.440 and complete an investigation in accordance with the
applicable traditional response or alternative response track investigation
rules.
b. Non-pilot participating
counties shall complete an investigation in accordance with the rules in this
section 30.520.
8.
Supervisory review of all findings and approval only when the county department
has completed a thorough investigation and the evidence justifies the
findings.
9. Notifying law
enforcement when criminal activity is suspected.
B. Beginning July 1, 2018 all substantiated
perpetrators shall be provided notice of the substantiation and their appeal
rights, as outlined in section 30.910.
C. In the event that a finding is determined
to be incorrect after supervisory approval, the county department shall take
the following applicable steps:
1. If the
finding was originally unsubstantiated and the finding is changing to
inconclusive, correct the finding in CAPS.
2. If the finding was originally inconclusive
and the finding is changing to unsubstantiated, correct the finding in
CAPS.
3. If the finding was
originally unsubstantiated or inconclusive and the finding is changing to
substantiated, correct the finding in CAPS and notify the alleged perpetrator
as outlined in Section 30.910.A-C.
4. If the finding was originally
substantiated and the finding is changing to unsubstantiated or inconclusive,
correct the finding in CAPS and notify the alleged perpetrator of the
correction as outlined in Section 30.910.C . If there is an open appeal at the
time of the correction, the county department shall notify the State Department
of the change in finding no later than ten (10) calendar days of identifying
the need to correct the finding.
D. Pursuant to Section
26-3.1-111(12),
beginning on or before January 1, 2022, the State
Department shall provide information to DORA when a licensed
healthcare professional is substantiated for mistreatment of an at-risk
adult.
1. Notification to DORA shall
be made by the State Department within ten (10) calendar days after a
substantiated finding.
2. The
information provided shall include, at a minimum:
a. The professional's name;
b. The professional's license
number;
c. The name of the
mistreated adult;
d. The location
or residence of the mistreated adult;
e. The location where the mistreatment
occurred;
f. The date of the
finding;
g. The county that
investigated the mistreatment;
h.
The type and severity of mistreatment;
i. The professional's right to an appeal of
the finding and the time frame to file an appeal and,
j. The unique CAPS identifier that ties the
perpetrator to the substantiated finding.
3. Information provided to DORA regarding a
substantiated finding of mistreatment caused by a licensed healthcare
professional is confidential, not subject to Part 2 of Article
72 of Title
24, of the C.R.S., and must be used for
purposes of a regulatory investigation conducted pursuant to Section
12-20-401, C.R.S.