Meeting Summary SB15-109 Sub Committee - Definitions September 24, 2015 Task Group Members in attendance: Mindy Kemp, Randy Kuykendall, Kasey Daniel (substitute Chair), Ann Patton, Stefanie Norred, Scott Storey, Marijo Rymer Task Group Members attending by conference call: Lori Thompson, Darla Stuart Pubic attending: Angela Lytle, Lexi Kuznick, Loren Snyder, Honey Raley, Jan Bock, Jane Walsh, Juanita Rios-Johnston Public attending by conference call: Rep. Dave Young, Rena Kuberski, Mike Seidinger, Grace Levinson, Kathryn Chacon, Deanne Major Mindy Kemp began the meeting at 1:10 and provided handouts to the attendees. Upon request, public testimony was heard first, by Jan Bock, mother and legal Guardian of Elizabeth, who has been a client of North Metro Community Services, Inc. which is the Single Entry Point for all services provided to people with developmental disabilities who live in Adams County. Ms. Bock stated that her daughter has suffered overmedication and multiple evictions from services, that the appeals process does not work, and that the executive director and residential director of North Metro (Randy Brodersen and Ryan Grygiel, respectively) are at least incompetent and at worst unwilling to provide services based on the needs of the individuals in their care. Mindy shared that there was a panel discussion on SB15-109 at the recent APS Conference held in Loveland. The panelists were Mindy Kemp, Stefanie Norred, and Darla Stuart. They provided and overview of the task force and work to date and Representative Young provided an overview of SB 15109 and his work on mandatory reporting in the Colorado General Assembly. The audience gave input, which turned out to be similar to what the task force had produced to date. A handout was sent out from Darla Stewart to the task force with the results from the panel discussion and feedback. Kasey Daniel began the meeting to focus on definitions. Scott Storey pointed out the existing (at risk elder) statute for mandatory reporting is in criminal statutes. He suggested there are two ways to produce definitions: combine the two statutes, applying existing definitions to persons with intellectual and developmental disabilities (I/DD), or develop the I/DD statute separately and independently. The group discussed the MANE provisions in rules, and the fact that mistreatment is not connected to a crime. It needs to be defined in such a way there is no ambiguity. For example, unnecessary restraint does not lead to a crime even though it must be reported. Abuse and exploitation can be tied to a crime and prosecuted. Scott Storey visualized adding I/DD to the existing statute and probably expanding the list of mandatory reporters.

Jane Walsh suggested mistreatment be included in both I/DD and elder abuse mandatory reporting, but it must be defined, otherwise mandatory reporters are not clear on what to report. Mindy Kemp noted that Colorado is the only state that requires the first report of abuse or neglect go directly to law enforcement. Other states require reports to go to Adult Protective Services (APS) or law enforcement. Scott Storey explained that the initial mandatory reporting law was created that way on purpose to ensure potential crimes are brought to the attention of law enforcement first. He said communication from APS to law enforcement is sometimes insufficient and crimes are missed so that is why it is important to have reports go directly to law enforcement first. There was no decision about whether to keep the reports going to law enforcement first, or recommend a change to the law to have the mandatory reports go to both law enforcement and APS. The committee discussed recommending the broad term of mistreatment be included in the statute, (in addition to abuse & exploitation) with a specific definition to be written later. Kasey Daniel asked if anyone is opposed to that recommendation. None were voiced. Kasey Daniel asked the group about “abuse” – whether there is currently anything missing with respect to I/DD in the mandatory reporting statute. Stefanie Norred noted that in rule the relationship alone, of provider to the person receiving services makes sexual contact a crime, and suggested it be included to be required to be reported under abuse. The committee agreed to the recommendation. Kasey Daniel asked whether the task force is expected to completely define/revise the statute by December. Representative Young said the task force can take more time to flesh out definitions if needed, but recommendations on the budget and funding issues need to be ready soon since they will be considered early in the legislative session. Mindy Kemp reminded the task force that they are required by law to have to have a report with recommendations finalized and to the legislature by December 1, 2015. The task force will need to have a final version ready by mid-November so the report can go through the Department’s clearance process before being finalized and submitted. The committee agreed the task force should have at least two more meetings to be sure we complete the work needed to make final recommendations. The meeting was adjourned at 2:30.

Meeting Summary SB15-109 Sub Committee – Sustainable Funding Sources September 24, 2015 Task Group Members in attendance: Mindy Kemp, Randy Kuykendall, Stefanie Norred, Lori Thompson Task Group Members attending by conference call: Gini Pingenot, Lexi Kuznick, Rep. Dave Young, David Ervin Public attending: Lexi Kuznick, Megan Davis, Juanita Rios-Johnston, Corey Hassey The meeting began at 2:35. Mindy Kemp explained that CDHS was asked to put a placeholder amount in the budget for Fiscal Year 2016-2017 for the cost to expand APS implementation of SB 15-109. The amount included was $2.6 million, some of which is from cash funds but the majority is from general funds. Projections were based on the Department’s experience rolling out mandatory reporting for atrisk elders over the past year. The question was raised as to whether law enforcement will also need a substantial amount of money to implement training and personnel. The committee agreed that we need data on the costs to CCBs to do investigations. It was pointed out that service providers actually do investigations and it is almost impossible (especially in this time frame) to aggregate data from all. David Ervin noted that any number will be pure extrapolation and very much a ballpark estimate. The group agreed that bottom line is that the investigation process with I/DD population is more complex requiring increased costs and time. The group spent time identifying funding information for existing investigations and assessments for APS and for individuals with I/DD. (See table on next page) The meeting was adjourned at 4:00 p.m.

Funding Sources APS annual allocation from state General Fund & matching funds by counties (80/20) (no federal funding exists)

$1 million for county Client Services allocated from the General Fund

What they pay for 60 County Human Services Departments manage APS reports and providing services in the state. Funding pays for state oversight and county caseworkers and supervisors for initial assessment, investigation, and protection services. Funds available to counties for one-time expenditures for clients’ needs (including I/DD population)

$25.51 per person enrolled paid by DD system to CCBs (50% general funds and 50% federal match) Annual Training funds - $80,000 CDHS

To provide quality assurance including investigation

County General Fund – for law enforcement & first responder training

Law Enforcement and first responders take reports of abuse and neglect, investigate the ones that could be a crime, and forward the cases to APS to follow up on the civil side Used for services and training

About 15 counties have mil levies for funding to serve individuals with I/DD through CCB systems HCPF – I/DD cash fund – one time use, not ongoing

Training funds provided to APS annually since implementation of mandatory reporting for POST, APS workers, mandatory reporters. Focus is awareness and procedures.

Waiting list reduction

The Gap When mandatory reporting became effective 7/1/14, there was an increase in reports to APS of 41% over the prior fiscal year, with funding provided for only a planned 15% increase in reports. As additional reports go to county APS programs, I/DD population will likely require extensive services to address their needs that are not available currently Current funds are not meeting the need for funding for CCBs to serve in this capacity Additional funding will be needed to implement SB 109 for specialized training for mandatory reporters, APS, and Law enforcement that addresses the needs of individuals with I/DD

These funds are not available since they are committed and are one time use funding