12 CCR 2518-1-30.620 - PROVISION OF SERVICES
A. The
county department shall provide protective services for the shortest duration
necessary to ensure the client's safety by implementing case plan goals as
quickly as possible in order to stabilize the client's situation and prevent
further mistreatment or self-neglect.
B. If the client appears to have capacity to
make decisions:
1. The client may refuse
protective services, but the county department shall attempt to obtain the
client's consent to additional visits or phone calls from the caseworker if the
situation appears to require further services. The caseworker shall document
the consent or refusal to additional visits or phone calls.
2. Caseworkers shall provide clients who
refuse services with the county department contact information for future
reference.
C. If a
client is suspected to lack capacity to make decisions, is at risk for harm,
and refuses to consent to services, the county department shall document the
client's inability to provide consent.
1.
Documentation shall include:
a. Observations
of client behaviors and actions;
b.
Medical documentation of client's suspected incapacity and safety concerns to
support involuntary case planning; and/or,
c. Investigative evidence.
2. The county department shall
ensure immediate safety and make its best effort to obtain an evaluation of the
client's decision making capacity from a qualified professional.
3. These situations shall be staffed with the
supervisor and/or county attorney to:
a.
Determine the client's risk and safety;
b. Assess the client's ability to
consent;
c. Determine urgency of
safety concerns if intervention is not taken;
d. Review previous interventions;
and,
e. Ensure the intervention is
done ethically and is the least restrictive intervention to ensure the client's
safety.
4. The county
department shall intervene when appropriate to coordinate with the responsible
agency in taking action to protect the immediate safety and health of the
client, such as:
a. Gaining access to the
client with assistance from law enforcement, family, or another person the
client trusts;
b. Emergency
hospitalization;
c. Coordinating
with municipal authorities to arrange a home clean up, when there is a clear
biohazard;
d. Mental health hold,
per Title 27, Article 65, C.R.S.;
e. Coordinating with family members, law
enforcement, or financial institutions to freeze client bank accounts to
prevent further loss of assets;
f.
Recommending a delayed disbursement of finances from the client's broker-dealer
pursuant to Title 11, Article 51, C.R.S.;
g. Emergency protection order, per Title 13,
Article 14, C.R.S.;
h.
Authorization of a Medical Proxy Decision Maker, per Title 15, Article 18.5,
C.R.S.;
i. Requesting a judicial
review of a fiduciary, per Title 15, Article 10, Part 5, C.R.S., and Title 15,
Article 14, Part 7, C.R.S.;
j.
Contacting the Social Security Administration or other pension administrator to
secure a representative payee;
k.
Petitioning the court for emergency guardianship and/or special
conservatorship, per Title 15 Article 14, Parts 3 and 4, C.R.S., or,
l. Alcohol and drug involuntary commitment,
per Title 27, Article 81, Part 112 and Title 27, Article 82, Part 108.
D. If a
client lacks capacity and has a fiduciary to make decisions on behalf of the
client, the county department shall consult with supervisors, the county
director, the county attorney, law enforcement, and/or the district attorney to
determine whether the county department should petition the court for a review
of the fiduciary's actions if:
1. The
fiduciary refuses to allow the provision of protective services, which places
the client at-risk for continued mistreatment or self-neglect; or,
2. There are allegations and evidence of
mistreatment of the client by the client's fiduciary.
3. The county department shall petition the
court under the appropriate statute:
a.
Uniform Power of Attorney Act, as outlined in Title 15, Article 14, Part 7,
C.R.S.;
b. Guardianship or
conservatorship statutes as outlined in Title 15, Article 14, Parts 3 and 4,
C.R.S.; and/or,
c. Fiduciary
oversight statute, as outlined in Title 15, Article 10, Part 5,
C.R.S.
E. The
county department shall maintain ongoing client contact as long as the case is
open.
1. For clients living in the community,
an in-person client contact shall occur at least once every month, not to
exceed thirty five calendar days (35) from the last in-person
contact.
2. For clients living in a
facility, an in-person client contact shall occur at least once every month,
not to exceed thirty five calendar days (35) from the last in-person contact.
a. The county department has the option of
substituting a phone call to the direct care provider to ascertain the client's
current status, in lieu of an in-person visit for every other required monthly
in-person contact.
b. If it has
been reported that the client has been mistreated at the facility, whether
caused by a staff person, visitor, or other resident, and the facility has not
appropriately resolved the cause of the mistreatment or put adequate safety
measures in place, then a phone call to ascertain the client's current status
is not appropriate and the required monthly contact shall be an in-person
visit.
3. During the
monthly contact, the county department shall:
a. Continue the investigation of allegations,
if applicable;
b. Continue
assessment of client's strengths and needs, including changes to the client's
status;
c. Pursue the continued
safety improvement and reduction and/or mitigation of risk;
d. Monitor the effectiveness of arranged
services to determine whether continued APS intervention is needed;
and,
e. Document information
gathered during the contact per the above monthly contact requirements and
update all contact records as information is obtained and/or changes occur for
the client, alleged perpetrator, reporting party, and supports within fourteen
(14) calendar days of the visit.
F. County departments may, as a courtesy,
complete monthly visits on behalf of other county departments, as follows:
1. When a client temporarily or permanently
relocates to a licensed facility more than seventy-five (75) miles outside the
county boundary and the county department of original jurisdiction maintains
the case, the county department of original jurisdiction shall ensure ongoing
protective services.
2. Monthly
contacts, required by Section 30.620, E, may be conducted by the county of
original jurisdiction or may be conducted via courtesy visits by the county
department in which the facility is located or by another county department
that is visiting the facility.
3.
No county department should be expected to provide more than three courtesy
visits per twelve (12) month period at the request of the county department of
original jurisdiction. County departments may negotiate to provide more than
three courtesy visits.
4. Upon
completion of each courtesy visit, the county department that conducted the
visit shall document the monthly contact in CAPS, including any identified need
for services or follow up by the county department of original jurisdiction, as
required in Section 30.620, E, within fourteen (14) calendar days of the
monthly contact. The county department of original jurisdiction shall be
advised immediately of any need for emergency services identified during the
courtesy visit.
5. The county
department of original jurisdiction is responsible for ensuring the courtesy
visit is conducted and is responsible for implementing any necessary services
or follow up identified during the courtesy visit.
6. A county department conducting a courtesy
visit shall not document the visit as a new report or case for the purpose of
data collection.
G. If
the client permanently relocates to another county and the client no longer
needs protective services, or the client permanently relocates to another
state, the county department shall close the case, as outlined in Section
30.660.
H. If the client relocates
to another county and the client continues to need protective services:
1. If either county is participating in the
Alternative Response pilot, the original county department must consult with
the state department to determine whether a transfer of case is required, based
on considerations including, but not limited to, equity to the client,
consistency of APS practice, and efficiency of case processes.
2. If neither the original county nor the
client's new county of residence are participating in the Alternative Response
pilot, the original county department shall transfer the case to the client's
new county of residence within five (5) calendar days of learning the move is
permanent.
3. When a transfer of
case is required, the original county department shall update the case in CAPS
prior to completing the transfer, as follows:
A. Update the client, perpetrator, reporting
party, and collateral contact information;
B. Update the investigation, assessment, case
plan, and case notes to include all information gathered to date;
and,
C. Call the receiving county
department supervisor to staff the case prior to the transfer.
I. When a client
permanently relocates to a new county, the case may remain with the former
county department only when:
1. The case is
within thirty-five (35) calendar days of resolution and the former county
department chooses to retain the case; OR,
2. The former county department holds
representative payeeship and chooses to retain the case; and/or,
3. The former county department holds
guardianship or conservatorship. Either county department may, with the
agreement of the receiving county department, petition the court for a transfer
of guardianship and/or conservatorship to the receiving county department;
and/or,
4. The jurisdiction
assignment has been authorized or required as a result of State consultation as
outlined in 30.620.H.1
J. County departments shall work
collaboratively to provide protective services to clients, as needed.
K. The county department shall reassess the
client's needs and review the provision of protective services as long as the
case remains open, as follows:
1. For cases in
which the county department is the guardian, conservator, or representative
payee:
a. An updated assessment shall be
completed at least annually; and,
b. A determination shall be made as to the
appropriateness of continued protective services, including whether the client:
I. Continues to be an at-risk adult, as
defined in Section 30.100,
II.
Continues to be in need of fiduciary support; and,
III. Needs updated services to address
identified needs or implement independence in areas of strength; and,
c. The case plan shall be updated
to include the client's services, service status, persons responsible for
implementing each service, and service dates.
2. For cases in which the county department
is not the appointed guardian, conservator, or representative payee:
a. An updated assessment shall be completed
no later than 180 days from the baseline assessment and every 60 days
thereafter; and,
b. A determination
shall be made as to the appropriateness of continued protective services,
including whether the client:
I. Continues to
be an at-risk adult, as defined in Section 30.100,
II. Continues to be in need of protective
services; and,
III. Needs updated
services to address identified needs or implement independence in areas of
strength; and,
c. The
case plan shall be updated to include the client's services, service status,
persons responsible for implementing each service, and service dates.
Notes
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