ALR= Assisted Living Residence
APS= Adult Protective Service
CCR= Code of Colorado Regulations
CDPH&E= Colorado Department of Health and Environment
DA= District Attorney
DHS= Department Of Human Services
HCPF= Health Care Policy & Finance
LE= Law enforcement
LTC= Long Term Care
MR= Mandatory Reporting/reporter
SNF= Skilled Nursing Facility
Problems with Colorado Criminal Laws for at risk Adults
Elements of the crime of assault (must have injury)
Elements of the crime of neglect (DA's prefer you to have knowingly to prosecute)
Omission of Harassment Statutes (harmful, painful, offensive contact is all but eliminated from the MR statutes)
Omission of statute preventing banned family members from harboring at-risk adults
The definition of at-risk is different for LE and DHS (over reporting, people who are not 70 years of age but vulnerable otherwise are being reported on against their will)
Should be several options to report abuse that are all regulated and funnel into one data sharing Records Management System
Some crimes against elders or those with an IDD are just random crimes which occur randomly by chance but require officers to complete lengthy MR reporting documents
Most LE agencies in Colorado except the 18th Judicial District must report abuse of elders and at-risk adults with an IDD to both DHS/APS and the DA's office because they have no system in place to report all at the same time
Problems with programs that support enforcement of abuse (Potential Initiatives)
No adult foster care (no place to safeguard adult victims from their abusers)
No State Guardianship program (no one to make decisions for those w/o a POA)
Ask administrators from SNF's, ALR's, LTC residences, Host Homes, Nursing Homes, Hospice, Hospitals where they received MR training from (Very few know the answer to this question)
No State central clearinghouse to accept and track allegations of abuse
64 separate Colorado counties investigating abuse 64 different ways. Nothing is standardized
No oversight enforcing LE to follow MR laws
No oversight enforcing LTC facilities to self report occurrences. Its suggested and if they don't no one knows about it until either family or LE advises CDPH&E. This is how facilities where chronic abuse occurs, still have 5 star ratings with the State.
No legal connection between a MR case & an occurrence self reporting
Low standards to qualify as a host home owners
No regulation for the qualifications of contracted respite care services
Low standards for the qualification of personal care workers
Until recently there was no way to track sustained or guilty abuse offenders (CAPS registry in effect now) However still no national tracking system
Lack of oversight for 50k plus LTC residences in Colorado. Only 9 CDPH&E State Investigators making sure 50K facilities are staying in compliance with regulations
No CDPH&E investigators become aware of MR investigations unless reporting facility voluntarily notifies CDPH&E of the occurrence
LE and DA offices did not get more money to increase staffing to handle the increased workload
Lack of State guidance has allowed for the 3rd largest County in the State to contaminate and delay investigations by accepting initial complaints of abuse. (Colorado Demographics.com)
No law, policy, or regulation (CCR) for cameras in facilities
APS still sends LE reports of self neglect. Self neglect is not a crime and therefore the police cannot intervene.
APS agencies do not take the time to determine jurisdiction and therefore police investigate crimes that did not occur in their jurisdiction. APS opens cases based on the victim's home address. This sends LE on wild goose chases.
Direction from Unknown sources within (CDPH&E) (HCPF) are advising Executive Directors of assisted living and skilled nursing facilities, Directors of Nursing and Supervisors to just report all occurrences to police and let police figure it out.
Problems with Long Term Care Living Facilities
Unprofessional work force
Profit over care is very apparent (Otherwise client on client abuse would not occur)
CG’s to client ratios are low- and no hard numbers are required by CCR’s.
No Cameras where it counts (Do cameras violate clients rights?) HIPPA laws and Patient rights do not indicate that a camera would violate any clients right. But it would hold agencies accountable and force the industry to become more professional.
What’s the standard for conducting comprehensive background checks of employees? (lacking)
MR’s are calling PD simply to get a report # much like a car accident with no injuries. This is done to satisfy mandatory reporting and knowing no one in mandatory reporting tells the State about the occurrence.
Problems with Law Enforcement & the Judicial system (LE)
Inadequate training, Who’s training LE. POST?
No funding to address staffing levels needed to keep up with the 60% call load increase.
No funding to address training that will need to be acquired to present prosecutable cases.
No funding for Judicial Districts to try and prosecute the sudden overload of abuse suspects.
Police policies and procedures were not considered. (examples of what prerequisites police departments have to send an officer to take a report) No injury, no witnesses, no crime.
Lack of interest to make a difference from Command level to Officers, who in LE is advocating for better laws, better strategies, better tactics to combat elder and at-risk adult abuse.
For these listed reasons, LEMRS can help you navigate MR laws in Colorado and help advocate for better laws for all professions tasked with protecting vulnerable adults.