First Regular Session Sixty-sixth General Assembly STATE OF COLORADO INTRODUCED LLS NO. 07-0272.02 Jane Ritter HOUSE BILL 07-1044 HOUSE SPONSORSHIP McFadyen, SENATE SPONSORSHIP Williams, House Committees Senate Committees Health and Human Services A BILL FOR AN ACT Concerning protective services for at-risk adults. Bill Summary (Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.) Requires an individual from a specified group of persons to make an oral report within 24 hours if he or she has observed mistreatment, self-neglect, or financial exploitation of an at-risk adult or has reasonable cause to believe that an at-risk adult has been mistreated, self-neglected, or financially exploited or is at imminent risk of mistreatment, self-neglect, or financial exploitation. Makes failure to report a class 3 misdemeanor. Sets forth separate reporting requirements for community centered board staff, caretakers, employees, volunteers, subcontractors, and consultants who provide services and supports to adults with developmental disabilities through the community centered board system. Requires the state department of human services ("department") to make annual reports to the general assembly concerning the abuse and financial exploitation of at-risk adults. Outlines the appropriate investigations, assessments, and responses an agency shall make to a report of abuse of an at-risk adult. Allows a county director of social services to petition the court for an order authorizing the provision of specific protective services, appointment of a guardian or conservator, or any combination of these actions if he or she determines that an at-risk adult lacks decision-making capacity or demonstrates behavior that strongly indicates an inability to receive and evaluate information. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. 26-3.1-102 (1), Colorado Revised Statutes, is amended, and the said 26-3.1-102 is further amended BY THE ADDITION OF THE FOLLOWING NEW SUBSECTIONS, to read: 26-3.1-102. Reporting requirements - rules. (1) (a) A person specified in paragraph (b) of this subsection (1) who has observed 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-neglected or is at imminent risk of mistreatment or self-neglect shall make or initiate an immediate oral report of abuse should be made or caused to be made within twenty-four hours to the county department, or, during non-business hours, to a local law enforcement agency responsible for investigating violations of state criminal laws protecting at-risk adults. by any person specified in paragraph (b) of this subsection (1) who has observed 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-neglected and is at imminent risk of mistreatment or self-neglect. (b) The following persons are urged to shall make or initiate an initial oral report to the county department, or, during non-business hours, to a local law enforcement agency responsible for investigating violations of state criminal laws protecting at-risk adults, within twenty-four hours followed by a written report within forty-eight hours: (I) Physicians, surgeons, nurse practitioners, physicians' assistants, or osteopaths, including physicians in training; (II) Medical examiners or coroners; (III) Registered nurses or licensed practical nurses; (IV) Hospital and nursing home personnel engaged in the admission, care, or treatment of patients; (V) Psychologists and other mental health professionals; (VI) Social work practitioners; (VII) Dentists; (VIII) Law enforcement officials and personnel; (IX) Court-appointed guardians and conservators; (X) Fire protection personnel; (XI) Pharmacists; (XII) Community-centered Community centered board staff, except as otherwise provided in paragraph (d) of this subsection (1); (XIII) Personnel of banks, savings and loan associations, credit unions, and other lending or financial institutions; (XIV) State and local long-term care ombudsmen; and (XV) Any A caretaker, staff member, or employee of or volunteer or consultant for any a licensed care facility, agency, home, or governing board, except as otherwise provided in paragraph (d) of this subsection (1). (c) In addition to those persons urged required by this subsection (1) to report known or suspected mistreatment or self-neglect of an at-risk adult and circumstances or conditions which that might reasonably result in mistreatment or self-neglect, any other person may report such known or suspected mistreatment or self-neglect and or circumstances or conditions which 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 the report, the receiving agency shall prepare a written report within forty-eight hours. (d) (I) A community centered board staff member, caretaker, employee, volunteer, subcontractor, or consultant who provides services and supports to adults with developmental disabilities through the community centered board system established pursuant to article 10.5 of title 27, C.R.S., shall not be required to report in the same manner as a person reporting pursuant to paragraph (b) of this subsection (1). (II) The state department is hereby authorized to promulgate rules to establish reporting requirements for community centered board staff members, caretakers, employees, volunteers, subcontractors, or consultants regarding at-risk adults with developmental disabilities who are served through the community centered board system established pursuant to article 10.5 of title 27, C.R.S. (III) Nothing in this paragraph (d) shall be construed to prohibit or discourage a community centered board staff member, caretaker, employee, volunteer, subcontractor, or consultant who provides services and supports to adults with developmental disabilities through the community centered board system established pursuant to article 10.5 of title 27, C.R.S., from making a report in the same manner as a person reporting pursuant to paragraph (b) of this subsection (1) or from requesting an investigation by a county department or a local law enforcement agency pursuant to the provisions of this part 1. (8) (a) On or before December 1, 2008, and on or before December 1 each year thereafter, the state department shall submit a written report to the health and human services committees of the house of representatives and the senate, or any successor committees. The report shall include, but need not be limited to, the following information for the preceding fiscal year: (I) The number of reports of mistreatment or self-neglect of at-risk adults made or caused to be made pursuant to this section, including the number of reports of physical abuse, sexual abuse, self-abuse or self-neglect, or caretaker neglect; (II) The number of face-to-face investigations and telephone investigations conducted and requests for information and referrals received pursuant to this part 1; (III) The average monthly caseload for each county; and (IV) The number of county guardianships held by each county as a result of investigations conducted pursuant to this part 1. (b) On or before January 30, 2009, and on or before January 30 each year thereafter, the state department shall orally present the information contained in the written report submitted pursuant to paragraph (a) of this subsection (8) to the health and human services committees of the house of representatives and the senate, or any successor committees. (9) A person who willfully violates the provisions of subsection (1) of this section: (a) Commits a class 3 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S.; and (b) Shall be liable for any damages proximately caused by the violation. SECTION 2. 26-3.1-103 (1), Colorado Revised Statutes, is amended, and the said 26-3.1-103 is further amended BY THE ADDITION OF A NEW SUBSECTION, to read: 26-3.1-103. Investigations - responses. (1) The agency receiving a report of mistreatment or self-neglect of an at-risk adult shall, make a thorough investigation immediately upon receipt of a report upon receipt of the report, respond immediately to assess the mistreatment or self-neglect involved and determine the appropriate response to the report. The agency shall conduct the assessment in accordance with rules adopted by the state board related to determining the risk of harm to an at-risk adult and appropriate responses to the risk. The immediate concern of the report, assessment, and response shall be the protection of the at-risk adult The investigation shall, at a minimum, include a face-to-face interview of the at-risk adult alleged to be mistreated or self-neglected. The county department shall arrange for its investigation to be conducted by persons trained to conduct such investigations. and the preservation of the at-risk adult's right to self-determination. Appropriate responses shall include, but need not be limited to: (a) Screening reports that do not require further investigation; (b) Providing appropriate intervention services; (c) Pursuing reports that require further investigation; and (d) Conducting immediate investigations. (1.5) The county department shall arrange for its investigation to be conducted by county department adult protective services personnel who are trained to conduct such investigations or, upon approval of county department adult protective services personnel, by an entity authorized by law or rule to conduct such investigations. SECTION 3. 26-3.1-104 (2), Colorado Revised Statutes, is amended to read: 26-3.1-104. Provision of protective services for at-risk adults - consent - nonconsent - least restrictive intervention. (2) If the county director or designee determines that an at-risk adult is being or has been mistreated or self-neglected, or is at imminent risk thereof, and if the at-risk adult does not consent to the receipt of protective services lacks decision-making capacity or demonstrates behavior that strongly indicates an inability to receive and evaluate information, 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. SECTION 4. 26-3.1-202, Colorado Revised Statutes, is amended to read: 26-3.1-202. Legislative declaration. The general assembly hereby finds that financial exploitation of at-risk adults is an area of significant concern. At-risk adults comprise an increasingly large segment of society, and the financial exploitation of such persons is occurring at an ever-increasing rate. Persons committing financial exploitation of at-risk adults may be persons known to the at-risk adult or strangers perpetrating fraudulent schemes. The general assembly further finds that certain persons are in unique positions to acquire early knowledge of financial exploitation by noticing indicators such as sudden changes in bank account activity or banking practices; unexplained withdrawals or atypical transactions involving withdrawals; abrupt changes to wills or other financial documents requested by the at-risk adult; the sudden appearance of previously uninvolved relatives claiming a right to the at-risk adult's affairs and possessions; and unexplained, sudden transfers of assets to a family member of the at-risk adult or another person outside of the at-risk adult's family. Therefore, the general assembly finds and determines that it is appropriate to urge require certain persons who may be in such a unique position positions to observe such indicators to report known or suspected financial exploitation of at-risk adults for the protection of at-risk adults and society. SECTION 5. 26-3.1-204 (1), Colorado Revised Statutes, is amended, and the said 26-3.1-204 is further amended BY THE ADDITION OF THE FOLLOWING NEW SUBSECTIONS, to read: 26-3.1-204. Reporting - rules. (1) (a) Any A person specified in paragraph (b) of this subsection (1) who observes an at-risk adult being subjected to circumstances or conditions that may reasonably result in the financial exploitation of the at-risk adult or who has reasonable cause to know or suspect that an at-risk adult has been financially exploited is strongly urged required to submit, within twenty-four hours after such the observation or after obtaining such reasonable cause, an oral report of known or suspected financial exploitation. Said The person may shall submit the report to the county department of the county in which the at-risk adult resides, if known, or, during non-business hours, to the local law enforcement agency for the jurisdiction in which the at-risk adult resides. (b) The following persons are strongly urged required to report known or suspected financial exploitation of at-risk adults, as provided in paragraph (a) of this subsection (1): (I) Physicians, surgeons, nurse practitioners, physicians' assistants, and osteopaths, including physicians in training; (II) Registered nurses and licensed practical nurses; (III) Hospital and nursing home personnel engaged in the admission, care, or treatment of patients; (IV) Dentists; (V) Psychologists and other mental health professionals; (VI) Social work practitioners; (VII) Law enforcement officials and personnel; (VIII) Court-appointed guardians and conservators; (IX) Pharmacists; (X) Community-centered Community centered board staff, except as otherwise provided in paragraph (d) of this subsection (1); (XI) Personnel of financial institutions; (XII) State and local long-term care ombudsmen; (XIII) Any caretaker, staff member, or employee of or volunteer at or consultant for any licensed care facility, or nursing facility; and (XIV) Attorneys, so long as such reporting does not violate the Colorado rules of professional conduct. (c) In addition to those persons who are strongly urged required under paragraph (b) of this subsection (1) to report known or suspected financial exploitation of an at-risk adult, any other person may report such known or suspected financial exploitation of an at-risk adult to the local law enforcement agency or the county department of the jurisdiction in which the at-risk adult resides. The receiving agency shall prepare a written report within forty-eight hours after receipt of such a the report. (d) (I) A community centered board staff member, caretaker, employee, volunteer, subcontractor, or consultant who provides services and supports to adults with developmental disabilities through the community centered board system established pursuant to article 10.5 of title 27, C.R.S., shall not be required to report in the same manner as a person reporting pursuant to paragraph (b) of this subsection (1). (II) The state department is hereby authorized to promulgate rules to establish reporting requirements for community centered board staff members, caretakers, employees, volunteers, subcontractors, or consultants regarding at-risk adults with developmental disabilities who are served through the community centered board system established pursuant to article 10.5 of title 27, C.R.S. (III) Nothing in this paragraph (d) shall be construed to prohibit or discourage a community centered board staff member, caretaker, employee, volunteer, subcontractor, or consultant who provides services and supports to adults with developmental disabilities through the community centered board system established pursuant to article 10.5 of title 27, C.R.S., from making a report in the same manner as a person reporting pursuant to paragraph (b) of this subsection (1) or from requesting an investigation by a county department or a local law enforcement agency pursuant to the provisions of this part 2. (8) (a) On or before December 1, 2008, and on or before December 1 each year thereafter, the state department shall submit a written report to the health and human services committees of the house of representatives and the senate, or any successor committees. The report shall include, but need not be limited to, the following information for the preceding fiscal year: (I) The number of reports of known or suspected financial exploitation of at-risk adults made or caused to be made pursuant to this section; (II) The number of face-to-face investigations and telephone investigations conducted and requests for information and referrals received pursuant to this part 2; and (III) The average monthly caseload for each county. (b) On or before January 30, 2009, and on or before January 30 each year thereafter, the state department shall orally present the information contained in the written report submitted pursuant to paragraph (a) of this subsection (8) to the health and human services committees of the house of representatives and the senate, or any successor committees. (9) A person who willfully violates the provisions of subsection (1) of this section: (a) Commits a class 3 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S.; and (b) Shall be liable for any damages proximately caused by the violation. SECTION 6. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.